Chapter 4765-15 EMT-Basics

4765-15-01 Emergency medical technician curriculum prior to September 1, 2012.

(A) Prior to September 1, 2012 an EMS training program for a certificate to practice as an emergency medical technician or an emergency medical technician refresher program shall be conducted in accordance with the curriculum as set forth in this rule or in rule 4765-15-05 of the Administrative Code. An EMS training program for a certificate to practice as an emergency medical technician or an emergency medical technician refresher program starting on or after September 1, 2012, shall be conducted in accordance with rule 4765-15-05 of the Administrative Code.

(B) An EMS training program for a certificate to practice as an emergency medical technician shall be conducted in accordance with division (C) of section 4765.16 of the Revised Code, and shall follow the United States department of transportation (USDOT) "1994 Emergency Medical Technician-Basic National Standard Curriculum," which can be found in the curriculum portion of the EMS web site at http://ems.ohio.gov/ems_education.stm. Such program shall be one hundred thirty hours, allocated as follows:

(1) Ninety-five hours devoted to emergency victim care, assessment, and management of the adult and pediatric patient;

(2) Three hours devoted to reading and interpreting the vital signs of a trauma victim;

(3) Two hours devoted to pathophysiology of the airway, ventilation, and respiration;

(4) Six hours devoted to mechanics of intubation, including dual lumen airway and endotracheal;

(5) Six hours of training in cardiopulmonary resuscitation;

(6) One hour devoted to pharmacology and subcutaneous auto-injection of epinephrine;

(7) Ten hours devoted to one of the following:

(a) Clinical experience;

(b) Prehospital internship;

(c) Combined clinical experience and prehospital internship;

(8) One hour of emergency vehicle operator training;

(9) Six hours of written and practical testing.

(C) An "Emergency Medical Technician:Basic Refresher Curriculum" (October 2003) , which can be found at http://ems.ohio.gov/ems_education.stm, shall consist of thirty hours according to objectives approved by the board for the number of hours listed in each of the following subject areas:

(1) Eight hours on trauma issues, two of which must pertain to triage and transportation protocols approved by the board;

(2) Six hours on pediatric issues;

(3) Six hours on medical emergencies;

(4) Two hours on geriatric issues;

(5) Two hours on cardiology;

(6) Two hours on airway and ventilation;

(7) Two hours on EMS operations;

(8) Two hours on obstetrics and gynecology.

(D) An accredited or approved institution offering a training program or refresher program, as outlined in paragraphs (B) and (C) of this rule, shall provide for regular evaluation of student performance and achievement through written and practical testing, prior to issuance of a certificate of completion.

Effective: 10/18/2013
R.C. 119.032 review dates: 07/15/2013 and 03/12/2018
Promulgated Under: 119.03
Statutory Authority: 4765.11
Rule Amplifies: 4765.16
Prior Effective Dates: 01/01/96, 01/25/99, 03/23/03, 08/30/08, 02/06/12

4765-15-02 EMT-basic bridge course requirement. [Rescinded].

Rescinded eff 8-3-08

4765-15-03 Emergency medical technician continuing education.

(A) Except as otherwise provided in section 4765.31 of the Revised Code and this chapter, when applying for renewal of a certificate to practice, a person who is certified as an emergency medical technician shall comply with one of the four following continuing education requirements by the expiration date of the current certificate:

(1) Completion of at least forty hours of continuing education, including all of the following:

(a) Six hours on pediatric issues;

(b) Two hours on geriatric issues;

(c) Eight hours on trauma issues, to include education on the trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code.

(2) Completion of a thirty-hour emergency medical technician refresher program, as outlined in paragraph (C) of rule 4765-15-01 of the Administrative Code or in paragraph (D) of rule 4765-15-05 of the Administrative Code, as evidenced by a certificate of completion issued in accordance with section 4765.24 of the Revised Code.

(3) Current registration with the national registry of emergency medical technicians at the emergency medical technician or equivalent level and completion of the education on trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code.

