The Great Divide

The data is clear, America is experiencing a dangerous income and wealth disparity in this country. Check out this link for more information on the historical disparities between the rich and the poor in this country. I think you will see that we do not have as much of a spending problem as we do a revenue problem facilitated by a decrease in taxes paid by the wealthy, decreases in taxes collected as a percentage of GDP and stagnant wages for the middle class, job insecurity and unemployment while .... while ... wait for it ... while Congress considers yet more tax cuts for the wealthy and the elimination of Social Security, Medicare, food programs for poor children, Head Start and more. This is not right my friends. http://www.slate.com/id/2266174/

Changes to EMS Training Announced By Bureau of Emergency Medical Services

This year is an exciting year for Cole Holland Training Center and the Utah Bureau of Emergency Medical Services. We have all  been working on implementing new standards of curriculum that will better educate Emergency Medical Technician’s.


In 1996, the National Highway Traffic Safety Administration (NHTSA) and the Health Resources and Services Administration (HRSA) published the consensus document titled EMS Agenda for the Future. The intent of the Agenda was to create a common vision for the future of EMS and was designed for use by government and private organizations at the national, state and local levels to help guide planning, decision making, and policy regarding EMS. In 2000, this document was followed by the EMS Education Agenda for the Future: A Systems Approach. The purpose of the Education Agenda is to establish a system of EMS education that more closely parallels that of other health care professions. The Core Content, Scope of Practice, and Education Standards have been completed. In 2007, the agenda began to be implemented across the states. (For additional information see www.naemso.org)

EMS Levels
So what does this mean for Utah and EMT students and providers? The Utah BEMS recently announced that they are ready to implement these new guidelines and levels of certification.  There are now four levels of certification. EMR (Emergency Medical Responder), EMT (Emergency Medical Technician), AEMT (Advanced Emergency Medical Technician), and Paramedic. These new levels of certification are now recognized nationwide. Not only will certifications transfer from state to state, but more importantly, the level of patient care will be greatly enhanced due to the responders’ abilities to provide additional procedures and care.   Testing for these new levels of certification will begin as follows:

• EMR- Current
• EMT- December of 2011
• AEMT- October of 2011
• Paramedic- December 2012 (NREMT testing)

The new levels of certification are primarily ‘competencies based’ rather then hourly based. The new recommended numbers of hours for each course are:

• §  EMR 60 hours
• §  EMT 150 hours
• §  AEMT 150-250 hours
• §  Paramedic  approximately 1400 hours

Again this is based on the students’ ability to achieve competency. If the student fails to reach competency during the recommended number of hours, the student will need to continue training until competency is met. Medical Directors, Course Coordinators and Instructors will decide if the student is competent to test.


Testing
Here is the best part. All new students will be required to go through initial testing which includes both written and practical evaluations. Once initial testing has been completed, it will be up to the individual to maintain their level of certification by attending, participating and tracking continuing education units. Cole Holland Training Center is  in the process of implementing a program that will deliver state recognized continuing education units to its students. We are currently in a national accreditation process that is reviewing meticulously our EMT programs; we have submitted our workshops to CECBEMS (Continuing Education Coordinating Board for Emergency Medical Services) and will be applying for training center status with the Utah BEMS in August 2011. These are steps Cole Holland is taking to better provide students with the resources not only to become certified, but to maintain certification. It is our goal to become a leader in the EMS industry in education and training. As partners in Emergency Preparedness and Response education, we highly endorse the efforts of the Utah Bureau of Emergency Services  in offering the most current, state of the art curriculum based on best practices and the refined and updated state mandates.

Bridge Requirements
There are no bridge requirements for EMR, EMT or Paramedic levels of certification. There are only bridge requirements for the AEMT. All currently certified EMT Intermediates will be required to bridge to the new level of AEMT by October 2013. Failure to bridge by this date will automatically retract their level of certification and place them at an EMT level. Utah’s EMT Intermediate course has always followed the 1985 national guidelines. When the other states advanced to the 1999 national guidelines, Utah did not. At one point in time, Utah offered an Advanced EMT level of certification that was complex, unorganized, independent study, skill based and ultimately a failed process. There were a handful of people that managed to make it through the process. This time, Utah BEMS has dismissed themselves from the teaching process and has left that up to the local agencies and schools to deliver the new curriculum. They will only be involved in the testing process.

Cole Holland Training Center will be launching not only an AEMT course, but an AEMT bridge course that will allow current EMT Intermediate students to obtain this new level of certification. This program will begin fall of 2011.

Content that will now be included in the AEMT curriculum are:

Preparatory: EMS Systems Patient safety; high risk activities; how errors happen; preventing errors, including medication administration safety (rights of drug administration) Research Importance of evidence-based decision making process.
Therapeutic communication contains section on required affective/behavioral characteristics. Medical, Legal, and Ethics Morals, ethics and ethical conflicts

Anatomy and Physiology; Pathophysiology: Fundamental elements of the life support chain including oxygenation, perfusion, and the cellular environment; composition of ambient air; airway patency; respiratory compromise; ventilation/perfusion mismatch; perfusion and shock, blood volume; myocardial effectiveness; microcirculation; blood pressure; alterations in cellular metabolism

Airway Management, Respiration, and Oxygenation: Airway anatomy; airway assessment; techniques of assuring an open airway; age-related variation in airway anatomy; anatomy of the respiratory system; physiology of respiration; pathophysiology of respiration; assessment of respiratory status; respiratory management; supplemental oxygen therapy; age-related respiratory variation; assessment of ventilation status; oxygenation; ventilation management (adequate, inadequate, apneic); differentiating normal from positive pressure ventilation; age-related ventilation variation

Patient Assessment: Orientation to the new terminology (may be covered in a handout) Patient Assessment: Monitoring Devices; Pulse Oximetry

Medicine: Neurology Stroke/TIA; stroke alert criteria; Medicine: Abdominal and Gastrointestinal Disorders Anatomy; assessment; management; gastrointestinal bleeding, peritonitis, ulcerative disease, age-related variations;  Infectious Disease Updated information on methicillin resistant Staphylococcus aurous (MRSA); human immunodeficiency virus (HIV); cleaning and disinfecting ambulance equipment; decontaminating ambulances; Endocrine Disorders Diabetes update; Psychiatric Agitated delirium; medical/legal considerations; use of medical restraint Cardiovascular Anatomy; physiology; pathophysiology; assessment; management; acute coronary syndrome; hypertensive emergencies; cardiogenic shock; aspirin administration, Respiratory Anatomy; assessment; management; specific respiratory conditions; metered dose inhalers; small volume nebulizers; ager-related variations;  Hematology Sickle cell disease; Genitourinary/Renal Anatomy; physiology; pathophysiology; dialysis emergencies; Shock and Resuscitation General shock; reasons for shock; mechanism of shock

Trauma: Overview Become familiar with the Centers for Disease Control (CDC) Field Triage; Decision Scheme: The National Trauma; Triage Protocol; Trauma: Chest Trauma Incidence; anatomy; physiology; pathophysiology; blunt or open trauma

Trauma: Abdominal and Genitourinary Trauma; Incidence; anatomy; physiology; specific injuries; assessment; management; Head, Facial, Neck, and Spine Trauma Assessment and management of neck, eye, dental; laryngeal injuries

Trauma: Nervous System; Traumatic brain injuries; Special Considerations in Trauma; Trauma in pregnancy, elderly, and cognitively impaired


Special Patient Populations: Obstetrics, Complications of pregnancy

EMS Operations: Principles of Safely Operating a Ground Ambulance; Safety issues during transport; Incident Management; Incident management system; EMS Operations: Hazardous Materials Awareness; Hazardous Waste Operations and Emergency Response (HAZWOPER) First Responder Awareness Level; Mass Casualty Incidents Due to Terrorism and Disaster Roles and responsibilities at the scene


Conclusion
For additional information on the new guidelines for EMS, you can visit www.naemsd.org or stop by or call Cole Holland Training Center where we would be happy to assist you and answer question you may have. We look forward to these changes and the impacts they will make on patient care. Citizens of Utah deserve competent, well trained professionals. For more information on other life saving courses, call 801.759.5164.

The Salt Lake Tribune: The Dignity of Work

Check out the article in the Salt Lake Tribune, March 19th. Click here to read the entire editorial.
http://www.sltrib.com/sltrib/opinion/51453286-82/dignity-opportunity-poor-ability.html.csp#disqus_thread