EMT-Intermediate Certification Class Requirements

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EMT-Intermediate Certification Class Requirements Welcome and thank you for choosing Pamlico Community College to continue your education!

1 EMT-Intermediate Certification Class Requirements Welcome and thank you for choosing Pamlico Community College to continue your education! The following list the requirements required to attend the EMT-Intermediate certification class at PCC. All requirements must be met according to the instructions and timelines listed below. Failure to do so will result in students not being allowed to enter the class or dismissal from the class. To register, schedule tests, or for questions contact: Kathy Swecker, Coordinator of OH & ES x 3017 Class Pre-requisites Submit a copy of High School Diploma or GED certificate. Submit copy of SAT, ACT, or college placement test scores such as Compass or Accuplacer or documentation of successful completion of a college level English and a college level Math. (students who do not meet this criteria and need to take a college placement test please contact Coordinator of OH & ES at PCC, Kathy Swecker, for additional information). Provide documentation of current EMT-Basic certification Successful completion of a pre-exam administered by PCC. Please contact Coordinator of OH & ES at PCC, Kathy Swecker, to schedule your pre-exam. Submit documentation of immunizations (additional guidelines for immunization submission listed below). Additional Class Requirements State Tuition Waiver Documentation: Students that are current members with a state agency that is eligible for the State Tuition Waiver must submit documentation prior to or on the first night of class. Acceptable documentation include: a current roster, a letter or from Chief/Captain from the state agency. The State Tuition Waiver will only cover the tuition fee and students are responsible for all additional costs. Failure to provide documentation by the first night of class will result in requirement of tuition payment. Tuition cost: $

2 Additional Class Requirements cont. Textbook: Jones & Bartlett Learning. Advanced Emergency: Care and Transportation of the Sick and Injured. Author(s): American Academy of Orthopedic Surgeons (AAOS) ISBN: (paperback). Can be purchased online. Price varies. Malpractice Insurance: Must be purchased through PCC first night of class. Cost is $ Background Check: Required before going to clinicals. Students will receive detailed information on where and when to obtain the first night of class. Cost is $ Current CPR certification by end of class.

3 GUIDELINES FOR COMPLETING IMMUNIZATION RECORD Immunization requirements are mandated by the clinical site and must be met prior to the first day of class unless otherwise indicated below. Acceptable immunization records may be obtained from any of the following: (please ensure your name and date of birth appear on each sheet and that all documents are submitted together. Records must be in black ink and the dates of vaccine administration must include the month, day, and year. It is recommended that you keep a copy for your records). High School or College/University Records Please be aware that high school or college records may not contain all of your immunization information. Personal Shot Records Must be verified by a doctor s stamp or signature or by a clinic or health department stamp. Local Health Department Military Records or WHO (World Health Organization Documents) Immunizations Requirements Rubella positive titer or proof of immunization, two doses of live Rubella vaccine or two live MMR Measles, Mumps and Rubella combined vaccine (Rubella & MMR must have been given at or after age 12 months during 1968 or later). Rubella immunity must be assured by this documentation if born before Two doses of live measles vaccine or two live MMR Measles, Mumps and Rubella combined vaccine (Both must have been given at or after age 12 months during 1968 or later). Tetanus / diphtheria or Tetanus vaccination within 10 ten years. (Tetanus/Diphtheria/acellular Pertussis (Tdap) is the preferred vaccine and students are strongly encouraged to receive it). Proof of a positive Varicella (chicken pox) titer. Hepatitis B vaccine (3 doses) or documentation that hepatitis B vaccine administration is in progress or proof of positive hepatitis B surface antibody titer. Although it is preferred that all Hepatitis B doses are complete before the first day of class, students will be allowed to enter the class if the first dose of the Hepatitis B vaccine has been administered and the student provides appropriate documentation prior to the first day of class. In addition students must obtain the second and third doses within the designated times and provide documentation of each dosage. Failure to do so will result in immediate dismissal from the class. 30 days prior to the start of clinicals, a tuberculin skin test (TST) must be obtained and documentation of negative results provided. If previous TB skin test reactor or converter, a questionnaire will be required to ensure student is free from TB symptoms. A Flu shot may be required prior to going to clinicals.

