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The Friesen Group contract for the Kansas EMS Transition will come to a close on December 31, 2013.

The web site with instructor and student documents will close on December 31, 2013. Course Coordinators are encouraged to download any needed materials as soon as possible. After that time, Course Coordinators will need to contact either the Board office or Friesen Group directly for any necessary files.

We have appreciated the opportunity to contract with the Board and support the transition process. Most of all, it has been a privilege to meet and learn to know many Kansas EMS professionals.

As someone who is not an EMS provider, my hope is that professional providers will continue to make decisions based on current best practices, the best research, hours and hours of practice, and what is best for this patient in this time and location.

With gratitude and best wishes,
Kathleen for Friesen Group

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.

Advanced EMT
Medication List

Kansas Board of EMS

May 1, 2012
Medication Method Application
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
18 Glucose Oral Acute hypoglycemia
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.

The update of the AEMT files is complete with the addition of the PowerPoint slides to the Acrobat.com site.  I/Cs and TOs who have been through the train the trainer course and who have access to the Acrobat.com site can now download the slides.

The slides have been left in a pptx file format. You can add content to the slides.  You may NOT delete content from the slides for from the AEMT program.  If you have questions or concerns, please contact us directly.

Yesterday the Board of EMS approved the updated curriculum for the AEMT.  The update includes all the medications that the Medical Advisory Council (MAC) approved for use by the AEMT.  What this means is that once we have packaged the new lesson plans and student manuals into the larger documents for students and instructors we will post them to the Acrobat site.  In addition, we are working to update the slides for the pharmacology section. These enhancements will take a couple of weeks and we’ll have them posted and ready to go.

Our good friends at Johnson County Med-Act produced some great videos showing both the end tidal CO2 Colorimetric device in action as well as capnography and capnometry.  Take a look:

End Tidal CO2 Capnometer
http://www.youtube.com/watch?v=FwQTXPj4cpo&feature=related

Capnometer/Capnograph
http://www.youtube.com/watch?v=KJk1i8Upd5s&feature=related
http://www.youtube.com/watch?v=sLLHrj_pFys&feature=related

There are numerous videos posted here.  You’ll know them as they are posted by “ttems”  Thanks to JoCo for sharing these!

Some of you are already into the EMT Transition process.  For those who aren’t, but are thinking about how to simulate different medications, here are some ideas.

For NTG we are using Altoids Smalls which are placed into NTG bottles (after they are washed with soap and water and then dried out).
NTG Placebo

For Aspirin placebos there is nothing as good as Mini M&Ms.  We use a baby aspirin bottle that has been washed out with soap and water and dried.  (We watch carefully for students overdosing in the corner of the classroom . . . )
ASA Placebo

A word of caution.  Wash those bottles out!  We also ensure that people are told that if they have allergies (ASA is a common one) that they should not partake of the placebos!

If you have other ideas that you use, we’d like to hear them so they can be shared as well.

For those educators who have been asking us about updated AEMT Instructor Manuals and Student Manuals, we are still waiting on the State of Kansas and Board to finalize a new contract. Once that is finalized, we will begin work on making the modifications.

If you are planning to begin teaching now, we recommend that you focus on the portions that will not be changed.

One of the things that has become apparent since we began the Train the Trainer courses is that some of the skills required in the transition courses will be problematic for local services.  This is either because of the expense of equipment or because the skill is not expected to be used by services (this may not make sense to you, but is a result of adopting the National Scope for each level as part of our scope).  As Friesen Group developed the curricula, we identified this about some specific skills such as mechanical CPR and automated transport ventilators.  However, a few additional items came to light and with this in mind we went back to the Board of EMS at their October meeting to request a few additions to the “Optional” list of skills. Bear in mind, these must still be covered in the didactic portion of the transition course – however – the skills are not required for successful completion.  Here is the list of optional skills by level.

EMR EMT AEMT
Application of ECG patches does NOT require an ECG monitor.  It does require patches and ECG limb lead cables Application of ECG patches does NOT require an ECG monitor.  It does require patches and ECG limb lead cables  Administraton of Nitrous Oxide is NOT required
     
Mechanical CPR device is NOT required (As Adopted) Use of Automatic Transport Ventilator is NOT required (As Adopted) Use of Automatic Transport Ventilator is NOT required (As Adopted)
     
  Use of Manually Triggered Ventilator is NOT required Use of Manually Triggered Ventilator is NOT required
     
  Automatic Blood Pressure acquisition is NOT required  
     
  EtCO2 Capnograph/Capnometer is NOT a required skill.  Colormetric devices ARE required.  

We received approval of the transition course curricula at the August 6, Kansas Board of EMS meeting in Topeka.  With this approval, we are moving forward to the train-the-trainer events.  Here is some information that persons responsible for the coordination of the transition courses in their communities and services will find useful.

General Information:

  1. The courses were approved by BEMS as competency based, not time based.  What this means is that students are doing more than just sitting in class. They must show competency in the knowledge, skills, and abilities.  This may take more or less time than is specified in the individual lesson plans.  Your local situation may vary depending upon the experience of the teacher(s) and students.  Be flexible and understand the importance of obtaining competency for all students.
  2. Only I/Cs and TOs who have attended a train the trainer course this fall will be approved to coordinate transition bridge courses.  They may find subject matter experts to teach the materials in the course or may, if qualified, teach it themselves.
  3. Completion of the entire bridge course, with acknowledgement of competency by the instructor and verification by the State Board of EMS will be required BEFORE any technician can use the new scope activities.  Local protocols will also need to be in place.  This is important to understand.  EMS Providers cannot begin using new skills at the end of a given class session or module. EMS Providers must complete the entire course and receive your new certification from the Kansas Board of EMS and the local protocols must reflect the new scope of practice.
  4. Sample course schedules and course hours for EMR, EMT, and AEMT are available on the documents page of this website or by clicking on each link in this sentence.

There have been a number of questions about the process of bridging to the new scope of practice at each level.  Here is a summary of the options.

First Responder:

  • First Responders transition to EMR via the EMR Transition Bridge.
  • First Responders opt out a transition bridge course and fail to renew certification.

Emergency Medical Technician:

  • Emergency Medical Technicians transition to EMT via the EMT Transition Bridge.
  • Emergency Medical Technicians may choose to transition to EMR via the EMR Transition Bridge.
  • Emergency Medical Technicians opt out a transition bridge course and fail to renew certification.

Emergency Medical Technician Intermediate:

  • Emergency Medical Technician – Intermediates transition to AEMT via the AEMT Transition Bridge.
  • Emergency Medical Technician – Intermediates may choose to transition to EMT via the EMT Transition Bridge.
  • Emergency Medical Technician – Intermediates may choose to transition to EMR via the EMR Transition Bridge.
  • Emergency Medical Technician – Intermediates opt out a transition bridge course and fail to renew certification.

Emergency Medical Technician Intermediate/Defibrillator:

  • Emergency Medical Technician – Intermediate/Defibrillators transition to AEMT via the AEMT Transition Bridge.
  • Emergency Medical Technician – Intermediate/Defibrillators may choose to transition to EMT via the EMT Transition Bridge.
  • Emergency Medical Technician – Intermediate/Defibrillators may choose to transition to EMR via the EMR Transition Bridge.
  • Emergency Medical Technician – Intermediate/Defibrillators opt out a transition bridge course and fail to renew certification.

Emergency Medical Technician Defibrillator:

  • Emergency Medical Technician – Defibrillator transition to AEMT via an existing EMT – Intermediate Curriculum and the AEMT Transition Bridge.
  • Emergency Medical Technician – Defibrillator may choose to transition to EMT via the EMT Transition Bridge.
  • Emergency Medical Technician – Defibrillator may choose to transition to EMR via the EMR Transition Bridge.
  • Emergency Medical Technician – Defibrillators opt out a transition bridge course and fail to renew certification.

Dates

June 2017
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