Emergency Medical Services: Standards and procedures

Procedures

Lab requirements and expectations

In emergency medicine there are many rules and regulations. The EMS classroom/lab is no different. General classroom/lab standards include:

  • Personal Protective Equipment (PPE) must be worn at all times (provided by the department). PPE includes but is not limited to safety goggles, gloves, and gowns.
  • No eating, drinking, smoking, or chewing tobacco in the laboratory.
  • Needles and sharps must be disposed of appropriately in the sharps container.
  • Put lab equipment away appropriately after use.
  • Equipment or supplies will not be loaned out or allowed to go home.
  • The Student Code of Conduct will be followed at all times. See the College policies section.
Clinical procedures performed on students

Clinical procedures will be demonstrated by instructors and/or performed by students on each other. This is done for the following reasons:

  1. Artificial training aids may be inadequate, or students may surpass the educational benefits of the training aids and need to perform certain procedures on human subjects to gain the requisite experience to practice pre-hospital emergency medicine efficiently and effectively.
  2. Students must become accustomed to the variability of normal human anatomy and physiology.
  3. Students gain insight into the patient’s perspective during the performance of procedures.

Some procedures that may be performed as directed by the instructor (within the scope of practice for the level of training) include:

  • Comprehensive physical examination
  • Electrocardiographic monitoring
  • Peripheral vascular access for cannulation or phlebotomy (paramedic)
  • Subcutaneous and intramuscular injections of non-toxic fluids
  • Capillary blood sampling
  • Vital signs
  • Other procedures for which the benefits of practice outweigh the risks

For each procedure, students will be provided with:

  1. A description of the procedure, risks, and possible complications
  2. The educational benefits
  3. Recognition of complications and instructions on how to deal with those complications

In light of the information provided above, and after having the opportunity to have any questions related to these procedures answered to their satisfaction, students will be asked to sign a consent form indicating their approval or disapproval of specific procedures. These consent forms will be retained as part of the student’s record. If at a later date but before the procedures are carried out, a student wishes to alter their decision, they will be required to complete another informed consent or refusal form. Consent will not be obtained through coercion, and a decision to refuse a procedure will not result in any disciplinary action.

Ethics and conduct

In accepting admission into the EMS program the student commits themself to the generally understood ethics of the health professions and specifically to the ethics of their chosen profession. Ethics will be addressed throughout the course of study.

Maintenance of patient confidentiality is a hallmark of all health professions. Patient medical records, including information obtained in the classroom, lab, clinical practicum, and field internship must not be disclosed to unauthorized individuals including friends and family. See Confidentiality and Privacy Policies, including FERPA and HIPAA (see the HIPAA section).

This handbook and the Portland Community College Student Code of Conduct (see the college policies section) clearly define what is considered appropriate conduct for students within the program. Refer to the due process for violations for information about program dismissal and appeals.

Oregon EMS Providers (including the program instructors and lab assistants) are bound by law to report dishonorable or unprofessional conduct of any EMS Provider to the Oregon Health Authority (OHA). See OAR 333-265-0080 – Reporting Obligations.

The following statutes and rules define dishonorable or unprofessional conduct:

Upon receiving a report, OHA will promptly commence an investigation (OAR 333-265-0085) and take appropriate disciplinary measures (OAR 333-265-0087).

College policies

Students are required to read, understand, and follow college and program policies, standards, and ethical guidelines. In addition to reviewing the policies linked in this section, any additional requirements described in the section for one’s program of study should be reviewed and followed. Students assigned to clinical sites are required to learn and follow the policies, rules, and regulations required by the site. Students are encouraged to reach out to program faculty and staff with any questions or clarification needed.

Comprehensive links to college policies can be found on the following webpages:

The policies of particular relevance to students include:

Conduct, professional standards, and ethics

It is especially important for students to comply with the following policies regarding conduct, professional standards, and ethics.

HIPAA

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. The US Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of HIPAA (Centers for Disease Control Public Health Law). Under this law, patients’ health information is protected. This includes individually identifiable health information that is transmitted or maintained in any form or medium (electronic, oral, or paper).

What does this mean for Healthcare and Emergency Professions students?

