OLTON CLASS MAY 2019 - OVAA Happenings · Click on 2018-2019 EMT Course . 1 OLTON EMS TRAINING...
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OLTON EMS TRAINING PROGRAM EMT-BASIC TRAINING COURSE COURSE SYLLABUS OLTON CLASS MAY 2019 TDSHS COURSE APPROVAL NUMBER: 614976
Transcript of OLTON CLASS MAY 2019 - OVAA Happenings · Click on 2018-2019 EMT Course . 1 OLTON EMS TRAINING...
OLTON EMS
TRAINING PROGRAM
EMT-BASIC
TRAINING COURSE
COURSE SYLLABUS
OLTON CLASS
MAY 2019
TDSHS COURSE APPROVAL NUMBER: 614976
2019 Olton EMT Course
Course Syllabus Guide
Click on the Section and you will be taken to that section:
Important Phone Numbers Policies and Procedures
Knowledge Objectives Clinical Objectives
Clinical Request Form
Hospital Clinical Rotation Forms Hospital Clinical Rotation Form (EXAMPLE)
EMS Clinical Rotation Forms EMS Clinical Rotation Form (EXAMPLE)
Skills Forms Certification Instructions
Instructor Evaluation Form Course Evaluation Form
OLTON EMS TRAINING PROGRAM 2019 OLTON EMT-B COURSE
IMPORTANT PHONE NUMBERS
Tyeson Powers, Lead Instructor Cell: 806-782-2941
Email: [email protected] *
Nyssa Powers, Instructor Cell: 806-782-2942
Email: [email protected]
Rusty Powers, Coordinator Cell: 806-786-7988
SPC: 806-716-4627
Email: [email protected] *
Covenant Hospital Plainview 806-296-5531(For last minute cancellations)
Plainview Fire Department Station 2 806-296-1173, or
(For last minute cancellations) 806-296-1122
Olton EMS 806-285-7701(For emergency contact during classroom hours)
*Do not send jokes or chain emails to these email addresses.
Website for notes and class information:
www.ovaa.wordpress.com Click on 2018-2019 EMT Course
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OLTON EMS
TRAINING PROGRAM
EMT-BASIC
TRAINING COURSE
POLICIES
AND
PROCEDURES
OLTON CLASS
MAY 2019
TDSHS COURSE APPROVAL NUMBER: 6144976
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Mission Statement
It is the mission of the Olton EMS Training Program to provide quality
health care education to program applicants, thereby increasing the level of
expertise in Pre-hospital Medicine provided to rural communities throughout
our region.
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Table of Contents
Goals and Objectives………………………………………………………. 5
Course Composition……………………………………………………….. 6
Medical Director………………………………………………………….... 6
Tuition……………………………………………………………… ……... 6
Prerequisites………………………………………… …………………… 6
High School Diploma or GED…………………………………….. 6
Computer, Internet, and Email Access………….…………………..6
Immunizations………………………………………………………7
Screening……………………………………………………………………7
Appeals……………………………………………………………………...7
Student Grievances………………………………………………………….7
Insubordination…………………………………………………………….. 7
Insurance…………………………………………………………………… 8
Liability…………………………………………………………………….. 8
Social Media/Photos/Texting/Emails……………………………………….8
Social Media……………………………………………………….. 8
Photos………………………………………………………………. 8
Texting/Emails…………………………………………………….. 8
Classroom Policies…………………………………………………………. 8
Student participation……………………………………………….. 8
Attendance…………………………………………………………. 9
Absences…………………………………………………………… 9
Cell Phone…………………………………………………………..9
Cleaning of Classroom……………………………………………...9
Make-up hours……………………………………………………... 9
Textbook…………………………………………………………… 9
Exams………………………………………………………………. 9
Cheating……………………………………………………………. 10
Grading policies…………………………………………...……….. 10
Student’s Responsibilities………………………………………….. 10
Skills and Skills Exams…………………………………………….. 11
Homework…………………………………………………………..11
Tobacco Use………………………………………………………...11
Parking……………………………………………………………... 11
EMS living quarters………………………………………………... 12
Clinical Rotations………………………………………………………….. 12
Required Clinical Rotations………………………………………... 12
Clinical Rotation Timeline…………………………………………. 12
Scheduling Clinical Rotations………………………………………13
Cancelling Clinical Rotations……………………………………….13
Rotation Documentation…………………………………………… 13
Time Extensions for Clinical Requirements……………………….. 14
Skills to be Performed at Clinicals………………………………….14
Dress Code…………………………………………………………. 14
Hospital Clinical Guidelines……………………………………………….. 15
Behavior, appearance, attitude…………………………………….. 15
Attendance…………………………………………………………. 16
Breaks……………………………………………………………….16
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Tobacco Use……………………………………………………….. 16
Universal precautions……………………………………………….16
Dress code………………………………………………………….. 17
Cooperation with hospital staff…………………………………….. 17
Patient/family interaction…………………………………………... 17
Telephone…………………………………………………………... 17
Visitors……………………………………………………………... 17
Alcohol/chemical use………………………………………………. 18
Clinical Paperwork………………………………………………….18
Ambulance clinical guidelines……………………………………………... 18
Attendance…………………………………………………………. 18
Tobacco use…………………………………………………………18
Universal precautions……………………………………………….19
Dress code………………………………………………………….. 19
Cooperation with EMS staff……………………………………….. 19
Patient/family interaction…………………………………………... 19
Telephone…………………………………………………………... 20
Visitors……………………………………………………………... 20
Alcohol/chemical use………………………………………………. 20
Purpose……………………………………………………………... 20
Meals……………………………………………………………….. 20
Living Quarters ……………………………………………………..20
Curfew……………………………………………………………... 20
Clinical paperwork…………………………………………………. 21
Course Completion………………………………………………………… 21
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Goals and Objectives
1. Provide and maintain a quality health education program for Pre-hospital
and hospital personnel
2. Provide and maintain staff education and continuing education for Olton
EMS and surrounding communities.
3. Provide quality health care to the citizens of the South Plains.
4. Strive for excellence in public education and accident prevention, promoting
health and well being to the community.
5. Participate in region and statewide quality improvement programs to provide
growth in quality care.
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COURSE COMPOSITION
This course will consist of 152 hours of classroom time and practical exercises. This course also
consists of 24 hours of emergency room hospital rotations and 24 hours of rotations at a paid
EMS department. All ER clinicals will be at Covenant Hospital Plainview Hospital. Paid EMS
departments will include Olton EMS (daytime), Plainview Fire/EMS, and other paid services
with an appropriate affiliation agreement and as approved by the Lead Instructor and
Coordinator. The student will also attempt to witness one vaginal childbirth at an approved
hospital. Students will be informed of all approved EMS departments and emergency
departments by the instructor prior to the scheduling of these rotations. During the EMS
rotations, a total of 5 EMS calls must be made by the student. Of these 5, one must be a major
medical and one must be a major trauma call. The definition of “major” is that advanced life
procedures were used by the crew; or would have been used by the crew if ALS were available.
EMS calls may count with any EMS service in which an affiliation agreement is signed and on
file with this program as long as a member of the crew is certified at the EMT level or above.
However, only the hours spent on the actual call will count towards the 24 hours required unless
it was made with a paid service as mentioned above.
MEDICAL DIRECTOR
According to rules and regulations of the Texas Department of State Health Services, all EMS
training programs must have a licensed physician to serve as the program’s medical director.
The role of the medical director is to provide medical oversight of the program. Many
procedures taught in the EMT class require medical direction to perform. This medical direction
is granted through the program medical director only during the classroom and clinical rotations
of this course. Practicing these skills outside the scope of the class may be considered practicing
medicine without a license.
The Medical Director for this course is Dr. Charles Addington II or Wolfforth.
TUITION
Tuition is due, in full, and payable on registration. The deadline for submitting payment will be
by the end of the first class. All payments must be made to the lead instructor. If a student is
unable to pay the full tuition at registration, a pay-out option is available where ½ of the tuition is
due upon registration and ½ due within 30 days. There will be a $50 administration fee for any
students who selects this option. No tuition refunds will be granted after 72 hours from
registration. Any request for refund must be received, in writing by the lead instructor, prior to
the 72 hour deadline. Any and all payments will still be due and payable unless the student
withdraws within the 72 hour deadline.
PRE-REQUISITES
High School Diploma or GED
Prospective students must hold a high school diploma or GED prior to taking the certification
exam. Students must also reach the age of 18 years prior to taking the certification exam. All
prospective students must meet all other requirements set forth by the National Registry.
Computer, Internet, and Email Access Students must have access to the internet with printing capabilities and a functioning email
address. Since many communications are handled via email, students should check their email
daily.
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Immunizations
Prior to beginning clinical or field rotations, each student must submit copies of the following
immunizations. Failure to provide these records will result in the student not being allowed to
begin clinical rotations and could result in the student being dismissed from the program. Note:
students who have not completed the Hepatitis B series must have completed the 2nd
immunization prior to scheduling rotations.
TB Skin Test Mantoux or PPD Must be within last 12 months
Tetanus Vaccine Td or DTP or DPT Must be within last 10 years
Measles/Mumps/Rubella MMR Vaccine or lab titer must be after
1980. If born before January 1,
1957, proof of vaccine not required
Hepatitis B Must have series of 3 doses. Doses #1 and #2 are required prior to
onset of clinical rotations, unless declined by student. If student
declines, student must submit a signed statement to the instructor
from a licensed physician that he/she declines to be vaccinated.
SCREENING
Prospective EMT students may be required to take a basic aptitude test. This exam will be used
to establish entry level knowledge. This exam may also be used to determine who is admitted
into the course should there be more applicants than the course will allow.
APPEALS
Any applicant not accepted into the course, who has been dismissed from the course, or who has
a grievance with any of the Olton EMS staff or instructors, will have the opportunity to appeal.
The appeal and request for a hearing must be written and submitted to the coordinator within five
(5) working days after being notified of action to be taken. The appeal will be reviewed by a
group made up of the course coordinator, a member of the Olton EMS Board of Directors, and
another instructor from a different EMS Training Program. A decision and explanation will be
provided to the appealing party within five (5) working days of the review.
STUDENT GRIEVANCES
A grievance is defined as an unsolved conflict that a student has with a member of the Olton
EMS staff, or instructor in regards to the enforcement or interpretation of an EMS Training
policy or procedure. If a grievance occurs, it is the student’s responsibility to file a written
grievance and submit it to the course coordinator within five (5) working days of the conflict.
The grievance with be reviewed by a group made up of the course coordinator, a member of the
Olton EMS Board of Directors, and another instructor not affiliated with the class in which the
complainant is enrolled. A decision and explanation will be provided within five (5) working
days of the review.
INSUBORDINATION
Any form of disruptive or unprofessional behavior will not be tolerated. All incidents will be
addressed directly by the instructor. If not resolved with the instructor, the situation will be dealt
with by the coordinator. Repeated or gross incidents of this manner will result in termination
from the program.
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INSURANCE
No health insurance is furnished by this program. It is advisable that all students have their
own personal insurance. The student assumes all personal liability and responsibility for any
personal injury that is a direct result of the student’s actions either intentional or otherwise.
LIABILITY
CHAPTER 773 SEC 773.009 OF THE HEALTH AND SAFETY CODE states “A person who
authorizes, sponsors, supports, finances or supervises the functions of emergency personnel and
emergency medical service personnel is not liable for civil damages for an act or omission
connected with training emergency medical personnel or with service or treatment given to
patient or potential patient by emergency medical service personnel if the training, services or
treatment is performed in accordance with standard of ordinary care”.
SOCIAL MEDIA/PHOTOS/TEXTING/EMAILS
With today’s technology, there are numerous opportunities for almost instantaneous
communications with a large number of persons. This creates challenges for EMS services in
regards to public perception, confidentiality, and professionalism.
Social Media
Students may not post ANY reference to rotations, clinical sites, preceptors, instructors, patients,
or any other person or facility associated with this course. This includes posts on Twitter,
Facebook, SnapChat, Instagram, or other social media sites. Any violation of this may result in
immediate dismissal from the program. If patient confidentiality is violated, civil and/or
criminal charges may be brought against the offending student.
Photos
No photos may be taken during ANY clinical rotation. Any violation of this may result in
immediate dismissal from the program. If patient confidentiality is violated, civil and/or
criminal charges may be brought against the offending student.
Texting/Emails
Students may NOT send or receive text messages or emails during class or while on EMS calls
or during hospital rotations. Texts and emails sent or received from personal computers may not
contain any patient information. Any derogatory remarks about preceptors, instructors, or other
persons affiliated with this program may result in immediate dismissal from the program. If
patient confidentiality is violated, civil and/or criminal charges may be brought against the
offending student.
CLASSROOM POLICIES
Student Participation
Students are expected to take an active roll in the learning process. Time is scheduled
throughout the course for skills instruction and practice. Failure to use this time for skills practice
can result in the dismissal of the student from the course. Students will not be allowed to leave
class early on these nights.
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Attendance
Classroom attendance is mandatory. Students must notify the instructor if they will not be
attending class. Students may be allowed to make up missed time for an excused absence. (see
absence policy below). Classes marked MANDATORY must be made up by the student on
his/her own time and at his/her own cost within 30 days of the missed scheduled class. Failure to
make up a class marked MANDATORY will result in the student not completing the course.
Absences
An excused absence is defined as an absence which occurs because of illness, work, or a family
emergency, and the instructor is notified before class of the absence. Students may be allowed to
make up missed time for an excused absence. If a student misses more than twelve (12) hours of
class, that student will be dismissed from the program. An appeal can be requested.
Cell Phones
Cell phones are allowed in the classroom during normal classes. However, the phones should be
set on silent or vibrate. Students must leave the classroom to answer or speak on cell phones. No
texting, surfing, or other use of cell phones are allowed during classroom lectures. No cell
phones will be allowed in the classroom during testing.
Cleaning of Classroom
Students are expected to straighten up the classroom after every class and place the chairs of top
of the tables. Following skills practice or testing, students are expected to assist the instructors in
picking up all manikins, skills supplies, and equipment prior to leaving.
Make up hours
Students who are allowed to make-up for excused absences will be limited to a total of 12 hours
make-up time. Make up hours can be from another EMT class or as assigned by the instructor.
Classes made up from another EMT class must be over the same topic(s) that was missed. The
ability to make up hours is NOT guaranteed. The lead instructor will consider this on a case by
case basis.
Textbook
The textbook for this course is the American Academy of Orthopedic Surgeons (AAOS)
Emergency Care for the Sick and Injured, 11h Edition. Each student is required to purchase and
bring to class the appropriate textbook. The student is responsible to purchase the textbook from
any source. Purchase of the designated textbook is MANDATORY. No sharing of
textbooks.
Exams
Students are required to take exams on the night the exam is scheduled. Only cases of extreme
emergency, such as work, family emergency, or an excused absence will be considered for
rescheduling of an exam. All rescheduling of an exam must be approved by the instructor prior
to the exam. Students who miss an exam must schedule and take the exam within five (5) days of
the initial exam. Exams not taken within this time frame will result in a zero. Students who
continually miss class on exam nights are subject to dismissal from the class.
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Cheating
Cheating will not be tolerated at any time. Students caught cheating will be dismissed from the
course. No cell phones will be allowed in the classroom during testing.
Grading Policies
The acceptable passing grade for this course will be a score of 70 percent. Students will be
required to maintain an average of 70 percent in order to participate in all clinical sites.
Students, whose class average drops below a 70, will lose, or be denied, the privilege to attend
all clinical sites. If the class average drops below 70%, the student will meet with the lead
instructor and/or course coordinator to develop a plan to correct the problem.
All modular (interim) exams and the final exam must be passed. If a student fails the initial
attempt at a modular or final exam, the student will be given one opportunity to pass a re-test.
Failure of any modular or final retest will result in dismissal from the course. A student will
only be allowed to retest two (2) major exams throughout the course. This includes the modular
(interim) exams and the final exam. Failure of more than two major exams will result in the
student being dismissed from the course.
Scheduling of retests of failed modular exams or the final exam shall be at the discretion and
convenience of the lead instructor. Failure to take the re-test at the designated time will result in
dismissal from the course. Failure of any modular or final retest will result in immediate
dismissal from the course.
Students who fail to complete clinical rotations because the class average is below a 70 will fail
the course and will not be placed on the course completion form.
In addition to the above criteria, all students must have at least a 70% for their final grade.
Final Grades will be based on the following criteria:
Daily Quizzes/Pop Quizzes/Assignments: 20% of final grade
Module Exams: 40% of final grade
CPR Exam: 10% of final grade
Final Exam: 30% of final grade
Student’s Responsibilities
It is the student’s responsibility:
To keep track of his/her absences.
To notify the instructor of the absence prior to class.
To make up any missed classroom hours.
To acquire lecture material and handouts.
To make arrangements to turn in homework that will be late due to an absence.
To make arrangements to take a make up exam within the allotted time.
To ensure EMS and/or clinical paperwork isn’t late due to an absence.
To read the material to be covered in class before class begins.
To arrive on time to class.
To practice skills during the allotted time.
To seek clarification on any subject matter that is not understood.
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Skills and Skills Exams
Skills are a very important aspect of the EMT program. All skills MUST be passed. Skills will
be tested according to the schedule in compliance with the State, National Registry, and Program
guidelines utilizing the Program testing sheets. Failed skills exams may be retested per the
schedule. Students will have 3 opportunities to pass each required skill. Some skills will be
tested more than once throughout the course. Failing of a skills test will result in a re-test.
Failure of a re-test will require that student to test before the Coordinator or a skills review panel
consisting of 2 to 3 instructors, NOT including the lead instructor. A date and time will be set
for the skills review panel by the lead instructor. Absence or tardiness for the review panel will
result in automatic failure. The lead instructor will present and manage the skill but will not
score the exam. Only the members of the review panel will score the skills exams. All students
will be allowed sufficient time to practice before both the re-test and the skills review panel.
Any student who is required to appear before the skills review panel will be required to sign a
contract stating that he/she understands that failure of the skills review panel exam will result in
dismissal from the program. The Coordinator, at his discretion, may choose to re-test a student
prior to scheduling a review board. If the student fails the Coordinator re-test, a review board
will be scheduled as described above.
Failure to pass the required skills will result in dismissal from the program
Homework
Homework will be assigned by the lead instructor. Homework is a MANDATORY part of the
course. Failure to do class assignments will result in a zero for that grade. Failure to turn in
homework assignments on time will result in points being deducted from the homework grade.
Failure to complete NIMS Courses listed below will result in suspension from the program.
Homework will include; but not limited to:
Take home quizzes
Other assignments as given by the lead instructor.
Online completion of NIMS training classes consisting of:
o IS-100.b (ICS 100) Introduction to Incident Command System
o IS-700.a (ICS-700) National Incident Management System (NIMS), an
Introduction
o Completion Certificates are required to be turned in to the lead instructor
according to the schedule
o These courses may be completed online at: http://training.fema.gov/IS/NIMS.asp
o No course completion certificate will be issued without documented proof of
completion of these two NIMS courses
Tobacco Use
Smoking is prohibited in the classroom. Smoking is allowed outside of the building or in
designated areas during allotted breaks. Smokeless tobacco is allowed so long as spit cups are in
a container with a lid and are not left in the classroom or offices. All spit cups shall be disposed
of in the dumpster and not in the trashcans or in the classroom building. The lead instructor
may alter this policy at his/her discretion. Vapor or E-cigarettes are not allowed in the
classroom.
Parking
Students will not be allowed to park in the reserved parking spaces or in front of the bays at
anytime. Students are to park in un-reserved spots at all times.
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EMS Living Quarters
The living quarters, which include the bedrooms, are off limits to students during class time
except as allowed by the instructor.
COURSE CLINICAL ROTATIONS
All clinical rotations must be completed within 60 days from the last day of class.
NO EXTENSIONS WILL BE GRANTED FOR ANY REASON!!
Required Clinical Rotations for EMT
Hospital Rotations: 24 hours of Emergency Department.
All Must be at Covenant Hospital Plainview (must be in 8 hour increments)
EMS Rotations: 24 hours at a paid EMS Department only when staff is at the EMS station.
Minimum of 8 hours at the Plainview Fire/EMS Department
Remaining 16 hours at any approved Paid EMS Department. This may include Plainview
Fire/EMS or other paid service where an approved affiliation agreement is on file as
approved by the Lead Instructor and Coordinator.
o If student has to do additional hours to meet call requirements, the additional
hours, the student may choose any department where an approved affiliation
agreement is on file.
5 EMS Calls
o One Major Trauma Call (as defined on page 6 “Course Composition”)
o One Major Medical Call (as defined on page 6 “Course Composition”)
o 3 additional calls (may be medical or trauma)
o Patient refusals and calls in which there is no patient transported will NOT count
toward any requirement unless there is significant care provided. Examples, that
would count, include a cardiac arrest that was worked for several minutes and
then called on scene or where a patient was treated extensively and then placed on
a helicopter or handed off to another EMS service. This type of call should be
discussed with the lead instructor prior to determining if the call will count.
Note: If a student is unable to get a major trauma or major medical call during the 24
hours of EMS rotations, this requirement will be waived if the student has performed a
minimum of 60 hours and has a minimum of 10 EMS runs.
Clinical Rotation Timeline
Hospital clinical rotations may begin after successful completion of the first 2 interims.
Ambulance clinical rotations may begin after successful completion of the 3rd interim. This
includes passage of all exams, skills exams, assignments, and full payment of tuition.
All rotations MUST be completed within 60 days of the last day of class.
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Scheduling Clinical Rotations
Students must schedule clinicals for Covenant Hospital Plainview and the Plainview Fire/EMS
Department through the lead instructor. Rotations at Plainview Fire/EMS Department will be
limited to one basic student at a time. Rotations at Covenant Hospital Plainview will be limited
to one basic student at a time.
All requests for rotations for Plainview Fire/EMS and Covenant Hospital Plainview shall be
submitted to the lead instructor, on the approved Rotation Form, by Thursday of any week; once
the student is eligible for rotations. The requests will be for the following week or beyond;
beginning with Monday. The lead instructor will then forward the requests to the Coordinator,
via email. The Coordinator will verify availability and will inform the lead instructor of granted
requests and assignments.
Scheduling EMS rotations at any other approved field internship site will be scheduled directly
through that service or per instructions of the lead instructor.
Students are encouraged to schedule ALL rotations at once. This will give a greater chance of
getting the requested shifts and will earlier completion of clinical requirements. Students should
not wait until the last minute to schedule rotations. As mentioned before, no extensions will be
granted; even if the student has the minimum hours but has not met the run requirements as
described on page 12.
NOTE: Students CANNOT write their names on the calendars at any clinical site or
contact the Coordinator to schedule rotations and Students CANNOT contact the
Coordinator directly to schedule rotations.
Cancelling Rotations
Last minute cancellations prevent other students from scheduling rotations. The lead instructor
will closely monitor cancelled or dropped rotations. The lead instructor MUST be notified of all
rotation cancellation PRIOR to the rotation. Cancellation of rotations at Plainview Fire/EMS and
Covenant Hospital Plainview must be done through the lead instructor; who will notify the
Coordinator. Cancellation of rotations at other sites will be via a phone call to the appropriate
site. All students MUST send the lead instructor an email for all cancelled rotations. Continued
last minute cancellations may result in loss/suspension of rotation privileges, deduction from
grades, or even dismissal from the course. The best way to avoid issues is to carefully plan your
rotations and stick to the scheduled rotations.
**Students are NOT to contact the Coordinator directly to cancel rotations; but cancel
through the lead Instructor; who will notify the Coordinator**
Rotation Documentation
All rotations MUST be documented on the appropriate forms. Each student is responsible to
make sufficient copies of all forms and evaluations PRIOR to attending rotations. All
documentation should be filled out “as you go” and given to your preceptor prior to the end of
the rotation. Do no wait until the last minute as preceptors may be busy, dealing with shift
change, or gone to bed.
Failure to adequately document rotations will result in that rotation being disallowed!
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Time Extensions for Clinical Requirements
Due to the end date reported to the Department of State Health Services for this class, No
extensions will be granted for any reason.
THERE WILL BE NO EXTENSIONS GRANTED.
ALL ROTATIONS MUST BE COMPLETED WITHIN 60 DAYS OF THE LAST
SCHEDULED CLASS
Skills to be Performed at Clinicals
EMT Basic students are allowed to perform ONLY BLS skills and those skills learned
throughout the EMT course. The performance of, or the attempt to perform any skills or
procedures that are not BLS or taught in the EMT course is strictly prohibited. Performance of
such skills will result in immediate dismissal from the program.
At the beginning of each clinical, the student should explain their training level to the
preceptor(s) and explain the skills that he/she are allowed to perform.
Dress Code Policy
Unless stated otherwise in a specific guideline
Clothing: Pants will be black or dark blue or black slacks or EMS pants. (EMS pants
preferred)
Shirts will be white polo style with a collar or other shirt as directed by the
coordinator. No t-shirts. No scrubs are allowed.
Shoes should be solid black, closed toe and in good condition. EMS “duty boots”
are preferred.
Jackets should be a dark, solid color. No major logos, writings, or certification
or other patches will be allowed. It is recommended that students bring an extra uniform in case of emergencies.
(ex: uniform being soiled with blood, vomit, etc.)
Caps/Hats No caps or hats are allowed during hospital rotations.
Baseball style caps are allowed during EMS clinicals so long as they are a solid
blue or black in color and will not detract from the appearance of professionalism
No business names, EMS or fire department logos, sports teams, or other verbiage
allowed. Caps with minor markings such as a manufacturer logo are acceptable.
Caps will be worn with the brim straight forward. Such caps should be approved
by the lead instructor PRIOR to wearing at a clinical site.
Undershirts/Undergarments:
Any clothing worn beneath the uniform shirt (undershirt, t-shirt, bra, camisole,
etc.) must be white and not visible through the uniform shirt.
Accessories: A watch capable of counting seconds is required. No rings allowed. Students
should carry at least 2 ink pens (black or blue ink) and paper to take notes.
Piercings: Females shall be allowed to wear earing studs only. Males must remove earrings.
All other visible piercings (male and female) must be removed during rotations.
If a piercing site has a visible “hole”, then that should be covered with a Band Aid
type bandage that is skin colored and does not distract from the professional
appearance.
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Hair and Beards:
Hair should not be allowed to interfere with providing patient care, nor
contaminate wounds or sterile fields. Hair should be kept clean and well
groomed. Hair longer than collar length must be pulled back or put up.
Beards or mustaches must be clean, short, and neatly trimmed.
Hygiene:
Cosmetics should be kept to a tasteful minimum with extreme colors avoided. Do
NOT wear cologne or perfume. Due to infection control, artificial nails are
prohibited. Good hygiene is essential for clinical rotations.
Please bathe or shower before clinicals and use a deodorant.
Tattoos: All tattoos must be covered and not visible while on rotations. A long sleeve
white undershirt, a long sleeve Polo style shirt, or other white material device may
be used to cover tattoos on the arms. All other tattoos must be covered as well.
Consult with your instructor if you need assistance in this matter.
Name Badges:
Students will be required to wear name badges with photograph at all times
during their clinical rotations at both the hospital and at EMS. Students not
wearing their name badges can be removed from the clinical site. The name
badges will be issued to you by the instructor prior to you beginning clinical
rotations. Replacement ID badges will require payment of $5 per badge.
Any questions or doubts about this policy should be addressed with the lead instructor
PRIOR to performing any clinical rotations.
Violation of the dress code policy can result being dismissal from the clinical site. Repeated
violations may result in dismissal from the program
HOSPITAL CLINICAL GUIDELINES
It is the student’s responsibility to read, understand, and comply with the department
attendance procedures. Failure to follow the guidelines could result in the dismissal from
the program. Each student is responsible for ensuring that he/she completed the total
number of hours required by this program.
All Hospital Rotations will be performed at Covenant Hospital Plainview. ER rotations
that are scheduled or performed at any facility, other than Covenant Hospital Plainview
will be disallowed and the student may be terminated from the course.
Students will not be allowed to park in the ER drive or ER patient parking slots. Those slots are
for patients and physicians only. Students will only be allowed to park in the designated spots,
which are located in the employee parking lot.
All hospital rotations will be performed only in 8 hour increments.
No cutting short or leaving early from a rotation is allowed except in cases of emergency.
Behavior, Appearance, Attitude
Always introduce yourself to the patient.
Do not consume food, beverages, or chew gum in the patient areas. This is only allowed
in the lounge or cafeteria.
Do not give your home address or phone number to the patients or their families.
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Acceptance of payment, gifts, or gratuities from the patients or their families is strictly
forbidden.
Be professional in your behavior, i.e. dependable, courteous, prepared and motivated.
Follow the dress code for the clinical site. Practice good hygiene.
Do not adjust or change any settings on any piece of equipment without direct
supervision from the appropriate personnel.
Do not perform any procedure that you have not been trained to perform during the
course. Covenant Hospital Plainview has different levels of EMS students. If asked to
perform a procedure such as an ECG or IV, politely inform the preceptor that you are a
Basic student and have not been trained in the requested procedure.
Use caution in exercising independence. For reasons of both liability and good practice,
check with the appropriate personnel before doing something you are unsure of or have
not been directly instructed to do.
Attendance
Students should arrive at least fifteen (15) minutes before the start of your clinical. If you are
going to be late or unable to attend a clinical, notify the person in charge of the clinical site, (ex:
charge nurse in the ER) and the course coordinator or an on duty instructor. All changes in
scheduling must be approved by the lead instructor.
Acceptable reasons for missing a clinical rotation are: illness, work, or a family emergency.
Clinical time will have to be rescheduled with the lead instructor.
Failure to attend a scheduled clinical rotation without notification will result in an immediate
dismissal from the course. An appeal may be filed.
All instances of tardiness or leaving early must be explained via an email to the lead instructor.
Breaks
Two 15 minute breaks will be allowed for each 8 hours of clinical shift with preceptor approval.
A meal break of 30 minutes (maximum) is allowed in each 8 hour shift with preceptor approval.
Any breaks which exceed the allotted time will be deducted from your clinical time. All breaks
will be taken after consulting with the assigned person in charge of the clinical site. Students are
not to leave the clinical site if it is busy and your help is needed. Students should bring either a
sack lunch or may eat in the cafeteria while at the hospital. All breaks must be approved by
your preceptor.
Tobacco Use
Smoking and the use of other tobacco products is prohibited within the clinical site. Covenant
Hospital Plainview is a “tobacco free facility” and tobacco is not allowed to be used anywhere on
their property. Students MUST comply with hospital tobacco policies. Students caught
violating these policies will be dismissed from the clinical site and could result in dismissal from
the course.
Universal Precautions
Universal Precautions are not an option, they are mandatory. Failure or refusal to utilize
Universal Precautions can result in dismissal from the course. If you are unsure about Universal
Precautions or Bio-Hazard procedures, ask the department supervisor or an on duty instructor
first.
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Dress Code
Students are required to be in proper uniform with proper identification badges (see dress code
policy). Students must have all required equipment and clinical documents with them. Students
will be sent home from a clinical site if dress code is not followed. Students who continue to not
follow the dress code policy can be dismissed from the course.
Cooperation With Hospital Staff
Cooperation with hospital staff is imperative and any deficiency in this area will not be tolerated.
Make yourself available to perform any necessary duties that are within your scope of training.
Try to stay as busy and maintain a good, positive attitude. If the clinical area is quiet and there
are no patients to observe or work with, use this time to study. Remember, patient care takes
priority over study.
If you are asked to do something that is beyond your level of training, respectfully advise the
staff member making the request that the procedure is beyond your scope of training.
Performance of procedures or duties beyond your level of training could result in dismissal from
the course.
Patient/Family Interaction
Confidentiality: Never discuss a patient, patient’s family or lifestyle, or any information form
the care of the patient with anyone. The student is not to offer his/her opinions or personal
knowledge of the patient to anyone. Patients have the right to confidentiality concerning their
care, personal matters and diagnosis. Violation of this rule will result in dismissal from the
course and can also result in criminal/civil charges being filed.
Courtesy: Students will treat patients, their families, visitors, hospital staff, and EMS staff with
courtesy and respect at all times.
Questions: All questions from the patient, the patient’s family, or visitors in regard to the
patient’s condition or treatment will be referred to the appropriate staff member or department
head. Students are not to offer their opinions about the condition of the patient, treatment the
patient has or has not received, or the patient’s diagnosis. Any violation of this rule will result
in dismissal from the course.
Telephone
Students are not allowed to answer the phone in the hospital unless directed to by a nurse or
physician. Identify the unit, yourself and your title. Refer all calls or messages to the
appropriate person immediately.
Personal calls are not allowed and will not be tolerated. Instruct friends and family not to call
the clinical site unless there is an emergency. Use of cellular phones during hospital rotations
is prohibited.
Students are not allowed to take telephone orders from a physician. Refer the caller to the
appropriate licensed nurse in the hospital.
Visitors
Personal visitors are not permitted during clinical rotations.
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Alcohol/Chemical Use
Consumption of alcohol or other chemicals on hospital grounds, EMS sites and vehicles or any
other sites related to the course is strictly prohibited. Any use of prescribed or non-prescribed
medications, with potential to affect ability to perform duties listed in the clinical objectives, is
prohibited. Possession of above described substances or paraphernalia is strictly prohibited.
Students who arrive to a clinical site under the influence will not be allowed to stay. Violation of
this policy will result in dismissal from the course.
Clinical Paperwork
Students will complete all clinical paperwork needed before leaving your clinical rotation. It is
the student’s responsibility to make and have available copies of all rotation documentation
forms. All paperwork is to be completed prior to having the preceptor sign. Paperwork not
completed appropriately and signed by the preceptor will not be accepted by the course
coordinator and will not be counted towards clinical requirements.
ANY VIOLATION OF THE ABOVE POLICIES AND PROCEDURES CAN RESULT IN
THE DISMISSAL FROM THE COURSE!!!!!!!!
AMBULANCE CLINICAL GUIDELINES
It is the student’s responsibility to read, understand, and comply with the departmental
attendance procedures. Failure to follow the guidelines could result in the dismissal from
the course. Each student is responsible for ensuring that he/she completes the total number
of hours required by this program.
Students will be doing “ride outs” on the ambulance with Plainview Fire/EMS or other service
approved by the instructor and coordinator. When you arrive at the station, please park in the
appropriate parking lot. Do not park in the reserved parking spaces. Parking is limited and is
needed for full-time, part-time staff, and volunteers. DO NOT PARK IN THE DRIVEWAY OR
IN THE AMBULANCE BAYS AS THESE ARE FOR EMERGENCY VEHICLES ONLY!
Attendance
Students should arrive at least fifteen (15) minutes prior to the start of your clinical. If you are
going to be late or unable to attend a clinical, notify the person in charge of the clinical site, (ex:
the course coordinator or an on duty instructor). All changes in scheduling must be approved by
the course coordinator or lead instructor.
Acceptable reasons for missing a clinical rotation are: illness, work, or a family emergency.
Clinical time will have to be rescheduled with the course coordinator or lead instructor.
Failure to attend a scheduled clinical rotation without notification may result in dismissal from
the course.
Tobacco Use
The Plainview Fire/EMS Department has a smoking and tobacco use policy. At the Plainview
Fire/EMS Station, smoking is allowed only outside of the station. Other tobacco products may
be used so long as the Plainview Fire/EMS policy is followed. Students are to inquire about the
policy and abide by all requirements.
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Students MUST abide by all tobacco use policies of any EMS clinical site.
No tobacco products may be used while on an EMS call!
No Tobacco use is allowed AT ALL at Covenant Hospital Plainview!
Universal Precautions
Universal Precautions are not an option, they are mandatory. Failure or refusal to utilize
Universal Precautions can result in dismissal from the course. If you are unsure about Universal
Precautions or Bio-Hazard procedures, ask the department supervisor or an on duty instructor
first.
Dress Code
Students are required to be in proper uniform with proper identification badges (see dress code
policy). Students must have all required equipment and clinical documents with them. Students
will be sent home from a clinical site if dress code is not followed. Students who continue to not
follow the dress code policy can be dismissed from the course.
Cooperation With EMS Staff
Cooperation with EMS staff is imperative and any deficiency in this area will not be tolerated.
Students are expected to participate in the daily maintenance and other duties of the shift. If
there is no calls, or other duties to perform around the station then use this time to study.
Students will not be allowed to watch television when it is prohibited for the on-duty EMS
personnel.
Do not perform any procedure that you have not been trained to perform during the course.
Plainview Fire/EMS has different levels of EMS students. If asked to perform a procedure such
as an ECG or IV, politely inform the preceptor that you are a Basic student and have not been
trained in the requested procedure.
Patient/Family Interaction
Confidentiality: Never discuss a patient, patient’s family or lifestyle, or any information form
the care of the patient with anyone. The student is not to offer his/her opinions or personal
knowledge of the patient to anyone. Patients have the right to confidentiality concerning their
care, personal matters and diagnosis. Violation of this rule will result in dismissal from the
course and can also result in criminal/civil charges being filed.
Courtesy: Students will treat patients, their families, visitors, hospital staff, and EMS staff with
courtesy and respect at all times.
Questions: All questions from the patient, the patient’s family, or visitors in regard to the
patient’s condition or treatment will be referred to the appropriate staff member or department
head. Students are not to offer their opinions about the condition of the patient, treatment the
patient has or has not received, or the patient’s diagnosis. Any violation of this rule will result
in dismissal from the course.
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Telephone
Students are not allowed to answer the phone unless directed to by the on duty crew. Identify the
station, yourself and your title. Refer all calls or messages to the appropriate person
immediately.
Personal calls are not allowed and will not be tolerated. Instruct friends and family not to call
the clinical site unless there is an emergency. Cellular phones are not allowed to be used when
on EMS calls. Use of cellular phones, while at the EMS station, is at the discretion of the
preceptor and the station supervisor. However, students must abide by the rules set forth under
Social Media/Photos/Texting/Emails as listed on page 8 if allowed to use cellular phones by their
preceptor and station supervisor.
Visitors
Personal visitors are not permitted during clinical rotations.
Alcohol/Chemical Use
Consumption of alcohol other chemicals on hospital grounds, EMS sites and vehicles or any
other sites related to the course are strictly prohibited. Any use of prescribed or non-prescribed
medications with potential to affect ability to perform duties listed in the clinical objectives is
prohibited. Possession of above described substances or paraphernalia is strictly prohibited.
Students who arrive to a clinical site under the influence will not be allowed to stay. Violation of
this policy will result in dismissal from the course.
Purpose
Students will be riding as a “third man” and are to assist as directed by the lead paramedic. Do
not attempt to perform any skills for which you have not been trained. You are to become
familiar with the emergency medical treatment and protocols. This is a time to learn and all calls
in which you participate must be well documented.
Meals
Students will be responsible for providing their own meals. If the EMS crew is cooking in and
the student is invited, the student will need to pay their share of the meal and help with cleanup.
The EMS crew is not required to take students to get meals. If the student needs to leave to get a
meal, he/she should advise the preceptor and use his/her personal vehicle.
Living Quarters
Students are not allowed in the sleeping quarters/bedroom areas of the EMS station without
permission of a preceptor. Students should not disturb the preceptors and EMS crews after they
have gone to bed or during down time when the EMS crews are in the bedroom area.
Curfew
All students will abide by the curfew policy of the ambulance rotation clinical site. The curfew
for the Plainview Fire/EMS Department is 2300 hours on all nights. Students must comply with
all curfew requirements at any other EMS clinical sites. Students are NOT allowed to sleep
during ANY clinical rotations.
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Clinical Paperwork
Students will complete all clinical paperwork needed before leaving your clinical rotation. All
paperwork is to be completed before having the on duty preceptor to sign. Clinical
documentation should be performed immediately after each run at the same time the EMS crew
is writing their report. This will allow the student easy access to the needed information and
allow for the preceptor to sign immediately and avoid any confusion or delays. Paperwork not
completed appropriately and signed by the on duty preceptor will not be accepted by the lead
instructor and will not be counted towards clinical requirements. All documentation must be
completed and signed before the EMS crew goes to bed.
DO NOT WAKE UP THE EMS CREW TO SIGN PAPERWORK!
ANY VIOLATION OF THE ABOVE POLICIES AND PROCEDURES CAN
RESULT IN THE DISMISSAL FROM THE COURSE!!!!!!!!
COURSE COMPLETION
Once a student completes all requirements as set forth, the student shall schedule an appointment
with the lead instructor. This appointment will be at the lead instructor’s convenience. The
student shall bring in all rotation documentations for review. No rotation documentation will be
accepted until such time as all rotations are completed.
Prior to meeting with the lead instructor, the student MUST have an
NR online application completed and paid for.
The student must separate all rotation forms according to type of rotation (EMS, ER, and OB).
Then, the rotation forms should be placed in chronological order. This will simplify and
expedite the review process.
Following review of the student’s folder and all rotation documentation, the lead instructor and
student will sign a completion document if all requirements are met. The lead instructor will
notify the course coordinator of successful completion. The course coordinator will then issue a
course completion certificate and authorize the student to test for the National Registry.
It is strongly recommended that the student make and keep copies of all
rotation documentation
ALL DOCUMENTATION MUST BE TURNED IN TO THE LEAD INSTRUCTOR
WITHIN 80 DAYS OF THE THE LAST DATE OF CLASS.
NO DOCUMENTION WILL BE ACCEPTED AFTER THIS DATE
IMPORTANT NOTICE: After submission of all rotation documentation OR after 60 days from
the last date of class (whichever comes first), students lose all rights and privileges to function as
an EMT Student. This means that students MAY NOT perform any function or procedure of an
EMT. Continuing to perform any skills of an EMT may constitute practicing medicine without a
license and is subject to prosecution; even if acting under the direct supervision of a TDSHS
certified EMT or higher level.
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OLTON EMS TRAINING PROGRAM
EMERGENCY MEDICAL TECHNICIAN
KNOWLEDGE OBJECTIVES
1. General
1.1. Describe the goal of the EMT National Standard Curriculum
1.2 Identify the components of a functioning EMS system
1.3. List four contributing agencies in your local EMT system
1.4. Describe the mechanism for accessing the local EMS system
1.5. List six roles and responsibilities of the EMT
1.6. List six areas of personal attitude and conduct expected of an EMT
1.7. Describe State requirements for EMT certification and recertification
2. Legal responsibilities
2.1 List three medical-legal aspects of emergency medical care
2.2. Understand the basis of legal responsibility--standard of care
2.3. Become knowledgeable concerning the doctrine of negligence
2.4. Become informed of the law of consent -implied--actual
2.5. Identify the various forms of immunity granted by the law
2.6. Distinguish between to respond and response on a volunteer basis
2.7. Appreciate the importance of keeping accurate records and reports
3. General and topical anatomy
3.1. Define the common terms used in topographic anatomy
3.2. Describe the major topography features of the head, neck, thorax, abdomen, pelvis, lower extremities,
shoulder girdle, and upper extremities
3.3. Describe the general function of the following major body systems:
a. Respiratory
b. Circulatory
c. Muscular
d. Skeletal
e. Nervous
f. Digestive
g. Genitourinary
h. Reproductive
3.4. Identify the major arterial pulse points
4. Patient Assessment
4.1. Distinguish between signs and symptoms
4.2. Describe the four vital signs pulse-respiration-blood pressure-temperature
six other skin color-capillary refill-pupil size-response to light-loc-ability to move and reaction to pain
4.3. Understand the sequence of assessment and treatment priorities, including the first assessment, arrival
at the scene, the initial survey, the chief complaint, vital signs, history of present illness, and the
detailed survey
4.4 Obtain a record of blood pressure by both auscultation and palpation
4.5. Perform initial survey
4.6. Perform detailed survey
4.8. Record and communicate in proper sequence, the patient assessment information
5. Respiratory system
5.1 Describe the significance of oxygen delivery to the tissues
5.2. Describe the breathing process
5.3. Understand the mechanism of breathing
5.4. What controls levels of carbon dioxide in blood
Metered Dose Inhalers a. State the generic name, dosage, methods of administration, actions
b. Indications, and contraindications of prescribed medications
c. List the trade name and the generic name of at least five Metered Dose Inhalers
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d. Describe the appropriate method of assisting a patient with a inhaler
e. Describe the actions of a beta-agonist bronchodilator
6. Basic life support
6.1 Comprehend the need for basic life support, to start or not to start CPR.
6.2 Describe techniques for opening the airway
6.3. Learn how to perform ventilation’s in adults and children
6.6 Demonstrate method of clearing obstructed airway in adult, child and infant
a. Conscious adult, child, infant
b. Unconscious adult, child, infant
7. Circulatory System
7.1 List four components of the circulatory system
7.2 Describe anatomy of heart
7.4 Learn pulse points
8. Cardiac Arrest Management AED
8.1 Define cardiac arrest
8.3 List three complications of CPR
Automatic External Defibrillators
a. Describe the attachment and location of pads, confirms that personnel are clear
b. What is next action immediately after three shocks are delivered
c. Describe care given if still there is no pulse or if pulse is now present
9. Ventilation Equipment and Oxygen Therapy
9.1 Define hypoxia and why some patient require supplemental oxygen
9.3 Study the use of suction equipment
9.5 Identify the hazards of supplemental oxygen
9.8 List the indications for the following devices, and demonstrate their use on manikin
a. Oropharyngeal airways, nasopharyngeal airways
b. Portable suction
c. Pocket mask, bag valve mask
d. Nasal cannula, simple face mask, venturi mask, nebulizers
Bronchodilator Administration-Small Volume Nebulizer
a. Knows medication, dosage, and route. Questions patient about allergies to medications
b. Confirms orders and verbalizes medication for contamination and
expiration date
c. Learn the appropriate method for preparing nebulizer
10. Control of Bleeding
10.1 Understanding the significance of bleeding, both internal and external
10.2 Methods of controlling bleeding, direct, indirect, tourniquet, splint,
10.3 List four signs of internal bleeding
11. Shock
11.1 Understand the basic physiology of shock
11.3 Describe all the types of shock, and five steps in treatment
11.4 Recognize the signs and symptoms common to all types of shock
Pneumatic Anti-Shock Garment
a. Describe the mechanism of action of the PASG
b. Describe the steps of application
c. List the contraindications of applying or deflating of the PASG
12. Injury
12.1. Define the mechanisms of injury
12.2. Identify the patterns of injury
12.3. Understand the basic principles of the treatment of injury
13. Soft Tissue Injury
13.1. Understand the anatomy and physiology of the skin.
13.2. List the layers of skin
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13.3. List two major functions of the skin
13.4. List four major structures within the skin and state the function of each
13.5. Describe the characteristics of closed and open ‘soft tissue injuries and learn how to treat them.
13.6. Describe how to care for a patient with an amputation and the care of the amputated part.
13.7. Become familiar with the general principles of the application of dressings and bandages.
14. The Musculoskeletal System
14.1. Describe the three types of muscle found 1st the human body: skeletal muscle, smooth muscle,
and cardiac muscle.
14.2. Be able to name and locate the major bones of the body.
15. Fractures, Dislocations, and Sprains
15.1. Describe the types and causes of musculoskeletal injuries.
15.2. Recognize the various types of fractures.
15.3. List five signs of fractures
15.4. List three signs of dislocations
15.5. List three signs of sprain
15.6. Learn how to carry out an examination of an injured limb.
15.7. Learn how to treat a musculoskeletal injury, including the various methods of splinting and the
proper way to transport a patient with art injured limb.
16. Shoulder and Upper Extremity Fractures and Dislocations
16.1. Learn how to identify and splint injuries to the clavicle, scapula, and proximal humerus.
16.2. Know how to recognize and immobilize a dislocation of the shoulder.
16.3. Learn how to splint and, if necessary, apply traction to realign humeral fracture fragments.
16.4. Appreciate the significance of elbow injuries.
16.5. Know how to splint injuries of the elbow.
16.6. Recognize fractures of the forearm and learn how to immobilize the injured arm.
16.7. Learn how to splint wrist and hand injuries using a bulky hand dressing.
17. Injuries of the Pelvis and Lower Extremity
17.1. Identify and know how to stabilize injuries of the pelvis, including fractures of the pelvis and
dislocation of the hip joint.
17.2. Learn how to evaluate and splint fractures of the proximal femur and the femoral shaft.
17.3. Become familiar with injuries about the knee, including injuries of the knee ligaments, dislocation
of the knee, fractures about the knee, and dislocation of the patella.
17.4. Know the techniques of splinting fractures of the tibia, fibula, ankle, and foot.
18. The Nervous System
18.1. Understand the anatomic and functional components of the nervous system.
18.2. Describe the central and peripheral nervous systems.
18.3. Describe the somatic and autonomic nervous systems.
18.4. Identify the protective coverings of the nervous system.
18.5. Describe how brain is protected from injury
18.6. List functions of central nervous system
18.7. List functions of peripheral nervous system
18.8. List functions of autonomic nervous system
18.9. State function of cerebrospinal fluid
19. Head Injuries
19.1. Understand the general principles of treatment for head injuries.
19.2. List types of brain injury and how they occur
19.3. List types of intracranial hematoma and how they occur
19.4. List signs/symptoms of possible brain injury
19.5. List signs/symptoms of possible skull fracture
19.6. Describe treatment for blood and/or cerebrospinal fluid loss of nose/ears
19.7. List steps in emergency care for patient with suspected skull fracture
19.8. Learn how to assess the severity of a head injury initial treatment.
20. Injury of the Spine
20.1. Describe fractures and dislocations of the spine.
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20.2. Identify the symptoms arid signs of spinal injury.
20.3. Know how to recognize spinal injury.
20.4. List three situations when a spinal injury should be suspected
20.5. Learn the emergency treatment of spine injury patients.
20.6. List steps in proper spinal cord injury management
20.7. List three instances when a short spine board shou1d be used
20.8. Become familiar with the complications of spinal cord injury.
21. Injuries of the Eye
21.1. Become familiar with the anatomy of the eye.
21.2. List anatomical structures of the eye and describe the function of each
21.3. List the possible normal/abnormal pupil reactions/size
21.4. Be alert for abnormalities of the eyes that may indicate underlying head injury.
21.5. Describe special considerations for patients with contact lenses
21.6. Know how to manage patients with contact lenses and artificial eyes.
21.7. Describe the treatment for chemical burns of the eye
21.8. Describe the treatment for thermal burns of the eye (lid)
21.9. Describe the treatment for light burns of the eye
21.10. Describe treatment for a lacerated eyelid or eyeball
21.11. Describe treatment for a lacerated eyeball
22. Injuries of the Face and Throat
22.1. Understand how facial injuries can lead to upper airway obstruction and learn how to treat soft
tissue wounds of the face, injuries of the nose, and facial fractures.
22.2. Learn how to treat patients with injuries of the neck and throat, including fractures of the larynx
and/or trachea.
23. Injuries of the chest
23.1. List the boundaries of the chest (thoracic) cavity
23.2. List the contents of the chest (thoracic) cavity
23.3. List the two classifications of chest injuries
23.4. Identify the signs and symptoms of chest injury.
23.5. Review the general principles of the care of chest injuries.
23.6. Recognize specific chest injuries and learn their emergency care.
23.7. List four signs/symptoms and describe emergency treatment for:
a. Pneumothorax
b. Hemothorax
c. Tension pneumothorax
d. Pericardial tamponade
e. Flail chest
f. Subcutaneous emphysema -
g. Sucking chest wounds
h. Traumatic asphyxia
23.8. Become familiar with the complications that can accompany chest injuries.
24. The Abdomen and Genitalia
24.1. Identify the boundaries, the bony landmarks, and the location of organs in the abdominal cavity.
24.2. Know the function of the various organs of the digestive system and learn how food is converted
into nutrients for use by the body’s cells.
24.3. Understand how food is propelled through the digestive tract by wavelike muscular contractions
called peristalsis.
24.4. Become familiar with the location and function of the organs of the urinary system.
24.5. Describe the organs of the genital system and understand their role in the reproductive process.
25. Injuries of the Abdomen and Genitalia
25.1. Describe complications/implications arising from injury to each abdominal organ
25.2. List 10 possible signs/symptoms of abdominal injury
25.3. Describe care of patient with abdominal evisceration
25.4. Describe care of patient with impaled object in abdomen
25.5. Describe care of patient with blunt abdominal injury
25.6. List components of external male genitalia
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25.7. List components of external female genitalia
25.8. Describe emergency care of injuries to external male genitalia
25.9. Describe emergency care of injuries to external female genitalia
25.10. Understand the special problems in dealing with victims of sexual assault and rape.
25.11. List local procures for dealing with sexual assault victims
26. Medical Emergencies
26.1. Understand the nature of a medical emergency and the usual causes of such events.
26.2. Relate each of these causes to its role in producing a medical emergency.
26.3. Distinguish between symptoms and clinical signs of medical illness and disease.
26.4. Identify acute, chronic, and periodic medical emergencies.
27. Poisons, Stings, and Bites
27.2 State how to contact nearest poison control center
27.5 List emergency care for victims of inhaled, injected, and absorbed poison
27.8 Discuss food and plant poisoning
27.11 When should vomiting not be induced
a. What is the dosage for activated charcoal?
b. What are the indications, what are contraindications?
c. When, how and with what should vomiting be induced?
27.15 Identify the signs and symptoms of stings from bees, wasp, hornets, and ants
27.18 State emergency care for a patient suffering from an allergic reaction
The Epinephrine Auto-Injector (Epi-Pen)
a. Knows medication, dosage, and route. Questions patient about allergies to meds
b. Confirms orders and verbalizes check of medication for contamination and expiration
dates
c. Explains procedure to patient
27.19 Learn to treat and identify scorpion and spider bites
27.20 Discuss treatment of snake bites; describe difference between coral and pit viper
27.26 Learn treatment for human, dog bites, and marine animal injuries
28. Heart Disease/Chest Pain
28.2 Define angina pectoris, list signs and symptoms
28.4 Explain how nitroglycerin relieves chest pain and why aspirin is given to someone with chest pain
a. Describes the dosage and route of each
b. Lists the contraindications for each
28.5 List the emergency care of angina
28.6 Define atherosclerosis
28.7 Define myocardial infarction
28.8 List 4 risk factors associated with heart disease
28.9 List 3 causes of a heart attack
28.12 List the signs and symptoms of a heart attack
28.14 Describe the cause and treatment for congestive heart failure
28.16 List the signs and symptoms of congestive heart failure
28.17 Describe the management of congestive heart failure
28.18 Describe the difference in providing care of a patient with coronary bypass history
28.19 Can you be injured by someone’s implanted automatic internal defibrillator?
29. Stroke
29.1 Understand how blood circulates through the brain
29.2 Define Stroke
29.3 List the signs and symptoms of a stroke
29.4 Identify three causes of a stroke
29.5 Describe the management of a patient with a stroke
29.6 List special considerations for treatment of stroke patients
30. Dyspnea
30.1 Describe the physiology of the body’s pulmonary system
30.2 Define dyspnea
30.3 Define pulmonary edema
30.4 Identify the non-traumatic or medical causes of dyspnea
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30.5 Define chronic obstructive pulmonary disease
30.6 List signs and symptoms of pulmonary edema
30.7 List signs and symptoms of COPD
30.8. Define hyperventilation
30.9. List signs/symptoms of hyperventilation
30.10. List steps in treatment of hyperventilation
31. Diabetes
31.1. Understand the role of glucose and insulin in the body.
31.2. Define Diabetes
31.3. Know how diabetes mellitus is caused.
31.4. List signs/symptoms of diabetic coma
31.5. List signs/symptoms of insulin shock
31.6. Describe causes of insulin shock
31.7. Describe causes of diabetic coma
31.8. Distinguish diabetic coma from insulin shock.
31.9. List steps in treatment of a conscious diabetic patient
31.10. List steps in treatment of unconscious diabetic patient
32. The Acute Abdomen
32.1. Define acute abdominal distress
32.2. Define the terms “acute abdomen” and “abdominal catastrophe.”
32.3. Understand the causes of an acute abdomen.
32.4. Describe the signs and symptoms of an acute abdomen.
32.5. List steps in the treatment of a patient with acute abdominal distress
32.6. List four special steps that should be used when examining a patient with acute abdominal distress
33. Common Medical Complaints
33.1. Identify and describe common gastrointestinal complaints not associated with injury or an acute
abdomen.
33.2. Identify and describe common genitourinary complaints not associated with injuries.
33.3. Define vertigo and hiccough and describe their causes.
33.4. Understand the special concerns of geriatric patients.
34. Communicab1e Diseases
34.1. Understand communicable diseases and the infectious process.
34.2. Become familiar with the characteristics end basic epidemiology of common communicable
diseases.
34.3. List three ways a communicable disease can be transmitted
34.4. Understand the role of the EMT in treating a patient with a communicable disease.
34.5. List steps EMS personnel can take to lessen personal exposure to a communicable disease
34.6. List steps EMS personnel must take in the maintenance of the emergency vehicle post-exposure to
a communicable disease
35. Substance Abuse
35.1. Define the terms substance abuse, drug, addiction, dependency, and tolerance.
35.2. List six signs/symptoms of a patient who has abused chemical substances
35.3. List the general treatment procedures to be taken when caring for substance abuse
Patients
35.4. Review the general effects of alcohol on a patient under the influence of alcohol.
35.5. Learn the emergency treatment for injuries and illnesses that occur as a result of alcohol abuse.
35.6. Review the general problems related to drug abuse, including the nature of the drug itself, the
route of administration, the use of more than one drug at a time, and the tolerance and sensitivity
that can develop in a drug user.
35.7. Know the specific acute treatment for the problems associated with several types of drug use and
with drug withdrawal.
35.8. Become familiar with other forms of substance abuse.
36. Unconsciousness and Epilepsy
36.1. Learn how to determine if the unconscious person needs basic life support.
36.2. Become familiar with the causes of unconsciousness and learn how to treat it.
7
36.3. Define seizure
36.4. Define convulsion
36.5. Describe the various types of epileptic seizures and learn how to manage seizures.
36.6. List steps in the emergency care of a patient during and post seizure/convulsion
36.7. Describe the treatment for status epilepticus
37. Pediatric Emergencies
37.1. Describe the pediatric patient.
37.2. State normal vital signs in children:
a. Newborn
b. 1 year
c. 3 years
d. 6 years
37.3. Know how to administer basic life support to a child.
37.4. Know how to clear an obstructed airway in a child.
37.5. List signs/symptoms of croup and epiglottitis
38. Childbirth
38.1. Identify on a diagram the following:
a. Uterus
b. Cervix
c. Vagina
d. Fetus
e. Placenta
f. Umbilical cord
g. Amniotic sac
h. Perineum
38.2. Understand the basic anatomy of the developing fetus.
38.3. Define:
a. Miscarriage/abortion
b. Bloody show
c. Crowning
d. Three states of labor
e. Presenting part
38.4. Recognize the complications of pregnancy.
38.5. List pre-delivery emergencies and state their emergency care
38.6. Identify the onset of labor.
38.7. Know how to assess the need for an emergency delivery of a baby.
38.8. Describe the three stages of labor and the role of the EMT in assisting the mother during the
childbirth process.
38.9. List and state purpose of emergency OB kit
38.10. List three indication-c of an imminent delivery
38.11 List steps involved in pre-delivery preparation of mother
38.12. List steps to assist in the delivery
38.13. Describe care of the baby as soon as head appears
38.11. Describe how/when to cut cord
38.15. List steps to assist in delivery of placenta
38.16. List steps in care of mother post-delivery
38.17. List special considerations for multiple births
38.18. Know the procedures for handling both abnormal deliveries and complications of childbirth.
38.19. Define premature baby and describe special considerations for care of this type of patient
38.20. Describe/demonstrate procedures for:
a. Breech birth
b. Prolapsed cord
c. Arm/leg presentation
d. List steps in care of mother with excessive bleeding
39. Burns
39.21 Review the anatomy of the skin.
39.22 List two functions of skin
39.23 Define and state the characteristics each of 1st degree, 2nd degree, and 3rd degree burns
8
39.24 Demonstrate knowledge of rules of 9s by dividing picture of human body into appropriate areas
39.25 Learn how to determine the seriousness of a thermal burn and the management of thermal burns.
39.26 List three examples of a critical/severe burn
39.27 List three examples of a moderate burn
39.28 List two examples of a minor burn
39.29 Identify the various types of chemical burns and learn how to treat them.
39.30 List three steps in management of chemical burns.
39.31 Understand how electrical energy, including lightning, enters and exit the body and how to treat
electrical burns and injuries.
39.32 List steps in treatment of electrical burn
39.33 List precautions to take at scene of electrical burn
39.34 Describe the effects of exposure to solar radiation arid nuclear radiation.
39.35 Learn the emergency medical care for exposure to radioactive materials.
40. Hazardous Materials
40.1. Stress the importance of assessing the scene of a hazardous material and establishing a hazard
zone before instituting emergency treatment.
40.2. State the local agency responsible for handling nuclear wastes to be contacted in case of accidents
involving nuclear radiation
40.3. State how exposure to radiation affects severity of burns
40.4. List seven steps to manage emergency scene involving hazardous materials
40.5. Describe the process of decontamination for the EMT as well as the patient.
40.6. Explain how triage works in a major hazardous materials accident.
41. Heat and Cold Exposure
41.1. Describe the three forms of heat exposure: heat cramps, heat exhaustion, and heat stroke.
41.2. List two signs/symptoms of heat cramps
41.3. List steps in emergency care of heat cramps
41.4. List three signs/symptoms of heat exhaustion
41.5. List steps in emergency care of heat exhaustion
41.6. List three signs/symptoms of heat stroke
41.7. List steps in emergency care of heat stroke
41.8. Identify the five ways the body can lose heat.
41.9. Define hypothermia
41.10. List five signs/symptoms of hypothermia
41.11. List three steps in emergency treatment of a hypothermic patient when transport time is less than
30 minutes from a medical facility
41.12. List three steps in emergency treatment of a hypothermic patient when transport time is greater
than 30 minutes from -a medical facility
41.13. List signs/symptoms of frostbite
41.14. List circumstances when frostbite should not be thawed outside of a medical facility
41.15. State the temperature at which water should be maintained when thawing frostbitten parts
41.16. Understand the importance of self-protection against cold exposure.
42. Water Hazards
42.1. Understand why drowning or near drowning occurs after submersion in water.
42.2. List steps in the emergency treatment of a drowning victim
42.3. Learn how to identify and treat potential spinal injuries associated with near-drowning accidents.
42.1. Become familiar with problems associated with diving, especially air embolism and
decompression sickness (the “bends”).
42.5. Define air embolism (from diving)
42.6. Define decompression sickness
42.7. State how to contact nearest recompression chamber
42.8. Recognize other water hazards, including hypothermia and breath-holding blackout.
43. Interacting with Patients
43.1. Define communication
43.2. List eight general principles of communication
43.3. Identify specific communication problems and learn how to communicate with patients
who have them.
9
43.4. List two methods of applying general principles of communication with each of the
following groups of patients: -
a. Geriatric
b. Pediatric
c. Deaf
d. Blind
e. Hon-English speaking
f. Mentally retarded/developmentally disabled
g. The confused patient
43.5. Recognize the common causes of disruptive behavior arid learn how to manage the
disruptive patient.
43.6. List six possible causes for patients displaying disruptive behavior.
43.7. List four steps EMS personnel can take to stabilize a disruptive situation
43.8. Demonstrate two methods of restraining and transporting patients in the
ambulance
44. Crisis Intervention
44.1. List four positive approaches the EMT may take to assist the patient or family in dealing with the
effects of crisis
44.2. List four possible responses that a patient’s family member may have to sudden death
44.3. List-four possible responses the EMS personnel may have to sudden death
44.4. Be prepared for facing sudden and unexpected death.
44.5. List four possible responses the terminally ill patient may display.
44.6. Know how to provide care for the terminally ill patient and emotional support for the family.
44.7. Learn how to treat abused patients and be aware of the additional responsibility of helping the
police in abuse cases.
44.8. List four signs/symptoms which should lead the EMT to suspect child abuse
44.9. List four responsibilities of the EMS personnel when responding to suspected child abuse
incidents
44.10. Realize that all suicide threats must be taken seriously, even after arriving at the scene in time.”
44.11. Learn how to cope the crisis of sudden infant death syndrome (SIDS).
44.12. List four signs/symptoms of stress syndrome in EMS personnel
44.13 List four positive steps the EMS personnel may apply to relieve stress
44.14. List three responses the family and friends of EMS personnel may display in times of stress
44.15. List three possible methods of relieving stress among the family and friends of EMS personnel
45. Patient Handling and Triage
45.1. Understand the basics of patient handling and the specifics of handling patients with
communicable diseases, pediatric patients, geriatric patients, and handicapped patients.
45.2. Learn how to lift and move patients safely from one location to another.
a. A direct 2-rescuer lifts of a patient from the ground and position him/her on a stretcher
b. Immobilize the neck and spine of a patient using a short backboard
c. Immobilize a patient on a long backboard and move to a stretcher
d. Properly position a patient on a stretcher; load and unload the stretcher from all carrying
positions in the ambulance.
45.3. Become familiar with special patient packaging techniques and ancillary
Patient handling equipment.
45.4. Define triage
45.5. Understand the concept of triage and the duties of a triage officer.
45.6. List three patients who would fall under each triage category
46. Extrication and Rescue
46.1. See how rescue operations are classified.
46.2. Identify the eight principles of extrication.
46.3. Become familiar with extrication techniques and tools.
46.4. Describe the proper methods and appropriate times to utilize the following extrication equipment:
a. Porta power
b. Hand winch
c. Pry axe
d. Air chisel
e. Cribbing
10
f. Bale Hook
g. Hack saw
h. Screw driver
i. Spring-loaded center punch
j. Other
46.5. Learn how to prepare and package a patient for removal to an ambulance.
46.6. Know what is required of specialized rescue in rough terrain, water, cold weather, ice, and in an
urban setting.
46.7. List the location of all extrication equipment on the EMS vehicle
46.8. Name the agency responsible for providing extrication equipment to a scene and how arid when
that equipment gets to the scene
47. The Modern Emergency Vehicle
47.1. Become familiar with modern emergency vehicle design as it relates to national, state, and local
standards.
47.2. Identify basic emergency vehicle equipment and supplies, including patient-care equipment and
supplies, a jump kit, and equipment for personal safety and extrication.
47.3. Identify all vehicle systems and equipment requiring daily inspection
47.4. Identify the proper storage location of all equipment carried on the ambulance
47.5. Recognize the increasing role of air ambulances and learn how to approach a MEDEVAC
helicopter safely and how to assist a MEDEVAC pilot in the sometimes difficult task of landing
the aircraft.
47.6. Learn the procedures for inspecting the emergency vehicle after a daily shift change, after a run,
and during periodic, scheduled maintenance checks.
48. Emergency Driving and Vehicle Operations
48.1. List four contributing factors to unsafe driving conditions
48.2. Identify four factors that contribute to the problem of excessive speed in driving the emergency
vehicle.
48.3. Quote all laws relating to the operation of the ambulance and privileges in any or all of the
following categories:
a. Speed
b. Warning lights
c. Sirens
d. Right-of-way
e. Parking
f. Turning
48.4. Become familiar with emergency vehicle control, including steering techniques, chassis set, fender
judgment, road position, controlled acceleration and braking, and special driving situations.
48.5. Become familiar with emergency vehicle operation, including right-of-way privileges, use of the
siren, planning alternate routes, intersection hazards, and safe driving guidelines.
48.6. Describe the qualifications needed to be en emergency vehicle driver.
48.7. Learn where the ambulance should be parked end how traffic should be controlled at the scene.
48.8. Describe in narrative the considerations that should be given to
a. Requests for escorts
b. Following an escort vehicle
c. Intersections
48.9. Describe the non-medical role of the EMS personnel at:
a. Traffic accidents
b. Crime scenes
c. Emergency Department
48.10. List all local and State protocols to be followed during any phase of an ambulance
run
48.11. List at least six of the eight phases of an ambulance run
49. Communications
49.1. Define key communication terminology.
49.2. Identify the training and skills an EMT needs for effective communication.
49.3. Describe the capabilities of EMT communications systems and how patients access the EMT
system.
11
49.4. Recognize the essential role of the dispatcher in the alert and dispatch phase of EMS
communication.
49.5. List agency contact capabilities of all two-way radio channels in the ambulance. List the correct
radio use procedures in the following phases of a typical run:
a. To the scene
b. At the scene
c. To the facility
d. At the facility
e. To the squad station
f. At the squad station
49.6. List the proper method of initiating and terminating a radio call
49.7. List the proper sequence of delivery of patient information.
49.8. Become familiar with radio communications, including the type of units, standard operating
procedures, medical communications capabilities, and the role of the Federal Communications
Commission.
50. Records and Reports
50.1. List the general information requirements of ambulance reports.
50.2. Describe the general procedures for record keeping, including how to fill a preliminary street form
and a permanent ambulance run report.
50.3. Describe what information is required in each area of the run report entered
50.4. Describe where run report forms should be left and how they are used
50.5. List all state and/or local record and reporting requirements
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1
OLTON EMS TRAINING PROGRAM
EMT-BASIC CLINICAL OBJECTIVES
A minimum of forty-eight (48) hours will be divided as shown among these areas.
Emergency Department: (24 hours) During this experience in the emergency department,
the student should have the opportunity to practice under the direct supervision and
demonstrated proficiency for each of the following:
Perform patient assessment including developing relevant medical history and
conduct a physical examination. The assessment should include, at a minimum,
taking and recording vital signs, and auscultation of lung sounds.
Assist and review the treatment of trauma cases requiring hemorrhage control and
splinting
Assist in cases of cardiac arrest including the performance of cardiopulmonary
resuscitation.
Perform oxygen administration.
Identify and observe or assist in management of patients presenting with the
following conditions:
o Major trauma to the head, thorax, abdomen, spine, and extremities
o Possible Myocardial Infarction
o Congestive Heart Failure
o Chronic Obstructive Pulmonary Disease
o Obstructed airway
o Diabetic emergencies
o Asthma attack
o Seizure
o Coma
o Obstetric problems
o Psychiatric problems
o Overdose
o Intoxication
Ambulance Internship: A minimum of 5 runs (24 hours) is required on an ambulance. In
order for an ambulance run to count toward the 5 required runs, care for the patient must
be provided. Care should include vital signs, patient assessment, and transport of the
patient. During the experience on the ambulance, the student should have the opportunity
to practice under direct supervision and demonstrate proficiency for each of the
following:
Perform patient assessment including developing relevant medical history,
making pertinent observations of the environment, and doing a pertinent physical
examination.
Maintain the airway in an unconscious patient using manipulations and
mechanical devises.
Perform oxygen administration.
Perform CPR.
2
Identify and manage patients presenting with the following problems:
o Major trauma to the head, thorax, abdomen, spine, and extremities
o Possible Myocardial Infarction
o Congestive Heart Failure
o Chronic Obstructive Pulmonary Disease
o Obstructed airway
o Diabetic emergencies
o Asthma attack
o Seizure
o Coma
o Obstetric problems
o Psychiatric problems
o Overdose
o Intoxication
Immobilize extremities in cases of fractures or dislocations.
Monitor vital signs and patient status during transport.
Perform spinal immobilization using short and long spine board.
Relay information to the physician in the correct sequence.
Assist in restocking and cleaning the ambulance and equipment following a call.
Labor and Delivery: No set number of hours. The student shall attempt to witness one
vaginal childbirth during clinical rotations at the emergency department. This is not a
mandatory requirement; but is strongly encouraged. During this experience, the student
should have the opportunity to witness and assist with the following:
Witness one vaginal childbirth.
Observe the care of a new born baby including:
o Tactile stimulation
o Drying of new born
o Preservation of body temperature of the new born
o Assigning the appropriate APGAR scores to the new born
o Witness the delivery and care of the placenta
o Witness the post delivery care of the mother
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EMT Rotation Request Form Students Name____________________________________________
EMT Class location_________________________________________
Please choose in the order of your preference.
Each 8 hour shift counts as one selection
Plainview Fire/EMS Request
Please assign me _________ of the following rotations
Date 7-3 3-11
Date 7-3 3-11
Date 7-3 3-11
Date 7-3 3-11
Date 7-3 3-11
Date 7-3 3-11
Covenant Hospital Plainview ER request
Please assign me ___________ of the following rotations
Date 7-3 3-11 11-7
Date 7-3 3-11 11-7
Date 7-3 3-11 11-7
Date 7-3 3-11 11-7
5/16
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OLTON EMS
TRAINING PROGRAM
EMERGENCY MEDICAL
TECHNICIAN
HOSPITAL INTERNSHIP REPORT
PLEASE PRINT
Students Name: Preceptor’s Name:
EMS Rotation Site: Instructor’s Name: Tyeson Powers
Date: Total Hours:
DESCRIPTION OF PATIENT CARE
INCLUDE: CHIEF COMPLAINT===VITAL SIGNS===CARE GIVEN===PATIENT OUTCOME
STUDENT SIGNATURE DATE / /
STUDENT IMPROVEMENT PLAN
CATEGORY RATING
5 is best
ASSESSMENT 1 2 3 4 5
RADIO COMMUNICATIONS 1 2 3 4 5
SKILLS PERFORMANCE 1 2 3 4 5
OVERALL 1 2 3 4 5
Vital signs 1 2 3 4 5
Patient relations 1 2 3 4 5
Staff relations 1 2 3 4 5
Lifting and moving 1 2 3 4 5
Mechanical Aids 1 2 3 4 5
CPR 1 2 3 4 5
Drug administration 1 2 3 4 5
Traction splint 1 2 3 4 5
Bandaging/Splinting 1 2 3 4 5
PRECEPTOR COMMENTS:
PRECEPTORS SIGNATURE DATE / /
COORDINATOR APPROVAL course # 614976
2019 Olton Class
Olton EMS Training Program EMT Students Evaluation of Preceptor at Clinical
Preceptor______________________________
Clinical Site____________________________ Date______________
Preceptor allowed you to perform skills that you have been trained for.
Excellent Good Poor
Preceptor was courteous.
Excellent Good Poor
Preceptor orients student to clinical area and introduces you to medical staff.
Excellent Good Poor
Preceptor communicates effectively and provides feedback to questions / concerns.
Excellent Good Poor
Preceptor encourages learner participation.
Excellent Good Poor
Preceptor communicates frequently to discuss patient care.
Excellent Good Poor
Preceptor solicits active participation from student to accomplish clinical objectives.
Excellent Good Poor
Optional
Comments_______________________________________________________________
Students Name_______________________________________________
Students Signature____________________________________________
2019 Olton Class
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OLTON EMS TRAINING PROGRAM
EMT-BASIC
FIELD INTERNSHIP REPORT (EMS ONLY)
Complete for EACH Patient Transported
Unit #: Date: / / Service # EMS Service:
TIMES Dispatched Enroute
1st Responder Arrive Scene Depart Scene Arrive Dest. Available
Level of Call: ALS BLS Age: Sex: M F
Incident Location: Transport to:
Current Meds: None Known Unknown
Allergies (Meds): None Known Unknown TIME
AVPU
Heart Rate
Resp. Rate
BP
Pupils
Skin
EKG
Pulse Ox
DC Shock
Epinephrine
Nitro
Other
Other
Other
NARRATIVE
HEENT:
LUNGS:
CHEST:
ABDOMEN:
PELVIS:
EXTREMITIES:
PAST MEDICAL HISTORY:
DOCUMENTORS’S SIGNATURE:
CREW MEMBERS: Glascow Coma Scale Revised Trauma Score
P1: Eyes Verbal Motor GCS RESP BP
P2 (DRIVER): 4 Spont 5 Oriented 6 Obeys 4 13-15 4 10-29 4 >89
P3: 3 Speech 4 Confused 5 Localizes 3 9-12 3 >29 3 76-89
P4: 2 Pain 3 Inapprop. 4 Withdraws 2 6-8 2 6-9 2 50-75
P5: 1 None 2 Garbled 3 Flexion 1 4-5 1 1-5 1 1-49 Initial GCS: ER GCS: Initial RTS: ER RTS: 1 None 2 Extension 0 3 0 None 0 0
1 None
2019 Olton Class
Olton EMS Training Program
Preceptor Evaluation of Student at Ambulance Rotation
Note: One evaluation per run must be filled out.
Students Name: Preceptor’s Name:
EMS Rotation Site: Instructor’s Name: Tyeson Powers
Date: Total Hours:
Student arrived to clinical on time and prepared.
Excellent Good Poor
Student complies with dress code policy.
Excellent Good Poor
Student demonstrated a professional attitude.
Excellent Good Poor
Please rate the student on the following categories: 1 is the poorest rating and 5 is the
best:
Assessment: 1 2 3 4 5 NA
Vital Signs: 1 2 3 4 5 NA
Patient Relations: 1 2 3 4 5 NA
Staff Relations: 1 2 3 4 5 NA
Lifting and Moving 1 2 3 4 5 NA
Mechanical Aids/Oxygen 1 2 3 4 5 NA
CPR 1 2 3 4 5 NA
Drug Administration 1 2 3 4 5 NA
Traction Splint 1 2 3 4 5 NA
Bandaging/Splinting 1 2 3 4 5 NA
Spinal Immobilization 1 2 3 4 5 NA
Radio Communications: 1 2 3 4 5 NA
OVERALL PERFORMANCE 1 2 3 4 5 NA
Optional Comments:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Preceptor Signature: __________________________________________
Date: _____________________ 2019 Olton Class
Olton EMS Training Program EMT Students Evaluation of Preceptor at Clinical
Preceptor______________________________
Clinical Site____________________________ Date______________
Preceptor allowed you to perform skills that you have been trained for.
