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EMS University EMR Student First Day Checklist Student Name: _______________________________________________ Item Evaluator Name Signature Date Completed Online Student Registration Form Payment Receipt Payment Agreement (If Applicable) Policies & Procedures (Collected) Disclosure Statements (Collected) Syllabus Signature Sheet (Collected) Student Questionnaire (Collected) I hereby certify that the above student has provided all the documentation above: Name: ____________________________ Signature: _____________________ Date: ________________

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Page 1: EMS University EMR Student First Day Checklist · 2012-12-05 · free plug-ins (such as Adobe® Reader®, Macromedia® Flash™, or Macromedia Shockwave®). Application Name PC Version

EMS University

EMR Student First Day Checklist Student Name: _______________________________________________

Item Evaluator Name Signature Date Completed

Online Student Registration Form

Payment Receipt

Payment Agreement (If Applicable)

Policies & Procedures (Collected)

Disclosure Statements (Collected)

Syllabus Signature Sheet (Collected)

Student Questionnaire (Collected) I hereby certify that the above student has provided all the documentation above: Name: ____________________________ Signature: _____________________ Date: ________________

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EMS University, LLC STUDENT PAYMENT PROFILE

Agreement Section Size or commencement of class may vary depending upon needs and availability. By filling out this form, signing, and submitting payment to EMS University, I hereby agree that I meet the necessary prerequisites to attend the course. Additionally, I agree to pay the registration fee above for this class unless payment has already been received.

Payment Method

(Circle One): Cash Check Credit Card Payment Plan Already Paid

Total Amount Paying: $________.____ If paying with a Payment Plan, fill out information on an Installment Agreement Form. If you are paying by cash, check or already paid, please disregard the credit card form below. Student Signature X______________________________________ Date: __________________ ------------------------------------------------------------------------------------------------------------------------------------------ If paying in full with a credit card, please fill out the information below: Name On Card: Card Number: Expiration Date: Card Verification Code: Billing Address: City State: Zip Code: I hereby authorize EMS University to charge my card in the amount of $____________.____. Student Signature X______________________________________ Date: __________________

Last Name:

First Name:

Course You Are Registering For: Course Start Date: Address:

Email Address:

City:

State: Zip Code:

How Did You Hear About Us?

Social Security Number:

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EMS University

Standard Operating Guidelines Installment Agreement Form 7-1201.01

I, ___________________ hereby request an installment agreement for the following course: EMS 201: Emergency Medical Responder EMS 202: Emergency Medical Technician Course Start Date(s): _____________________________________________________________ Installment Agreement Type (please check the program packet or call (800) 728-0209 to obtain information regarding installment plans available): I agree to pay the registration fee of: $______.____ within 30 days prior to the start of class. I agree to pay tuition every: Week (Weekly) Two Weeks (Bi-Weekly) with the first payment due on the first day of class in the amount of $______.____ and the same amount being due according to the payment schedule selected above until the balance of tuition is paid in full. Select Payment Method Electronic Check Money Order Credit Card Credit Card Information (If Applicable):

Name On Card:

Card Number:

Expiration Date: Card Verification Code:

Billing Address:

City State: Zip Code: I agree to have my card or bank account debited for the amount above until the balance is paid in full. Signature: ________________________________________________ Date: ________________ (If you have any questions regarding this form or the installment amounts and due dates, please check the

program packet or call us at (800) 728-0209.)

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Created: December 4, 2012 Updated: December 4, 2012 EMS 201 Course Syllabus 1

Course Title and Number: EMS 201: Emergency Medical Responder Course Hours: 48 Prerequisites: Appropriate Placement Score, CPR, also See Program

Packet Course Length: 48 Hours: 48 hours of didactic instruction Course Materials: Le Baudour, Christopher J. and David Bergeron (2012). Emergency Medical Responder: First on Scene, 9th ed. Upper Saddle River, NJ: Prentice Hall. ISBN: 0135125707 Le Baudour, Christopher J., et. all (2012). Workbook for Emergency Medical Responder: First on Scene, 9th ed. Upper Saddle River, NJ: Prentice Hall. ISBN: 0135125723. Course Compass (Electronic Resource) EMS Testing (Electronic Resource)

*Students must have access to these materials in order to successfully progress through the course.

Mission Statement Our mission is to train and educate individuals to become the most highly skilled Emergency Medical Service professionals. Continuous quality improvement is the primary focus of our educational training program. We take every possible step to instill knowledge from our previous experience through continuous evaluation and improvement. Each member of our team participates in this process, as an open atmosphere leads to innovation, quality education, and instruction. Our students are trained to these high standards and exemplify the character of our organization after successful completion of their course or program of study. Course Description Formerly titled, First Responder, in addition to the EMT Program, you can also become certified in the state of Arizona as an Emergency Medical Responder. This 48 hour course consists of introductory material into the EMS system and components relating to medical practice in the prehospital field. EMRs understand a great deal relating to

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Created: December 4, 2012 Updated: December 4, 2012 EMS 201 Course Syllabus 2

both medical and trauma situations, including how to deal with cuts, burns, bites, stings, heart attacks, stroke, diabetes, etc. Technology Requirements EMS 201 requires the use of software in order to complete class requirements. Students must ensure these requirements in order to successfully complete the course. This is the sole responsibility of the student. Information regarding specific requirements are listed below. These requirements are subject to change at any time without notice. Operating Systems and Browsers To work in Course Compass and EMS Testing, your computer must meet at least the 56 Kps (kilobits per second) connection speed and be using one of the following operating system and browser configurations.

Operating System Version Browser

Microsoft Windows XP, Vista, 7

Firefox 3.6, 8.0 Internet Explorer 8.0, 9.0

Mac OS 10.7 Firefox 3.6, 8.0 Safari 5.1

To check your operating system, turn on your computer and look for information on your operating system as the computer boots up. You can also find this information in your computer settings. For example, if you have a PC you can look at "View System Information" in "My Computer," which is accessible from the Start menu. If you are unsure of the browser version you are using, launch the browser and select Help from the menu bar. Next, select "About Browser" (the browser name and the exact wording of the selection will vary) and a window will open with your browser name and version. COOKIES AND JAVASCRIPT OPTIONS Course Compass and EMS Testing may use both cookies and JavaScript technology. (Cookies provide a way for the website to identify users and keep track of their preferences.) Both of these features must be turned on in your browser and are usually enabled by default. See your browser Help for instructions on how to view or change these browser options.

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Created: December 4, 2012 Updated: December 4, 2012 EMS 201 Course Syllabus 3

POP-UP WINDOWS Some features of this website display in a pop-up browser window. If you are using a browser that offers pop-up control or are running an add-on program to control pop-ups, you may need to take steps to use such features. The steps to take depend on the browser or add-on program you are using. Plug-Ins You will need the following applications to use Course Compass and EMS Testing. Depending on the content at your site, you may also need to download one or more free plug-ins (such as Adobe® Reader®, Macromedia® Flash™, or Macromedia Shockwave®).