In the course of their study, healthcare and emergency professions students will work in patient-focused settings, which could include providing patient care at the dental clinic, at off-site clinics, with ambulance services, and in hospitals, and/or could include responsibilities for managing patient data. Additionally, patient data and images, including radiographic images, will be part of the classroom and lab instruction. Often, students will act as patients during lab and practice sessions and confidentiality policies will apply. Students will have access to confidential patient data in these settings and are expected to:

  • protect patient and student confidentiality at all times,
  • comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
  • strictly follow all policies and procedures at the facilities in which off-site clinicals, internships, practicums, and co-ops are held,
  • uphold the professional ethics guidelines of their field of study, and
  • adhere to Portland Community College’s confidentiality policies, including Family Educational Rights and Privacy Act (FERPA)

Specific guidelines related to HIPAA and confidentiality include, but are not limited to:

  • Any information (including images, and written or verbal) related to patient care is strictly confidential and is:
    • not to be shared, copied, or discussed with anyone outside of the direct care of the patient, and
    • not to be removed from a healthcare facility or service unless written permission has been given by the clinical agency to remove such information. Information may be disclosed only as defined in HIPAA guidelines for educational purposes.
  • Radiographic images that are used for image critiques, case study, or lab sessions must have all patient and hospital identification removed. Students attending critique sessions away from their home sites may bring radiographic images only on approved devices that follow HIPAA requirements. No images taken with cell phones are allowed.
  • Photographs, recordings, and videos of patients must never be taken, whether a patient gives permission or not. If patient images are being considered for an educational purpose, the student must check with the instructor who will determine policies at the practicum site.
  • Absolutely no reference to a patient, even if de-identified, should ever be shared electronically via email outside of MyPCC email or on social networking sites such as Facebook. The instructor may direct students to share select de-identified patient information via MyPCC email or D2L for course preparation or learning purposes.
  • No facility or facility staff information should be shared via personal email, on social networking sites, or by other means outside the learning environment.
Required training
  • Read about the Health Insurance Portability and Accountability Act (HIPAA).
  • Students are required to complete a HIPAA training module through the college’s third-party vendor, CastleBranch.
  • Ongoing training and guidance will be provided as appropriate throughout the instructional courses.
  • Students participating in off-site clinicals, internships, practicums, and co-ops are required to attend their clinical site’s HIPAA training to become educated on the facility’s confidentiality policies and procedures.
Violations of HIPAA and confidentiality

Any action that violates patient or student confidentiality will have long-lasting consequences for the student’s career and a serious impact on their standing in the program. All actions will be addressed quickly and will prompt a review process in which program probation or dismissal is considered. See Due process for violations. The off-site clinical, internship, practicum, or co-op facility could impose further disciplinary actions, including immediate dismissal from the site.

Dress code

The purpose of these guidelines is to establish clear dress code and appearance standards to maintain a safe, professional, and inclusive environment at Portland Community College (PCC) in the Healthcare and Emergency Professions Pathway (HEP). These requirements ensure safety and infection control, as well as prepare students for clinical and professional settings. These guidelines are in accordance with applicable PCC policies. Students participating in clinicals, internships, practicums, co-ops, and other external educational settings may need to adhere to additional procedures and guidelines set by their assigned facility.

Dress code
  • Attire:
    • Clothing should be clean, neat, and appropriate for an academic setting.
    • Attire should not have offensive language, images, or messages in accordance with the college’s Nondiscrimination and Non-harassment Policy.
    • Footwear should be safe and suitable for the lab and clinical environment. Closed-toe shoes made of leather or a similar material that is resistant to needles and liquids are required.
    • Hats are not permitted in clinical settings (hair coverings worn for religious purposes are not an issue).
  • Uniform standards:
    • Certain programs may require uniforms or specific attire. These requirements must be followed.
    • Uniforms and shoes should be clean with no wrinkles or tears, properly fitted, and worn as intended.
  • Personal Protective Equipment (PPE):
    • Students in labs, workshops, and other hands-on environments must wear appropriate PPE as specified by their instructors.
    • PPE may include items such as safety glasses, gloves, lab coats, and closed-toe shoes. There may be additional/different PPE requirements based on the nature of the program.
Appearance
  • Grooming standards:
    • Students are expected to practice good personal hygiene.
    • Hair, including facial hair, should be clean and well-maintained.
      • Hair should be secured to prevent it from getting caught in equipment or interfering with the task at hand.
      • Facial hair should be groomed to ensure a proper seal with an N-95 mask, if required.
    • Students should avoid strong fragrances that may cause discomfort or allergic reactions.
    • Nails: Federal and state laws specify that artificial nails should not be worn when having direct contact with patients. The maximum nail length is 1/4 inch and nails should not pose a risk of tearing gloves. Nail polish, if worn, should be tidy and unchipped for hygiene purposes.
    • Ensure hands are clean and washed before touching or performing clinical procedures.
  • Tattoos and piercings:
    • Visible tattoos that conflict with professional standards and college policies may need to be covered.
    • Piercings are allowed provided they do not interfere with tasks, such as patient care. In some settings, jewelry that could get caught on equipment and pose a safety risk is not allowed. Please refer to program-specific requirements for further details.
Accommodation and exceptions

