Sub-Section 3-490-88 - Paramedic Academy Terminal Competency Form (long-form)

CMH EMS Education Manual

Citizens Memorial Hospital - Emergency Medical Services Education Department hereby certifies that the candidate listed below has successfully completed all the terminal competencies required for graduation from the Paramedic education program as a minimally competent, entry-level Paramedic and as such is eligible for State and National Certification written and practical examination in accordance with our published policies and procedures.

Name of graduate:

Overall score: % (80% minimum overall score). [PROOF ATTACHED (OzarksEMS Transcript)]
Total contact hours: (1,000 minimum hours: 500 classroom/laboratory + 250 hospital clinical + 250 ambulance clinical [as requried by MO 19 CSR 30-40.311(2)(L)]). [PROOF ATTACHED (OzarksEMS Transcript)]
Semester-level requirements:

	EMS 501 (Paramedicine I)	EMS 511 (Paramedicine II)	EMS 521 (Paramedicine III)
ECG Quizzes (70% minimum average of all quizzes)	%	%	%
Pharmacology Quizzes (70% minimum average of all quizzes)	%	%	%
JBL Quizzes (70% minimum average of all quizzes)	%	%	%
Simulations (70% minimum average of all simulations)	%	%	%
Affective Evaluations (70% minimum "pass" rate on all evaluations)
Final Psychomotor Exams (70% minimum on at least one attempt)	%	%	%
Final Written Exams (70% minimum on at least one attempt)	%	%	%

Sub-Section 3-490-46 - Laboratory Simulation and Skill Requirements [PROOF ATTACHED].

Pathology/Complaint/Condition	Minimum Simulations
Trauma (Adult)	1
Trauma (Pediatric)	1
Psychiatric/Behavioral	1
Complicated Obstetric Delivery (Prolapsed Cord)	1
Complicated Obstetric Delivery (Breech Delivery)	1
Distressed Neonate	1
Cardiac-Related Chest Pain	1
Cardiac Arrest	1
Nerologic (Geriatric Stroke)	1
Respiratory (Geriatric)	1
Respiratory (Pediatric)	1
Sepsis (Geriatric)	1

Sub-Section 3-490-46 - Laboratory Simulation and Skill Requirements [PROOF ATTACHED].

Skill	Minimum Skills
Establish IV access	2
Administer IV infusion medication	2
Administer IV bolus medication	2
Administer IM injection	2
Establish IO access	4
Perform PPV with BVM	4
Perform oral endotracheal intubation	2
Perform endotracheal suctioning	2
Perform FBAO removal using Magill Forceps	2
Perform cricothyrotomy	2
Insert supraglottic airway	2
Perform needle decompression of the chest	2
Perform synchronized cardioversion	2
Perform defibrillation	2
Perform transcutaneous pacing	2
Perform chest compressions	2

Sub-Section 3-490-46 - Laboratory Simulation and Skill Requirements [PROOF ATTACHED].

Skill	Minimum EMT Skills
Insert NPA	1
Insert OPA	1
Perform oral suctioning	1
Perform FBAO - Adult	1
Perform FBAO - Infant	1
Administer oxygen by nasal cannula	1
Administer oxygen by face mask	1
Ventilate an adult patient with a BVM	1
Ventilate a pediatric patient with a BVM	1
Ventilate a neonate patient with a BVM	1
Apply a tourniquet	1
Apply a cervical collar	1
Perform spine motion restriction	1
Lift and transfer a patient to the stretcher	1
Splint a suspected long bone injury	1
Splint a suspected joint injury	1
Stabilize an impaled object	1
Dress and bandage a soft tissue injury	1
Apply an occlusive dressing to an open wound to the thorax	1
Perform uncomplicated delivery	1
Assess vital signs	1
Perform a comprehensive physical assessment	1
Perform CPR - Adult	1
Perform CPR - Pediatric	1
Perform CPR - Neonate	1

Sub-Section 3-490-46 - Clinical Requirements [PROOF ATTACHED].

Age	Minimum Formative (some assistance) Contacts During: Note: Must be completed prior to Summitive. EMS 506 (Clinical I), EMS 516 (Clinical II), and/or EMS 526 (Field Experience)	Minimum Summitive (no assistance) Contacts During: EMS 506 (Clinical I), EMS 516 (Clinical II), EMS 526 (Field Experience), and/or EMS 536 (Field Internship)
Pediatric Note: At least two contacts must fall within the following sub-categories: Neonate (0-30 days) Infant (1-12 months) Toddler (1-2 years) Preschool (3-5 years) School-Aged (6-12 years) Adolescent (13-18 years)	15	15
Adult (19-65 years)	30	30
Geriatric (>65 years)	9	9

Sub-Section 3-490-46 - Clinical Requirements [PROOF ATTACHED].

Pathology/Complaint/Condition	Minimum Formative (some assistance) Contacts During: EMS 506 (Clinical I), EMS 516 (Clinical II), and/or EMS 526 (Field Experience)	Minimum Summitive (no assistance) Contacts During: EMS 536 (Field Internship)
Trauma	18	9
Psychiatric/Behavioral	12	6
Obstetric delivery with normal newborn care	2	2**
Complicated obstetric delivery	2**	2**
Distressed neonate	2**	2**
Cardiac (ACS or chest pain)	12	6
Cardiac arrest	2**	1**
Cardiac dysrhythmias	10	6
Neurologic (stroke, syncope, AMS)	8	4
Respiratory	8	4
Other	12	6

Sub-Section 3-490-46 - Clinical Requirements [PROOF ATTACHED].

Skill	Minimum Skills on Live Patients
Establish IV access	52
Administer IV infusion medication	2
Administer IV bolus medication	10
Administer IM injection	2
Establish IO access	2**
Perform PPV with BVM	10**
Perform oral endotracheal intubation	10**
Perform endotracheal suctioning	2**
Perform FBAO removal using Magill Forceps	2**
Perform cricothyrotomy	2**
Insert supraglottic airway	10**
Perform needle decompression of the chest	2**
Perform synchronized cardioversion	10**
Perform defibrillation	10**
Perform transcutaneous pacing	10**
Perform chest compressions	2**

Sub-Section 3-490-46 - Clinical Requirements [PROOF ATTACHED].

Minimum Formative (TEAM MEMBER) Contacts During: EMS 526 (Field Experience)	Minimum Summitive (TEAM LEADER) Contacts During: EMS 536 (Field Internship)
30	30

Student counseling (as applicable). Notes:
Required course certifications:

ACLS. [PROOF ATTACHED]
PALS. [PROOF ATTACHED]

Field internship mentor approval form. [PROOF ATTACHED]
Fourth trimester post-field internship exams:

Cognitive: Platinum timed comprehensive adaptive test, or cumulative summary results with "Good" in all categories.[PROOF ATTACHED (Platinum)]
Affective: Final comprehensive eval with "PASS" status. [PROOF ATTACHED (Google Drive)]
Psychomotor: NIEMT psychomotor "PASS" results [PROOF ATTACHED (NREMT)].

Medical Director interview (if applicable).
Student completed resource assessment survey.

Program requirements successfully and fully completed on:

Program Director signature:

Medical Director signature:

Change Log:

Date	Link to previous version	Description of change
01/19/23		Created this form as a result of CoAEMSP site visit recommendations.

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