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Instructors: Please note that there are new requirements outlined below.
Several questions have been asked regarding the AEMT curriculum. Here’s a short explanation and process direction to use in working through these items.
Missing Check Sheets
Check sheets for Intraosseous (IO) and for Rectal Administration are not included in the curriculum. There are task sheets for these skills. In talking with the Kansas Board of EMS today (August 3, 2012), they stated that instructors must develop check sheets with which to assess these skills. Since the skills are referenced in the curriculum, they must be assessed and will be checked in the event of an audit. These check sheets must be included with the AEMT Student Lab Manual.
If anyone has already developed a check sheet for these skills and would like to share it, please email it to us, and we’d be happy to share this with the rest of the AEMT Transition community.
New Medications Added to Formulary
The Kansas Board of EMS, working with the medical advisory committee (MAC) has made additional recommendations in 2012 to the medications carried by AEMTs. These include the addition of Ondansetron and changes to the routes of administration for Lidocaine and Amiodarone. See the table below for a current PROPOSED formulary and use description for AEMTs. These changes are included in proposed regulation which is working through the approval process.
As with the above check sheets, in talking with the Kansas Board of EMS, in the case of added medications indications, and routes, (the addition of Ondansetron and changes to the routes of administration for Lidocaine and Amiodarone) they expect instructors to develop these course materials to be added to the AEMT course including: a lesson plan, media, formulary, task list, task analysis, and check sheet for the Student Lab Manual for each new medication. These check sheets must be included with the AEMT Student Lab Manual. They must be assessed and will be checked in the event of an audit.
If anyone has already developed the lesson plan, media, formulary, task list, task analysis, and check sheet for these skills, please email it to us, and we’d be happy to share this with the rest of the AEMT Transition community.
Kansas Board of EMS
May 1, 2012
|1||Activated charcoal||Oral||Non-caustic overdoses|
|2||Albuterol inhaler||Aerosolized, inhaled, nebulized||Acute asthmatic attacks, bronchospasm|
|3||Albuterol and Ipratropium - premix combined||Aerosolized, nebulized||Acute asthmatic attacks, bronchospasm|
|4||Amiodarone||IO bolus or IV bolus only; either bolus may be repeated. Continuous infusion not allowed.||Pulseless ventricular tachycardia; Refractory ventricular fibrillation; andinterfacility transfers only.|
|5||Antidote – Any||Auto injector||Self or peer care|
|6||Aspirin||Oral||Chest pain of suspected ischemic origin only|
|7||Atropine/Pralidoxime chloride||Auto injector||Cholinergic/nerve gas poisoning|
|8||Atrovent (Ipratropium) – Pt. assisted only||Nebulized, metered dose inhaler||Dyspnea and wheezing|
|9||Benzodiazepine||IM, IO, IV, intranasal, rectal||Status epilepticus only|
|10||Beta agonist||Determined by protocol or directcontact with a physician.||Dyspnea and wheezing|
|11||Dextrose Solutions – (D10, D25, D50)||IO, IV||Acute hypoglycemia|
|12||Diphenhydramine hydrochloride||IM, IV, oral||Acute allergic reactions|
|13||Dopamine hydrochloride||IV with pump only||Maintenance during interfacility transfer only|
|14||Epinephrine||Auto injector||Anaphylactic reactions|
|15||Epinephrine 1:10,000||IO, IV||Cardiac arrest only|
|16||Fentanyl||IO, IV, intranasal||Noncardiac pain relief only|
|17||Glucagon||IM||Acute hypoglycemia where oral glucose or IO/IV medications cannot be given|
|19||Ipratropium||Nebulized, inhalation||Acute asthmatic attacks, bronchospasm|
|20||IV electrolytes/antibiotic additives||IV with pump only||Maintenance during interfacility transfer only|
|21||IV fluids without medications or nutrients;monitor, maintain and shut off||IV gravity or pump||Established by medical protocols|
|22||IV solutions – Any combination of fluids||IO, IV||Medication administration, volume expansion|
|23||Lidocaine||IO bolus or IV bolus only; either bolus may be repeated. Continuous infusion not allowed.||Pulseless ventricular tachycardia; Refractory ventricular fibrillation; andinterfacility transfers only.|
|24||Medicated inhaler – Pt. assisted only||Nebulized or metered dose||Acute asthmatic attacks, bronchospasm|
|25||Morphine||IO, IV||Noncardiac pain relief only|
|26||Naloxone||IM, IO, IV, SQ, intranasal||Reversal of narcotic overdose|
|27||Nitroglycerine/nitro preparation||Dermal, oral, oral spray sublingual||Anginal pain relief|
|28||Nitrous oxide||Inhalation||Pain relief|
|29||Ondansetron||Oral, IV, IO, IM||Nausea/Vomiting|
|30||Over the counter oral medications||Oral||Not specified|
|Legend: IM = Intramuscular, IO = Intraossesous, IV = Intraveneous, Pt. = Patient, SQ = Subcutaneous|
This list was accessed on August 2, 2012 and is available from the Board web site.
Please direct questions regarding this information to the Board office. If you have questions about whether or not your check sheets will meet the requirements, please contact the Board office.
This week the Kansas Board of EMS will be meeting in Topeka. On their list of items to discuss and decide on are the full range of medications for the AEMT. Additionally, they will be discussing and making decisions about the implementation of regulations to support Senate Bill 262 which goes into effect January 15, 2011. One option that they have discussed is delaying implementation of regulations until December 31, 2011. This decision would allow for more work to go into the regulations (making for better regulations) and also allow more time for attendants to complete the bridge courses for the new curricula.
If you cannot be in Topeka this week, keep an ear to the process through your regional representatives. Decisions will either be made or not made; but either way how we do our work as educators in helping to bridge people to the new scope will be affected.
We’ve been finding the occasional item that needs editing each time we do a train the trainer. And, we’ve been cleaning those up as we go. Nothing like a set of fresh eyes in each train the trainer course to sniff out what has become transparent to those of us who have been staring at the information since the beginning! In talking with the Board of EMS staff, we decided that we would not be posting updated versions until after the last train the trainer session in Overland Park on November 20/21. So, for those who have keys to the Acrobat.com site, be patient and we’ll get it all cleaned up before posting the final version.
An update to let interested parties know that we are forging ahead:
The EMR and EMT bridge courses are in the hands of our physician and peer reviewers for review and recommendations. We have begun revisions of both courses based on initial feedback from reviewers. Media and activity development is underway.
The first draft of the AEMT bridge course is rapidly moving toward completion. It will be sent for physician and peer review within the next two weeks.
We encourage people to continue to download scope documents and begin reviewing supporting material in preparation for instructing and participating in the transition.
I close this post with a quote from physicist, author, and systems thinker, Poul Anderson, “I have yet to see any problem, however complicated, which, when looked at in the right way, did not become still more complicated.”