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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.
Here are some links that may prove useful for Course Coordinators:
The Board of EMS has issued a transition course checklist:
Scope of Practice Transition Course Guide
Here is a page summarizing the regulations, including links for downloading them or reading online:
February 2012 – Regulation Update
For Course Coordinators only, a link to the most current instructor and student manuals:
EMS Transition Curricula
The Board office issued two memos:
The transition requires all providers to pass written and skills tests
Changing Transition Course Dates and/or Times
Education standards for new, original courses of instruction for the new levels, EMR, EMT, and AEMT were created by Hutchinson Community College and posted by KSBEMS here.
Local services as well as many of the Kansas Community Colleges are offering transition courses.
Just a reminder to all of those who attended the train-the-trainer courses in 2010 who wish to download the newest manuals that the download site is: http://www.acrobat.com. We have added this information to the Documents and Links page too.
If you are a student in the transition, you will receive your student manual from your course instructor.
The transition is a complicated process. Moving approximately 8,000 people from an existing level to a new and higher level of practice requires attention to detail by individual instructors and coordinators.
I’ll use myself as an example. I can’t monitor quality in your classroom but I can in mine. As an instructor, my focus is on ensuring that I am teaching the transition bridge materials in a manner that meets what the State is asking of me, what my students need from me, what the subject requires, and with the end goal in mind that my students need to know the scope of practice to the same standard as every other certified provider at the same level in Kansas. By working to ensure this in my little corner of the world I help make the transition process successful. Your responsibility is the same.
The transition is an exciting time. For some, add to that excitement the word “scary.” This is not just for those needing to transition, but for those who are responsible for teaching them. Despite some fear mixed in with the excitement, this is a wonderful opportunity for educators at all levels to make a strong and long-lasting impact on EMS in Kansas.
If you are a Service Director or transition coordinator, you need to be talking with your Medical Director about the Kansas EMS transition. For Medical Directors, Bill 262 states that all providers must deliver EMS care under medical director supervision and protocol. This includes not only EMS agencies, but all providers of EMS services in the community including first responders, fire-based responders, and private industry responders.
The transition should include a review of the local scope of practice and required skills. Updated local protocols for each level will need to be put into place before providers are certified to begin practicing at the new levels.
If a currently Kansas certified First Responder, EMT-Basic, EMT-Defibrillator, or EMT-Intermediate does not complete the transition within the alloted time, that provider will no longer be a certified EMS provider in Kansas.
In short, yes. The leeway that coordinators and instructors have is that some students will enter class having already mastered some of the content. An example is the use of a blood glucometer. In this case, the information in the lesson plan must be presented. However, the instructor would be able to make this more of a discussion rather than a lecture because of students’ pre-existing knowledge.
Regarding assessment: For the practical skills, they still need to show competency, but this can be often be achieved with less lab practice time for those individuals who are already using the skill. The students will still be expected to pass the module Post-Test with a 75% or higher score.
Assessment of successful completion of the transition bridge curricula, as approved by the Kansas Board of EMS, is a 75% or greater score on the module Post-Tests as included in the curricula and two successful demonstrations of skill competency as detailed on the Skill Check Sheets in the curricula. The assessment of competency is done using test and check sheet tools provided.
Each course has a lesson plan, formulary, media, task analysis for each skill in the course, skill check sheets, lab support materials, pre-tests, and post-tests. The skill check sheets are used to determine competency in each skill. Competency is to be shown two times with no critical errors by each student – at separate times. From the course designer standpoint, these should be done on different days. In other words, competency shows should not be done back to back. The idea is that by having the competency shows at separate times, there is a higher possibility that the student will retain the information and skill. The check sheets must be signed by the student and instructor.
As noted previously, the Post-Tests and signed Skill Check Sheets must be retained for five (5) years.
- First Responder to Emergency Medical Responder will be approximately 16 hours in length.
- EMT-Basic to EMT will be approximately 28 hours in length.
- EMT-Intermediate to Advanced EMT will be approximately 116 hours in length.
- EMT-Defibrillator to Advanced EMT requires completion of an EMT-Intermediate Course before the bridge course is taken and will be approximately 200 – 250 hour total between the two courses.
Did you notice the word “approximately” in each line? I use that word intentionally because the curricula, as approved by the Kansas Board of EMS, are competency based. This means that as an instructor you have some estimate of the time it should take to teach each lesson, but in the end it depends upon the ability of the student to show competency. So, it could take less or more time, depending upon the student, the student to instructor ratios, and other variables in the classroom.
As of this writing, the final AEMT scope remains in question. We will continue to post updates as further information is made available.