TFRD Procedures & Guides

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=====B-65 Pathway To Paramedic======
===Non-Emergency Manual=== 
==Date Revised: 07/30/2023==
<sub>Last Modified: ~~LASTMOD~~ </sub>

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**Purpose**

The following guidance will be used by TFRD members wishing to become paramedics, and newly hired, probationary employees that have a State of Ohio paramedic certification in good standing to detail the TFRD paramedic internship program.

**Policy/Procedure**

**BEFORE ENTERING A PARAMEDIC PROGRAM:**

**1.**	TFRD members are eligible for education reimbursement if attending an accredited paramedic education program.

**2.**	__**Before**__ registering with an accredited paramedic education program, the TFRD Executive Financial Administrator (EFA) Shall be notified of the student’s intent. The TFRD EFA will provide the prospective paramedic student instructions regarding eligibility and requirements of the education reimbursement program of The City of Toledo (COT). The student must submit the City of Toledo Educational Reimbursement Benefit Request for Approval; the form is found on Target Solutions.

**3.**	Understanding that each paramedic program and student may progress at a different pace, the TFRD paramedic student shall make regular contact with the TFRD Training Bureau regarding class status and progression, and to provide any unforeseen changes in graduation date.

**AFTER GRADUATING ACCREDITED PARAMEDIC TRAINING PROGRAM:**

**Paramedic Internship Program consists of 2 phases:**

*TFRD Recruits, hired with a State of Ohio paramedic certification will be addressed at the end of this procedure*

**Paramedic Internship – Phase 1**

**1.**	Once a paramedic has graduated from an accredited program, they are to alert both the Training and EMS Bureaus when they have received their National Registry or State of Ohio paramedic certification and provide copies of their certifications.

**2.**	Once a paramedic is awarded their State of Ohio paramedic certificate, they will be enrolled in the TFRD paramedic internship program that consists of additional ALS transport ride time and education as deemed necessary by the TFRD Medical Director, Training, and EMS Bureaus. (Refer to the CBA between the COT and L92, Section [[https://www.tfrdweb.com/dokuwiki/doku.php?id=contracts:local-92-2021-2024#paramedic_program|2125.100]]):

Every attempt will be made to schedule the paramedic internship hours on duty within a reasonable amount of time.
During the paramedic internship program, the paramedic will be required to complete the following:

  - A minimum of 96 hours of ALS medic ride time and 20 documented patient contacts as a third EMS (ALS) provider. Each electronic health record (EHR) that the intern creates will be reviewed and signed by the senior paramedic assigned to the medic unit during the ride time. The intern will not be documented as the “lead provider,” but will take the opportunity to act as the lead and have their assessment, interview, and intervention skills evaluated by senior paramedics on scene.\\ \\ 
    - Every attempt will be made to allow the intern to complete the ride time in 12- hour blocks, preferably 0700-1900, to better allow for quality hands on training and instruction.\\ \\
    - During each of the ride-time blocks, the intern will be responsible for completing an “open book” protocol review quiz, assigned by the TFRD Training Bureau.\\ \\ 
      - During the ride-time, the intern will be required to complete practical skill assessments, evaluated by either the PTO, EMS, or Training Bureau staff.\\ \\
        - The practical assessments are educational in nature and if the intern requires more instruction, they will be offered additional time to complete the assessments.\\ \\
      - Additional Training/education may be offered the intern during their ride-time if available.\\ \\
      - Completion of the ALS skill sheet (located in ALS protocol Admin 200; J-2)\\ \\
    - After the 96-hour ride time has been completed, the intern will be detailed to the Training Bureau during their regularly scheduled shift to complete a written protocol exam and practical skill test with Training or EMS Bureau staff.\\ \\
      - The Practical skill challenge will consist of essential skills that all line paramedics must possess, according to TFRD ALS protocol.\\ \\
    - If the intern is unsuccessful in passing any quiz, test, or practical assessment during the TFRD paramedic internship program, they will be allowed additional instruction until they are successfully able to meet the TFRD standard of care.\\ \\
      - Drug test- This will be scheduled by the Health and Wellness Officer after notification from the TFRD EMS Bureau and must be completed before an intern is released from the internship program and permitted to work as a TFRD paramedic.\\ \\
      - Documented ride time with either a PTO/Training Bureau/EMS Bureau staff member.\\ \\
      - Meet the TFRD Medical Director for expectations of performance and protocol/skill review.\\ \\
      - Education at the TFRD annex, for medication exchange, after-hours access, and emergency procedures.\\ \\
      - Security access to vending machines.\\ \\

