TRAINING
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3002
POLICIES AND PROCEDURES
Subject: Manpower/Training
Instructor Qualifications
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional policy for North Coast EMS to maintain the right
to approve requests of an individual to act as a Course Instructor for
a North Coast EMS-approved Training Program.
III. North Coast EMS reserves the right to approve course instructors for all
North Coast EMS-Approved Training Programs.
A. Along with the criteria outlined in Title 22, Division 9, North
Coast EMS will employ the following criteria to determine an
individual's qualifications for becoming a Principal Instructor:
1. Length of individual's experience in medical care in a related
field.
2. Length of individual's teaching experience in the medical care
field.
3. Performance of individual while certified/authorized.
4. Individual's record of suspensions or decertifications.
5. Evaluations of individual's previous students.
6. Written communication received by the Agency concerning
individual's performance in the field or in the classroom
setting.
7. North Coast EMS Staff evaluations during course on-site visits.
8. Willingness to comply fully with Agency requirements.
B. If the Agency has reason to believe an individual should not be a
Principal Instructor, that individual will be sent a letter stating
the reasons.
C. If the Agency has a reason why an individual should not be a
Principal Instructor, possible actions to rectify the problem could
include:
1. Counseling the Instructor.
2. Remedial training or study.
3. Follow-up classroom on-site visits and evaluations.
4. Denial, suspension, revocation of approval of Principal
Instructor.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3102
POLICIES AND PROCEDURES
Subject: Manpower/Training
First Responder Training Structure and Instructor Qualifications
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish qualifications for sponsoring a First Responder Training
Program, and to articulate the teaching and management structure and
instructor qualifications of a North Coast EMS approved program.
III. Training Program Qualifications
First Responder Training Programs may be sponsored by any of the
following institutions:
A. Accredited universities and colleges, school districts, regional
occupational training programs, and private post-secondary schools.
B. Medical training units of a branch of the Armed Forces or Coast
Guard.
C. Licensed general acute care hospitals.
D. Agencies of government.
E. Public safety agencies.
F. Local EMS agencies.
G. Private organizations with a recognized role in first aid or
prehospital care training.
IV. Each First Responder Training Program is required to provide for the
functions of administrative direction, medical quality assurance, and
actual program instruction. One or more persons, as qualified and
approved in writing by North Coast EMS, are required to be responsible
for the following specific functions:
A. A First Responder Training Program shall have a Program Director
who is qualified by education and experience in methods, materials,
and evaluation of instruction, or is an administrative officer
within the sponsoring institution.
B. A First Responder Training Program shall have a Principal Instructor
who, at a minimum:
1. must be a currently certified EMT-I, and
2. must have at least two years of experience in the practice of
prehospital emergency medical care in the last five years, or
3. has successfully completed a North Coast EMS-approved First
Responder Instructor Course.
C. A First Responder Training Program may have one or more Teaching
Assistants, who are qualified by training and experience to assist
with teaching of the course.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3103
POLICIES AND PROCEDURES
Subject: Manpower/Training
First Responder Training Program Approval
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish the procedure for obtaining and maintaining training
approval of First Responder Training Programs.
III. Procedure for Program Approval
A. Eligible Training Institutions shall submit a completed North Coast
EMS First Responder Program Approval Package to North Coast EMS at
least thirty (30) days before the first class session.
B. Program Approval shall be for a period of two (2) years, unless
withdrawn, suspended, or revoked by one of the parties, in
accordance with agreements signed within the Program Approval
Package.
C. Program Approval may be renewed by the Training Institution every
two (2) years by following the same procedures.
D. There is a Training Program Fee for all private organizations with
a recognized interest in first aid or prehospital care training
applying for approval. The fee must be submitted with the North
Coast EMS Program Approval Package.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3104
POLICIES AND PROCEDURES Page 1 of 2
Subject: Manpower/Training
First Responder Training Program - Course Content
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. U.S. Department of Transportation, National Highway Traffic
Safety Administration "Instructor Lesson Plans" of the Emergency
Medical Services: First Responder Training Course.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish a minimum standard for time and content requirements of
North Coast EMS-approved First Responder and Refresher Courses.