4 Name: A complete immunization record from a physician or clinic may be attached to this form. IMMUNIZATION RECORD To be completed and signed by physician or clinic. A complete immunization record from a physician or clinic may be attached to this form. Date Date Date Date DTP or Td (#1) (#2) (#3) (#4) Td booster (Tdap) within 10 years Polio MMR (after first birthday) MR (after first birthday) Measles (after first birthday) **Disease Date ****Titer Date & Mumps Rubella ***(Disease Date NOT Accepted) ***(Disease Date NOT Accepted) ****Titer Date & ****Titer Date & Hepatitis B Series/Titer (#1) (#2) (#3) ***Titer Date & Varicella (Chicken pox) series of two doses AND positive titer after the two doses. May have positive immunity by titer due to disease even if no vaccine Disease Date not Accepted; positive titer without Vaccination accepted Tuberculin (TST) Test (within 3 months of entrance) Date Read mm induration ) ***Titer Date & Chest x-ray, if positive TST; annual surveillance form Influenza (Required annually during flu season with due date announced each Fall Semester) Date Date Signature or Clinic Stamp REQUIRED: Signature of Physician/Physician Assistant/Nurse Practitioner Date Print Name of Physician/Physician Assistant/Nurse Practitioner Phone Number Office Address City State Zip Code ** Must repeat Rubella (measles) vaccine if received even one day prior to 12 months of age. *** Only laboratory proof of immunity is acceptable, not history of disease, if the vaccine is not taken. **** Attach Lab report

5 TB SURVEILLANCE QUESTIONNAIRE Please note that this questionnaire is for students who have identified themselves and/or presented documents that determine a documented positive TB test reaction or converter, and will be a part of the student medical record. *It is important that you furnish records of the initial conversion/reaction to the TB test and all treatments given, if any. Submit a report of any x-ray completed at the time of the treatment or since then as available. Printed Name Are you having any of these symptoms? 1. Unplanned weight loss (more than 10 percent of body weight)? 2. Night sweats (that cause you to have to change the bed sheets)? 3. Chronic cough in absence of cold or flu (greater than 3 weeks)? 4. Coughing blood-streaked sputum? 5. Fever lasting several weeks? 6. Pain in chest when taking a breath? 7. Unusual tiredness or weakness lasting several weeks? 8. Have you been diagnosed with diabetes, silicosis, renal disease, or liver disease or said to be immunocompromised? 9. Have you been diagnosed with pneumonia during the past year? 10. Have you traveled outside of the United States within the past year since you were previously evaluated for signs/symptoms of tuberculosis? Signature Date

6 GUIDELINES FOR TECHNICAL/FUNCTIONAL ABILITIES REQUIRED EMT-Intermediate Certification Class Certain functional abilities are essential for the delivery of safe, effective care during clinical experience activities. The EMS Continuing Education Staff, utilizing clinical site standards, has determined that certain technical standards are a requisite for progression and graduation from the EMT-Intermediate certification class. The student must be able to: Walk, stand for long periods of time, stoop, reach, lift, and bend. Lift, turn, support, move, position and transport patients of all weights and ages (newborns, pediatrics, adolescents, adults, and geriatrics). Access all patient bedsides and to respond immediately to an emergency situation anywhere in the hospital. Reach for, finger and handle records/reports in keying of data into a computer or other device. Use manual dexterity to render patient care. See and fully communicate (both orally and written) with patients, doctors, and other employees either in person or over the telephone. Work effectively with others demonstrating tact, discretion, and diplomacy. Must be able to maintain calm, effective, and accurate performance in stressful situations. Follows directions and performs assigned activities. Work around blood and bodily fluids, and potentially infectious organisms. I have read and understand the technical standards listed above and the inability to perform said standards may result in dismissal from the class. Signature Date

DO NOT SEPARATE THESE FORMS

DO NOT SEPARATE THESE FORMS Isothermal Community College Practical Nurse Education Mailing Address: Office Location: Isothermal Community College Rutherford Learning Center PO Box 804 134 Maple Street Spindale, NC 28160 Rutherfordton,