(1) Ongoing training and evaluation programs (OTEP):
(a) Must provide knowledge and skill evaluations following completion of each topic presentation to determine student competence of topic content.
(i) Must record practical skill evaluations on skill evaluation forms from nationally recognized training programs, or on department-approved practical skill evaluation forms, for the level of certification being taught.
(ii) If an evaluation form is not provided, a skill evaluation form must be developed and approved by the MPD and the department to evaluate the skill;
(b) Must be conducted at least on a quarterly basis;
(c) Must be approved by the MPD and the department. Any additions or major changes to an approved OTEP requires documented approval from the county MPD and the department;
(d) Must be presented and evaluated by course personnel meeting the following qualifications:
(i) Evaluators must:
(A) Be a currently certified Washington EMS provider who has completed at least one certification cycle. Certification must be at or above the level of certification being evaluated;
(B) Complete an MPD approved evaluator's workshop, specific to the level of certification being evaluated, which teaches participants to properly evaluate practical skills using the skill evaluation forms identified in (a) of this subsection. Participants must demonstrate proficiency to successfully complete the workshop;
(C) Complete the evaluator application, DOH Form 530-012;
(I) Be approved by the county MPD and the department; and
(II) Submit the MPD approved EMS evaluator application to the department.
(D) Meet education and participation requirements as identified by the county medical program director;
(E) Be recommended for reapproval by the county medical program director upon EMS credential recertification.
(ii) Instructors must:
(A) Be a currently approved EMS evaluator at or above the level of certification being taught;
(B) Be approved by the county MPD to instruct and evaluate EMS topics;
(iii) Guest lecturers, when used, must have specific knowledge and experience in the skills of the prehospital emergency care field for the topic being presented and be approved by the county MPD to instruct EMS topics;
(e) May use online training to provide all or a portion of an OTEP when:
(i) Online training provides sufficient topic content to meet all annual and certification period requirements;
(ii) Each didactic training topic requires an online cognitive evaluation after the training. Successful completion of the topic evaluation is required to receive credit for the topic;
(iii) Instruction and demonstration of all practical skills are provided in person by an SEI or qualified EMS evaluator approved by the MPD to instruct the practical skills;
(iv) Each practical evaluation is completed and scored in the presence of a state approved EMS evaluator or SEI. Each evaluation must be successfully completed to receive credit for the practical skill.
(2) To complete the OTEP method of recertification, the EMS provider:
(a) Must complete a county MPD and department-approved OTEP that includes requirements indicated in Table A of this section, for the certification period, appropriate to the level of certification;
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. |
* | Individuals obtaining education through the CME method must complete the total number of educational course hours indicated above. However, due to the competency-based nature of OTEP, fewer class hours may be needed to complete these requirements than the total course hours indicated above. |
(b) Complete and document the skills maintenance requirements, indicated in Table B of this section, appropriate to the level of certification. Skill maintenance requirements may be obtained as part of the OTEP.
Table B
Skills Maintenance Requirements for the OTEP Method
| EMR | EMT | AEMT | Paramedic |
First Certification Period or Three Years |
□ | First Year | | | | |
| IV starts | | EMT w/IV therapy skill | 12 | 12 |
| | | 12 | | |
| Human endotracheal intubations | | | | 4 |
| 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 | 24 | 24 |
| | | 12 | | |
| Human endotracheal intubations over the two-year period | | | | 8 |
| Intraosseous infusion placement | | EMT w/IV therapy skill | X | X |
| | | X | | |
During the Certification Period |
| Pediatric airway management | | EMR & EMT | X | X |
| | | 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 | | |
| Human endotracheal intubation | | | | 2 |
| Intraosseous infusion placement | | EMT w/IV therapy skill | X | X |
| | | X | | |
□ | During the Certification Period | | | | |
| Pediatric airway management | | EMR & EMT | X | X |
| | | 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. |
(c) EMS providers using the OTEP method meet skill maintenance requirements by demonstrating proficiency in the application of those skills to the county MPD during the OTEP.
(d) Any EMS provider changing from the OTEP method to the CME method must meet all requirements of the CME method.
(3) Skill maintenance requirements for applicants requesting reciprocal certification:
(a) Reciprocity applicants credentialed less than three years must meet Washington state's skill maintenance requirements for the initial certification period identified above.
(b) Reciprocity applicants credentialed three years or more must meet Washington state's skill maintenance requirements for second and subsequent certification periods.
(c) The county MPD may evaluate an EMS provider's skills to determine proficiency in the application of those skills prior to recommending certification. The MPD may recommend that an EMS provider obtain specific training to become proficient in any skills deemed insufficient by the MPD or delegate.
(4) 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; and
(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.
(c) Infectious disease: Infectious disease training must meet the requirements of chapter
70.24 RCW.
(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.