Application Name PC Version Mac Version

Adobe Flash Player 8 8.0

Microsoft PowerPoint Viewer 2003 2004

Adobe Reader 7.0.5 7.0.5

Educational Objectives At the completion of this course you should be able to: 1. Describe the roles of EMS in the health care system. 2. Demonstrate the professional attributes expected of EMRs. 3. Perform the roles and responsibilities of an EMR with regard to personal

safety and wellness, as well as the safety of others. 4. Perform the duties of an EMR with regard for medical-legal and ethical

issues, including functioning under medical direction and within the scope of practice.

5. Apply principles of anatomy, physiology, pathophysiology, life-span development, and therapeutic communications to the assessment and management of patients.

6. Identify the need for and perform immediately life-saving interventions to manage a patient’s airway, breathing, and circulation.

7. Assess and manage patients of all ages with a variety of complaints, medical conditions and traumatic injuries.

8. Apply principles of emergency medical services operations, including considerations in ambulance and air medical transportation, multiple casualty incidents, gaining access to and extricating patients, hazardous materials

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Created: December 4, 2012 Updated: December 4, 2012 EMS 201 Course Syllabus 4

incidents, and responding to situations involving weapons of mass destruction.

Requirements for successful completion of this course A minimum passing grade of 75% is required for successful completion of this course. Grading Scale: Grades will be issued for this course as A,B,C, and F. The grading scale is: Grade Point Value Grade 90 - 100% A 80 - 89% B 75 - 79% C Below 75% F Incomplete I Withdrawal W Method of Evaluation: My Brady Lab Assignments EMS Testing Examinations 25%

Midterm Examination 20% Chapter Examinations 25%

Final Examination 30% Student Workbook Up to 15% Extra Credit

Miscellaneous Notes:

Students may retake an examination (Midterm and Final Examination NOT included) within 1 week of taking the initial exam if the score is less than 75% on that examination. If the student’s score on the 1st retake is less than 75%, the student may retake the examination a third time within 1 week. If the student achieves a score of less than 75% on the third attempt, they shall be dismissed from the program/course.

Students who fail an examination must remediate any questions that were missed. Remediation is not permitted for the Midterm and Final Examinations. Remediation is demonstrated by filling out and turning in a remediation form due upon the next day of class. In no case, will the instructor provide the student with the answer to the question prior to the student turning in the remediation form.

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Created: December 4, 2012 Updated: December 4, 2012 EMS 201 Course Syllabus 5

If a student does not identify the correct answer and properly remediate a majority of questions, the student shall forfeit their option to retake the examination and be provided with a grade of 0% on that retake.

A student MUST pass every examination in order to progress through the course. A student passing an examination on a retake shall be given the grade of 75% for that examination.

Students are permitted to fail 2 examinations on their initial attempt. If a student fails 3 initial examinations, they will be dismissed from the class.

Failure of an examination may require the student to retake the examination during their class lecture period. They may miss additional material as a result of examination failure. Students are expected to understand that this is a potential consequence of examination failure.

All students must receive a score of 75% or higher in order to pass the final examination.

Students who fail the final examination, will have no more than 2 subsequent attempts to pass the examination with a score of 75% or higher.

A score of 75% or higher is required to pass this course.

Students MUST meet all course hour requirements. Students unable to do so, may be summarily dismissed from the program.

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Created: December 4, 2012 Updated: December 4, 2012 EMS 201 Course Syllabus 6

SIGNATURE PAGE Student Name: _____________________________ Signature: _________________________________ Date: ___________________ By my signature of this document, I hereby affirm that I understand the above requirements and shall comply with them as a condition of my enrollment in the EMS University EMR Course.

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EMS 201: Emergency Medical Responder

Remediation Form

Page | 1

Name: ______________________________________ Date: ______________________ Name of Exam You Are Remediating (Ex. Unit 1 Exam): __________________________ Version: ____ Date of Examination: ____________________ Exam Score (%): ________ Purpose: The purpose of the remediation process is to ensure that you understand deficiencies in your exam which resulted in your score that was less than the acceptable standard. This is NOT a punitive process. It is designed to help you be more successful in the future. Note, that this form is required to be completed in its entirety in order for you to be eligible to take the alternative version of the examination that was failed. It is also required for you to receive a grade of 50% or higher Instructions: On a separate sheet of paper or papers, please identify the correct answer and write or type at least 2 sentences, but no more than 10 which explain why the answer is correct. Typing your answers is the preferred format. Please see the Short Answer and Essay Rubric. By signing this form, I understand the requirements of this form and that this form is required as a condition of my eligibility to retake the above identified examination and that the highest score I will be given on this examination is 75%. Student Signature: ____________________________________ --------------------------------------------------------------------------------------------------------------------- Instructor Use (Please place scores according to the rubric next to student answers. The scores below are cumulative. A rubric score of 2 is required in each category to answer the question correctly):

Number of Questions Circled:

Number of Questions Answered Correctly:

Percentage (50% Required to Pass):

I hereby certify that that is student is eligible/not eligible (CIRCLE ONE) to take the next version of this examination. Instructor Name: _________________________________________________________ Signature: __________________________________________ Date: ________________

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EMS 201: Emergency Medical Responder

Short Answer and Essay Rubric

Page | 1

The following is a guide to instructors and student to use in the evaluation of short answers and essays. Generally, a score of 2 is required in each category to pass, while a score of less than 2 is considered failure:

Unacceptable Needs

Improvement Satisfactory

Meets Expectations

Exceptional

Score 0 1 2 3 4

Content Did not answer

question.

Answers are partial or

incomplete. Key points are

not clear. Question not adequately answered.

Answers are not comprehensive or completely

stated. Key points are

addressed, but not well

supported.

Answers are accurate and

complete. Key points are stated and supported.

Answers are comprehensive,

accurate and complete. Key

ideas are clearly stated, explained, and

well supported.

Content Did not answer

question.

Organization and structure detract from the answer.

Inadequate organization or development.

Structure of the answer is not

easy to follow.

Organization is mostly clear and easy to

follow.

Well organized, coherently

developed, and easy to follow.

Organization Did not answer

question.

Displays over five errors in

spelling, punctuation,

grammar, and sentence structure.

Displays three to five errors in

spelling, punctuation,

grammar, and sentence structure.

Displays one to three errors in

spelling, punctuation,

grammar, and sentence structure.

Displays no errors in spelling,

punctuation, grammar, and

sentence structure.

