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At the conclusion of this course, the student should be able to:
1. Identify and discuss anatomy and physiology of the eye and ear
2. Perform eye and ear medication instillations and washes/irrigations
3. Perform visual and auditory acuity testing
4. Identify and discuss obstetric, gynecological and prenatal exams
5. Assist the provider with all obstetric, gynecological, and prenatal exams
6. Identify and discuss all aspects of a pediatric exam
7. Assist provider with all pediatric exams
8. Identify and discuss anatomy and physiology of the heart
9. Identify and record specific components of a 3 channel, 12-lead electrocardiograph (EKG)
10. Apply a Holter monitor
11. Recognize and identify specific cardiac arrhythmias and the etiology of each
12. Perform spirometry and peak flow rate testing
13. Identify and demonstrate specific patient positions utilized in radiography
14. Identify and explain the purpose of specific types of diagnostic imaging procedures, e.g.
computerized tomography scan, magnetic resonance imaging, ultrasonography
15. Distinguish between emergency and non-emergency situations
16. Explain and apply principles of various emergency medical procedures utilized in the
outpatient setting
17. Meet current requirements for preparing and administering parenteral, oral, topical, otic and
opthalmic medication at an intermediate level
18. Communicate effectively during all skill performances
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I. Eye and Ear Assessment and Procedures
A. The eye
B. Structure of the eye
C. Visual acuity
1. assessment of distance visual acuity
2. assessment of near visual acuity
D. Assessment of color vision - Ishihara test
E. Eye irrigation
F. The ear
G. Structure of the ear
H. Assessment of hearing acuity
1. types of hearing loss
2. hearing acuity tests
I. Ear irrigation
J. Competencies*
1. assess distance visual acuity*
2. assess near visual acuity*
3. assess color vision*
4. perform an eye irrigation*
5. perform an ear irrigation*
6. perform eye drop instillation*
7. perform ear drop instillation*
II. Gynecologic Exam and Prenatal Care
A. Gynecology exam
B. Breast exam
C. Pelvic exam
1. inspection of external genitalia, vagina, and cervix
2. pap test
3. bimanual pelvic exam
4. rectal-vaginal exam
D. Vaginal infections
1. trichomoniasis
2. candidiasis
3. chlamydia
4. gonorrhea
E. Prenatal care
F. Obstetrics
G. Prenatal visits
1. first prenatal visit
2. prenatal record
3. initial prenatal exam
4. return prenatal visits
5. special tests and procedures
H. Six week postpartum visit
I. Competencies*
1. instruct patient in the procedure for a breast self exam*
2. prepare patient for gynecological exam*
3. assist the physician with a gynecological exam*
4. complete a cytology requisition form*
5. assist in the collection of a vaginal microbiologic specimen*
6. document the patient's pregnancy in terms of gravidity and parity*
7. calculate the expected date of delivery*
8. complete a prenatal history*
9. assist with an initial prenatal exam*
10. assist with a return prenatal exam*
11. assist with a six week postpartum exam*
III. Pediatric Exam
A. Pediatric office visits
B. Developing a rapport
C. Carrying the infant
1. cradle position
2. upright position
D. Growth measurements
1. weight
2. length and height
3. head and chest circumference
4. growth charts
E. Pediatric blood pressure measurements
1. special guidelines for children
2. correct cuff size
3. cooperation of the child
4. blood pressure classifications
F. Collection of a urine specimen
G. Pediatric injections
1. types of needles
2. intramuscular injection sites
H. Immunizations - National childhood vaccine injury act
I. Newborn screening tests
J. Competencies*
1. carry an infant using the following positions*
a. cradle*
b. upright*
2. plot pediatric growth values on a growth chart*
3. measure the weight and length of an infant*
4. measure the head and chest circumference of an infant*
