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Original Contribution

Industry Best Practice: When Your Level of Training Isn`t Enough

March 2009

     When providers at Lecanto, FL-based Nature Coast EMS realized they were not equipped to handle some of their more critically ill and injured patients, they took matters into their own hands and developed a training program that would meet their needs.

     "In our area, the only critical care transports available are for neonates, so it falls to local EMS services all over the state to handle critical care patients," says education director Jane Bedford, RN, CCEMT-P. "The DOT paramedic curriculum does not address critical care transports or the interfacility aspect of critically ill or injured patients."

     Once Nature Coast identified the need for more training, they worked with the Florida Bureau of EMS Advisory Council to develop a minimum critical care curriculum for paramedics, says Bedford. The Council is now working to develop legislation to include the curriculum in training centers around the state.

     Although the training was not mandatory, 80% (24) of Nature Coast's paramedics took the 100+-hour class, which was paid for by the agency. The training, says Bedford, has made a significant difference in the quality of care.

     "If you're doing an interfacility transfer of a critical patient and you aren't familiar with the equipment or current treatment the patient is under, you don't always know the right questions to ask," she says. "This training has given paramedics a level of knowledge that allows them to make informed decisions and treat their patients better. Also, because they're more familiar with the situation or the patient's condition, they know when to say, 'I need an extra set of hands.' In the past, we just took patients and ran. EMS is not rescue anymore. What we do now is prehospital medicine, and when we transfer a patient from one hospital to another, we don't want the standard of care to drop. We want that patient to be appropriately ventilated with a ventilator that our clinicians know how to operate, and this new level of training allows that to happen."

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