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EMR Disclosure Statements – Page 1

EMR Program Disclosure Statements

Emergency Medical Services University, LLC

Section I: Program Responsibilities A. EMS University shall establish, implement and annually review its policies to

ensure that they are meeting applicable requirements. Section II: Student Enrollment A. Admissions Requirements and Procedures - Each applicant for admission must

fill out an Application for Admission or Registration Form specifying the course(s) the student desires to take. The student is permitted to choose the start date of the course assuming prerequisites are met. Students also sign an agreement that course registration is subject to availability. Finally, students warrant and guarantee that they meet the requirements for entry to the program.

B. Qualification of Admission - To qualify for admission, the prospective student

must meet the following requirements: 1. The applicant must be eighteen years of age or older at the time he or

she starts his or her program of study. Participants who are less than 18 years of age at the time of registration, must provide parental approval of all written and electronic forms.

a. Applicants under 21 years of age should be aware of the possible limitations of employment which might occur due to motor vehicle insurance restrictions. Certification and/or passing the course does not guarantee employment. In no case will EMS University offer job placement or guarantee job placement.

2. Applicants must pay the registration and tuition fees. 3. Accepted applicants are bound to the agreement contained on the

registration form. 4. Proficiency in cardiopulmonary resuscitation (Not Expiring within the next

6 months, taken with a LIVE instructor), demonstrated by one of the following:

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EMR Disclosure Statements – Page 2

a. EMS University CPR for the Healthcare Provider; b. AHA Healthcare Provider certification; c. ASHI CPR Pro; d. American Red Cross Professional Rescuer CPR certification. 5. The applicant must demonstrate proficiency in reading at the 9th grade

level. This will be verified through the presence of a High School Diploma, Home School Diploma, or GED.

Section III: Course Information

A. Course Content

Chapter Subject

N/A Course Introduction and Overview

1 Introduction to EMS Systems

2 Legal and Ethical Principles of Emergency Care

3 Wellness and Safety of the Emergency Medical Responder

4 Introduction to Medical Terminology, Human Anatomy, and Lifespan Development

5 Principles of Lifting, Moving, and Positioning of Patients

6 Principles of Effective Communication

7 Principles of Effective Documentation

1-7 Preparatory Module Level Test

1-7 Exam and Review of Exam

8 Airway Management and Ventilation

9 Oxygen Therapy

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EMR Disclosure Statements – Page 3

8-9 Airway & Oxygen Module Level Test

10 Resuscitation and the Use of the Automated External Defibrilator

11 Obtaining a Medical History and Vital Signs

12 Principles of Patient Assessment

10, 12 Circulation Module Level Test

8-12 Lab: Airway, Scene Size-Up, Patient Assessment, History and Vital Signs; Review of Previous Skills

8-12 Exam and Review of Exam

13 Cardiac Emergencies

14 Respiratory Emergencies

15 Caring for Common Medical Emergencies

16 Environmental Emergencies

17 Caring for Soft-Tissue Injuries and Bleeding

18 Recognition and Care of Shock

19 Caring for Muscle and Bone Injuries

20 Caring for Head and Spine Injuries

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EMR Disclosure Statements – Page 4

21 Caring for Chest and Abdominal Emergencies

13-21 Illness & Injury Module Level Test

13-21 Lab: Medical and Trauma Patients; Review of Previous Skills

1-21 Exam and Review of Exam

22 Care During Pregnancy and Childbirth

23 Caring for Infants and Children

24 Special Considerations for the Geriatric Patient

25 Introduction to EMS Operations and Hazardous Response

22-23 Childbirth & Children Module Level Test

26 Introduction to Multiple-Casualty Incidents, the Incident Command System, and Triage

22-26 Lab: Pregnancy and Childbirth, Infants and Children, Geriatrics,

Hazmat and Multiple Casualty Incidents; Review of Previous Skills

25-26 Operations Module Level Test

22-26 Exam and Review of Exam

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EMR Disclosure Statements – Page 5

1-26 Lab: All Skills

1-45 Comprehensive Test

1-26 Final Exams

B. Course Hours: 48 Hours: 48 hours of didactic instruction C. Course Fees – The cost of tuition and fees for the EMR course is located below.

The cost of the course is non-transferrable and subject to change with appropriate notification to the student/applicant. Course costs may include other fees which may fluctuate according to market conditions. The following is an estimate of costs included below:

1. Non-Refundable Registration Fee: $50.00 2. Tuition (Not Including Registration Fee: $200.00

Program Total Cost: $250.00

3. Books $195.00 Supplemental Estimated Costs: $195.00

4. Blood pressure cuff $ 25.00 5. Stethoscope $ 40.00 6. Penlight $ 5.00 7. Pocket mask with oxygen port $ 15.00

Recommended Materials Estimated Costs Total: $ 85.00 Total: $530.00

D. Course Completion - The EMR student is required to achieve an overall average minimum grade average and final examination score of 75% or greater in order to pass the course. This grade percentage may be increased at the discretion of the Program Director or designee with reasonable notice to the student. In all cases, a grade average of less than 75% will constitute unsatisfactory grades and shall result in failure/expulsion from this EMR Program.

Section IV: Required & Recommended EMR Books, Equipment and Supplies

A. Emergency Medical Responder (9th Edition) --- ISBN: 0135028108 (Required)

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EMR Disclosure Statements – Page 6

B. Workbook for Emergency Medical Responder, 9th Edition --- ISBN: 0135125723 (Required)

C. Course Compass (Electronic Resource) D. EMS Testing (Electronic Resource) E. Uniform T-Shirt F. Blood pressure cuff G. Stethoscope H. Penlight I. Pocket Mask

Section V: Notification Requirements A. Physician’s Statement - Students with a health or physical problem may be

asked to obtain a physician’s statement, at the student’s cost, that the condition will not be aggravated by or endanger clients/patients associated with the student in required coursework.

B. Physical Activity Requirements – The EMR student shall have the ability to lift and move as well as take physical action similar to that of an EMR in the EMS field on an ambulance. Because this program is designed for those who may eventually be seeking employment as an EMR, the student shall be required to have the ability to perform his/her tasks while in class and in the externship setting. Specifically, this will include and is not limited to the following: lifting patients on a stretcher with limited help, lifting objects using proper lifting techniques, moving objects and patients to and from the ground, moving patients down stairs and stairwells, twisting, bending and other movements required in the EMS field as occurs by EMS professionals. The student hereby certifies that he/she has such abilities as described herein and understands further that it is his/her responsibility to investigate these matters to fully understand what is required prior to this information being provided in the EMR course as to prevent problems which might occur. EMS University shall make reasonable accommodations upon the student requests made within a reasonable time period in accordance with applicable law.

