The following model has been designed to instruct Recruitment Trainees (RT’s) with no prior experience in pre-hospital emergency care. Services may use the program with the following understanding:

• No state certification will be provided at the conclusion of the program.

• Services have flexibility in how the program may be implemented.

• RT’s shall be directed by certified providers, therefore ambulances must provide the minimum crew, as directed by the Vermont Emergency Medical Services Rules, in addition to RT’s.
• First Response Services should not allow RT’s to respond on their own without one certified provider also responding.
• The program provides minimum needs for the RT so as to be safe and useful in an emergency pre-hospital situation.

Notes:

1. Services may utilize the RT program for recruitment purposes, as probationary training, in addition to driver training programs, or in preparation to a certification course. It should be stressed that the RT program does not prepare an individual to provide undirected care outside of the RT acting as a Good Samaritan. RT’s responding with a service should only do so with direction.
2. It is strongly recommended that the RT be assigned to a certified provider and that the RT not be allowed to jump any call (unless responding as a first responder and only with a certified provider).
3. The RT should complete a program, such as this one, prior to responding with a crew to any call.
4. Although requiring the RT to attend a certification course following their initial instruction is not mandated, services are encouraged to move the RT in this direction.

Overview:

These guidelines have been divided into three sections: Administrative, Safety, and Directed Patient Care.

• Administrative:

1. Roles and Responsibilities

2. Dispatch Procedures
3. Patient Confidentiality
4. Basic Patient Communication

• Safety:

1. OSHA Bloodborne Pathogens (BBP) and Airborne Pathogens Training. Includes offering RT HBV vaccination

2. Protective Clothing

3. Scene Size-Up

4. Lifting and moving patients

• Directed Patient Care:

1. CPR (American Heart Association Healthcare Provider or American Red Cross Professional CPR).

2. Basic bleeding control.

3. Immobilizing c-spine manually.

4. Equipment location.

Administrative (1-2 hours):

1. Roles and Responsibilities

• RT represents service.
• Provide care as directed by certified providers and not above skills trained.
• Structure of typical on-duty crew for service.
• Locate and retrieve equipment.
• (OPTIONAL) Trained as a driver.

Expectations

• Other than acting as a "Good Samaritan", RT not expected to be alone with a patient.
• Training requires maintenance of skills.

Different Types of Calls

• Medical vs. Trauma
• Calls unique to service area.
• Motor Vehicle Crashes
• Calls requiring law enforcement assistance.

Interrelationships with other Agencies

- Other ambulances, first responders, fire department, law enforcement agencies

2. Dispatch Procedures

• Specific to service.

3. Patient Confidentiality

• Even though not certified, RT must maintain the same patient confidentiality as any other Representative of the service.

4. Basic Patient Communication

• How to talk to a conscious patient … listen to other providers and follow their lead.
• Maintain calm composure.
• Do not judge patients.
• (OPTION) Record basic patient biographical data on the scene (name, DOB, address, Medical Record Number)

Safety (4 – 4.5 hours):

1. OSHA Bloodborne Pathogens (BBP) and Airborne Pathogens Training. (1.5 – 2 hours)

- based on service’s Infectious Disease Plan

2. Protective clothing (.5 hours)

- jumpsuit or uniform

- footwear

- cloves (leather)

- coat

3. Scene Size-Up (HAZMAT?) (1 hour)

• Scene Size-Up based on EMT-B transition course module
• An assessment of the scene and surroundings that will provided valuable information to the providers.
• Scene Safety, assessment to assure the safety and well being of the providers. Is the scene safe to approach to include:
• Crash/rescue scenes
• Toxic substances – low oxygen areas
• Crime scenes – potential for violence
• Unstable surfaces: slopes, ice, water
• Protection of the patient – environmental considerations
• Protection of bystanders – if appropriate, help the bystander avoid becoming a patient.
• If scene is unsafe, do not enter.
• HAZMAT? What a placard is. Stay wind.

4. Lifting and moving patient’s (stretcher handling, proper lifting techniques). (1 hour)

- Stretcher operation (patient transfer, loading and unloading from ambulance,making up stretcher)

• Lifting techniques based on EMT-B transition course
• Use legs, not back, to lift.
• Keep back in a locked-in position and refrain from twisting.
• Flex at the hips, not the waist; bend at the knees.
• Keep elbows bent with arms close to the sides.
• Keep weight close to the body as possible.
• Avoid reaching more than 15 – 20 inches in front of the body.
• Do not hyperextend the back (avoid leaning back from the waist).
• Consider weight of patient and need for additional help.
• Know own physical ability and limitations.
• Have feet positioned properly.
• Communicate clearly and frequently with partner.
• Push rather than pull, whenever possible.
• Avoid pushing or pulling from an overhead object if possible.
• If weight is below the waist, use kneeling position.
• When possible, transport patients in devices that can be rolled.

- Assisting with log-rolling patient

Directed Patient Care:

1. CPR (American Heart Association Healthcare Provider or American Red Cross Professional CPR).

- Adult CPR (1 and 2 rescuer)

- Child and infant CPR

- FBOA for infant, child, and adult

- Pocket mask

2. Basic bleeding control (.5 hour)

- Universal precautions

- Direct pressure, elevation, pressure bandage

3. Immobilizing c-spine manually (.5 hour).

- Manual immobilization only.

- Practice with simulated conscious patient.

- Practice with simulated unconscious patient (including jaw thrust).

4. Equipment location (two 1 hour sessions split over time).

- Understand names of equipment and kits

- Identify location of equipment and kits (emphasis on what kit is, not contents).

 Total estimated time: