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by Nick White - Thursday, 20 December 2018, 4:09 PM


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by Nick White - Thursday, 15 November 2018, 3:03 PM


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by Nick White - Friday, 19 October 2018, 12:16 PM



Available courses






A complete how-to-guide on how to perform an accurate, concise, and professional call in report.

Please find attached job descriptions for Paramedic/AEMT/EMT-B, and Dispatch.

It is unrealistic to expect our crew members to memorize every address, street, landmark, or target hazard in their jurisdiction. However, it is reasonable to expect our drivers and co-pilots to know the quickest and most efficient route to a scene and hospital destination.  In our agency, we expect our new personnel to learn the major roads within our regional area.

In addition to the above information, we encourage new personnel to learn the location of all hospitals and the addresses and cross-streets of every hospital facility.

New employees at ART are in an extremely difficult situation. No matter how much training or orientation you receive, you will be unavoidably thrust into the world of EMS. With the high volume of work here at ART, a new employee must always be prepared to deal with situations that they have never come across. You must also be prepared to acclimate yourself to the different personalities and procedures that you will encounter.

All personnel with a significant amount of time here at ART will be expected to assist and train new employees. This training will include paperwork, procedures, and driving among other things. All ART “veterans” and new employees are expected to get along and work together. Leave all personality conflicts outside. We are a comparatively small company that does a high volume of work. The staff needs to function as a closely-knit group.

All new employees will be evaluated on paperwork, attitude, and overall performance. Use this manual and your common sense to consistently improve all aspects of your performance.

Acute Rescue & Transport is committed to providing a safe and healthful work environment for our entire staff. In pursuit of this endeavor, the following exposure control plan (ECP) is provided to eliminate or minimize occupational exposure to bloodborne pathogens in accordance with OSHA standard 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens."

The ECP is a key document to assist our agency in implementing and ensuring compliance with the standard, thereby protecting our employees.


This exam will test and assess for advanced understanding at the EMT-B level.

First introduced in the early 90's, the Coaching the Emergency Vehicle Operator™ (CEVO) courses for ambulance, fire and police personnel quickly became accepted as standards in driver training for these fields. Since then, over 500,000 emergency professionals have been trained with the CEVO™ programs.

Course Sessions Overview:

  1. Self-Appraisal (Pre-Training Assessment)
  2. Vehicle Inspection & Characteristics Review
  3. Critical Elements (SCC – Scanning, Cushion of Safety, Communicating)
  4. Situational Driving in both Emergency and Non-Emergency Driving (Applying the principles of SCC in congested driving environments)
  5. Situational Driving Continued in both Emergency and Non-Emergency Driving (Applying the principles of SCC in open roadway environments)
  6. Special Considerations (Backing, Adverse Weather, Driving at Night, Rotaries, The ‘Move Over Law’, Toll Areas)
  7. You Be The Coach (Emergency Driving Scenarios Analyses)

HIPAA: Health Insurance Portability and Accountability Act, a US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers. Developed by the Department of Health and Human Services, these new standards provide patients with access to their medical records and more control over how their personal health information is used and disclosed. They represent a uniform, federal floor of privacy protections for consumers across the country. State laws providing additional protections to consumers are not affected by this new rule. HIPAA took effect on April 14, 2003.

Hospital Destination Protocol

This course is designed to train employees on the St. Luke's Concussion Clinic standards and expectations. 


This course is an application training instruction on the use of Operative IQ.  It will introduce Operative IQ, the various applications (tabs) that are within it and how to enter all applicable data during employee shifts. This course was constructed for employee peace of mind, knowing the equipment and supplies they need for patient care are accounted for and serviceable.  

The presentation will cover numerous topics, some of them are:

- How to Log In and Log Out                       - Part inventory

- Part Request                                             - Narcotic Use and Tag Check

- Unit Inspections                                        - Incident Reporting

Those topics listed above, as well as many others, will be explained step by step to ensure accuracy in entering the required data per company SOP.   






The condition brought about by decreased insulin production, or the inability of the body cells to use insulin properly (which prevents the body’s cells from taking the simple sugar called glucose from the bloodstream)

Inside EMS, a podcast series that features hosts Chris Cebollero and Kelly Grayson, brings expert perspective to hot topics, clinical issues, operational and leadership lessons to EMS personnel and leaders to be safe and successful.

Mastering the vent.  Ventilator management skills.

The heart has an internal electrical system that controls the rhythm of the heartbeat. Problems can cause abnormal heart rhythms, called arrhythmias. There are many types of arrhythmia. During an arrhythmia, the heart can beat too fast, too slow, or it can stop beating. Sudden cardiac arrest (SCA) occurs when the heart develops an arrhythmia that causes it to stop beating. This is different than a heart attack, where the heart usually continues to beat but blood flow to the heart is blocked.



A stroke is a "brain attack". It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost.

How a person is affected by their stroke depends on where the stroke occurs in the brain and how much the brain is damaged. For example, someone who had a small stroke may only have minor problems such as temporary weakness of an arm or leg. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

A left ventricular assist device, or LVAD, is a mechanical pump that is implanted inside a person's chest to help a weakened heart pump blood.

Unlike a total artificial heart, the LVAD doesn't replace the heart. It just helps it do its job. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery or for people waiting for a heart transplant. LVADs are often called a "bridge to transplant."

LVADs may also be used as ''destination therapy.'' This means it is used long-term in some terminally ill people whose condition makes it impossible for them to get a heart transplant.

The community standard of care for AMI is rapid catheterization. A key component of this would be the rapid assessment of the patient, 12 lead EKG acquisition, and transmission of all pertinent data to the appropriate hospital to allow for decreased door to cath lab time. In the case of likely MI (manifested by 12 lead changes, unstable angina patterns, or failure to respond to treatment) care should be focused with this goal in mind.

This protocol covers allergic, anaphylactic, and anaphylactoid reactions of all severities.

Behavioral emergencies and combative patients are some of the most pitfall filled patients EMS personnel will encounter. Many of these patients will have multiple underlying pathologies, including illicit drug use, which will pose many challenges to overcome. Patient care should be focused with preventing/mitigating hyperthermia, agitated delirium, positional asphyxia, hypoxia, and physical self-harm.

This course provides one hour of instruction including evaluation and knowledge checks and is presented in a linear format. Please read each page and review the associated materials thoroughly.

This protocol covers isolated extremity crush injury with entrapment.

Cystic fibrosis is an inherited disease that causes thick, sticky mucus to build up in the lungs and digestive tract. It is one of the most common chronic lung diseases in children and young adults, and may result in early death.

Heat illness or heat-related illness is a spectrum of disorders due to environmental exposure to heat. It includes minor conditions such as heat cramps, heat syncope, and heat exhaustion as well as the more severe condition known as heat stroke.

A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history.

Hypotension is defined as a symptomatic blood pressure less than 90 mm/Hg. Use of good clinical judgment is essential to
determine cause and how aggressively to treat the hypotension.  This protocol includes shock and hypotension from a myriad of causes. Follow a more specific protocol if appropriate (i.e. Dehydration or Allergic Reaction). Fluid administration use should be used with caution in CHF patents.


A recently born infant, usually considered the first few hours of life


Considered the first 28 days of life

EMS providers must be capable of identifying any and all immediate or potential life threats in a child. Obtaining a reliable history and physical exam on a pediatric patient can be challenging at best, and communication tactics are certainly important to their success. This document will address some simple, yet effective tactics for pediatric assessment, along with a few pearls for success in procedural performance.

Right ventricular infarction was first recognized in a subgroup of patients with inferior wall myocardial infarctions who demonstrated right ventricular failure and elevated right ventricular filling pressures despite relatively normal left ventricular filling pressures. Increasing recognition of right ventricular infarction, either in association with left ventricular infarction or as an isolated event, emphasizes the clinical significance of the right ventricle to total cardiac function.

Interest in recognizing right ventricular infarction noninvasively has grown because of the therapeutic implications of distinguishing patients with right ventricular dysfunction from those with the more usual clinical presentation of left ventricular dysfunction. Patients with right ventricular infarctions associated with inferior infarctions have much higher rates of significant hypotension, bradycardia requiring pacing support, and in-hospital mortality than isolated inferior infarctions.

Shock: In medicine, a critical condition that is brought on by a sudden drop in blood flow through the body. The circulatory system fails to maintain adequate blood flow, sharply curtailing the delivery of oxygen and nutrients to vital organs. It also compromises the kidneys and so restricts the removal of wastes from the body. Shock can be due to a number of different mechanisms, including not enough blood volume and not enough output of blood by the heart. The signs and symptoms of shock include low blood pressure (hypotension); overbreathing (hyperventilation); a weak, rapid pulse; cold, clammy, grayish-bluish (cyanotic) skin; decreased urine flow (oliguria); and a sense of great anxiety and foreboding, confusion, and sometimes combativeness. Shock, which is a major medical emergency, is common after serious injury. Emergency care for shock involves keeping the patient warm, giving fluids by mouth or, if necessary, intravenously, and frequently the administration of drugs that act to improve cardiac and circulatory function.

The body's balance between acidity and alkalinity is referred to as acid-base balance.

The blood's acid-base balance is precisely controlled because even a minor deviation from the normal range can severely affect many organs. The body uses different mechanisms to control the blood's acid-base balance. These mechanisms involve the

  • Lungs
  • Kidneys
  • Buffer systems

Excellence in Critical Care Transport 2.0 (CCT)

Chapter 1: Introduction to Critical Care Transport

Chapter 2: Medicolegal Issues

Chapter 3: Air Transport Fundamentals

Chapter 4: Flight Physiology

Chapter 5: Airway and Respiratory

Chapter 6: Critical Care Pharmacology

Chapter 7: Lab Analysis

Chapter 8: Shock and MODS

Chapter 9: Trauma

Chapter 10: Burns

Chapter 11: Neurology

Chapter 12: Cardiology

Chapter 13: Hemodynamics

Chapter 14: IABP

Chapter 15: GI/GUChapter 16: Endocrinology

V.A.C. VERAFLO™ Therapy combines the benefits of V.A.C.® Therapy with automated topical wound solution distribution and removal. 

V.A.C. VERAFLO™ Therapy can help: 
  • Cleanse with the instillation of topical wound cleansers
  • Treat with the instillation of topical antimicrobial and antiseptic wound solutions
  • Heal the wound and prepare for closure

This is a general protocol for non-specific OB emergencies, including contractions of non-specific etiology and vaginal bleeding (other than post partum). When possible this protocol should supplement other, more specific protocols based on clinical assessments and judgment.

This course provides one hour of instruction including evaluation and knowledge checks and is presented in a linear format. Please read each page and review the associated materials thoroughly.

The course consists of the following components:

  • Course Instructions
  • Course Sections
  • Knowledge-Check Quizzes
  • Course Summary
  • Post-Test/Final Exam

Oxygenation: The addition of oxygen to any system, including the human body. Oxygenation may also refer to the process of treating a patient with oxygen, or of combining a medication or other substance with oxygen.

Pain management: The process of providing medical care that alleviates or reduces pain. Mild to moderate pain can usually be treated with analgesic medications, such as aspirin. For chronic or severe pain, opiates and other narcotics may be used, sometimes in concert with analgesics; with steroids or nonsteroidal anti-inflammatory drugs when the pain is related to inflammation; or with antidepressants, which can potentiate some pain medications without raising the actual dose of the drug and which affect the brain's perception of pain. Narcotics carry with them the potential for side effects and addiction. However, the risk of addiction is not normally a concern in the care of terminal patients. For hospitalized patients with severe pain, devices for self-administration of narcotics are frequently used. Other procedures can also be useful in pain management programs.

Intraosseous infusion is a method of gaining access to the circulatory system in infants and children, in which a specialized trocar is placed in the proximal tibia. All IV drugs and fluids may be given by the intraosseous route.

Intranasal (IN) and Rectal (PR) administration of certain medications are alternatives when traditional vascular access (IV, IO) is not available or not desired. IN and PR administration may also be utilized when other routes (IM, SQ) would take too long to reach peak effects.

A needle thoracotomy is an invasive procedure that allows for emergency chest decompression in patients with respiratory and/or hemodynamic compromise secondary to suspected tension pneumothorax.


ZOFRAN is indicated for the prevention of nausea and vomiting associated with:

  • highly emetogenic cancer chemotherapy, including cisplatin greater than or equal to 50 mg/m2
  • initial and repeat courses of moderately emetogenic cancer chemotherapy
  • radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen

ZOFRAN is also indicated for the prevention of postoperative nausea and/or vomiting.

Short-acting, lipophilic sedative/hypnotic; causes global CNS depression, presumably through agonist actions on GABAa receptors




A co-oximeter is a blood gas analyzer that, in addition to the status of gas tensions provided by traditional blood gas measurements, measures concentrations of oxygenated hemoglobin (oxyHb), deoxygenated hemoglobin (deoxyHb or reduced Hb), carboxyhemoglobin (COHb), and methemoglobin (MetHb) as a percentage of the total hemoglobin concentration in the blood sample.


          -ART SWO


          -Baxter Flo-Gard 6301 Dual Channel Volumetric Infusion Pump

Airway management is arguably one of the most important skills for an EMT-P to master because failure to secure an adequate airway can quickly lead to death or disability.  Endotracheal intubation using rapid sequence intubation (RSI) is the cornerstone of emergency airway management.

The decision to intubate is sometimes difficult. Clinical experience is required to recognize signs of impending respiratory failure. Patients who require intubation have at least one of the following 5 indications:

  • Inability to maintain airway patency
  • Inability to protect the airway against aspiration
  • Failure to ventilate
  • Failure to oxygenate
  • Anticipation of a deteriorating course that will eventually lead to respiratory failure

Cricothyrotomy is an emergency life-saving procedure.  It is an invasive technique which allows a patent airway to be rapidly established for temporary ventilation and oxygenation of those patients in whom airway control is not possible by other means.




Invasive (intra-arterial) blood pressure (IBP) monitoring is a commonly used technique in the Intensive Care Unit (ICU) and is also often used in the operating theatre.

This technique involves direct measurement of arterial pressure by inserting a cannula needle in a suitable artery.  The cannula must be connected to a sterile, fluid filled system which is connected to an electronic patient monitor.  The advantage of this system is that a patient’s blood pressure is constantly monitored beat-by-beat, and a waveform can be displayed.