III. Minimum Course Content for a Basic First Responder Course - FORTY (40)
HOURS):
A. General First Aid Principles.
1. Primary patient survey and evaluation.
2. Shock.
3. Bleeding.
4. Trauma and care of injuries:
a. soft tissues and internal organs.
b. extremities, including splinting and immobilization,
skeletal and muscular.
c. head and spine.
d. chest.
e. multi-system.
5. Care of medical emergencies:
a. chest pain, coronary artery disease, etc.
b. stroke.
c. diabetes.
d. neurological emergencies, including seizures and altered
states of consciousness.
e. poisoning, including drugs and alcohol.
6. Care of environmental emergencies:
a. heat emergencies.
b. cold exposure emergencies.
c. burns.
7. Immediate rescue and short distance transfer.
B. Cardiopulmonary Resuscitation:
1. Respiration and maintenance of airway.
2. Obstructed airway.
3. Rescue breathing/positive pressure ventilation.
4. Signs of cardiac arrest.
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3104
POLICIES AND PROCEDURES Page 2 of 2
Subject: Manpower/Training
First Responder Training Program - Course Content
5. One and two rescuer CPR for:
a. adults.
b. children.
c. infants.
C. EMS System Orientation:
1. Local EMS system structure.
2. Incident command system structure.
3. Local EMS system prehospital emergency medical care personnel.
4. Local EMS system policies and procedures, including but not
limited to, BLS Treatment Guidelines.
5. Use of Helicopter and Interface with Ambulance.
6. Documentation.
D. Basic Triage:
1. Review of vital and diagnostic signs.
2. START Triage/use of Mettag.
E. Airway and Ventilation Adjuncts:
1. Oropharyngeal/nasopharyngeal airways.
2. Soft and rigid upper airway catheter suction devices.
3. Liter flow oxygen delivery devices.
4. Manual and mechanical ventilating devices designed for
prehospital use.
F. Obstetrical Emergencies and Emergency Childbirth:
1. Normal.
2. Abnormal.
3. Neonatal care.
G. SIDS.
H. Extrication/Rescue/Hazardous Material.
IV. Minimum Course Content for a First Responder Refresher Course - SIXTEEN
(16) HOURS - Same course content as Basic Course, above:
A. General First Aid Principles.
B. Cardiopulmonary Resuscitation.
C. EMS System Orientation.
D. Basic Triage.
E. Airway and Ventilation Adjuncts.
F. Obstetrical Emergencies and Emergency Childbirth.
G. SIDS.
H. Extrication/Rescue/Hazardous Material.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3202
POLICIES AND PROCEDURES
Subject: Manpower/Training
EMT-I Training Program Approval
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish the procedure for obtaining and maintaining training
approval of EMT-I Training Programs.
III. Procedure for Program Approval
A. Eligible Training Institutions shall submit a completed North Coast
EMS EMT-I Program Approval Package to North Coast EMS at least
thirty (30) days before the first class session.
B. Program Approval shall be for a period of two (2) years, unless
withdrawn, suspended, or revoked by one of the parties, in
accordance with agreements signed within the Program Approval
Package.
C. If Program Approval is received for a Basic EMT-I Program, Training
Program must present an EMT-I Refresher Course.
D. Program Approval may be renewed by Training Institution every two
(2) years by following the same procedures.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3203
POLICIES AND PROCEDURES
Subject: Manpower/Training
Student Eligibility to Enter an Independent
Ambulance Module Training Program
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional policy for eligibility to enter North Coast EMS-
approved Ambulance Module Training Courses.
III. Policy
A. Any individual entering an approved Independent Ambulance Module
Training Program shall, at a minimum, have documented evidence of
successful completion of a California-approved EMT-INA or FS
Training Program.
B. Documentation that verifies the above must be submitted when
requesting North Coast EMS EMT-IA Certification.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3204
POLICIES AND PROCEDURES
Subject: Manpower/Training
Independent Ambulance Module Training Program Approval
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish the procedure for obtaining and maintaining training
approval of Independent Ambulance Module Training Programs.
III. Procedure for Program Approval
A. Eligible Training Institutions shall submit a completed North Coast
EMS Independent Ambulance Module Program Approval Package to North
Coast EMS at least thirty (30) days before the first class session.
B. Program Approval shall be for a period of two (2) years, unless
withdrawn, suspended, or revoked by one of the parties, in
accordance with agreements signed within Program Approval Package.
C. Program Approval may be renewed by Training Institution every two
(2) years by following the same procedures.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3301
POLICIES AND PROCEDURES
Subject: Manpower/Training
Student Eligibility to Enter Manual EMT-I(D) Training Program
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of regulations, Chapter 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional policy for eligibility to enter North Coast EMS-
approved EMT-I Manual Defibrillation Training Courses.
III. Policy
A. Persons eligible for entrance into an EMT-I Optional Skill
Defibrillation Program shall:
1. Possess a valid EMT-I(A) or EMT-I(NA) Certificate in the State
of California, and
2. be an employee or active volunteer with a public safety agency
or private sector ambulance service which is recognized by North
Coast EMS as providing emergency medical services, and have been
a member of such an agency or service for at least six (6)
months as a certified EMT-I.
B. Documentation that verifies the above must be submitted when
requesting North Coast EMS EMT-I(D) Certification.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3302
POLICIES AND PROCEDURES
Subject: Manpower/Training
EMT-I(D) Manual Training Program Approval
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish the procedure for obtaining and maintaining training
approval of EMT-I(D) Manual Training Programs.
III. Procedure for Program Approval
A. Eligible Training Institutions shall submit a completed North Coast
EMS EMT-I(D) Manual Program Approval Package to North Coast EMS at
least thirty (30) days before the first class session.
B. Program Approval shall be for a period of two (2) years, unless
withdrawn, suspended, or revoked by one of the parties, in
accordance with agreements signed within the Program Approval
Package.
C. Program Approval may be renewed by Training Institution every two
(2) years by following the same procedures.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3303
POLICIES AND PROCEDURES
Subject: Manpower/Training
Student Eligibility To Enter An Early Defibrillation Training Program
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapters 1.5 and 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional policy for eligibility to enter North Coast EMS-
approved Early Defibrillation Training Courses.
III. Policy
A. Any individual entering an approved Early Defibrillation Training
Program shall, at a minimum:
1. Have documented evidence of training in first aid and CPR which
meet the requirements of Title 22, Code of Regulations, Section
100020, and
2. Be an employee or active volunteer with a public safety agency
or ambulance service which is recognized by North Coast EMS as
providing emergency medical services.
B. Documentation that verifies the above must be submitted when
requesting North Coast EMS Early Defibrillation Certification.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3306
POLICIES AND PROCEDURES Page 1 of 2
Subject: Manpower/Training
Automatic Defibrillation Training Program - Course Content
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapters 1.5 and 2 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional time and content requirements of North Coast EMS-
approved Automatic Defibrillation Training Courses.
III. Course Content (4 HOURS)
A. Introduction and Typical Paperwork. (10 min. approx.)
Course scope, emphasis, and procedures.
B. Lecture 1: (20 min. approx.)
Cardiology for the Automated External Defibrillation Provider.
Anatomy and Physiology of the Heart.
Importance and physiology of defibrillation, Ventricular
Fibrillation, Asystole, Electromechanical Disassociation (EMD),
Ventricular Tachycardia.
C. Demonstration 1: (20 min. approx.)
Orientation to an Automated External Defibrillator.