(4) A passing score within three attempts on an examination approved by the board, pursuant to rule 4765-8-05 of the Administrative Code, to demonstrate competence to have a certificate to practice as an emergency medical technician renewed without completing an EMS continuing education program. This examination may only be taken during the last six months of an emergency medical technician's current certification period or during a board approved extension granted pursuant to rule 4765-19-03 of the Administrative Code.

(B) An individual that receives a board approved extension to complete continuing education requirements listed in paragraph (A) of this rule, must complete the requirements and submit an "EMS Application-Renewal" or form "EMS 0043" (June, 2008), which can be found at http://ems.ohio.gov/ems_forms.stm, to the division, no later than the expiration date of the granted extension.

Effective: 10/18/2013
R.C. 119.032 review dates: 07/15/2013 and 03/12/2018
Promulgated Under: 119.03
Statutory Authority: 4765.11
Rule Amplifies: 4765.16 , 4765.24 , 4765.31
Prior Effective Dates: 01/01/96, 02/22/99, 05/01/03, 07/02/09, 02/06/12

4765-15-04 Emergency medical technician scope of practice.

(A) In addition to the emergency medical services listed in rule 4765-12-04 of the Administrative Code and in accordance with division (B) of section 4765.37 of the Revised Code, an emergency medical technician may perform the following emergency medical services:

(1) Endotracheal suctioning through a previously established airway;

(2) Endotracheal suctioning through a stoma;

(3) Oxygen administration, including the following:

(a) Partial rebreather masks;

(b) Venturi masks.

(4) Ventilation management, to include the use of a positive pressure ventilation device, including the following:

(a) Manually triggered ventilators;

(b) Automatic transportation ventilators.

(5) Traction splint;

(6) Rapid extrication procedures;

(B) In accordance with division (C) of section 4765.37 of the Revised Code, an emergency medical technician may perform the following additional emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (D) of section 4765.37 of the Revised Code:

(1) Pulse oximeter and capnography equipment application and reading;

(2) Until January 1, 2013, orotracheal intubation of pulseless and apneic patients only;

(3) Dual lumen airway of pulseless and apneic patients only;

(4) Oxygen humidifier equipment application and monitoring;

(5) Extraglottic airway of pulseless and apneic patients only;

(6) Continuous positive airway pressure (CPAP);

(7) End tidal carbon dioxide monitoring and detecting;

(8) Chest compression assist devices;

(9) Administration of aspirin;

(10) Pneumatic anti-shock garment;

(11) Helmet removal;

(12) Glucose monitoring system;

(13) Administration of oral glucose;

(14) Administration of activated charcoal;

(15) Administration of epinephrine auto-injector to a patient suffering from anaphylaxis;

(16) Assisted administration of sublingual nitroglycerin, which shall consist of either of the following:

(a) Assisting with patient's prescribed nitroglycerin upon the patient's request and with written protocol;

(b) Assisting with EMS-provided nitroglycerin with verbal medical direction.

(17) Assisted administration of aerosolized or nebulized medications, which shall consist of either of the following:

(a) Assisting with a patient's prescribed aerosolized or nebulized medications upon the patient's request and with written protocol;

(b) Assisting with EMS-provided aerosolized or nebulized medications with verbal medical direction.

(18) Pre-hospital advanced life support assistance, to include the setting up of an intravenous administration kit in the presence of an advanced emergency medical technician or paramedic;

(19) Set up and application of a cardiac monitor in the presence of an advanced emergency medical technician or paramedic;

(20) Set up and application of a twelve-lead electrocardiogram, in accordance with written protocols, in either of the following instances:

(a) When the emergency medical technician is assisting an paramedic; or

(b) For the purpose of electronic transmission by the emergency medical technician, provided the following conditions are met:

(i) The emergency medical technician does not interpret the electrocardiogram;

(ii) The emergency medical technician minimizes any delay of patient transport to obtain a twelve-lead electrocardiogram;

(iii) The EMT utilizes the twelve-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.

(21) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code;

(22) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.

(C) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those emergency medical technicians who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code.

(D) An emergency medical technician shall not perform emergency medical services within this rule unless the emergency medical technician has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the emergency medical technician scope of practice, were not included in the training specified in this paragraph, the emergency medical technician must have received training regarding such services approved by the local medical director before performing those services.

