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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.

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.

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.

The Road Ahead

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.”

Dates

June 2017
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