5. measure the blood pressure of a child*
6. collect a urine specimen using a pediatric urine collector*
7. locate the following pediatric intramuscular injection sites*:
a. vastus lateralis*
b. deltoid*
8. administer an intramuscular injection to an infant*
9. administer a subcutaneous injection to an infant*
10. read and interpret a vaccine information statement*
11. document information on an immunization administration record*
12. collect a specimen for a newborn screening test*
IV. Cardiopulmonary Assessment and Procedures
A. Structure of the heart
B. Conduction system of the heart
C. Cardiac cycle
1. waves
2. baseline, segments, and intervals
D. Electrocardiograph (EKG) paper
E. Standardization of the EKG
F. EKG leads
1. electrodes
2. bipolar leads
3. augmented leads
4. chest leads
G. Paper speed
H. Patient preparation
I. Maintenance of the EKG
J. EKG capabilities
1. three-channel recording capability
2. interpretive EKG
3. electronic medical record (EMR) connectivity
4. teletransmission
K. Artifacts
1. muscle artifact
2. wandering baseline artifact
3. 60-cycle interference artifact
4. interrupted baseine artifact
L. Holter monitor EKG
1. purpose
2. digital holter monitor
3. patient preparation
4. electrode placement
5. patient diary
6. event marker
7. evaluating results
8. maintenance of the Holter monitor
M. Cardiac dysrhythmias
1. premature atrial contraction
2. paroxysmal atrial tachycardia
3. atrial flutter
4. atrial fibrillation
5. premature ventricular contraction
6. ventricular tachycardia
7. ventricular fibrillation
N. Pulmonary function tests
1. spirometry
2. post-bronchodilator spirometry
O. Peak flow measurement
1. asthma
2. peak flow meter
3. peak flow rate
P. Home oxygen therapy
1. oxygen prescription
2. oxygen delivery systems
3. oxygen administration devices
4. oxygen guidelines
Q. Competencies*
1. record a 12-lead, 3 channel EKG*
2. instruct a patient in the guidelines for wearing Holter monitor*
3. apply a Holter monitor*
4. identify cardiac dysrhythmias on a 12-lead EKG*
5. perform a spirometry test*
6. measure a patients peak flow rate*
V. Radiology and Diagnostic Imaging
A. Contrast media
B. Fluoroscopy
C. Positioning the patient
D. Specific radiographic exams
1. mammography
2. bone density scan
3. gastrointestinal series
4. intravenous pyelography
5. other types of radiograph
E. Ultrasonography - patient preparation
F. Computed tomography - patient preparation
G. Magnetic resonance imaging - patient preparation
H. Nuclear medicine
1. bone scans
2. nuclear cardiac stress tests
3. guidelines
I. Digital radiography
J. Competencies*
1. Instruct a patient in the proper preparation necessary for each of the following types of
radiographic exams*
a. mammography*
b. bone density scan*
c. upper gastrointestinal radiography*
d. lower gastrointestinal radiography*
e. intravenous pyelography*
2. Instruct a patient on the purpose and advance preparation for each of the following
diagnostic imaging procedures*
a. ultrasonography*
b. computed tomography*
c. magnetic resonance imaging*
d. nuclear medicine*
VI. Emergency Medical Procedures
A. Office crash cart
B. Emergency medical services system
C. First aid kit
D. OSHA safety precautions
E. Guidelines for providing emergency care
1. respiratory distress
2. emphysema
3. hyperventilation
4. heart attack
5. stroke
6. shock
7. bleeding
8. wounds
9. musculoskeletal injuries
10. burns
11. seizures
12. poisoning
13. heat and cold exposure
14. diabetic emergencies
F. Competencies* - Respond to common emergency situations*
VII. Continuation of Medication Administration at the Intermediate Level - Competencies*
A. Preparing and administering parenteral medications including intramuscular, intradermal,
and subcutaneous injections*
B. Preparing and administering otic and opthalmic medications*
*These items are introduced in lecture, and the related skills are performed in the lab. Communication skills are included with every skill performance.