Section VI: Indemnification & Limitation of Liability To the fullest extent permitted by law, you agree to defend, indemnify and hold harmless EMS University from and against any and all claims, charges, demands, damages, losses, expenses, and liabilities of whatever nature and howsoever arising (including, but not limited to, any legal or other professional fees and the costs of defending or prosecuting any claim), incurred or suffered by EMS University directly or indirectly. TO THE MAXIMUM EXTENT PERMITTED BY LAW, NEITHER EMSU NOR ANYONE ELSE WHO HAS BEEN INVOLVED ON BEHALF OF EMSU IN THE CREATION, PRODUCTION OR

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EMR Disclosure Statements – Page 7

DELIVERY OF A COURSE OR ANY SERVICES PROVIDED IN CONNECTION THEREWITH, SHALL BE LIABLE FOR ANY SPECIAL, CONSEQUENTIAL, OR INCIDENTAL DAMAGES (INCLUDING DAMAGE FOR LOSS OF BUSINESS PROFIT, BUSINESS INTERRUPTION, LOSS OF DATA, AND THE LIKE) ARISING OUT OF THE USE OR INABILITY TO USE THE COURSE, EVEN IF EMSU HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. IN NO EVENT SHALL EMSU OR ITS LICENSORS OR SUPPLIER'S TOTAL CUMULATIVE LIABILITY FOR LOSS OR DAMAGE UNDER THIS AGREEMENT EXCEED THE AMOUNT OF FEES PAID BY YOU FOR THE COURSE(S). Detrimental Reliance - If you rely on this agreement to your detriment, and if it is found that damages exist under this agreement, you are only entitled to no more than amount you paid for the course. Responsibility - You agree that your certification is your sole responsibility. This means that you are solely responsible and provide warranty to EMSU that you meet the criteria to register for the course(s) you choose to register for and that EMSU cannot be held responsible for any oversight, negligence or breach of duty and/or due diligence in this respect. Limitation of Liability & Insurance – EMS University STRONGLY recommends that you obtain and maintain adequate health insurance coverage during the course in order to mitigate the potential for any damages to you and in order for you to adequately care for any unforeseen medical conditions or injuries occurring during the course. Additionally, you agree to indemnify and hold harmless EMS University for any injury which you may sustain while completing clinical and vehicular assignments at places to include, but not limited to hospitals, clinics, inside ambulances and fire trucks, on medical and traumatic scenes, and other foreseeable places wherein injury may occur. Section VII: Integration You agree to be bound and this agreement is integrated into the Course Syllabus, Policies and Procedures, and registration terms available at www.arizonaemt.com/?q=terms. This is a complete integration, meaning that no prior oral agreement shall be binding upon these written/electronic agreements. Section VIII: Severability If for any reason a court of competent jurisdiction finds any provision of this Agreement, or portion thereof, to be unenforceable, that provision of the Agreement shall be enforced to the maximum extent permissible so as to affect the intent of the parties, and the remainder of this Agreement shall continue in full force and effect. If there is a conflict in the written instruments, this instrument shall prevail.

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EMR Disclosure Statements – Page 8

Section IX: Choice of Law and Forum This Agreement shall be governed by the laws of the State of Arizona without regard to that body of law known as conflicts of law, and excluding the United Nations Convention on Contracts for the Sale of Goods. You agree that any dispute arising under this Agreement shall be brought solely and exclusively in a court of competent jurisdiction located in the state of Arizona, USA, and agree to submit to personal jurisdiction in the State of Arizona for that purpose. Section X: EMS University Standard Operating Guidelines You hereby agree to be bound to EMS University Standard Operating Guidelines which shall be available upon written request to administrative staff upon reasonable notice at any time and shall be provided within a reasonable time to the student.

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EMR Disclosure Statements – Page 9

SIGNATURE PAGE Student Name: _____________________________ Signature: _________________________________ Date: ___________________ By my signature of this document, I hereby affirm that I understand the above requirements and shall comply with them as a condition of my enrollment in the EMS University EMR Course.

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EMR Policies and Procedures – Page 1

EMR Program Policies and Procedures

Emergency Medical Services University, LLC

Section I: Program Responsibilities A. EMS University shall establish, implement and annually review its policies to

ensure that they are meeting applicable requirements. Section II: Student Enrollment A. Admissions Requirements and Procedures - Each applicant for admission must

fill out an Application for Admission or Registration Form specifying the course(s) the student desires to take. The student is permitted to choose the start date of the course assuming prerequisites are met. Students also sign an agreement that course registration is subject to availability. Finally, students warrant and guarantee that they meet the requirements for entry to the program.

B. Qualification of Admission - To qualify for admission, the prospective student

must meet the following requirements: 1. The applicant must be eighteen years of age or older at the time he or

she starts his or her program of study. Participants who are less than 18 years of age at the time of registration, must provide parental approval of all written and electronic forms.

a. Applicants under 21 years of age should be aware of the possible limitations of employment which might occur due to motor vehicle insurance restrictions. Certification and/or passing the course does not guarantee employment. In no case will EMS University offer job placement or guarantee job placement.

2. Applicants must pay the registration and tuition fees. 3. Accepted applicants are bound to the agreement contained on the

registration form. 4. Proficiency in cardiopulmonary resuscitation (Not Expiring within the next

6 months, taken with a LIVE instructor), demonstrated by one of the following:

a. EMS University CPR for the Healthcare Provider; b. AHA Healthcare Provider certification;

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EMR Policies and Procedures – Page 2

c. ASHI CPR Pro; d. American Red Cross Professional Rescuer CPR certification. 5. The applicant must demonstrate proficiency in reading at the 9th grade

level. This will be verified through the presence of a High School Diploma, Home School Diploma, or GED.

Section III: Student Attendance A. The EMS University EMR Course consists of a total of 48 hours. Specifically, this is

a total of 48 hours of didactic instruction. This course shall meet and/or exceed the United States Department of Transportation, National Highway Transportation Safety Administration, Emergency Medical Technician National Standard Curriculum guidelines, the National EMS Education Standards as well as meet Arizona Department of Health Services, Bureau of EMS education standards. A student is not permitted to be absent from the course. Students who miss more than 10 hours from the class may be dismissed from the program and will not receive a refund of course fees.

B. In the event of absence from class, the student assumes the responsibility of immediately notifying the program and for making arrangements with individual instructors for work missed.

C. Students are required to be on time and stay for the duration of class. The student assumes the responsibility for making arrangements with individual instructors for any and all makeup of work missed as a result of being late for classes or leaving classes early. Time missed in class due to a student’s tardiness or leaving early is recorded as time absent from class.

D. EMS University does not allow leaves of absences. In the event of an extended absence, a student may be dismissed from the program.

Section IV: Grading A. The EMR student is required to achieve an overall average minimum grade

average and final examination score of 75% or greater in order to pass the course. This grade percentage may be increased at the discretion of the Program Director or designee with reasonable notice to the student. In all cases, a grade average of less than 75% will constitute unsatisfactory grades and shall result in failure/expulsion from this EMR Program.

B. Students who do not achieve a grade of at least 75% on an examination (with the exception of the final examination and midterm examinations) will be required to remediate. This percentage requirement may be increased at the discretion of the Program Director or designee with reasonable notice to the student.

C. Students who score lower than the minimum of 75% on 3 examinations may be dismissed from the program and will not receive a refund of any course fees.

D. Grading requirements are subject to change by the Program Director or designee at any time upon reasonable notice to the student. Reasonable notice includes,

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EMR Policies and Procedures – Page 3

but is not limited to the initial course syllabus provided to the student on the first day of class.

Section V: Administration of Final Examinations A. The student is required to pass the course final EMR final with a grade of 75% or

higher in order to pass the course. B. This program follows the Arizona Department of Health Services requirement

that for final examinations for EMT Programs. Although this is an EMR Program, the following shall apply: “a student may not receive verbal or written assistance from any other individual or use notes, books, or documents of any kind as an aid in taking the examination,” any student violating this provision will not be permitted to complete the exam or the course. (AZ DHS Rules R9-25-304).

C. EMS University will administer a final written examination and a final comprehensive practical skills examination for the EMR course as per AZ DHS Rules. This EMR Course final written examination will be closed book and shall: a. Include 150 multiple-choice questions with one absolutely correct answer, one incorrect answer, and two distractors, neither of which is “all of the above” or “none of the above”; b. Cover the learning objectives of the course with representation from each of the course modules; and c. Require a passing score of 75% or better in no more than three attempts… A final comprehensive practical skills examination is required and shall: a. Evaluate a student’s technical proficiency…; and b. Enable a student to meet NREMT registration requirements. (AZ DHS Rules, R9-25-306). Successfully passing the NREMT examination is required for state certification.

D. The student must be at least 18 years of age to take the EMR Course Final Examination.

Section VI: Student Conduct A. Code of Conduct- Students are required to follow standards of conduct that are

typical of the working world. Students may be placed on probation, suspended or terminated for violation of the school’s personal conduct standards. Violations include dishonesty, theft, unprofessional conduct, use of profanity, possession of firearms or weapons, cheating, insubordination, noncompliance with safety rules, use of or being under the influence of alcohol or illegal drugs on school property, and vandalism of school property or equipment.

B. Cheating – Students are expected not to cheat and to conduct themselves during

class without unfair advantage over other students. Those caught cheating may be penalized. Penalty for such infraction may include all available measures up to and including expulsion from the program. For purposes of this section,

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EMR Policies and Procedures – Page 4

suggesting to instructors or other students to cheat shall be considered cheating. By signing this agreement, students shall agree to the above definition.

Section VII: Media Release A. Purpose - The purpose of a media release is to enable EMS University to

demonstrate to other students and prospective students, skills and activities which EMS providers might benefit by their production.

B. Consent - I hereby release, indemnify, and agree to hold harmless, EMS

University for the utilization of media materials for any purpose related to marketing or otherwise displaying without remuneration or compensation. All marketing materials as identified above become the property of EMS University.

Section VIII: Student Records A. Student Records - EMS University maintains accurate and confidential student

records. Students have access to their educational records in accordance with the law. Student records, with certain exceptions, will not be released without prior consent of the student. Students have the right to review and question the content of their educational records. If there are any questions as to the accuracy or appropriateness of the records, an opportunity for a review of the records may be scheduled with administrative staff as necessary.

B. Medical Records - EMS University shall keep accurate and confidential student

medical records in accordance with the Health Insurance Portability and Accountability Act (HIPAA) regulations. Additionally, the department requires that all students and staff will comply with HIPAA and follow regulations regarding protected health information when handling any medical records. The same policies and procedures which govern student records shall apply to student medical records for the EMS University EMR Course.

C. Federal and State Regulations – EMS University complies with state and federal

regulations governing confidentiality, privacy and security.

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EMR Policies and Procedures – Page 5

SIGNATURE PAGE Student Name: _____________________________ Signature: _________________________________ Date: ___________________ By my signature of this document, I hereby affirm that I understand the above requirements and shall comply with them as a condition of my enrollment in the EMS University EMR Course.

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Contents: Entry Requirements Application Process Certification Process Cognitive Examination Cognitive Exam Retest Information Psychomotor Examination Expiration Date Lapsed Certification ADA Compliancy Disciplinary Policy and Rights of Appeal Responsibilities of Certified First Responders First Responder Recertification Entry Requirements Individuals applying for First Responder / EMR certification must meet the following requirements:

• Successful completion of a state-approved First Responder / EMR course that meets or exceeds the U.S. Department of Transportation First Responder National Standard Curriculum. You must have completed the course within the past two years. Your Program Director must verify your successful completion of the course on the NREMT web site. If you are seeking national certification as a First Responder / EMR and are currently state licensed, you must document successful completion of a First Responder / EMR refresher training program within the past two years. If you are not currently state licensed and it has been more than two years from the completion of your First Responder / EMR course, you must complete an entire state-approved First Responder / EMR course prior to applying for National Certification.

• Verification from the Program Director that you hold a current CPR credential for health care providers and have demonstrated competence in First Responder / EMR skills.

• Successful completion of a state-approved First Responder / EMR psychomotor exam. Application Process

• Create a login on this website. • Complete a National Registry online application including truthfully completing the Licensing Action and

Felony statements. click here for more information on the NREMT Felony Policy. The NREMT may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a felony conviction has occurred.

• Pay the application fee of $65.00 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.

• You will receive an Authorization to Test (ATT) once you are eligible for the exam. The ATT letter contains scheduling instructions and important details concerning proper identification required at testing centers.

Certification Process National First Responder / EMR certification requires successful completion of both a cognitive and psychomotor exam. The passed portion of the cognitive examination remains valid for 12 months and the psychomotor examination remains valid for 24 months (beginning 1/1/2012 EMR psychomotor exams will only be valid for 12 months).

Cognitive Examination The NREMT First Responder / EMR cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the First Responder / EMR exam will range from 80 to 110. The maximum amount of time given to complete the exam is 1 hour 45 minutes. The exam will cover the entire spectrum of EMS care including: Airway, Ventilation, Oxygenation; Trauma; Cardiology; Medical; and EMS Operations. Items related to patient care are focused on adult patients (85%) and

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pediatric patients (15%). In order to pass the exam, you must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.

Cognitive Exam Retest Information In the event you are unsuccessful passing the cognitive exam, the NREMT will provide feedback on your performance. You may apply to retest 15 days after your last examination. Candidates are given three opportunities to pass the cognitive examination provided all other requirements for National EMS Certification are met. Candidates who fail the examination on the third attempt will be required to repeat the entire First Responder / EMR program in order to apply for subsequent examination attempts.

Psychomotor Examination The psychomotor exam provides a hands-on opportunity for you to demonstrate the skills you have learned. Speak with your instructor or state EMS Office about the format and logistics of completing a state-approved First Responder / EMR psychomotor exam.