In cases where assigned facilities for clinicals, internships, practicums, and co-ops have specific dress and personal appearance codes, those regulations and any applicable process for accommodations will be used by the facility. For circumstances when PCC is the decision maker, the college will provide reasonable accommodations or modifications that do not fundamentally alter any program standard or compromise safety, health, and hygiene standards.

All students are responsible for adhering to the appearance and dress code standards of the Healthcare and Emergency Professions pathway, program, and the clinical setting (if applicable). For safety reasons, students who do not comply with the dress code will be asked to leave the course session to correct their attire and return only after making the necessary changes. Attendance and tardiness rules will apply when such corrections are necessary. Students not in compliance with these standards could be subject to a disciplinary review process. See Due process for violations.

Program-specific requirements

In addition to the Healthcare & Emergency Professions pathway dress code and appearance standards, Emergency Medical Services program students are required to adhere to the guidelines below.

EMT student dress code
  • White PCC EMT student shirt (available for purchase at the Cascade Campus Bookstore). The shirt must be neatly tucked into pants.
  • Student identification visibly worn on the uniform shirt (available at the student services office on any campus)
  • EMS quarter-zip pullover sweatshirt – optional (available for purchase at the Cascade Campus Bookstore)
  • Any shirt worn under the uniform shirt must be a clean, plain white T-shirt or turtleneck (no printing or graphics).
  • Non-department items such as pins, patches, etc., are not permitted.
  • Pants: black or dark blue pants. Denim pants and sweats are not permitted.
  • If pants have belt loops, a plain black or brown belt must be worn also.
  • Shoes or boots must be worn. No sandals, flip-flops, open-toe, or tennis shoes.

During cold weather students may wear a white long-sleeved T-shirt made of moisture wick material under the uniform shirt. It is permissible to wear the EMS quarter zip pullover sweatshirt or a plain black sweatshirt or jacket.

Noncompliance with the uniform policy has a direct impact on students’ affective grade each time it occurs.

Paramedic student dress code
  • PCC navy blue scrubs (required attire for labs and clinical rotations)*
  • PCC Paramedic uniform polo (required for non-lab days)*
  • PCC pullover sweatshirt and/or PCC vest*
  • Student Identification card visibly worn on the uniform shirt  (available at the student services office on any campus)
  • Clean closed-toe shoes (worn anytime except on field internship)
  • Black boots or shoes (required for field internship)

All PCC attire must also have the students’ Oregon EMS patch for their provider level (see the Oregon EMS Association store). Optional attire for travel, labs, and field shifts are the PCC cap, skull cap, and stocking cap. No other clothing is allowed in the classroom, including outerwear and headwear. During cold weather, students may wear a black or dark gray long-sleeve T-shirt or similar material under the polo shirt and scrubs. The undershirt cannot have visible printing of any kind on them.

Noncompliance with the uniform policy has a direct impact on students’ affective grade each time it occurs.

*purchase information will be provided in EMS 238

Attendance

Attendance at the first class is mandatory – no exceptions. Students missing the first class will be dropped from the roster by the EMS program Attendance policies are included in the course syllabi. Students are expected to be on time and prepared for classes. Attendance is strictly monitored by the course instructor. Tardiness and early departures from class periods are documented.

Clear communication is crucial in the healthcare field, including EMS. Students are expected to proactively communicate with the instructor regarding any planned absences, such as for jury duty, appointments, or scheduled events. Moreover, students should promptly notify the instructor in the event of absence due to illness, injury, or emergency. All absences will result in a score of 0 for that day. However, in the case of excused absences, students may have the opportunity to make up missed hours by attending another section offered during the term. Any exceptions to this policy will be determined on a case-by-case basis by the instructor, clinical coordinator, department chair, or program director accordingly. In the event of an absence, it is the student’s responsibility to obtain the course material and notes from other students for the missed class sessions.

Communication

Personal and professional communication

Students in the Healthcare & Emergency Professions pathway are trained to become professionals in their chosen careers. In these roles, they will have the privilege of interacting with a diverse group of people. During the course of their professional education, students will strengthen their personal communication skills to improve effectiveness with people. Communication involves interactions between students, patients, faculty, staff, and guests located on campus or at off-campus learning sites (agencies, clinical facilities, or other settings). Respect for individual differences in opinions, beliefs, gender, lifestyle practices, religious, racial, cultural, or social backgrounds should be demonstrated by using effective listening and communication skills, as well as showing respect for physical space and privacy issues.

Communication methods and standards
  • Email: The primary mode for program and instructor communication will be via students’ PCC email address. See PCC’s Communication Policy.
  • D2L Brightspace: Communications specific to each course will be delivered via announcements and postings in D2L Brightspace learning platform.
  • Office hours: Full-time instructors are available for selected in-person and virtual office hours each week. Appointments are made through the individual instructor.
  • Chain of communication:
    • Course syllabus and D2L Brightspace: Refer to the course syllabus and D2L Brightspace for questions and concerns related to course requirements.
    • Course instructor: Refer questions and concerns directly to the assigned faculty instructor. Students who have difficulties with individual faculty should first aim to resolve the issues directly with that faculty. For clinical experiences, reach out to the assigned clinical instructor and clinical coordinator, if applicable.
    • If the preceding steps have been followed without questions or concerns being adequately addressed, the student may next contact the faculty department chair (FDC).
    • Individual questions, concerns, and comments about the program overall can be discussed with the program dean, as escalated by FDC.
    • There are opportunities for students to provide feedback about courses throughout the year through course evaluations. Some programs invite student representation on committees.
Use of electronic devices

Use of cellular phones or other electronic devices that may interfere with learning activities are prohibited during classroom, laboratory, and clinical laboratory practice activities and examinations, unless features such as amplification, magnification, or transcription tools are used as learning aids. Students should limit use of such devices to breaks and turn them off (or silence them) upon return. Use of cell phones for recording or taking images in the clinical setting is prohibited as it can be a HIPAA violation (see the HIPAA section). Permission from fellow students, faculty, and staff is required prior to any pictures taken on campus.

Social media

Students are expected to adhere to the following guidelines in order to maintain the professional and ethical standards of the program and the clinical affiliates:

  • Do not post anything that would violate FERPA (student privacy) and HIPAA (see the HIPAA section) (patient privacy) regulations. Activities that occur during clinical rotations or that involve patients are not to be shared.
  • Photos which contain any animal not owned by the student or activities surrounding the use of these animals in classes or labs shall not be posted to social media accounts unless as related to adoption, or when given express permission by the owner of the animal.
  • Be mindful of the language used when discussing the affiliate, program, fellow students, faculty, or staff, and avoid any comments that could be perceived as derogatory or harmful. Instead, address concerns by following the Grievance process.
  • Do not ask to connect with instructors on social networks in order to maintain an appropriate professional relationship. Upon graduation, instructors and students may connect if all parties agree.
  • Use good judgment before posting personal pictures. Be aware that information you post online may be available to anyone, and could be misconstrued.
  • See related college policies and guidelines:

Nothing in this social media section is intended to restrict any expressive activity that is legally protected.

Employment while in program

Students can work while they are in the paramedic program. However, they cannot perform clinical or capstone field rotations as a student while they are also on a work-related shift, either paid or unpaid (volunteer).

Per the Oregon Health Authority Public Health Division Oregon Administrative Rules, OAR 333-265-0016, “(5) A student participating in an internship shall not be considered one of the minimum staff required for an ambulance as described in OAR Chapter 333, Division 250.” Students have to always be the third rider and cannot be one of the two paid employees on the ambulance while they are participating in student rotations.

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Fieldwork