Effective: 10/18/2013
R.C. 119.032 review dates: 07/15/2013 and 03/12/2018
Promulgated Under: 119.03
Statutory Authority: 4765.11
Rule Amplifies: 4765.37
Prior Effective Dates: 3/23/03, 5/29/08, 02/06/12

4765-15-05 Emergency medical technician curriculum.

(A) Effective September 1, 2012, an EMS training program for a certificate to practice as an emergency medical technician or an emergency medical technician refresher program started on or after this date, shall be conducted in accordance with this rule. Prior to September 1, 2012, an EMS training program for a certificate to practice as an emergency medical technician or an emergency medical technician refresher program may, but is not required to, teach the curriculum in accordance with this rule.

(B) An EMS training program for a certificate to practice as an emergency medical technician shall be conducted in accordance with division (C) of section 4765.16 of the Revised Code and this rule. The EMS training program shall be conducted in accordance with the National EMS Education Standards" (August, 2009) approved by NHTSA, the "Ohio Approved EMS Curriculum Standards" (February, 2012) approved by the board, and the scope of practice set forth in rule 4765-15-04 of the Administrative Code. The " National EMS Education Standards" (August, 2009)approved by NHTSA and the "Ohio Approved EMS Curriculum Standards" (February, 2012)approved by the board can be found at http://ems.ohio.gov/ems_education.stm. Such EMS training program shall consist of a minimum of one hundred fifty hours to include all of the following:

(1) Preparatory;

(2) Anatomy and physiology;

(3) Medical terminology;

(4) Physiology;

(5) Life span development;

(6) Public health;

(7) Pharmacology;

(8) Airway management, respiration, and artificial ventilation, to include:

(a) Insertion of extraglottic and dual lumen airway devices on apneic and pulseless patients;

(b) Endotracheal suctioning through a stoma;

(c) Continuous positive airway pressure device administration and management;

(d) Flow restricted oxygen powered device;

(e) End tidal carbon dioxide monitoring and detection;

(f) Pulse oximeter and capnography equipment application and reading;

(g) Use of a positive pressure ventilation device:

(i) Manually triggered ventilators;

(ii) Automatic transportation ventilators.

(9) Patient assessment;

(10) Medicine, to include:

(a) Blood glucose monitoring;

(b) Chest compression assist device;

(c) Patient-assisted epinephrine auto-injection administration.

(11) Shock and resuscitation;

(12) Trauma, to include:

(a) Care and transportation of a trauma patient;

(b) Helmet removal;

(c) Trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code.

(13) Special patient populations;

(14) EMS operations;

(15) Clinical prehospital, to include:

(a) At least ten hours devoted to combined clinical experience and prehospital internship;

(b) Ten patient assessments to include one pediatric patient assessment.

(C) An accredited institution offering an EMS training program as set forth in paragraph (B) of this rule, shall provide for regular written and practical evaluations of student performance and achievement throughout the course of the program. Evaluations shall include a comprehensive written examination and an examination of practical skills, prior to issuance of a certificate of completion.

(D) An emergency medical technician refresher program shall consist of thirty hours according to the "Emergency Medical Technician Refresher Training Program" (May, 2012) education standards approved by the board, which can be found at http://ems.ohio.gov/ems_education.stm, for the number of hours listed in each of the following subject areas:

(1) Eight hours on trauma issues, to include education on the trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code;

(2) Six hours on pediatric issues;

(3) Six hours on medical emergencies;

(4) Two hours on geriatric issues;

(5) Two hours on cardiology;

(6) Two hours on airway and ventilation to include education of positive pressure ventilation devices;

(7) Two hours on EMS operations;

(8) Two hours on obstetrics and gynecology.

(E) An accredited or approved institution offering a refresher program, outlined in paragraph (D) of this rule, shall provide for regular evaluation of student performance and achievement through written and practical examinations, prior to issuance of a certificate of completion.

Effective: 10/18/2013
R.C. 119.032 review dates: 07/15/2013 and 03/12/2018
Promulgated Under: 119.03
Statutory Authority: 4765.11
Rule Amplifies: 4765.16
Prior Effective Dates: 02/06/12