**3.** __Copies of the following must be submitted to the TFRD Training Bureau Supervisor before a member can be added to the TFRD Pharmacy License: refer to ALS protocols Admin 200-J for more information.__

    * Completed paramedic skill sheet
    * Valid driver’s license
    * AHA BLS cert. card
    * National Registry Certification card
    * Current State of Ohio Paramedic Certification card
    * ACLS cert. card
    * Meet with TFRD Medical Director
      * //The meeting may include protocol and practical skill review.//
      * //The Medical Director may elect to do this in person, virtually, or by webinar.//

**4.**	When all requirements of the TFRD internship have been satisfied, the member will be added to the pharmacy license and move to Phase 2 of the internship program.

**Paramedic Internship – Phase 2**

The second phase of the internship program will begin at the time the paramedic has been added onto the TFRD Pharmacy License.

**1.**	A paramedic that has been added to the TFRD pharmacy license will be partnered with an experienced paramedic for a minimum of 480 hours on an ALS medic unit as a second (paramedic) EMS provider. At this time, the intern has progressed to a full-fledged paramedic; but will have an opportunity to work together with an experienced paramedic, recognizing that this will be a different experience than riding as a third provider.

**2.**	The Training Bureau and/or EMS Bureau will periodically check on the intern’s progress and to assess protocol retention and hands-on skills. These interactions will be scheduled with the intern, and they will have an opportunity to prepare for the assessments.

**3.**	12 months after the intern has been added to the TFRD pharmacy license, the intern will be detailed to the Training Bureau for a final protocol test and physical skill challenge. This will be scheduled through the Senior Battalion Chief of that shift in accordance with the detailing agreement.
  -	If the intern is unable to pass the protocol review test or skill challenge, the intern will be offered education and/or instruction to assist them in successfully completing the assessments.

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**Newly hired paramedics:**

**1.**	Recruits that currently have a State of Ohio paramedic certification are required to complete the paramedic internship program.

**2.**	Every attempt will be made to allow the intern to complete their first phase of the internship while in recruit status.

  -	While the recruit class is in EMT-Basic training; assigned to the TFRD Training Bureau, the paramedic recruits will be entered into the TFRD paramedic internship program.

**3.**	When the recruits graduate from the Fire Academy, the paramedic probationary employees will work as paramedics during their 3 rotations.

  - __First Rotation__ – The paramedic probationary employee will be allowed to practice within their certification only while under the guidance of an experienced TFRD paramedic.\\ \\
    - At no time will 1st rotation, paramedic be utilized as the sole paramedic on any rig, or scene.\\ \\
    - Giving the probationary employee an opportunity to work to their certification level will allow them to keep valuable skills up to date.\\ \\
    - 1st round paramedic, probationary employees will not be listed as paramedics in Vector Solutions.\\ \\
  - __Second Rotation__ – The paramedic, probationary employees will be listed with a “RED” P in Vector Solutions, and will be allowed to use their paramedic skills only while operating under the supervision of an experienced TFRD paramedic.\\ \\
    - 	If the paramedic, probationary employee is scheduled to ride a medic unit, they will do so with an experienced TFRD paramedic.\\ \\
      - The paramedic, probationary employee will not be the sole paramedic on a TFRD engine, truck, squad, or medic unit.\\ \\
  - __Third Rotation__ – The paramedic, probationary employee will be listed with a “YELLOW’ P in Vector Scheduling; allowed to function independently as a TFRD paramedic.

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**TFRD ALS CE Requirements, refer to TFRD ALS Protocol 200-H**

**1.**	Once the paramedic has received their State of Ohio paramedic certification, they shall attend TFRD ALS Continuing Education (CE).

**2.**	TFRD paramedics are responsible for signing up for monthly ALS CE, on their own. CE dates can be scheduled on Target Solutions. The EMS Bureau can assist new paramedics with the scheduling process. 419-245-1275.

**3.**	Students attending in-person CE must sign 2 rosters. The first roster is to be signed at the beginning of class to certify attendance. The Second roster is to be signed upon completion of CE to certify completing that month’s CE, and to declare CTE or OT.
  - TFRD EMS Bureau will enter time into Target Scheduling for compensation, once the rosters are provided by the CE training center.

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See Also:
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