Explanation of the various functions of the Automated External
Defibrillator, safety issues, event documentation.
D. Lecture 2: (20 min. approx.)
Treatment Guidelines and Protocols.
North Coast EMS Policies and Procedures, indications for use, 200 vs
360 joules, maximum number of shocks.
E. Demonstration 2: (15 min. approx.)
Demonstration of Automated Defibrillation Protocols.
Basic patient assessment, proper defibrillation pad placement, shock
assessment, and CPR.
F. Demonstration 3: (20 min. approx.)
Integrated Scenarios-Cardiac Arrest Management.
Integration of the "Chain of Survival" concept; bystander CPR, early
defibrillation, post shock patient care, prompt ALS, and rapid
transport.
G. Small-Group Teaching Practicals: (90 min. approx.)
Use of an Automated External Defibrillator.
H. Lecture 3 (15 min. approx.)
Other Issues.
Continuing education, skills maintenance, and documentation.
I. Practical skills testing (30 min. approx.)
Administer a North Coast EMS-approved Early Defibrillation Skills
Exam.
J. Written Test
Administer the North Coast EMS Early Defibrillation Written Exam.
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3306
POLICIES AND PROCEDURES Page 2 of 2
Subject: Manpower/Training
Automatic Defibrillation Training Program - Course Content
IV. Application
It is the responsibility of the Training Program to develop lesson plans
according to this time and content requirement and include lesson plans
in the Program Approval Package.
Approved: Date:
Approved As to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3401
POLICIES AND PROCEDURES
Subject: Manpower/Training
Student Eligibility for EMT-II and Paramedic Training Programs
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 3 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional policy for eligibility to enter North Coast EMS-
approved EMT-II and EMT-P Training Courses.
III. Policy
A. Student must be certified as EMT-IA upon entering either program.
B. EMT-II:
1. Students entering an EMT-II Training Program shall have been
certified as an EMT-I continuously for one full year prior to
the beginning of the EMT-II Program, and
2. Student must be able to demonstrate that he/she was affiliated
with an ambulance service or a fire department active in patient
care as an EMT-I for at least twelve (12) months within the two
(2) years immediately prior to the date of the beginning of the
EMT-II Program.
C. Documentation that verifies the above must be submitted when
requesting North Coast EMS EMT-II or EMT-P Certification.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3402
POLICIES AND PROCEDURES
Subject: Manpower/Training
EMT-II Training Program Approval
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 3 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish the procedure for obtaining and maintaining training
approval of EMT-II Training Programs.
III. Procedure for Program Approval
A. Eligible Training Institutions shall submit a completed North Coast
EMS EMT-II Program Approval Package to North Coast EMS at least
thirty (30) days before the first class session.
B. Program Approval shall be for a period of two (2) years, unless
withdrawn, suspended, or revoked by one of the parties, in
accordance with agreements signed within Program Approval Package.
C. Program Approval may be renewed by Training Institution every two
(2) years by following the same procedures.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3403
POLICIES AND PROCEDURES Page 1 of 2
Subject: Manpower/Training
EMT-II Optional Scope of Practice Training
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, California Code of Regulations, Chapter 3 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To provide a method by which eligible individuals may obtain skill
certification in any, or all, of the North Coast EMS-approved EMT-II
optional scope of practice procedures or medications. These are:
A. Medications
1. Morphine Sulfate.
2. Calcium Chloride.
B. Procedures
1. Snake bite kit.
2. Adult and pediatric laryngoscopy and endotracheal intubation
and/or removal of foreign body with Magill forceps.
3. Adult and pediatric endotracheal suctioning.
4. Adult and pediatric endotracheal extubation.
III. Policy
Individuals who need to certify in any, or all, of the North Coast EMS-
approved optional scope of practice procedures or medications near the
time that a scheduled course is being offered, such as an EMT-II or P
Training Program, will be asked to attend such course. If no such course
is available within one (1) month of the individual's request for
approval to practice in the region, individual must complete the method
below.
IV. Procedure
A. A minimum of two (2) didactic and skills hours of instruction in the
use of optional medications and use of the snake bite kit, with
emphasis on North Coast EMS Policies, Procedures, and Protocols.
B. Approved training may be offered by the Prehospital Care Medical
Director or Prehospital Care Nurse Coordinator at the individual's
assigned Base Hospital.
C. For training in Adult and Pediatric Endotracheal Intubation: See
North Coast EMS Policies #3404 and #3405.
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3403
POLICIES AND PROCEDURES Page 2 of 2
Subject: Manpower/Training
EMT-II Optional Scope of Practice Training
V. EMT-II Skills Certification
A. Eligibility requires documentation of successful completion of
approved training, including, but not limited to, clinical
observation, if required.
B. Certification to utilize scope of practice will be issued
upon Agency receipt of all required documentation. Notification
of certification will be made by the North Coast EMS Medical
Director to the EMT-II, and his/her provider and Base Hospital.
C. Before initital certification as an EMT-II in the North Coast EMS
Region, the applicant must be trained in the use of all medications
and procedures as outlined above.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3404
POLICIES AND PROCEDURES
Subject: Manpower/Training
Option for Individual Instruction of Adult Endotracheal Intubation
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 3 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To provide a method by which eligible individuals may obtain skill
certification in Adult Endotracheal Intubation.
III. Procedure
Individuals who need to certify in Adult Endotracheal Intubation near
the time that a scheduled course is being offered, such as an EMT-II/P
Training Program, will be asked to attend such a course, in addition to
completing section IV. B., D., E., and F. If no such course is
available within one month of the individual's request for approval to
practice in the Region, individual must complete the Self-paced Program
described below.
IV. The individual shall:
A. Attend a 1 1/2-hour Advanced Airway Management/Demonstration Lecture
provided by the individual's Base Hospital Prehospital Care
Medical Director. This lecture must follow the North Coast EMS
Endotracheal Intubation Course Outline and Guidelines.
B. Observe controlled adult intubations in the operating room of the
individual's Base Hospital as arranged by the Prehospital Care Nurse
Coordinator.
C. Attend 4+ hours of clinical practice involving intubation of
approved adult manikins, to be monitored by the individual's Base
Hospital Prehospital Care Medical Director.
D. Successfully complete any oral examinations given during the
clinical session, at the discretion of the physician involved.
E. Successfully complete the North Coast EMS Adult Endotracheal
Intubation Written Examination.
F. Successfully complete the North Coast EMS Adult Endotracheal
Intubation Skills Examination, to be monitored by the individual's
Base Hospital Prehospital Care Medical Director.
V. Testing Process
The individual's Base Hospital Prehospital Care Nurse Coordinator
shall obtain the skills exam from North Coast EMS. Completed exams
shall be returned to North Coast EMS by the Prehospital Care Nurse
Coordinator. The written exam shall be administered by North Coast EMS
staff at a regularly scheduled testing session.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3405
POLICIES AND PROCEDURES
Subject: Manpower/Training
Option for Individual Instruction of Pediatric Endotracheal Intubation
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 3 of Division 9.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To provide a method by which eligible individuals may obtain skill
certification in Pediatric Endotracheal Intubation.
III. Procedure
Individuals who need to certify in Pediatric Endotracheal Intubation
near the time that a scheduled course is being offered, such as the
EMT-II/P Training Program, will be asked to attend such a course, in
addition to completing section IV. B, D, E, and F. If no such course is
available within one month of the individual's request for approval to
practice in the Region, individual must complete the Self-Paced Program
described below.
IV. The individual shall:
A. View a 2-hour video on Pediatric Endotracheal Intubation and submit
a minimum 1/2 page summary of the contents of the video for approval
to North Coast Emergency Medical Services.
B. Observe controlled pediatric intubations in the operating room of
the individual's Base Hospital, as arranged by the Prehospital Care
Nurse Coordinator.
C. Arrange with the individual's Base Hospital Prehospital Care
Medical Director to successfully complete the pediatric portion of
the Endotracheal Intubation Training and Skill Examination in the
presence of that physician. The physician must sign the skills
exam verifying the individual's competence at the conclusion of
the training.
D. Successfully complete any oral examinations given during the
clinical session, at the descretion of the physician involved.
E. Successfully complete the North Coast EMS Pediatric Endotracheal
Intubation Written Examination.
F. Successfully complete the North Coast EMS Pediatric Endotracheal
Intubation Skills Examination, to be monitored by the individual's
Base Hospital Prehospital Care Medical Director.
V. Certification Testing Process
The individual's Base Hospital Prehospital Care Nurse Coordinator
shall obtain the skills exams from North Coast EMS. Completed exams
shall be returned to North Coast EMS by the Prehospital Care Nurse
Coordinator. The written exam shall be administered by North Coast EMS
staff at a regularly scheduled testing session.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3503
POLICIES AND PROCEDURES
Subject: Manpower/Training
EMT-Paramedic State Skills Examination Eligibility Requirements
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code, Sections 1797.172 and
1797.185.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To identify eligibility requirements for taking the EMT-Paramedic State
Skills Examination.
III. Policy
To be eligible to take the EMT-Paramedic State Skills Examination, the
following criteria must be fulfilled:
A. Documentation of one of the following:
1. Current enrollment in an approved EMT-P Training Program in
the State of California
2. Previous EMT-P certification in the State of California
3. Current or previous EMT-P certification from another state,
territory, country, or National Registry of Emergency Medical
Technicians
4. Current licensure as a physician, registered nurse, or
physician assistant in the State of California or any other
state in the United States.
B. Verification that the applicant has not failed the EMT-Paramedic
State Skills Examination within the last thirty (30) days.
C. Verification that the applicant has not failed the EMT-Paramedic
State Skills Examination three (3) times within the previous
twelve (12) months.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3504
POLICIES AND PROCEDURES Page 1 of 2
Subject: Manpower/Training
EMT-Paramedic State Skills Examination
Pass, Fail, and Retake Criteria
I. Authority and Reference (Incorporated Herein by Reference)
A. Division 2.5 of the Health and Safety Code, Sections 1797.172 and
1797.185.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To identify the pass, fail, and retake criteria for the EMT-Paramedic
State Skills Examination.
III. Policy
To establish the process for, and the pass, fail, and retake criteria
for, the EMT-Paramedic State Skills Examination:
A. Process:
1. EMT-P students will take the Skills Exam as a component of the
course.
2. Challenge candidates may either contact North Coast EMS for an
appointment on a regularly-scheduled skills test day or contact
an existing training program. In either case, the candidate
must provide North Coast EMS with proof of eligibility to take
the skills test.
B. Pass Criteria:
1. Pass all critical tasks as identified in the State-approved
testing tool for each of the eight skills listed below:
a. Adult Oral Endotracheal Intubation.
b. Esophageal Obturator Airway.
c. Laryngoscope and Magill Forceps.
d. IV Medication Administration.
e. Needle Thoracostomy.
f. Cardiac Arrest Management.
g. Synchronized Cardioversion.
h. Patient Assessment.
2. All examinees, other than those currently enrolled in a
Paramedic Training Program, who successfully pass the EMT-
Paramedic State Skills Examination, must receive a document
which verifies that they successfully passed. The document
must include the name of the individual, the name of the
institution that administered the exam, and the date of the
examination.
C. Fail Criteria:
1. Failure of any three (3) skills warrants failure of the entire
Skills Examination.
2. Failure of any retake of a skill warrants failure of the entire
Skills Examination.
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3504
POLICIES AND PROCEDURES Page 2 of 2
Subject: Manpower/Training
EMT-Paramedic State Skills Examination
Pass, Fail, and Retake Criteria
3. Three (3) failures of the entire Skills Examination within one
(1) year of the examinee's first attempt will require the
examinee to repeat an entire EMT-Paramedic Training Course.
4. The EMS Authority must be notified, within five (5) working
days, of failure by any examinee not currently enrolled in an
EMT-Paramedic Training Program. Likewise, the EMS Authority
must be notified, within five (5) working days, when same
individual subsequently successfully passes the State Skills
Examination.
D. Retake Criteria:
1. If an examinee fails one (1) or two (2) skills out of the
eight (8) skills tested, the examinee is eligible to retake a
maximum of two (2) skills.
2. The retake of one (1) or two (2) skills is scheduled by the
Test Administrator, and must be taken within two (2) weeks of
the original Skills Examination date.
3. If, due to failure of the Skills Examination, the examinee
wishes to retake the entire Skills Examination, the examinee
must wait at least thirty days (30) before attempting a retake
of the entire Skills Examination.
4. The retake of the Skills Examinations will be conducted within
the same guidelines as set forth by the State EMS Authority and
North Coast EMS.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3405
POLICIES AND PROCEDURES
Subject: Manpower/Training
Option for Individual Instruction of Nasotracheal Intubation
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. Title 22, Code of Regulations, Chapter 4 of Division 4.
C. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To provide a method by which individuals may obtain skill certification
in Nasotracheal Intubation. Eligibility will be determined by State Law
and North Coast EMS.
III. Procedure
Individuals who need to certify in Nasotracheal Intubation near the time
that a scheduled course is being offered, such as an EMT-Paramedic
Training Program, will be asked to attend such a course, in addition to
completing Section IV. C and D. If no such course is available within
one month of the individual's request for accreditation to practice in
the Region, they shall complete the Self-Paced Program, described below.
IV. The individual shall:
A. View a video on advanced airway techniques and submit a minimum 1/2
page summary of the contents of the video for approval by North
Coast Emergency Medical Services. The contents of the summary shall
include the important differences between Nasotracheal and
Orotracheal Intubation equipment and techniques. The video shall be
supplied by North Coast EMS.
B. Arrange with the individual's Base Hospital Prehospital Care
Medical Director to successfully complete the Nasotracheal Training
C. Arrange with the individual's Base Hospital Prehospital Care
Medical Director to successfully complete the North Coast EMS
Nasotracheal Intubation Skills Examination in the presence of that
physician. The physician must sign the Skills Exam, verifying the
individual's competence at the conclusion of the training.
D. Successfully complete the North Coast Emergency Medical Services
Nasotracheal Intubation Written Examination.
V. Testing Process
The individual's Base Hospital Prehospital Care Nurse Coordinator shall
obtain the Skills Exams from North Coast EMS. Completed exams shall be
returned to North Coast EMS by the Prehospital Care Nurse Coordinator.
The written exam shall be administered by North Coast EMS staff at a
regularly-scheduled testing session.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3602
POLICIES AND PROCEDURES
Subject: Manpower/Training
Student Eligibility to Enter MICN Training Programs
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish regional policy for eligibility to enter North Coast EMS-
approved MICN Training Courses.
III. Procedure
Students entering an approved basic MICN Program for authorization
purposes shall meet the following requirements:
A. Current licensure as a registered nurse in the State of California.
B. A minimum of 500 hours experience as a registered nurse in an
emergency department of an acute care hospital within the last year.
C. Current ACLS certification.
D. Documentation verifying the above shall be submitted when requesting
North Coast EMS MICN Authorization.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3603
POLICIES AND PROCEDURES Page 1 of 2
Subject: Manpower/Training
MICN Training Structure
and Instructor Qualifications
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish qualifications for sponsoring a Mobile Intensive Care
Nurse Training Program, and to articulate the management structure and
instructor qualifications of the approved programs.
III. Training Program Qualifications
MICN Training Programs may be sponsored by any of the following
institutions:
A. Accredited universities and colleges, including junior colleges,
community colleges, and private post-secondary schools.
