Provided by the Kentucky Association of EMTs

KBEMS' draft proposal for EMT-I program

This document was obtained by Bobby Thacker, president of the Kentucky Association of EMTs and is supposed to be the document presented to and approved for pilot status by the Kentucky Board of EMS on Mar. 7.

KAEMT is collecting comments on this issue, which they plan to deliver to the Kentucky Board of EMS. Electronic comments can be submitted at http://www.kaemt.org/emt-i.htm.

EMT Intermediate Program Implementation

DRAFT BOARD PROPOSAL

Request authorization from the Board for Board staff to identify locations for and to authorize no fewer than 2 nor more than 4 pilot programs utilizing the National Standard Curriculum for EMT Intermediate Curriculum for training and the National Registry Exam for the testing/certification process beginning no later than August 1, 2002 with initial testing completed no later than December 31, 2002.

DOT Recommended Curriculum Hours – Anticipated Maximum

225 - Didactic Classroom

  75 - Clinical Rotations

100 - Field Internship

395 - Total Hours

These hours are subject to adjustment based on a variety of classroom factors however, for the purpose of field testing, Board staff will develop and mandate the number of instructional, clinical, and field internship hours for the pilot programs. These programs will be conducted in a variety of settings with varying hours. The training process will begin no later than August 1, 2002, with initial testing completed no later than December 31, 2002. The Board further authorizes Board staff to serve as adjunct faculty for these courses should they be needed.

Training Sites

Confirmed Sites:

          Louisville Fire and Rescue – Louisville

          Madisonville Technical Community College – Madisonville

Yet To Be Confirmed Sites:

          Paintsville

          Estill County

Courses would be limited to 25 students per course.

Skills

This is a partial listing of skills, which the EMT Intermediate can be trained to perform. It should not be considered all-inclusive by any means. The EMT Intermediate will be responsible for all Basic level skills performed by the EMT in addition to those skills shown below.

Airway Skills – Partial Listing

          Pulse Oximetry

            End Tidal CO2 Detection

            O2 Delivery via cannual, simple, partial and total nonrebreather and venturi mask

            Medication administration by nebulizer

            Bag Mask

            Transport Ventilators

            Flow Restricted Oxygen Powered Ventilators

            Sellick Maneuvers

            Use of Magill Forceps

            Suctioning including tracheobronchial and stoma suctioning

            NG/OG Tubes Adult, Pediatric and Newborn Patients

            Oral and nasal airways

            ET Intubation – Adult and Pediatric

            Replacement of a tracheostomy tube in a stoma

IV Skills – Partial Listing

            Peripheral IV placement                                      Intraosseous IV placement

            Administration of parenteral medications              IV Medication Administration

Drawing a blood sample

Medication Listing – Partial Listing

            Acetylsalicylic Acid                                              Adenosine

            Atropine                                                            Bronchodilators – 7 listed

            Dexamethasone                                                 Methylprednisolone

            Dextrose 50%                                                    Diazepam

            Epinephrine 1:1000 and 1:10,000 solutions           Furosemide                                          

            Lidocaine 2%                                                     Morphine Sulfate                                                  

            Naloxone                                                           Nitroglycerine

Local jurisdictions are given the ability to expand that listing. If it is the desire of the Board to expand that listing I would recommend that we do so prior to the implementation of the pilot programs.

Other Skills – Partial Listing

            Needle Decompression

            ECG Monitoring, including 3 and 12 lead monitoring

            Transcutaneous Pacing

Implementation Schedule

March 7, 2002    Board approval of proposal.

April 1, 2002      Complete identification of sites for pilot programs.

May 1, 2002       Staff to complete all course design plans and associated paperwork.

May 2002          Meetings with training agencies to outline requirements and plans for course.

May 31, 2002     Training agencies to confirm equipment and staff available.

June 14, 2002    All staff will be provided with a copy of the curriculum with their assignments. 

July 2002           Orientation of training staff and site visits at training centers by field staff. Screening and selection of students by training centers by July 15, 2002

August 1, 2002   Student orientation sessions – Courses begin. EMT Intermediate regulations draft complete and submitted to LRC.

Dec. 31, 2002    All initial exams complete.

January 2003     Post completion meetings with training centers and training staff to identify problems during programs

February 2003   Revisions or refinements completed.

March 1, 2003    Statewide availability. 

Reasons for Request

• Some areas of the state will never be able to recruit, afford, or retain paramedics to provide advanced life support due to economics, run volume and other contributing factors. The EMT Intermediate level will give those areas to opportunity to upgrade their level of care utilizing existing EMT’s, which is more likely to occur for a variety of factors.

• Ambulance providers utilizing EMT Intermediates would have to upgrade their licenses to Class 1 ALS and meet all of the additional equipment requirements in the regulation. By doing so they would be eligible for ALS reimbursement under the new Medicare Fee Schedule.

• With the anticipated implementation of House Bill 469, there have been some concerns voiced regarding a potential shortage of Paramedics. Implementation of an EMT Intermediate level would help to meet any shortage that may occur.

• Board approval at this stage will allow Board staff sufficient time to recruit, orient and initiate training programs by or shortly following the effective date of House Bill 469. Assuming that the pilot programs are successful, regulations could be drafted and a statewide EMT Intermediate program could be ready in the first quarter of 2003.

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