Chapter 4765-17 EMT-Paramedics

4765-17-01 Paramedic curriculum prior to September 2012.

(A) Prior to September 1, 2012, an EMS training program for a certificate to practice as a paramedic or an paramedic refresher program shall be conducted in accordance with the curriculum as set forth in this rule or in rule 4765-17-04 of the Administrative Code. An EMS training program for a certificate to practice as a paramedic or a paramedic refresher program starting on or after September 1, 2012, shall be conducted in accordance with rule 4765-17-04 of the Administrative Code.

(B) A training program for a certificate to practice as a paramedic shall be in accordance with division (E) of section 4765.16 of the Revised Code, and shall follow the United States department of transportation (USDOT) "1998 Emergency Medical Technician Paramedic: National Standard Curriculum," which can be located in the curriculum portion of the EMS web site at http://ems.ohio.gov/ems_education.stm. Such program shall be between six hundred and eight hundred hours, allocated as follows:

(1) Two hundred to two hundred seventy hours shall be devoted to the didactic portion of the course;

(2) Four hundred to five hundred thirty hours shall be devoted to lab, clinical, and field training;

(3) A ten percent adjustment between didactic and lab, clinical, and field training hours is permitted.

(C) If the advisory board of an accredited training program approves the supplemental modules in the USDOT national standard curriculum, the training program may be increased with approval of the EMS board.

(D) A paramedic refresher course shall consist of forty-eight hours according to the "Ohio EMT-Paramedic Refresher Curriculum" (January, 2004) objectives approved by the board, which can ne found at http://ems.ohio.gov/ems_education.stm, for the number of hours listed in each of the following subject areas:

(1) Twelve hours on pediatric issues;

(2) Eight hours on trauma issues, two of which must pertain to triage and transportation determination pursuant to rule 4765-14-02 of the Administrative Code;

(3) Ten hours on medical emergencies;

(4) Four hours on geriatric issues;

(5) Six hours on cardiology;

(6) Four hours on airway and ventilation;

(7) Two hours on EMS operations;

(8) Two hours on obstetrics and gynecology.

(E) An accredited or approved institution offering an EMS training program or refresher program , as outlined in paragraphs (B), (C) and (D) 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: 1/1/96, 3/1/01, 3/23/03, 8/30/08, 2/6/12

4765-17-02 Paramedic 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 a paramedic shall comply with one of the four following education requirements by the expiration date of the current certificate:

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

(a) Twelve hours on pediatric issues;

(b) Four 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;

(d) Six hours on emergency cardiac care continuing education, which may be satisfied upon successful completion of one of the following:

(i) An advanced cardiac life support course of the American heart association, which will satisfy this requirement;

(ii) An advanced cardiac life support course of the American safety and health institute, which will satisfy this requirement;

(iii) An equivalent program approved or designated by the board which can be found at http://http://www.publicsafety.ohio.gov/links/ems_ce_requirements [File Link Not Available].

(iv) Six hours of continuing education in emergency cardiac care.

(2) Completion of both of the following:

(a) A paramedic refresher course, as outlined in rule 4765-17-01 of the Administrative Code or paragraph (F) of rule 4765-17-04 of the Administrative Code as evidenced by a certificate of completion issued in accordance with section 4765.24 of the Revised Code, which will satisfy forty-eight hours of the required eighty-six hours of continuing education;

(b) Completion of the remaining thirty-eight hours of continuing education.

(3) Current registration with the national registry of emergency medical technicians at the paramedic or equivalent level and completion of the continuing 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 paramedic renewed without completing an EMS continuing education program. This examination may only be taken during the last six months of a paramedic'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, 04/28/02, 03/23/03, 07/02/09, 02/06/12

4765-17-03 Paramedic scope of practice.

(A) In addition to the skills listed in rules 4765-12-04 , 4765-15-04 and 4765-16-04 of the Administrative Code, and in accordance with section 4765.39 of the Revised Code, a paramedic may perform the following 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 (C) of section 4765.39 of the Revised Code:

(1) Orotracheal intubation;

(2) Nasotracheal intubation;

(3) Cricothyrotomy (surgical);

(4) Cricothyrotomy (needle);

(5) Positive end-expiratory pressure;

(6) Bilevel positive air pressure;

(7) Ventilator management of patients sixteen years of age or older;

(8) Chest tube monitoring and management;

(9) Central line monitoring;

(10) Transcutaneous cardiac pacing;

(11) Administration of cardiac medication;

(12) Cardioversion;

(13) Carotid massage;

(14) Twelve-lead electrocardiogram performance and interpretation;