Excellent Good Poor
Preceptor was courteous.
Excellent Good Poor
Preceptor orients student to clinical area and introduces you to medical staff.
Excellent Good Poor
Preceptor communicates effectively and provides feedback to questions / concerns.
Excellent Good Poor
Preceptor encourages learner participation.
Excellent Good Poor
Preceptor communicates frequently to discuss patient care.
Excellent Good Poor
Preceptor solicits active participation from student to accomplish clinical objectives.
Excellent Good Poor
Optional
Comments_______________________________________________________________
Students Name_______________________________________________
Students Signature____________________________________________
2019 Olton Class
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Olton EMS Training Program 8/10
MECHANICAL AIDS TO BREATHING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST OXYGEN [5 MINUTES] START TIME:
END TIME:
0 1 2 1. Prepares and assembles equipment 0 2 *2. Assembles regulator to tank 0 1 2 3. Checks tank pressure (Examiner shall ask for gauge reading and safe residual) 0 1 2 *4. Adjusts liter flow to 15 liters per minute (lpm) or greater 0 2 *5. Prefills reservoir bag 0 1 2 *6. Applies and adjusts mask with reservoir to the patient’s face 0 2 *7. Removes the mask prior to discontinuation of oxygen flow 0 1 2 *8. Shuts off regulator 0 1 2 *9. Maintains safety precautions throughout Candidate’s Total Points (minimum passing total: 13 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OROPHARYNGEAL AIRWAY [2 MINUTES] START TIME:
END TIME:
0 1 2 *1. Selects proper size, measuring from earlobe to corner of mouth or other appropriate method 0 1 2 *2. Inserts airway 0 2 *3. Removes airway Candidate’s Total Points (minimum passing total: 4 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
MECHANICAL AIDS TO BREATHING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST MOUTH-TO-MASK [3 MINUTES] START TIME:
END TIME:
0 2 1. Connects one-way valve to mask 0 1 2 *2. Positions mask properly and opens airway 0 1 2 3. Establishes and maintains a proper mask-to-face seal 0 1 2 *4. Begins effective ventilations within 30 seconds of beginning of station time 0 2 *5. Performs effective ventilations for one (1) minute at rate of 10-20 ventilations per minute 0 2 6. Connects mask to oxygen source and adjusts liter flow 0 2 *7. Resumes ventilations within 15 seconds and continues effective ventilations for 30 seconds
at rate of 10-20 ventilations per minute Candidate’s Total Points (minimum passing total: 10 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
MECHANICAL AIDS TO BREATHING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST BAG-VALVE-MASK [3 MINUTES] START TIME:
END TIME:
0 1 2 *1. Positions mask properly and opens airway 0 1 2 2. Maintains adequate seal around mouth and nose 0 1 2 *3. Begins effective ventilations (chest or lung inflation) within 30 seconds of beginning of
station time 0 1 2 *4. Performs effective ventilations for one (1) minute at a rate of 10-20 ventilations per minute 0 2 5. Connects BVM to oxygen source and adjusts liter flow 0 2 *6. Resumes ventilations within 15 seconds and continues effective ventilations for 30 seconds
at rate of 10-20 ventilations per minute Candidate’s Total Points (minimum passing total: 7 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SUCTIONING [2 MINUTES] START TIME:
END TIME:
0 2 *1. Positions patient to prevent aspiration by turning patient's head to side or turning the
patient to the side as a unit 0 2 *2. Prepares suction device 0 1 2 *3. Inserts catheter and applies suction properly 0 1 2 *4. Suctions for 5-15 seconds Candidate’s Total Points (minimum passing total: 6 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
PATIENT ASSESSMENT VITAL SIGNS
CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:
END TIME:
0 1 2 *1. Calculates and reports pulse Candidate _ ____
Examiner Difference 0 1 2 *2. Calculates and reports respiratory rate Candidate ______
Examiner Difference 0 1 2 *3. Palpates and reports systolic blood pressure Candidate _____
Examiner Difference 0 1 2 *4. Auscultates and reports auscultated blood pressure Candidate Systolic
Examiner Difference
Candidate Diastolic Examiner Difference
Candidate’s Total Points (Minimum pasing total: 6 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
BRONCHODILATOR ADMINISTRATION-HANDHELD METERED DOSE INHALER CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:
END TIME:
0 2 *1. Avoids contamination of equipment or replaces contaminated equipment prior to use. 0 2 *2. Confirms order (medication, dosage and route) 0 1 2 *3. Informs patient of order for medication and inquires about allergies and recent doses of
other bronchodilators 0 2 *4. Selects correct medication from drug box as requested by Examiner 0 2 *5. Verbalizes check of medication for contamination and expiration date 0 2 *6. Shakes the inhaler 0 2 7. Attaches spacer to inhaler, if ordered 0 2 8. Verbalizes recheck of the medication label 0 2 9. Removes nonrebreather mask from patient 0 2 10. Verbalizes recheck of the medication label 0 2 *11. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the
medication label 0 2 12. Instructs patient to exhale deeply 0 2 *13. Instructs patient to put the mouthpiece in mouth and make a seal with lips 0 2 *14. Instructs patient to depress the inhaler canister while inhaling and then hold breath as
long as comfortable 0 2 *15. Replaces non-rebreather mask on patient Candidate’s Total Points (Minimum pasing total: 21 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
BRONCHODILATOR ADMINISTRATION-SMALL VOLUME NEBULIZER CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:
END TIME:
0 2 *1. Avoids contamination of equipment or replaces contaminated equipment prior to use. 0 2 *2. Confirms order (medication, dosage and route) 0 1 2 *3. Informs patient of order for medication and inquires about allergies and recent doses of
other bronchodilators 0 2 *4. Selects correct medication from drug box as requested by Examiner 0 2 *5. Verbalizes check of medication for contamination and expiration date 0 2 *6. Adds appropriate volume of medication to the nebulizer 0 2 *7. Assembles nebulizer according to the manufacturer’s standard (or local protocol) and
connects to oxygen regulator 0 2 8. Verbalizes recheck of the medication label 0 1 2 *9. Adjusts oxygen liter flow as ordered and allows mist to fill breathing tube or mask prior
to applying to patient 0 2 10. Verbalizes recheck of the medication label 0 2 *11. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the
medication label 0 2 *12. Removes non-rebreather mask and positions nebulizer device on patient Candidate’s Total Points (Minimum pasing total: 17 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Programs 8/10
BANDAGING [STATION TIME 10 MINUTES]
CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST INJURY: START TIME:
END TIME
0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Checks circulation (pulse or capillary refill), motor function and
sensation distal to injury before bandaging 0 2 3. Covers injury completely with clean dressing(s) demonstrating aseptic technique 0 1 2 *4. Secures dressing using appropriate pressure with no excessive movement 0 1 2 *5. Uses bandaging technique appropriate to injury 0 2 *6. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury
after bandaging Note: The examiner must now inform candidate that the wound continues to bleed (on extremity sites
only) 0 2 *7. The student shall verbalize the correct placement of a tourniquet if wound is on extremity. Candidate’s Total Points (minimum passing total: 9 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Programs 8/10
SPLINTING [STATION TIME 10 MINUTES]
CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST INJURY: START TIME:
END TIME
0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury
before splinting 0 1 2 *3 Immobilizes injury 0 2 *4. Checks circulation (pulse or capillary refill), motor function and sensation distal to injury
after splinting Candidate’s Total Points (minimum passing total: 7 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
TRACTION SPLINTING CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL COURSE RENEWAL EQUIVALENCY RETEST STATION TIME 10 MINUTES START TIME:
END TIME
CANDIDATE PULLING TRACTION CANDIDATE APPLYING SPLINT 0 2 *1. Takes BSI Precautions 0 1 2 *2. Checks circulation, motor function, and sensation distal to injury before applying ankle hitch 0 2 *3. Applies ankle hitch 0 1 2 *4. Applies and maintains traction, elevation, and gentleness 0 2 *5. Monitors circulation, motor function, and sensation distal to injury after procedure is completed 0 1 2 6. Communicates with partner & patient Minimum passing total: 9 points
0 2 *1. Takes BSI Precautions 0 1 2 2. Prepares equipment 0 2 *3. Stabilizes fracture while ankle hitch applied 0 2 *4. Positions splint 0 1 2 5. Fastens ischial strap 0 1 2 6. Connects hitch to frame 0 2 *7. Tightens mechanical device to achieve traction and immobilize injury 0 1 2 *8. Secures cravats or velcro straps without aggravating injury 0 2 9. Verbalizes securing torso and splint to longboard to immobilize hip and prevent movement of splint 0 1 2 10. Communicates with partner & patient Minimum passing total: 17 points
Candidate’s Total Points
Partner’s Name (Print):
Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner:
Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
SPINAL IMMOBILIZATION OF SEATED PATIENT CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 10 MINUTES START TIME:
END TIME
0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Directs partner to establish and maintain neutral spinal alignment 0 2 *3. Checks circulation, motor function, and sensation in all four extremities 0 1 2 *4. Applies extrication collar 0 1 2 *5. Positions short device 0 2 *6. Secures short device to patient's torso 0 2 *7. Secures short device to patient's head to assure neutral cervical spine alignment 0 2 *8. Checks circulation, motor function, and sensation in all four extremities 0 2 9. Performs steps 1-7 in sequence 0 2 *10. Does not compromise airway or impede respirations 0 1 2 11. Communicates Candidate’s Total Points (minimum passing total: 16 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
SPINAL IMMOBILIZATION OF SUPINE PATIENT CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 10 MINUTES START TIME:
END TIME
0 2 *1. Takes or verbalizes body substance isolation precautions 0 2 *2. Directs partner to establish and maintain neutral spinal alignment. 0 2 *3. Checks circulation, motor function, and sensation in all four extremities 0 1 2 *4. Applies extrication collar 0 1 2 *5. Moves patient onto device without compromising integrity of spine 0 2 *6. Secures patient to long device 0 2 *7. Checks circulation, motor function, and sensation in all four extremities 0 2 8. Performs steps 1-7 in sequence 0 2 *9. Does not compromise airway or impede respirations 0 1 2 10. Communicates Candidate’s Total Points (minimum passing total: 15 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
PATIENT ASSESSMENT PHYSICAL SURVEY
CANDIDATE’S NAME: DATE: ECA EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 15 MINUTES START TIME:
END TIME:
0 2 *1. Takes or verbalizes body substance isolation precautions 0 1 2 *2. Performs scene size-up
-*Assures scene is safe -Number of patients -Mechanism of Injury
0 2 *3. Performs primary assessment/Immobilizes c-spine as indicated 0 2 *4. Describes interventions for problems found during primary assessment 0 2 *5. Identifies patient priority; makes transport decisions 0 1 2 *6. Performs rapid trauma scab or focused physical examination as indicated 0 2 *7. Obtains baseline vital signs 0 2 *8. Obtains SAMPLE history from patient or others 0 1 2 *9. Describes interventions for problems identified during history and focused examination
(Indicate care described on attached sheet.) 0 1 2 10. Performs detailed physical examination, as indicated by patient’s condition 0 1 2 11. Reports to hospital after obtaining appropriate information
-Age and sex -Treatments -Chief Complaint/MOI -Pertinent History -Vital Signs -ETA
0 2 *12. Describes reassessment Candidate’s Total Points (Minimum passing total: 18 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 12/11
CARDIAC ARREST MANAGEMENT/AED CANDIDATE’S NAME: DATE: EMT EMTI EMTP SCHOOL #: INITIAL RENEWAL EQUIVALENCY RETEST STATION TIME 5 MINUTES START TIME:
END TIME:
0 2 *1. Takes or verbalizes body substance isolation precautions
0 2 *2. Assures scene safety
0 1 2 3. Attempts to question any bystanders about arrest events
0 2 4. Checks patient responsiveness
0 2 *5. Checks pulse and breathing simultaneously (no more than 10 seconds)
0 2 *6. Begins immediate chest compressions (No breaths given prior to compressions)
0 2 7. Requests additional EMS response
0 1 2 *8. Performs 2 minutes of high quality 1-Rescuer CPR
0 1 2 *9. Adequate depth and rate
0 1 2 *10. Correct compression to ventilation ratio
0 1 2 *11. Allows chest to recoil completely
0 1 2 *12. Adequate volume for each breath
0 2 *13. Minimal interruptions of less than 10 seconds throughout
0 2 14. Assesses patient for return of spontaneous pulse
0 2 *15. Directs second rescuer to resume CPR while candidate applies AED
0 2 16. Turns on power to AED
0 2 *17. Follows prompts and properly places pads on patient
0 2 *18. Directs rescuer to stop CPR and to “CLEAR”
0 2 *19. Initiates analysis of rhythm if not automatically performed by AED
0 2 *20. Confirms that personnel are clear
0 2 *21. Delivers shock (3 shocks if AED is configured to 2000 Standards)
0 2 *22. Directs rescuer to immediately resume chest compressions (no pulse check) Candidate’s Total Points (Minimum passing total: 32 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
Olton EMS Training Program 8/10
EPINEPHRINE AUTO INJECTOR Candidate’s Name: Date: EMT EMTI EMTP School #: Initial Renewal Equivalency Retest Station Time 5 Minutes Start Time:
End Time:
0 2 *1. Takes or verbalizes proper BSI precautions 0 2 *2. Avoids contamination of equipment or replaces contaminated equipment prior to use. 0 2 *3. Confirms order (medication, dosage and route) 0 1 2 *4. Informs patient of order for medication and inquires about allergies 0 2 *5. Selects correct medication from drug box as requested by Examiner 0 2 *6. Verbalizes check of medication for contamination and expiration date 0 2 *7. Selects appropriate site and identifies it by pointing to (touching) the site on self 0 2 8. Verbalizes recheck of the medication label 0 1 2 9. Prepares the injection site 0 2 10. Verbalizes recheck of the medication label 0 2 *11. Removes safety cap from the injector 0 2 *12. Performs steps 1-10 prior to step 12 and performs at least one (1) recheck of the
medication label 0 2 *13. Places the tip of auto-injector against the injection site and pushes the injector firmly
against the injection site 0 1 2 *14. Holds auto-injector against the site for 10 seconds 0 2 15. Removes auto-injector and applies pressure 0 2 *16. Disposes of contaminated equipment Candidate’s Total Points (minimum passing total: 23 points) Absolutes satisfied: Yes No (Must have at least one point for each step marked with an *)
Pass Fail
Examiner: Cert. No. (if assigned):
Documenting Comments:
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CERTIFICATION INSTRUCTIONS
In order to become certified, you MUST pass the NR written exam AND complete a State of
Texas Application.
NR Application Process:
Follow the instructions on the Brochure (next page)
Brochure is found at:
https://content.nremt.org/static/documents/exam-pathway.pdf
You can also watch an video giving instructions by going to: https://www.youtube.com/watch?v=vJcB66etThM&feature=youtu.be&list=PLEU9dZYd
J1OaxJxOW44OHH8hPm83A38GE and click on “Step by Step Instruction for Applying
Online for the NREMT Test
When filling out the online application, it will ask about your training site. Under Texas,
select “Olton EMS Training Program”
Your application status will then show something like “Awaiting Verification”
o Once you have completed ALL requirements for the course and have turned
everything in, the lead instructor will inform the coordinator to authorize you to
test. Once you are authorized, you may precede with Step 6 of the NR application
instructions.
NOTE: you need to complete the NR application AND make the payment BEFORE taking the
NR Skills Exams and prior to turning in your final paperwork
State Application Process: Perform AFTER gaining NR Certification
Online State Application is available at:
http://www.dshs.texas.gov/emstraumasystems/txonlinelinks.shtm
o Click on “Online Licensing System”
o Create a User and password
o After signing in, select “Choose Board”
Select “Emergency Medical Services”
o Select “Choose Application”
Select “EMS Personnel Initial Online Application”
o Fill out the online application
Your Course Approval Number is: 614976
Be sure and answer ALL questions
Pay your fee with a credit or debit card
State Application (Paper Form) is available at
http://www.dshs.texas.gov/emstraumasystems/certinfo.shtm
o Scroll down to Application
o Click on “Initial Application”
o Fill out the application
Your Course Approval Number is: 614976
Be sure and answer ALL questions
You will need to mail them your payment of $124.00 with the application,
OR if you are with a volunteer EMS, you EMS Director may fill out and
sign for the Volunteer Sign Off on page the application
Pay your fee with a credit or debit card
If you have an existing Texas EMS certification, you do NOT have to do the FBI
fingerprint criminal history check
https://www.youtube.com/watch?v=vJcB66etThM&feature=youtu.be&list=PLEU9dZYdJ1OaxJxOW44OHH8hPm83A38GE
Follow these easy steps 3 to 4 weeks in advance of when you plan to test. If you need additional assistance, please contact the NREMT at 614-888-4484. We’re ready to help!
Step 1: Create Your Account• Go to nremt.org and click on ‘Login’ (found in the blue bar at the top of the NREMT home page).
• Click on ‘Set Up New Account’ and follow the instructions.
Step 2: Login• After you have completed Step 1, you can follow the link and login
with the username and password you created.
Step 3: Manage Your Account Information• Complete all the information in the Personal Account Information
fi elds as prompted. The name you include in this area should be the same as what appears on your drivers license (or the ID you will present at the testing center), and is what will appear on your application, National Registry certifi cate and card upon successful completion of the examination.
Read this to avoid delay! Make sure the name you use to set up your Account matches the name on your drivers license EXACTLY (or the ID you will present at the testing center) or you will be denied access to the testing center on the day of your exam!
Step 4: Create a New Application• Click on ‘Create a New Application’ to apply to take your exam.
• Review the Personal Information Summary – if any items are incorrect, you can make corrections by clicking on ‘Manage Account Information’.
• Select the application level you wish to complete.
Step 5: Pay Application Fee• It is recommended that you pay your application fee at the time you
complete your online application. However, if you choose, you may pay at a later date.
Read this to avoid delay! An Authorization to Test (ATT) Letter allowing you to schedule your exam will not be issued until payment has been received and all other verifi cations are complete.
• You can pay by credit/debit online or print a money order tracking slip for mailing your money order to the NREMT.
Step 6: Check to See if You Are Approved to Take Your Exam
• When all areas of the application process are completed and have been verifi ed, you will see the following link: ‘Print ATT Letter’.
Read this to avoid delay! You will only see ‘Print ATT Letter’ when you have been verifi ed to test! This link will not appear if the verifi cation process is not yet complete!
• Monitor the progress of your application and watch for your Authorization to Test (ATT) Letter by going to the NREMT home page and logging in using your username and password.
• Click on ‘Candidate Services’.
• Click on ‘Application Status’.
• If you see ‘Submitted’ next to ‘Course Completion Verifi cation’, this means the NREMT has submitted your information to the program you indicated, and is waiting for authorization from the program indicating that you have completed the course.
• If you see the link ‘Print ATT Letter’, click on the link.
Step 7: Print the ATT Letter to Schedule Your Exam
• Scroll down to see if the ‘Print ATT Letter’ appears.
Read this to avoid delay! Click on this link to print your ATT Letter. Print and follow the instructions in your ATT Letter.
Step 8: Call Pearson VUE to Schedule Your Exam• Your ATT Letter will contain the Pearson VUE phone number to call
to schedule your examination.
• Your ATT Letter will also include other important information you should read carefully!
• Read this to avoid delay!
– You can reschedule your exam up to 24 hours in advance by calling Pearson VUE at 1-866-673-6896 or visiting the Pearson VUE website. If you fail to appear for your
exam, you will have to complete a new application and pay another application fee!
– Refunds cannot be issued for no-shows.
– If you arrive late for your exam, you may lose your appointment!
EMS Students!
Additional informational can be found on the NREMT instructional DVD. Ask your instructor for more information or visit the NREMT website at www.NREMT.org.
Revisions and updates may be necessary to make the CBT transition as smooth as possible. Please refer to the NREMT website for the most currrent policies and procedures.Release date 11/06 Revised 6/07
Follow These Steps to Take The NREMT Exam
*ATTENTION* EMS personnel must submit an application for EMS
Certification/licensure, Criminal History Pre-Screen Petition, or an
Administrator of Record (AOR) form before completing the
fingerprint process. Completing fingerprints without submitting
an application and/or AOR form to DSHS will cause a delay in
processing your application.
DEPT OF STATE HEALTH SVCS (EMT/EMS)
DEPARTMENT OF STATE HEALTH SVCS (DSHS) (EMT/EMS)
To schedule your ten-minute fingerprint appointment, simply visit
https://www.identogo.com and enter the following Service Code
11BSBH
Service Code is unique to your hiring/licensing agency. Do not use this code for another purpose.
Background Check Waiver
I certify that all information I provided in relation to this criminal history record check is true and
accurate. I authorize the Texas Department of Public Safety (DPS) to access Texas and Federal
criminal history record information that pertains to me and disseminate that information to the
designated Authorized Agency or Qualified Entity with which I am or am seeking to be employed or to
serve as a volunteer, through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as
authorized by Texas Government Code Chapter 411 and any other applicable state or federal statute
or policy.
I authorize the Texas Department of Public Safety to submit my fingerprints and other application
information to the FBI for the purpose of comparing the submitted information to available records in
order to identify other information that may be pertinent to the application. I authorize the FBI to
disclose potentially pertinent information to the DPS during the processing of this application and for
as long hereafter as may be relevant to the activity for which this application is being submitted. I
understand that the FBI may also retain my fingerprints and other applicant information in the FBI’s
permanent collection of fingerprints and related information, where all such data will be subject to
comparisons against other submissions received by the FBI and to further disseminations by the FBI
as may be authorized under the Privacy Act of 1974 (5 USC 552a). I understand my fingerprints will
be searched by and against civil, criminal and latent fingerprints in the Next Generation Identification
(NGI) system. I understand I am entitled to obtain a copy of any criminal history record check and
challenge the accuracy and completeness of the information before a final determination is made by
the Qualified Entity. I also understand the Qualified Entity may deny me access to children, the elderly,
or individuals with disabilities until the criminal history record check is completed. If a need arises to
challenge the FBI record response, you may contact the agency that submitted the information to the
FBI, or you may send a written challenge request to the FBI's Criminal Justice Information Services
(CJIS) Division at FBI CJIS Division, Attention: Correspondence Group, 1000 Custer Hollow Road,
Clarksburg, WV 26306.
Don’t have access to the Internet? You can still schedule an appointment by calling 888.467.2080
Texas Fingerprint Service Code Form
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Olton EMS Training Program
Student Evaluation of Instructor
Date: ______________________ Course #: 614976
Course Location: Olton Course Level: EMT
Instructor: ____Tyeson Powers___ Topic: _OVERALL__
On a scale of 1 to 5, evaluate the instructor.
1-unacceptable
2-poor
3-fair
4-good
5-excellent Unacceptable Excellent
1. The instructor was on time for class. 1 2 3 4 5
2. The instructor was knowledgeable of and 1 2 3 4 5
Prepared for the topic(s) covered.
3. The instructor presented the topic in a 1 2 3 4 5
Manner that was easy to understand.
4. The instructor was concerned for the 1 2 3 4 5
Students needs.
5. The instructor used the class time 1 2 3 4 5
effectively.
6. The instructor demonstrated skills in an 1 2 3 4 5
orderly, easy to follow manner.
7. The instructor was courteous and helpful. 1 2 3 4 5
8. My overall rating of this instructor is …… 1 2 3 4 5
9. What could this instructor do to better serve the needs of the student?
__________________________________________________________________
10. What did you like about this instructor?
__________________________________________________________________
__________________________________________________________________
Additional comments: (use back if necessary)
Olton EMS Training Program
Student Evaluation of EMS Course
Date: ________________ Course #: 614976 Course Location: Olton
Course Level: EMT
Instructions to Student: This form will be used to evaluate the effectiveness of your
course. Please complete the questions carefully, honestly and candidly. ECA candidates
will not answer Section B. Your signature is NOT required. CIRCLE THE BEST
RATING FOR EACH STATEMENT.
RATING SCALE:
1 – Unacceptable 2 – Below Average
3 – Average 4 – Above average
5 – Excellent
SECTION A: CLASSROOM AND SKILLS
1. Instructors used films, slides, posters, video tapes and other visual aids that 1 2 3 4 5
were other visual aids that were current and appropriate for the class.
2. Classroom was comfortable and well-suited for study and learning. 1 2 3 4 5
3. Skills equipment was clean and in good operating condition. 1 2 3 4 5
4. Skills equipment was present in sufficient quantities 1 2 3 4 5
5. Instructors were well prepared and organized. 1 2 3 4 5
6. Instructors stressed important concepts clearly in a sequence logical 1 2 3 4 5
to the course content.
7. Instructors had a positive attitude towards the students and the profession. 1 2 3 4 5
8. Instructors regularly met scheduled classes for full class period. 1 2 3 4 5
9. Exams covered the material taught. 1 2 3 4 5
10. Instructor reviewed exams and provided feedback about my progress. 1 2 3 4 5
11. Instructors provided the published D.O.T. knowledge objectives for the 1 2 3 4 5
course and skills testing sheets.
SECTION B: CLINICAL AND AMBULANCE
12. Objectives for the hospital clinical rotation were clearly presented. 1 2 3 4 5
13. Objectives for the ambulance rotations were clearly presented. 1 2 3 4 5
14. Preceptors for hospital clinical rotations were knowledgeable and helpful 1 2 3 4 5
15. Preceptors for ambulance rotations were knowledgeable and helpful. 1 2 3 4 5
16. Hospital clinical rotations provided valuable learning experiences. 1 2 3 4 5
17. Ambulance rotations provided valuable learning experiences. 1 2 3 4 5
SECTION C: OVERALL
18. Overall, I found my experiences to be worthwhile and would recommend this 1 2 3 4 5
course to others.
SECTION D: PLEASE USE SPACE BELOW AND BACK OF THIS FORM TO GO INTO
FURTHER DETAIL OR MAKE ADDITIONAL COMMENTS.
