EMT and Paramedic County Certification Procedure

Section 1 - ADMINISTRATIVE POLICIES

1.17 EMT / PARAMEDIC COUNTY CERTIFICATION PROCEDURE

This certification procedure is to be followed by all Emergency Medical Technicians (EMTs) and Paramedics employed by the Seminole County EMS (SCEMS) system to function under the license and direction of the Seminole County Medical Director. The following agencies compose the SCEMS: Lake Mary FD, Longwood FD, Oviedo FD, Sanford FD and Seminole County FD. Seminole County certification is required in order to function as an EMT or Paramedic within the geographical confines of Seminole County.

EMT/PARAMEDIC PROVISIONAL CERTIFICATION (INTERNSHIP)

To obtain Seminole County EMT certification or Paramedic provisional Certification, candidates must successfully complete the written protocol examination and clinical skills assessment.

• A timed written examination shall consist of one hundred (100) questions for Paramedics and fifty (50) for EMT’s derived from and cross referenced to the most current Seminole County EMS System Practice Parameters.
• Paramedics will be required to pass a timed EKG static dysrhythmia recognition evaluation containing a minimum of twenty (20) static EKG rhythms (including 12-lead).
• Practical Skills assessment for EMT shall consist of the following skills:
  • Patient assessment -Medical & Trauma
  • Airway, Oxygenation and Ventilation Skills.
  • Trauma Management.
  • Cardiac Arrest Management/AED operation.
  • ALS assistance
• Practical Skills assessment for PARAMEDIC shall consist of the following skills:
  • Successful demonstration of assessment for and treatment of the following skills:
    • Needle chest decompression of a tension pneumothorax
    • Surgical and needle cricothyroidotomy
    • Insertion of an intraosseous infusion
    • Insertion of peripheral intravenous access point
    • Oral tracheal intubation, adult and infant
    • Insertion of Supraglottic advanced airway device

SUCCESSFUL COMPLETION OF SEMINOLE COUNTY INITIAL PROVISIONAL EMT/PARAMEDIC CERTIFICATION CONSIST OF ALL OF THE FOLLOWING ELEMENTS:

• All agencies’ new hire employees who are also new to the Seminole County EMS System MUST complete the EMT certification process including skills evaluations.
• Obtaining a minimum score of 80% on the Seminole County Practice Parameters evaluation exam, and;
• EKG static dysrhythmia recognition evaluation:
  • The paramedic candidate must complete an EKG static dysrhythmia recognition (including 12 lead diagnostic rhythms) evaluation achieving a 90% or better score.
    • Candidates who do not achieve a 90% on the first attempt must wait 24 hrs before all subsequent retesting.
    • After the third attempt, the candidate must undergo an approved self-paced remediation program and meet with the Medical Director for final evaluation.
• Agency EMS Officers are also granted full access to the candidates’ written evaluations to assist them with the management of candidates and agency’s training needs.
• Successful demonstration of all clinical skills (by certification level EMT or Paramedic) described in section-two.

SEMINOLE COUNTY PROTOCOL WRITTEN AND CLINICAL SKILL TESTING WILL BE ADMINISTERED UTILIZING THE FOLLOWING PROCEDURE:

• Written and EKG examinations will be scheduled with the Seminole County Office of EMS Performance Management (EMS Office) during standard business hours of 0800-1700 Monday through Friday.
  • The written and EKG Examinations may be taken up to two (2) times. If successful completion is not obtained in two (2) attempts the applicant will not be eligible to retake the County Certification process for thirty (30) days during which time they will be required to successfully complete an individualized remediation program as established by the Seminole County EMS Medical Director and the EMS Office in conjunction with the agency EMS Officer.
  • The Medical Director reserves the right to waive or modify the examination retake requirements for just cause. The Medical Director also retains final authority and decision making in all provisional certification requirements, retake procedures and reserves the right to modify, adjust, or mandate further requirements to be met by the provisional paramedic to insure competency prior to being released. In addition, the Medical Director reserves the right to grant or revoke full or provisional certification to any and all EMT’s and Paramedics providing services under his license at any given time.
• Practical Skills assessments will be scheduled with the hiring agency’s EMS Officer and/or Training Officer.
  • Should the applicant not successfully complete the practical skills assessment they may retake the examination provided there is twenty four (24) hours between the exams.
  • The practical skills assessment may be taken two (2) times. If successful completion is not obtained in two (2) attempts the applicant will not be eligible to retake the County Certification process for thirty (30) days during which time they will be required to successfully complete an individualized remediation program as established by the Seminole County EMS Medical Director and the EMS Office in conjunction with the agency EMS Officer.
  • Upon successful completion of the individualized remediation program the applicant will be given a third attempt to successfully complete the County Certification process. Should the applicant be unsuccessful they will be ineligible to retake the county certification process for one (1) year.
  • In the event the candidate is unsuccessful in completing the Paramedic certification process, the sponsoring agency may permit the candidate to function as an EMT.

COUNTY EMT/PARAMEDIC CERTIFICATION

County EMT/Paramedic Certification authorizes the individual to practice solo and is achieved after the following requirements are met:

• All provisional certification requirements and testing have been successfully satisfied.
• Internship - Complete the agency’s internship in accordance with the Paramedic Clinical Assessment Program (PCAP) under the observation of a paramedic/mentor/field officer.
• Medical Director Face-to-Face Meetings – EMTs are required to attend one (1) meeting within 90 days of being County certified and Paramedics are required to attend three (3) meetings. Paramedics must present a minimum of five (5) patient care reports, two (2) of which must be patient refusal reports, for review by the Medical Director. These reports must be ones where the Provisional Paramedic presenting the report was the lead Paramedic and wrote the report in its entirety by him (her) self.
• EMT Patient Refusal Report -- EMTs are required to bring to a Medical Director Meeting one (1) refusal report, documented accordingly by said EMT. In the event this requirement is not completed prior to the EMT receiving their County certification letter, the employee MUST complete this requirement within 6 months of being County certified.
• Critical Thinking Skills – It is expected that during the course of the paramedic’s internship and face-to-face meetings with the Medical Director that their critical thinking skills will be evaluated. In the event, that the paramedic is not performing up to expectation, OR is a new employee with no prior EMS experience, OR has a lack of challenging calls; the Medical Director may request that they submit to mega-code testing on the human patient simulator (SIM Man).
• Completion of Provisional Certification Form – is signed off by all of the following:
  • Provisional paramedic
  • Candidate’s preceptor/mentor/field officer
  • Agency of record EMS officer

BIENNIAL RECERTIFICATION REQUIREMENTS

Recertification requirements coincide within the same time frame as State certification.

EMERGENCY MEDICAL TECHNICIAN (EMT)

• Maintain current Florida State EMT certification
• Maintain current CPR Healthcare Provider certification (AHA, ARC or equivalent) as approved by Seminole County Medical Director/EMS Office.
• Demonstrate proficiency and recurring education in Pre-Hospital Trauma Life Support (PHTLS) or International Trauma Life Support (ITLS) provider or instructor certification.
• Successful completion of thirty (30) continuing education units (CEUs) as required in F.A.C. 64J-1.008 2(a) and approved through the Seminole County Medical Director/EMS Office.
• Attend a minimum of two (2) Medical Directors meetings per year, for a total of four (4) meetings per recertification period. Each meeting has been approved for two (2) CEUs. In addition, to attending the above meetings EMTs will be required to view a video of any meeting they miss containing new core material presented by the Medical Director. Meetings containing new core material will be videotaped quarterly and disseminated to each agency. Videos must be archived for periodic reference and orientation of new personnel. Videos have been approved for one (1) CEU.

FAILURE TO COMPLY WITH THE RECERTIFICATION REQUIREMENTS SHALL RESULT IN IMMEDIATE SUSPENSION OF SEMINOLE COUNTY CERTIFICATION AND THE INABILITY TO FUNCTION AS AN EMT.

To have their County Certification reinstated the EMT must successfully complete an individualized remediation program as established by the Seminole County Medical Director/EMS Office within fourteen (14) days of the suspension notice.

Should the EMT be unsuccessful in completing the individualized remediation program Seminole County Certification will be revoked for one (1) year. After completion of the one (1) year the EMT may request to have their County Certification reinstated after successfully completing the Primary Seminole County Certification Process. Should the EMT fail to successfully complete the Primary County Certification Process they may not function as an EMT in the Seminole County EMS System.

PARAMEDIC

• Maintain current Florida State Paramedic certification.
• Maintain current CPR Healthcare Provider certification (AHA, ARC or equivalent) as approved by Seminole County Medical Director/EMS Office.
• Maintain current Advanced Cardiac Life Support (ACLS) certification (AHA or equivalent) as approved by Seminole County Medical Director/EMS Office.
• Demonstrate proficiency and recurring education in PHTLS or ITLS provider or instructor certification and Pediatric Education for Pre-Hospital Provider (PEPP) or Pediatric Advanced Life Support (PALS) provider or instructor certification.
• Successful completion of thirty (30) continuing education units (CEUs) as required by F.A.C. 64J-1.009 2(a) and approved through the Seminole County Medical Director / EMS Office.
• Attend a minimum of two (2) Medical Directors meetings per year, for a total of four (4) meetings per recertification period. Each meeting has been approved for two (2) CEUs. In addition to attending the above meetings, paramedics will be required to view a video of any meeting they miss containing new core material presented by the Medical Director. Meetings containing new core material will be videotaped quarterly and disseminated to each agency. Videos must be archived for periodic reference and orientation of new personnel. Videos have been approved for one (1) CEU.

FAILURE TO COMPLY WITH THE RECERTIFICATION REQUIREMENTS SHALL RESULT IN IMMEDIATE SUSPENSION OF SEMINOLE COUNTY CERTIFICATION AND THE INABILITY TO FUNCTION AS A PARAMEDIC.

During this time they may function as an EMT, provided they maintain State EMT certification or can obtain EMT certification. To have their County Certification reinstated the Paramedic must successfully complete an individualized remediation program as established by Seminole County Medical Director/EMS Office within fourteen (14) days of the suspension notice. Should the Paramedic be unsuccessful in completing the individualized remediation program Seminole County Certification will be revoked for one (1) year.

After completion of the one (1) year the Paramedic may request to have their County Certification reinstated after successfully completing the Primary Seminole County Certification Process.

In order for the Paramedic to function as an EMT during the one (1) year period their Paramedic County Certification is revoked they must successfully complete the Primary County Certification Process for EMT and successfully complete that year’s recertification process.

Should the Paramedic fail to successfully complete the Primary County Certification Process they may not function as an EMT or a Paramedic in the Seminole County EMS System.

CONTINUING EDUCATION UNITS (CEU) APPROVAL PROCESS

Continuing education units (CEUs) are required for National, State and County Certification processes. A CEU is defined as fifty (50) minutes of education coupled with a ten (10) minute break to complete one (1) hour of education/training. In order for these CEUs to be utilized for these certifications they must be approved by the Seminole County EMS System Medical Director. The following information must be submitted:

CONTINUING EDUCATION APPROVAL

• Course name
• Course date
• Institution
• Instructor’s Name
• Course Objectives
• Attachments (Please attach one of the following: Lesson Outline, Conference Brochure, or Copy of PowerPoint Presentation)
• Submitted By
• Submitted Date
• Number of CEU's requested