(15) Administration of nitroglycerin;

(16) Administration of aerosolized or nebulized medication;

(17) Placement of nasogastric or orogastric tubes;

(18) Administration of cardiac medication;

(19) Administration of other medications pursuant to written protocols;

(20) Intravenous infusion pump;

(21) Blood chemistry analysis;

(22) Thrombolytic therapy initiation and monitoring;

(23) Maintenance of medicated intravenous fluids;

(24) Maintenance of blood administration;

(25) Eye irrigation morgan lens;

(26) Withdraw blood for the purpose of determining the alcohol, drug, controlled substance, metabolite of a controlled substance, or combination content of the whole blood, blood serum, or blood plasma as provided in division (D) of section 4765.39 of the Revised Code when performed in accordance with the criteria established in rule 4765-6-06 of the Administrative Code and the protocols established by the medical director of the emergency medical service organization with which the paramedic is affiliated;

(27) 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;

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

(B) 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 paramedics 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 to include the withdrawing of blood for evidence collection.

(C) A paramedic shall not perform emergency medical services within this rule unless the paramedic 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 paramedic scope of practice, were not included in the training specified in this paragraph, the paramedic 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 , 4765.39
Rule Amplifies: 1547.11 , 4506.17 , 4511.19 , 4765.39
Prior Effective Dates: 3/23/03, 5/29/08, 12/2/10, 02/06/12

4765-17-04 Paramedic curriculum.

(A) Effective September 1, 2012, an EMS training program for a certificate to practice as a paramedic or a paramedic 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 a paramedic or a paramedic 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 a paramedic shall be in accordance with division (E) of section 4765.16 of the Revised Code and this rule and shall require all students complete an anatomy and physiology course as a prerequisite for admission into the EMS training program for a certificate to practice as a paramedic. 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 4765-17-03 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 at least nine hundred hours, to include all of the following subject hours:

(1) At least five hundred hours shall be devoted to the didactic and laboratory portion of the EMS training program;

(2) At least four hundred hours shall be devoted to the clinical and field training portion, to include minimum skill set competency as outlined in paragraph (D) of this rule.

(C) An EMS training program for paramedic certification shall include all of the following subject areas:

(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;

(9) Patient assessment;

(10) Medicine, to include chest compression assist devices;

(11) Shock and resuscitation;

(12) Trauma, to include trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code;

(13) Special patient populations;

(14) EMS operations.

(D) In addition to meeting the requirements in paragraphs (B) and (C) of this rule, during the EMS training program, students must demonstrate competencies by successfully completing the following skills on patients, unless otherwise noted:

(1) A minimum of ninety patient assessments, to include:

(a) A minimum of fifty adult assessments;

(b) A minimum of thirty geriatric assessments;

(c) A minimum of ten pediatric assessments;

(d) Within the ninety patient assessments, the following must be included:

(i) Fifteen chest complaints;

(ii) Fifteen shortness of breath complaints;

(iii) Fifteen abdominal pain complaints;

(iv) Fifteen altered mental status complaints.

(2) A minimum of fifteen medication administrations, to include:

(a) A minimum of two intravenous medication administrations;

(b) A minimum of one subcutaneous injection, which may be completed on a mannequin or simulator;

(c) A minimum of three intramuscular injections;

(d) A minimum of five bronchodilator administrations.

(3) A minimum of thirty intravenous accesses and maintenance;

(4) A minimum of three intubations;

(5) A minimum of thirty electrocardiogram interpretations;

(6) A minimum of fifty advanced life support ambulance runs;

(7) A minimum of two intraosseous initiations, which may be completed on a mannequin or simulator;

(8) A minimum of one manual defibrillation, which may be completed on a mannequin or simulator.

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

(F) A paramedic refresher program shall consist of at least forty-eight hours according to the "Paramedic 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) Twelve hours on pediatric issues;

(2) Eight hours on trauma issues, to include education on each of the following:

(a) The trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code;

(b) Chest tube monitoring;

(c) Maintenance of blood products.

(3) Ten hours on medical emergencies to include education on each of the following:

(a) Blood chemistry analysis;

(b) Morgan lens.

(4) Four hours on geriatric issues;

(5) Six hours on cardiac emergencies to include education on thrombolytic initiation and monitoring;

(6) Fours hours on airway and ventilation to include education on positive end-expiratory pressure;

(7) Two hours on EMS operations;

(8) Two hours on obstetrics and gynecology.

(G) An accredited or approved institution offering a refresher program, as outlined in paragraph (F) 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: 02/06/12