To complete the CME method of recertification, an EMS provider must:

(1) Complete and document the requirements, indicated in Table A of this section, appropriate to the level of certification for each certification period.

Table A

Education Requirements for Recertification

	EMR	EMT	AEMT	Paramedic
Annual Requirements
Cardiovascular education and training	X	X	X	X
Spinal immobilization	X	X	X	X
Patient assessment	X	X	X	X
Certification Period Requirements
Infectious disease	X	X	X	X
Trauma	X	X	X	X
Pharmacology		X	X	X
Other pediatric topics	X	X	X	X
Total minimum education hours per certification period:	15 hrs	30 hrs	60 hrs	150 hrs

"X"	Indicates an individual must demonstrate knowledge and competency in the topic or skill.

(2) Complete and document the skills maintenance requirements, indicated in Table B of this section, appropriate to the level of certification.

Table B

Skills Maintenance Requirements for the CME Method

		EMR	EMT	AEMT	Paramedic
First Certification Period or Three Years
□	First Year
	IV starts		EMT w/IV therapy skill	36	36
			36
	Endotracheal intubations (4 must be performed on humans)				12
	Intraosseous infusion placement		EMT w/IV therapy skill	X	X
			X
□	Second and Third Years
	IV starts over the two-year period		EMT w/IV therapy skill	72	72
			72
	Endotracheal intubations over the two-year period (4 per year must be performed on humans)				24
	Intraosseous infusion placement		EMT w/IV therapy skill
			X
During the Certification Period
	Pediatric airway management				X
	Supraglottic airway placement		EMT w/supraglottic airway skill	X	X
			X
	Defibrillation	X	X	X	X
Later Certification Periods
□	Annual Requirements
	IV starts		EMT w/IV therapy skill	X	X
			X
	Endotracheal intubations (2 per year must be performed on humans)				4
	Intraosseous infusion placement		EMT w/IV therapy skill	X	X
			X
□	During the Certification Period
	Pediatric airway management				X
	Supraglottic airway placement		EMT w/supraglottic airway skill	X	X
			X
	Defibrillation	X	X	X	X

"X"	Indicates an individual must demonstrate proficiency of the skill to the satisfaction of the MPD.

(3) An EMS provider must successfully complete department-approved knowledge and practical skill examinations as identified in WAC 246-976-171.

(4) An EMS provider changing from the CME method to the OTEP method must meet all requirements of the OTEP method.

(5) Definitions of selected terms used in Tables A and B of this section:

(a) Cardiovascular education and training for adults, children, and infants includes:

(i) Nationally recognized training programs for CPR, foreign body airway obstruction (FBAO), and defibrillation and patient care appropriate to the level of certification;

(ii) The use of airway adjuncts appropriate to the level of certification;

(iii) The care of cardiac and stroke patients.

(b) Endotracheal intubation: Proficiency includes the verification of proper tube placement and continued placement of the endotracheal tube in the trachea through procedures identified in county MPD protocols.

(d) Intraosseous infusion: Proficiency in intraosseous line placement.

(e) IV starts: Proficiency in intravenous catheterization performed on sick, injured, or preoperative adult and pediatric patients. With written authorization of the MPD, IV starts may be performed on artificial training aids.

(f) Supraglottic airway placement: Proficiency includes the verification of tube placement and continued placement of the supraglottic airway, in a skill lab setting, through procedures identified in county MPD protocols.

(g) Other pediatric topics: This includes anatomy and physiology and medical problems including special needs patients appropriate to the level of certification.

(h) Patient assessment: This includes adult, pediatric and geriatric patients appropriate to the level of certification.

(i) Pharmacology: Pharmacology specific to the medications approved by the MPD (not required for EMRs).

(j) Proficiency: Ability to demonstrate and perform all aspects of a skill properly to the satisfaction of the MPD or delegate.

(k) Spinal immobilization and packaging: This includes adult, pediatric, and geriatric patients appropriate to the level of certification

(l) Trauma: For adult, pediatric, and geriatric patients appropriate to the level of certification.

PDFWAC 246-976-162

The CME method of recertification.