Expiration Date Initial expiration dates are determined by the date of successful completion of the entire certification process. Individuals successfully completing the certification process between the dates of January 1 - June 30 will receive an expiration date of September 30 two years in the future. Individuals successfully completing the certification process between July 1 and December 31 will receive an expiration date of September 30 three years in the future. For example: successful completion of February 14, 2009, certification expiration = September 30, 2011 successful completion of July 7, 2009, certification expiration = September 30, 2012 All subsequent certification periods will be for a two-year period (October 1 - September 30).

Lapsed Certification If your National EMS Certification lapsed as a First Responder / EMR within a two year period or you are currently state licensed as a First Responder / EMR, you can obtain National EMS Certification by completing a state-approved Refresher course and successfully completing the cognitive and psychomotor examinations. If your EMS certification expired more than two years ago, you must complete an entire state-approved First Responder / EMR course, and complete the cognitive and psychomotor examinations.

ADA Compliancy The NREMT complies with the Americans with Disabilities Act (ADA) of 1990, and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant. Complete information about the NREMT Accommodations Disability Policy can be found here.

Disciplinary Policy and Rights of Appeal The NREMT has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the NREMT Disciplinary Policy and Rights of Appeal can be found here.

Responsibilities of Certified First Responders / EMRs Certified First Responders / EMRs must notify the NREMT within 30 days regarding the following matters:

• change in mailing address.

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• any felony conviction. • disciplinary action taken by any state has resulted in suspension, revocation, or expiration of state

registration/licensure; termination of right to practice; voluntary surrender of state registration/licensure while under investigation.

The NREMT considers the individual to be solely responsible for their certification.

First Responder / EMR Recertification In applying for recertification, certified EMS professionals agree to comply with all recertification requirements, rules and standards of the National Registry of Emergency Medical Technicians (NREMT). The recertification applicant bears the burden of demonstrating and maintaining compliance at all times.

To Apply For Recertification You Must: 1. Be actively working within an emergency medical service, rescue service, or patient health care facility using

your First Responder / EMR skills. 2. Complete all educational requirements prior to September 30. 3. Complete the recertification report in its entirety and submit the completed report prior to September 30. 4. Complete a total of 12 hours of continuing education.

Detailed First Responder / EMR Recertification Requirements The First Responder / EMR refresher course can be completed through two different options:

o Traditional refresher course - an approved DOT National Standard First Responder / EMR Refresher or CECBEMS approved refresher course

o Continuing education topical hours* - refresher may be completed by continuing education and must include the topics and hours listed below:

Topics Hours

Required Suggested Courses

Preparatory 1 hour Roles and Responsibilities, Well-being of the First Responder / EMR, Medical Direction, Quality Improvement, Personal Protection, Scene Safety, Medical/Legal, Human Anatomy, Lifting and Moving

Airway 2 hours Basic Airway Management, Advanced Airway Management, Oxygen Delivery Systems and Techniques Adjuncts, Oxygen Therapy

Patient Assessment 2 hours Scene Size-up, Initial Assessment, Vital Signs and History Taking, Assessment of Trauma Patients, Assessment of Medical Patients, Ongoing Assessment, Communications, Documentation

Circulation 3 hours Management of Shock, Cardiac Emergencies, Bleeding/Wounds/Shock, CPR and Arrest Management

Illness & Injury 3 hours

General Pharmacology, Respiration Emergencies, Environmental Emergencies, Acute Abdominal Emergencies, Diabetic Emergencies, Allergic Reactions, Poisoning and Overdose, Behavioral Emergencies, Soft-Tissue Injuries, Musculoskeletal Injuries, Injuries to Head and Spine

Childbirth & Children 1 hour

Obstetrical Emergencies, Gynecological Emergencies, Childbirth and Complications, Care of the Newborn, Assessing the Pediatric Patient, Medical Emergencies in Children, Airway Management in Pediatrics, Trauma Emergencies and Care in Children

Total 12 hours

* Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state’s particular requirements.

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Courses that Can Not Be Applied Towards Continuing Education Hours: Clinical Rotations, CPR, Home Study Programs, Instructor Courses, Management/Leadership Courses, Performance of Duty, Serving as a skill examination, and Volunteer time with agencies

5. Obtain CPR certification at the appropriate level current to September 30. 6. Maintain skills as verified by your Training Program Director or Supervisor (requires signature on your

recertification application, validating competency of skills). 7. Submit recertification application processing fee of $10.00 (US funds). The application fee is non-

transferable and non-refundable. Download the First Responder Recertification Requirements Brochure Exam Option Certified EMS professionals may make one attempt to demonstrate continued cognitive competency by taking an examination (in lieu of documenting continuing education) within six months of their expiration date (June 1 through September 30). Log in to the NREMT website and complete an application for recertification by examination. Pay the $65 examination fee prior to scheduling of exam.

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National Registry of Emergency Medical Technicians®

Emergency Medical Responder Psychomotor Examination

BVM VENTILATION OF AN APNEIC PATIENT

Candidate: Examiner:

Date: Signature:

Actual Time Started: __________ Possible Points

Points Awarded

Takes or verbalizes appropriate body substance isolation precautions 1

Checks responsiveness NOTE: After checking responsiveness and breathing for at least 5 but no more than 10 seconds, examiner informs the candidate, “The

patient is unresponsive and apneic.”

1

Checks breathing 1

Requests additional EMS assistance 1

Checks pulse for at least 5 but no more than 10 seconds 1

NOTE: The examiner must now inform the candidate, “You palpate a weak carotid pulse at a rate of 60.”

Opens airway properly 1

NOTE: The examiner must now inform the candidate, “The mouth is full of secretions and vomitus.”

Prepares rigid suction catheter 1

Turns on power to suction device or retrieves manual suction device 1

Inserts rigid suction catheter without applying suction 1

Suctions the mouth and oropharynx 1

NOTE: The examiner must now inform the candidate, “The mouth and oropharynx are clear.”

Opens the airway manually 1

Inserts oropharyngeal airway 1

NOTE: The examiner must now inform the candidate, “No gag reflex is present and the patient accepts the airway adjunct.”

**Ventilates the patient immediately using a BVM device unattached to oxygen

[**Award this point if candidate elects to ventilate initially with BVM attached to reservoir and oxygen so long as first ventilation is delivered within 30 seconds.]

1

NOTE: The examiner must now inform the candidate that ventilation is being properly performed without difficulty.

Re-checks pulse for at least 5 but no more than 10 seconds 1

Attaches the BVM assembly [mask, bag, reservoir] to oxygen [15 L/minute] 1

Ventilates the patient adequately

-Proper volume to make chest rise (1 point)

-Proper rate [10 – 12/minute but not to exceed 12/minute] (1 point)

2

NOTE: The examiner must now ask the candidate, “How would you know if you are delivering appropriate volumes with each

ventilation?”

Actual Time Ended: ___________ TOTAL 17

CRITICAL CRITERIA

____ After suctioning the patient, failure to initiate ventilations within 30 seconds or interrupts ventilations for greater than 30 seconds at any time

____ Failure to take or verbalize appropriate body substance isolation precautions

____ Failure to suction airway before ventilating the patient

____ Suctions the patient for an excessive and prolonged time

____ Failure to check responsiveness and breathing for at least 5 seconds but no more than 10 seconds

____ Failure to check pulse for at least 5 seconds but no more than 10 seconds

____ Failure to voice and ultimately provide high oxygen concentration [at least 85%]

____ Failure to ventilate the patient at a rate of at least 10/minute and no more than 12/minute

____ Failure to provide adequate volumes per breath [maximum 2 errors/minute permissible]

____ Insertion or use of any adjunct in a manner dangerous to the patient

____ Failure to manage the patient as a competent EMR

____ Exhibits unacceptable affect with patient or other personnel

____ Uses or orders a dangerous or inappropriate intervention

You must factually document your rationale for checking any of the above critical items on the reverse side of this form.

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All materials subject to this copyright may be photocopied for the non-commercial purpose of educational or scientific advancement.

Takes or verbalizes appropriate body substance isolation precautions 1

Determines the scene/situation is safe 1

Attempts to question bystanders about arrest events 1

Checks patient responsiveness 1

NOTE: The examiner must now inform the candidate, “The patient is unresponsive.”

Assesses patient for signs of breathing [observes the patient and determines the absence of breathing or

abnormal breathing (gasping or agonal respirations)] 1

NOTE: The examiner must now inform the candidate, “The patient is apneic,” or, “The patient has gasping, agonal respirations.”

Checks carotid pulse [no more than 10 seconds] 1

NOTE: The examiner must now inform the candidate, “The patient is pulseless.”

NOTE: The examiner must now inform the candidate, “The patient is pulseless.”

NOTE: The examiner must now inform the candidate, “The patient is pulseless.”

Immediately begins chest compressions [adequate depth and rate; allows the chest to recoil completely] 1

Requests additional EMS response 1

Performs 2 minutes of high-quality, 1-rescuer adult CPR

Adequate depth and rate (1 point)

Correct compression-to-ventilation ratio (1 point)

Allows the chest to recoil completely (1 point)

Adequate volumes for each breath (1 point)

Minimal interruptions of less than 10 seconds throughout (1 point)

5

NOTE: After 2 minutes (5 cycles), patient is assessed and second rescuer resumes compressions while candidate

operates AED.

Turns-on power to AED 1

Follows prompts and correctly attaches AED to patient 1

Stops CPR and ensures all individuals are clear of the patient during rhythm analysis 1

Ensures that all individuals are clear of the patient and delivers shock from AED 1

Immediately directs rescuer to resume chest compressions 1

National Registry of Emergency Medical Technicians®

Emergency Medical Responder Psychomotor Examination

CARDIAC ARREST MANAGEMENT / AED

Candidate: Examiner:

Date: Signature:

Actual Time Started: __________ Possible

Points

Points

Awarded

Actual Time Ended: ___________ TOTAL 18

Critical Criteria

____ Failure to take or verbalize appropriate body substance isolation precautions

____ Failure to immediately begin chest compressions as soon as pulselessness is confirmed

____ Failure to demonstrate acceptable high-quality, 1-rescuer adult CPR

____ Interrupts CPR for more than 10 seconds at any point

____ Failure to correctly attach the AED to the patient

____ Failure to operate the AED properly

____ Failure to deliver shock in a timely manner

____ Failure to assure that all individuals are clear of patient during rhythm analysis and before delivering shock [verbalizes “All clear” and

observes]

____ Failure to immediately resume compressions after shock delivered

____ Failure to manage the patient as a competent EMR

____ Exhibits unacceptable affect with patient or other personnel

____ Uses or orders a dangerous or inappropriate intervention

You must factually document your rationale for checking any of the above critical items on the reverse side of this form.

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National Registry of Emergency Medical Technicians®

Emergency Medical Responder Psychomotor Examination

PATIENT ASSESSMENT/MANAGEMENT – MEDICAL

Candidate: Examiner:

Date: Signature:

Scenario #

Actual Time Started: __________ Possible Points

Points Awarded

Takes or verbalizes appropriate body substance isolation precautions 1

SCENE SIZE-UP

Determines the scene/situation is safe 1

Determines the mechanism of injury/nature of illness 1

Requests additional EMS assistance if necessary 1

Considers stabilization of the spine 1

PRIMARY SURVEY/RESUSCITATION

Determines responsiveness/level of consciousness (AVPU) 1

Determines chief complaint/apparent life-threats 1

Assesses airway and breathing

-Assessment (1 point) -Assures adequate ventilation (1 point) -Initiates appropriate oxygen therapy (1 point) 3

Assesses circulation

-Assesses/controls major bleeding (1 point) -Checks pulse (1 point)

-Assesses skin [either skin color, temperature or condition] (1 point)

3

Identifies patient priority and makes treatment/transport decision 1

HISTORY TAKING

History of the present illness

-Onset (1 point) -Quality (1 point) -Severity (1 point)

-Provocation (1 point) -Radiation (1 point) -Time (1 point)

-Clarifying questions of associated signs and symptoms related to OPQRST (2 points)

8

Past medical history

-Allergies (1 point) -Past pertinent history (1 point) -Events leading to present illness (1 point)

-Medications (1 point) -Last oral intake (1 point)

5

SECONDARY ASSESSMENT

Assesses affected body part/system

-Cardiovascular -Neurological -Integumentary -Reproductive

-Pulmonary -Musculoskeletal -GI/GU -Psychological/Social

5

VITAL SIGNS

-Blood pressure (1 point) -Pulse (1 point) -Respiratory rate and quality (1 point each) 4

States field impression of patient 1

Interventions [verbalizes proper interventions/treatment] 1

REASSESSMENT

Demonstrates how and when to reassess the patient to determine changes in condition 1

Provides accurate verbal report to arriving EMS unit 1

Actual Time Ended: TOTAL 40

CRITICAL CRITERIA

____ Failure to initiate or call for transport of the patient within 15 minute time limit

____ Failure to take or verbalize appropriate body substance isolation precautions

____ Failure to determine scene safety before approaching patient

____ Failure to voice and ultimately provide appropriate oxygen therapy

____ Failure to assess/provide adequate ventilation

____ Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock

____ Failure to differentiate patient’s need for immediate transportation versus continued assessment or treatment at the scene

____ Performs secondary examination before assessing and treating threats to airway, breathing and circulation

____ Orders a dangerous or inappropriate intervention

____ Failure to provide accurate report to arriving EMS unit

____ Failure to manage the patient as a competent EMR

____ Exhibits unacceptable affect with patient or other personnel

____ Uses or orders a dangerous or inappropriate intervention

You must factually document your rationale for checking any of the above critical items on the reverse side of this form.

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National Registry of Emergency Medical Technicians®

Emergency Medical Responder Psychomotor Examination

OXYGEN ADMINISTRATION BY NON-REBREATHER MASK

Candidate: Examiner:

Date: Signature:

Actual Time Started: __________ Possible Points

Points Awarded

Takes or verbalizes appropriate body substance isolation precautions 1

Gathers appropriate equipment 1

Cracks valve on the oxygen tank 1

Assembles the regulator to the oxygen tank 1

Opens the oxygen tank valve 1

Checks oxygen tank pressure 1

Checks for leaks 1

Attaches non-rebreather mask to correct port of regulator 1

Turns on oxygen flow to prefill reservoir bag 1

Adjusts regulator to assure oxygen flow rate of at least 10 L/minute 1

Attaches mask to patient’s face and adjusts to fit snugly 1

Actual Time Ended: ___________ TOTAL

11

CRITICAL CRITERIA

____ Failure to take or verbalize appropriate body substance isolation precautions

____ Failure to assemble the oxygen tank and regulator without leaks

____ Failure to prefill the reservoir bag

____ Failure to adjust the oxygen flow rate to the non-rebreather mask of at least 10 L/minute

____ Failure to assure a tight mask seal to patient’s face

____ Failure to manage the patient as a competent EMR

____ Exhibits unacceptable affect with patient or other personnel

____ Uses or orders a dangerous or inappropriate intervention

You must factually document your rationale for checking any of the above critical items on the reverse side of this form.

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National Registry of Emergency Medical Technicians®

Emergency Medical Responder Psychomotor Examination

PATIENT ASSESSMENT/MANAGEMENT – TRAUMA

Candidate: Examiner: Date: Signature: Scenario #

Actual Time Started: __________ Note: Areas denoted by “**” may be integrated within sequence of Primary Survey/Resuscitation Possible Points

Points Awarded

Takes or verbalizes appropriate body substance isolation precautions 1 SCENE SIZE-UP

Determines the scene/situation is safe 1 Determines the mechanism of injury/nature of illness 1 Requests additional EMS assistance if necessary 1 Considers stabilization of the spine 1 PRIMARY SURVEY/RESUSCITATION

Determines responsiveness/level of consciousness 1 Determines chief complaint/apparent life-threats 1 Airway -Opens and assesses airway (1 point) -Inserts adjunct as indicated (1 point)

2 Breathing

-Assess breathing (1 point) -Assures adequate ventilation (1 point)

-Initiates appropriate oxygen therapy (1 point) -Manages any injury which may compromise breathing/ventilation (1 point)

4

Circulation

-Checks pulse (1point)

-Assess skin [either skin color, temperature or condition] (1 point)

-Assesses for and controls major bleeding if present (1 point)

-Initiates shock management [positions patient properly, conserves body heat] (1 point)

4

Identifies patient priority and makes treatment/transport decision (based upon calculated GCS) 1 HISTORY TAKING

Attempts to obtain SAMPLE history 1 SECONDARY ASSESSMENT

Head

-Inspects and palpates scalp and ears (1 point) ** -Assesses eyes (1 point)

-Inspects mouth**, nose** and assesses facial area (1 point) - (1 point)

3

Neck**

-Checks position of trachea (1 point) -Checks jugular veins (1 point) -Palpates cervical spine (1 point) 3

Chest**

-Inspects chest (1 point) -Palpates chest (1 point) -Auscultates chest (1 point) 3

Abdomen/pelvis**

-Inspects and palpates abdomen (1 point) -Assesses pelvis (1 point)

-Verbalizes assessment of genitalia/perineum as needed (1 point)

3

Lower extremities**

-Inspects, palpates and assesses motor, sensory and distal circulatory functions (1 point/leg) 2

Upper extremities

-Inspects, palpates and assesses motor, sensory and distal circulatory functions (1 point/arm) 2

Posterior thorax, lumbar and buttocks**

-Inspects and palpates posterior thorax (1 point) -Inspects and palpates lumbar and buttocks areas (1 point) 2

VITAL SIGNS

Obtains baseline vital signs [must include BP, P and R] (1point) 1 Manages secondary injuries and wounds appropriately 1 REASSESSMENT

Demonstrates how and when to reassess the patient 1 Actual Time Ended: __________ TOTAL 40 CRITICAL CRITERIA ____ Failure to initiate or call for transport of the patient within 10 minute time limit ____ Failure to take or verbalize appropriate body substance isolation precautions ____ Failure to determine scene safety ____ Failure to assess for and provide spinal protection when indicated ____ Failure to voice and ultimately provide high concentration of oxygen ____ Failure to assess/provide adequate ventilation ____ Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock ____ Failure to differentiate patient’s need for immediate transportation versus continued assessment/treatment at the scene ____ Performs other assessment before assessing/treating threats to airway, breathing and circulation ____ Failure to manage the patient as a competent EMR ____ Exhibits unacceptable affect with patient or other personnel ____ Uses or orders a dangerous or inappropriate intervention

You must factually document your rationale for checking any of the above critical items on the reverse side of this form.

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EMS 201: Emergency Medical Responder

Student Questionnaire

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Name: ______________________________________ Date: ___________________ This is a short questionnaire which will help us to better tailor our courses to future students and to understand their motivation for registration in our programs. Please answer these questions to the best of your ability. Answering questions is optional, but this form MUST be turned in by each student upon the conclusion of the course. 1. What is your primary reason for registering for the EMR program? 2. How much time do you plan to dedicate to the EMR Program per week (in hours)? 3. What is your highest level of education completed? 4. What do you expect to do at the conclusion of the EMR Program? 5. What do you think makes a good EMR Program or educational program in general? 6. What do you think it takes to be a good EMR? 7. Does your family support your decision to become an EMR? Please explain… 8. What is your biggest concern about becoming an EMR? 9. What would you like to see from your instructors and/or the staff to assist you the most during the program? 10. What is your biggest concern about this program?

Page 36: EMS University EMR Student First Day Checklist · 2012-12-05 · free plug-ins (such as Adobe® Reader®, Macromedia® Flash™, or Macromedia Shockwave®). Application Name PC Version

EMS University Suggestion Box

In an effort to ensure that students, instructors, administrative staff, and guests have adequate input, we have placed a suggestion box in the classroom for you to fill out if you have any comments, questions or concerns that you would like to make. You may leave a personal or anonymous comment in the suggestion box. If you wish, you may also make an electronic suggestion at the website address below:

http://www.emsuniversity.com/?q=suggestions Thank you for taking the time to comment on our program. Your opinion is highly valued!