B. Medical Training Units of a branch of the Armed Forces or Coast
Guard of the United States.
C. General acute care hospitals which are licensed in the State of
California and meet the following requirements:
1. Hold a special permit to operate a basic or comprehensive
emergency medical service or have been approved for utilization
as a Base Hospital by North Coast EMS, and
2. Provide continuing education to other health care
professionals, and
3. Are accredited by the Joint Commission of the Accreditation of
Hospitals.
D. Agencies of Government.
E. Private providers of continuing education for registered nurses.
IV. Each MICN Training Program is required to provide for the functions of
administrative direction, medical quality coordination, and actual
program instruction. One or more persons, as qualified, are required to
be responsible for the following specific functions, and shall be
approved for that function by North Coast EMS:
A. A MICN Training Program shall have a Program Director who shall be a
physician or registered nurse, currently licensed in the State of
California. The Director must have a minimum of one (1) year
academic or clinical experience in ALS prehospital care within the
last five (5) years.
B. Each MICN Training Program shall have a Principal Instructor, who
shall be a registered nurse currently licensed in the State of
California. This instructor must have a minimum of two (2) years
of academic or clinical experience as an R.N. in prehospital
emergency care within the last five (5) years.
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3603
POLICIES AND PROCEDURES Page 2 of 2
Subject: Manpower/Training
MICN Training Structure
and Instructor Qualifications
C. Each MICN Training Program may have a teaching assistant(s) who
shall be qualified by training and experience to assist with
teaching this course.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3604
POLICIES AND PROCEDURES
Subject: Manpower/Training
MICN Training Program Approval
I. Authority and Reference (incorporated herein by reference)
A. Division 2.5 of the Health and Safety Code.
B. North Coast Emergency Medical Services Policies and Procedures.
II. Purpose
To establish the procedure for obtaining and maintaining training
approval for Mobile Intensive Care Nurse Training Programs.
III. Procedure for Program Approval
A. Eligible Training Institutions shall submit a completed North Coast
EMS MICN Program Approval Package to North Coast EMS at least (30)
days before the first class session.
B. Program Approval shall be for a period of two (2) years, unless
withdrawn, suspended, or revoked by one of the parties, in
accordance with agreements signed within Program Approval Package.
C. Program Approval may be renewed by Training Institution every two
(2) years by following the same procedures.
Approved: Date:
Approved as to Form: Date:
NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 3605
POLICIES AND PROCEDURES
Subject: Manpower/Training
MICN - Training Program Required Hours
I. Purpose
To establish the number of hours and course content for an MICN training
program in the North Coast region.
II. Procedure
A. The MICN course shall consist of not less than 60 hours, divided as
follows:
1. A minimum of 36 hours of didactic education, as described below
and
2. A minimum 24 hours clinical education, including:
a. 12 hours simulated field emergency situations to include use
of field communication techniques.
b. 8 hours field observation on an ALS unit.
c. 4 hours additional clinical education, to include base
hospital observation and tape or chart reviews.
B. MICN - Training Program Course Outline
The content of the MICN course shall include instruction and skills
practice in the following:
1. Introduction to the EMS System
2. Field Assessment, Reporting, and Special Considerations
3. Shock
4. Pharmacology
5. Respiratory Emergencies
6. Cardiac Emergencies
7. Neurological Emergencies
8. Soft Tissue Emergencies
9. Musculoskeletal Injuries
10. OB/GYN Emergencies
11. Pediatric Emergencies
12. Geriatric Emergencies
13. Behavioral Emergencies
14. Other Medical Emergencies
15. Major Trauma & Triage Criteria, including Environmental
16. Telemetry and Communications
17. Local Policies and Procedures, and treatment Protocols
18. Ambulance equipment
19. Helicopter activation, MCI, and Disaster considerations
Approved: Date:
Approved: Date:
: