Starting an EMT Program at Your High School

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Tim Klein
Teacher
Palmdale High School
Palmdale, CA

Emphasis for this session will be placed on local, state and national requirements; required supplies/costs; challenges of being in a high school setting; and procedures for starting and maintaining a program.

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Starting an EMT Program at Your High School

  1. 1. EMT in the High School
  2. 2. What are EMTs? <ul><li>Emergency Medical Technicians </li></ul><ul><ul><li>Provide basic medical care and transportation between scene and hospital </li></ul></ul><ul><ul><li>Nationally recognized certification </li></ul></ul><ul><ul><ul><li>Required for application to most fire departments / fire protection districts </li></ul></ul></ul><ul><ul><ul><li>Highly recommended to have when applying for law enforcement positions </li></ul></ul></ul><ul><ul><ul><li>Also found working in emergency rooms, 9-1-1 dispatch centers, and FEMA / Homeland Security </li></ul></ul></ul>
  3. 3. Levels of EMS Service <ul><li>First Responder </li></ul><ul><ul><li>80-hour course taught to most police officers and commercial </li></ul></ul><ul><ul><li>safety officers that usually includes some components of CPR, </li></ul></ul><ul><ul><li>first aid and emergency/disaster response. </li></ul></ul><ul><li>Emergency Medical Technician (EMT-B) </li></ul><ul><li>Minimum 110-hour didactic and 10-hour clinical course to teach basic life support procedures (CPR and AED use, spinal immobilization, basic medication administration, etc.) and emergency care and transport. </li></ul><ul><li>Paramedic (EMT-P) </li></ul><ul><li>Minimum 630-hour didactic and 480-hour clinical course to teach advanced life support procedures (manual cardiac defibrillation, endotracheal intubation and advanced airways, IV and pre-hospital medications, etc.) </li></ul>
  4. 4. National Job Outlook <ul><li>“ Employment of emergency medical technicians and paramedics is expected to grow by 19 percent between 2006 and 2016, which is faster than the average for all occupations.” </li></ul><ul><li>Full-time paid EMTs and paramedics will be needed to replace unpaid volunteers because of the amount of training and the large time commitment these positions require. </li></ul><ul><li>“ Furthermore, as a large segment of the population—aging members of the baby boom generation—becomes more likely to have medical emergencies, demand will increase for EMTs and paramedics.” </li></ul><ul><li>Continued demand for part-time, volunteer EMTs and paramedics in rural areas and smaller metropolitan areas. </li></ul><ul><li>Source: Occupational Outlook Handbook ; US Dept of Labor; Bureau of Labor Statistics (2006). </li></ul>
  5. 5. National Curriculum <ul><li>Governed by the National Highway Traffic and Safety Administration </li></ul><ul><li>Minimum of 110 hours didactic and 10 hours of clinical experience </li></ul><ul><li>Allows state EMS agencies to develop emergency treatment and transport protocols for all levels of first responders </li></ul>
  6. 6. AVUHSD EMT Program <ul><li>Started through the Antelope Valley ROP for students 18 years of age and older </li></ul><ul><li>Sought accreditation through LA County EMS Agency in the high school in 2007 </li></ul><ul><li>Allow students more employment opportunities after high school </li></ul><ul><li>EMT profession is expected to grow by 34.5% in Los Angeles County from 2004-2014 ( www.labormarketinfo.edd.ca.gov ) </li></ul>
  7. 7. Accreditation <ul><li>Currently 23 approved EMT I schools in Los Angeles County </li></ul><ul><li>Accreditation process </li></ul><ul><ul><li>Differs from county to county </li></ul></ul><ul><ul><ul><li>Requires that all NHTSA guidelines are followed </li></ul></ul></ul><ul><ul><ul><li>May have specific requirements or certification procedures for each individual county </li></ul></ul></ul><ul><ul><ul><ul><li>Los Angeles County EMS requires additional 8 hours of education on county-specific protocols and procedures for any EMT training to certify or work in LA County. </li></ul></ul></ul></ul>
  8. 8. Palmdale High School <ul><li>Antelope Valley </li></ul><ul><li>Title I School </li></ul><ul><li>Student Population of 3,700 </li></ul><ul><li>Ethnic Breakdown </li></ul><ul><li>63% Hispanic </li></ul><ul><li>18% African American </li></ul><ul><li>12% White, Non-Hispanic </li></ul><ul><li> 7% Other </li></ul>
  9. 9. Health Careers Academy <ul><li>4 year comprehensive program </li></ul><ul><li>450 students </li></ul><ul><li>Job shadowing during their junior year and internship during their senior year </li></ul><ul><li>Option for Sports Medicine their Junior year </li></ul><ul><li>Joint effort between ROP and Palmdale High School </li></ul>
  10. 10. Palmdale HCA Prerequisites <ul><li>Senior level - Health Career Academy </li></ul><ul><li>Students must have a current American Heart Association CPR for the Health Care Provider certificate </li></ul><ul><li>Anatomy and physiology </li></ul><ul><li>Approval to enroll from the Program Director </li></ul>
  11. 11. EMT Course Credit Hours <ul><li>NTHSA minimum requirement is 110 didactic hours and 10 clinical hours </li></ul><ul><ul><li>Many universities and community colleges offer courses that run 130 – 200 hrs in length. </li></ul></ul><ul><ul><ul><li>AVROP EMT course for high school is 180 hours based on a 16-week semester </li></ul></ul></ul><ul><ul><ul><ul><li>Roughly three didactic hours and two laboratory hours per week. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Clinical rotations are the student’s responsibility to perform outside of class / school hours </li></ul></ul></ul></ul>
  12. 12. EMT Student Expectations <ul><li>Defining Adulthood </li></ul><ul><ul><li>Many young EMS students may still be in high school or have recently graduated from high school. </li></ul></ul><ul><ul><ul><li>Students in transition </li></ul></ul></ul><ul><ul><ul><ul><li>Life roles and responsibilities are not those normally considered to be fully adult </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Students do not have experiences necessary to achieve adulthood, and it may be reflected in their conduct </li></ul></ul></ul></ul><ul><ul><li>But because of the considerable responsibility that comes with being EMS providers, they must be held accountable as adults. </li></ul></ul>
  13. 13. EMT Student Expectations <ul><li>Sensitive Subjects </li></ul><ul><ul><li>Maturity of the student and must be constantly monitored </li></ul></ul><ul><ul><ul><li>Particularly important when discussing emergency care and treatment for: </li></ul></ul></ul><ul><ul><ul><ul><li>Obstetrics and Emergency Childbirth </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Sexual Assault </li></ul></ul></ul></ul><ul><ul><ul><ul><li>HIV / AIDS and communicable disease patients </li></ul></ul></ul></ul><ul><ul><ul><li>Remove emotion from course subject matter </li></ul></ul></ul><ul><ul><ul><ul><li>Personal attacks on the rescuer / first responder </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Child / Elder Abuse </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Sudden (Traumatic) Death / Suicide </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Death of a child or infant </li></ul></ul></ul></ul>
  14. 14. Student Evaluations <ul><li>EMS Education is in transition from objective-based learning to competency-based learning </li></ul><ul><ul><li>EMT Educational Standards </li></ul></ul><ul><ul><ul><li>Meeting the core content for each nationally recognized level of practice. </li></ul></ul></ul><ul><ul><ul><ul><li>Most EMS textbooks and support materials are written directly from the content of the EMT National Standard Curricula. </li></ul></ul></ul></ul><ul><ul><ul><li>But hands-on skills are equally as important in developing the EMT student’s learning. </li></ul></ul></ul>
  15. 15. Competency-based Education <ul><li>“ CBE focused on preparing students to perform the prescribed competencies of a profession under real-life conditions at a level or proficiency required for workers on the job,” (Alexander, 120) </li></ul>Equipment, supplies and teaching scenarios need to reflect real-world applications.
  16. 16. National Registry of EMTs <ul><li>National Registry exam required for EMT certification in California </li></ul><ul><ul><li>Computer-based testing </li></ul></ul><ul><ul><ul><li>Six key areas of knowledge are tested </li></ul></ul></ul><ul><ul><ul><ul><li>Airway </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Cardiology </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Trauma </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Medical Emergencies </li></ul></ul></ul></ul><ul><ul><ul><ul><li>OB / Pediatrics </li></ul></ul></ul></ul><ul><ul><ul><ul><li>EMS Operations </li></ul></ul></ul></ul><ul><ul><ul><li>Computer-adaptive testing </li></ul></ul></ul><ul><ul><li>Students must pass each key area with a score of 75% or better </li></ul></ul>
  17. 17. Effects of Culture and Gender <ul><li>EMS was traditionally thought of as a “man’s job”. </li></ul><ul><li>Today 75% of all EMS professionals are male, but trends are showing more females entering EMS than at any other time. </li></ul><ul><ul><li>In 2005, there were 1,347 women on 136 CA fire departments (896 women in CA Dept of Forestry, San Francisco, Los Angeles City & San Diego FDs), 115 engineers (70 on CDF), 10 lieutenants, 60 captains, 15 chiefs, 7 chiefs of department. </li></ul></ul><ul><ul><li>(Status Report, 2005; Women in the Fire Service, Inc.) </li></ul></ul>
  18. 18. <ul><li>Cultural bias </li></ul><ul><ul><li>EMS is a helping profession. The instructor must be </li></ul></ul><ul><ul><li>culturally aware and promote an atmosphere of cultural </li></ul></ul><ul><ul><li>understanding. </li></ul></ul><ul><ul><ul><li>Be aware and respectful of social and religious customs </li></ul></ul></ul><ul><ul><ul><li>Men’s and women’s roles in culture and EMS </li></ul></ul></ul><ul><ul><ul><li>Care of patients by the opposite sex </li></ul></ul></ul><ul><ul><ul><li>Non-native English speaking students </li></ul></ul></ul><ul><ul><ul><li>Body language </li></ul></ul></ul>
  19. 19. NHTSA Guidelines for EMS Instructors <ul><li>10 professional skills sets and professional attributes for EMS instructors </li></ul><ul><ul><li>Understands essential concepts and tools for each of the EMS levels and their individual content areas. </li></ul></ul><ul><ul><li>Understands adult learning and use the knowledge to support student development </li></ul></ul><ul><ul><li>Understands learning styles and be able to adapt learning experiences to the student </li></ul></ul><ul><ul><li>Promotes higher-thinking and problem-solving strategies. </li></ul></ul><ul><ul><li>Utilizes knowledge of individual and group motivation and dynamics to create a positive learning environment </li></ul></ul>
  20. 20. NHTSA Guidelines for EMS Instructors <ul><li>10 professional skills sets and professional attributes for EMS instructors </li></ul><ul><ul><li>Uses effective verbal and nonverbal communication to encourage student inquiry and interaction </li></ul></ul><ul><ul><li>Competently plans instruction drawing upon knowledge of subject matter, principles of learning and curriculum objectives </li></ul></ul><ul><ul><li>Uses effective formative and summative evaluation criteria in all facets of the program </li></ul></ul><ul><ul><li>Is a reflective practitioner who consistently uses self-evaluation to seek opportunities for professional growth and development </li></ul></ul><ul><ul><li>Cultivates professional relationships with colleagues to improve instruction. </li></ul></ul>
  21. 21. Field and Clinical Rotations <ul><li>Each approved EMT-Basic training program shall have written agreements with one or more general acute hospitals and/or operational ambulance provider(s) or rescue vehicle provider(s) for the clinical portion of the course (CA Title XXII). </li></ul><ul><li>No more than 3 students per 1 qualified supervisor and students must assess a minimum of 5 patients with adequate documentation </li></ul>
  22. 22. Program Director <ul><li>Also known as the Course Coordinator </li></ul><ul><ul><li>Education and experience in methods, materials and evaluation of instruction which shall be documented by at least 40 hours of teaching methodology (CA Title XXII) </li></ul></ul><ul><ul><li>Current certification as an EMT-Basic or higher </li></ul></ul><ul><ul><li>Responsible for course planning, operation, and evaluation </li></ul></ul><ul><ul><li>National Registry preparation and tracking </li></ul></ul><ul><ul><li>Approval of all clinical and field activities </li></ul></ul>
  23. 23. Clinical Director <ul><li>Also known as the Medical Director </li></ul><ul><ul><li>Currently licensed physician, nurse, physician assistant, or paramedic with 2 years of academic or administrative ED experience </li></ul></ul><ul><ul><li>Acts as the ultimate medical authority regarding course content, procedures, and protocols. </li></ul></ul><ul><ul><li>Should provide input on all examinations </li></ul></ul>
  24. 24. Principal Instructor / Primary Instructor <ul><li>As Defined by Title 22: </li></ul><ul><ul><li>May be the program clinical coordinator or program director; or </li></ul></ul><ul><ul><li>Be a physician, registered nurse, physician assistant, or paramedic currently licensed in California; </li></ul></ul><ul><ul><li>Be an EMT-I who is currently certified in California; </li></ul></ul><ul><ul><li>Have at least two (2) years of academic or clinical experience in the practice of emergency medicine or prehospital care in the last five (5) years; </li></ul></ul><ul><ul><li>Be approved by the program director in coordination with the program clinical coordinator as qualified to teach the topics to which s/he is assigned. </li></ul></ul>
  25. 25. Secondary Instructor <ul><li>“Teaching Assistant” </li></ul><ul><ul><li>“...qualified by training and experience to assist with teaching of the course.” </li></ul></ul>
  26. 26. 40 Hour Education <ul><li>Forty hour teaching methodology course </li></ul><ul><ul><li>California State Fire Marshal, “Fire Instructor 1A and 1B” </li></ul></ul><ul><ul><li>National Fire Academy’s “Fire Service Instructional Methodology Course” </li></ul></ul><ul><ul><li>EMS Educator Course (NAEMSE) </li></ul></ul><ul><ul><li>Any other coursework that meets the US DOT/NHTSA 2002 Guidelines for EMS Instructors </li></ul></ul>
  27. 27. <ul><li>The mission of The National Association of EMS Educators is to inspire excellence in EMS education and lifelong learning. </li></ul><ul><li>The NAEMSE Educator Course represents the didactic component and practical application of the beginning education process to become an EMS instructor. </li></ul><ul><li>Course has been designed to provide a basic introduction of concepts for the beginning EMS educator. </li></ul><ul><li>Instructor education is crafted to develop professional EMS educators using NAEMSE developed modules that follow the curriculum objectives of the DOT/NHTSA 2002 National Guidelines for Educating EMS Instructors. </li></ul><ul><li>3 day course, 8-9 hours per day </li></ul><ul><ul><ul><li>$275.00 for members </li></ul></ul></ul><ul><ul><ul><li>$370.00 for non-members </li></ul></ul></ul><ul><li>www.naemse.org </li></ul>
  28. 28. Supplies <ul><li>Well-Being of the EMT-Basic </li></ul><ul><li>Eye protection, gowns, gloves, masks, forms </li></ul><ul><li>The Human Body </li></ul><ul><li>Anatomy models </li></ul><ul><li>Vital Signs </li></ul><ul><li>Stethoscopes, blood pressure cuffs (adult, child, infant), penlights. Ratio 1:6 </li></ul><ul><li>Lifting and Moving Patients </li></ul><ul><li>Stair chair, scoop stretcher, flexible stretcher, gurney, long and short backboards, bed </li></ul>
  29. 29. Supplies <ul><li>Airway </li></ul><ul><li>Pocket mask, bag-valve-mask, flow restricted oxygen powered ventilation device, oral airways, nasal airways, suction units, suction catheters, oxygen tank, regulator, nonrebreather mask, nasal cannula, tongue blade, lubricant, combi-tube, ET tube </li></ul>
  30. 30. Supplies <ul><li>Cardiac Emergencies </li></ul><ul><li>CPR manikins, artificial ventilation manikins, automated external defibrillator </li></ul><ul><li>General pharmacology </li></ul><ul><li>Epinephrine auto-injector trainers, activated charcoal, glucose, nitroglycerin, inhaler </li></ul><ul><li>Behavioral </li></ul><ul><li>Restraints, stretcher </li></ul>
  31. 31. Supplies <ul><li>Obstetrics </li></ul><ul><li>Childbirth kit, OB manikin </li></ul><ul><li>Trauma </li></ul><ul><li>Dressings, 4x4 gauze, occlusive dressings, pneumatic anti-shock garment, triangular bandage, roller bandages, air splints, traction splints, rigid splints, cervical collars, blankets, burn sheets, ladder splint </li></ul>
  32. 32. Estimated start-up costs <ul><ul><li>Paperwork Filing Fees </li></ul></ul><ul><ul><ul><li>Dependent county to county </li></ul></ul></ul><ul><ul><li>Durable Equipment </li></ul></ul><ul><ul><ul><li>$10 – 20k (including gurney) </li></ul></ul></ul><ul><ul><li>Medical Supplies </li></ul></ul><ul><ul><ul><li>$3 – 8k </li></ul></ul></ul><ul><ul><li>EMT Text </li></ul></ul><ul><ul><ul><li>$60 - $90 per textbook </li></ul></ul></ul><ul><ul><ul><li>Can use any text that supports DOT/NHTSA guidelines. </li></ul></ul></ul><ul><ul><ul><li>Available from Mosby/JEMS, Brady/Pearson-Prentice Hall, </li></ul></ul></ul><ul><ul><ul><li>Elsevier publishers </li></ul></ul></ul>
  33. 34. EMT A V ROP TRAINED. TESTED. COMPETENT. CONFIDENT. DON’T BOTHER CALLING 9-1-1. I’M ALREADY HERE.
  34. 35. Contact <ul><li>Tim Klein, MPH, NREMT </li></ul><ul><li>[email_address] </li></ul><ul><li>661 273-3181 ext 333 </li></ul>

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