Emergency Medical Services
Ongoing Training & Evaluation Program

PDF Version of WAC 246-976-161

(1) Education is required for the recertification of all certified EMS personnel. This education may be obtained by completing the continuing medical education (CME) method, or through the ongoing training and evaluation program (OTEP) method, identified below.

     (a) CME topic content:

     (i) Must meet annual and certification period educational requirements identified in Table A of this section, utilizing:

     (A) Cognitive, affective and psychomotor objectives found in curricula identified in WAC 246-976-021, for the level of certification being taught.

     (B) Current national standards published for CPR, foreign body airway obstruction (FBAO), and automatic defibrillation.

     (C) County medical program director (MPD) protocols, regional patient care procedures, and county operating procedures.

     (D) Training updates in standards as identified by the department.

     (ii) Must be approved by the MPD.

     (iii) May incorporate nationally recognized training programs as part of CME for content identified in (a)(i)(A) of this subsection.

     (b) To complete the CME method you must:

     (i) Complete and document the educational requirements, indicated in Table A of this section, appropriate to your level of certification.

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

     (A) IV starts for IV technicians, combined IV/airway technicians, ILS technicians, combined ILS/airway technicians, or paramedics:

     (I) During your first certification period, you must perform a minimum of one hundred eight successful IV starts.

     • During the first year, you must perform a minimum of thirty-six successful IV starts.

     • During the second and third year, you must perform a minimum of thirty-six successful IV starts per year, which may be averaged over the second and third years of the certification period.

     (II) If you have completed a certification period, you must demonstrate proficiency in starting IVs to the satisfaction of the MPD (see later certification periods in Table B of this section).

     (B) Endotracheal intubations for airway technicians, combined IV/airway technicians, combined ILS/airway technicians or paramedics:

     (I) During your first certification period, you must perform a minimum of thirty-six successful endotracheal intubations.

     • During the first year, you must perform a minimum of twelve successful endotracheal intubations of which four of the endotracheal intubations must be performed on humans.

     • During the second and third year, you must perform a minimum of twelve endotracheal intubations per year, which may be averaged over the second and third years of the certification period. Four of these endotracheal intubations per year must be performed on humans.

     (II) If you have completed a certification period, you must perform a minimum of four successful human endotracheal intubations per year, which may be averaged over the three-year certification period (see later certification periods in Table B of this section).

     (III) Upon approval of the MPD, individuals unable to complete the required endotracheal intubations during the certification period, may meet the endotracheal intubation requirements by completing a MPD and department-approved intensive airway management training program, utilizing cognitive, affective and psychomotor objectives covering all aspects of emergency airway management.

     (iii) Successfully complete the Washington state written examination and practical skills examination as identified in WAC 246-976-171.

     (c) Any applicant changing from the CME method to the OTEP method must meet all requirements of the OTEP method.

     (d) Ongoing training and evaluation programs:

     (i) Must meet annual and certification period educational requirements identified in Table A, utilizing:

     (A) Cognitive, affective and psychomotor objectives found in curricula identified in WAC 246-976-021, for the level of certification being taught, in the following core content areas:

     (I) Airway/ventilation (including intensive airway management training for personnel with advanced airway qualifications to determine competency).

     (II) Cardiovascular.

     (III) Medical emergencies/behavioral.

     (IV) Trauma (including intensive IV therapy training for personnel with qualifications to determine competency).

     (V) Obstetrics and pediatrics.

     (VI) Operations.

     (B) The current national standards published for CPR, foreign body airway obstruction (FBAO), and defibrillation and patient care appropriate to the level of certification.

     (C) County medical program director (MPD) protocols, regional patient care procedures, and county operating procedures.

     (D) Training updates in standards as identified by the department.

     (ii) Must provide cognitive, affective and psychomotor evaluations following completion of each topic presentation to determine student competence of topic content.

     Psychomotor skill evaluations must be recorded on skill evaluation forms from nationally recognized training programs, or on forms provided in approved curricula identified in WAC 246-976-021, for the level of certification being taught. If an evaluation form is not provided, a skill evaluation form must be developed and approved by the MPD to evaluate the skill.

     (iii) Must be approved by the MPD; any additions or major changes to an approved OTEP require documented approval from the county MPD and the department.

     (iv) Must be presented and evaluated by course personnel meeting the following qualifications:

     (A) Evaluators must:

     (I) Be a currently certified BLS or ALS provider who has completed at least one certification cycle. Certification must be at or above the level of certification being evaluated.

     (II) Complete an MPD approved evaluator's workshop, specific to the level of certification being evaluated, and teach proficiency in utilizing skill evaluation forms identified in (d) (ii) of this subsection;

     (III) Complete the evaluator application, DOH Form 530-012;

     (IV) Be approved by the county MPD and the department.

     (B) Instructors must:

     (I) Be a currently certified BLS or ALS provider who has completed at least one certification cycle at or above the level of certification being taught.

     (II) Be a currently approved evaluator at the level of certification being taught.

     (III) Be approved by the county MPD to instruct and evaluate EMS topics.

     (C) Guest lecturers, when utilized, 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.

     (v) May incorporate nationally recognized training programs within an OTEP for the core content areas identified in (d)(i)(A) of this subsection.

     (e) To complete the OTEP method you must:

     (i) Complete a department- and MPD-approved OTEP that includes requirements indicated in Table A of this section, appropriate to your level of certification.

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

     (A) IV starts for IV technicians, combined IV/airway technicians, ILS technicians, combined ILS/airway technicians, or paramedics:

     (I) During your first certification period, you must perform a minimum of thirty-six successful IV starts.

     • During the first year, you must perform a minimum of twelve successful IV starts.

     • During the second and third year, you must perform a minimum of twelve successful IV starts per year, which may be averaged over the second and third years of the certification period.

     (II) If you have completed a certification period, you must demonstrate proficiency in starting IVs to the satisfaction of the MPD (see later certification periods in Table B of this section).

     (B) Endotracheal intubations for airway technicians, combined IV/airway technicians, combined ILS/airway technicians or paramedics:

     (I) During your first certification period, you must perform a minimum of twelve successful endotracheal intubations.

     • During the first year, you must perform a minimum of four successful human endotracheal intubations.

     • During the second and third year, you must perform a minimum of four human endotracheal intubations per year, which may be averaged over the second and third years of the certification period.

     (II) If you have completed a certification period, you must perform a minimum of two successful human endotracheal intubations per year, which may be averaged over the three-year certification period (see later certification periods in Table B of this section).

     (C) Skills maintenance requirements may be obtained as part of the OTEP.

     (D) Individuals participating in an OTEP meet skill maintenance requirements by demonstrating proficiency in the application of those skills to the county MPD during the OTEP.

     (f) Any applicant changing from the OTEP method to the CME method must meet all requirements of the CME method.

     (g) Education requirements for recertification - Table A: