Frequently Asked Questions About the EMT-Basic Program

Why are EMT-Basic Program students required to have a Caregiver Background Check?

Why are EMT-Basic students required to have immunizations?

Why is CPR a prerequisite for the EMT-Basic program and not part of the training itself?

Why are EMT-Basic Program students required to have a Caregiver Background Check?

Caregiver Background Checks are required by law to protect patients as well as to avoid civil liability.

In October 1998, Wisconsin enacted a Caregiver Background Check Law. Briefly, this law requires health care providers to protect patients by requiring Caregiver Background Checks for all people who may come in contact with their patients. This law includes students. All NWTC students having contact with patients must complete this background check.

EMT-Basic program students are required to have five (5) patient contacts in order to complete training. Regardless of where students complete these patient contacts, whether in a hospital or with their sponsoring ambulance service, they are considered NWTC students when doing the contacts. The college is obligated to protect patients when students encounter them in the course of performing patient contacts. It is NWTC's responsibility to assure that each student has obtained a Caregiver Background Check and is safe to have contact with patients whether the patient contact occurs with their sponsoring ambulance service or in a hospital.

Additional information on the Caregiver Background Check law can be obtained at the DHFS website: www.dhfs.state.wi.us .

The Wisconsin administrative rule governing EMT-Basic training in Wisconsin says the following regarding the curriculum to be used for Wisconsin-approved EMT-Basic courses.

HFS 110.07 (1) (c) 2 - "The training shall include training covered in the national standard curriculum for training EMTs and additional training approved by the department as part of the state standard curriculum."

Why are EMT-Basic students required to have immunizations?

Immunizations are a health necessity and they are also needed to avoid civil liability.

EMT-Basic program students are required to have five (5) patient contacts in order to complete training. Regardless of where students complete these patient contacts, whether with their sponsoring ambulance service or at a hospital, they are considered NWTC students when they are doing the contacts. Therefore the college is responsible for protecting students and patients during these encounters. NWTC must make sure that its students are safe and that students don't pose any preventable risks to patients. There is no law requiring EMT-Basic students to have immunizations - it is a health and safety issue. When students have contact with patients, diseases could be transmitted by patients to students or vice versa. If this were to occur then NWTC would be held liable if it didn't take necessary steps to prevent disease transmission in accordance with current curriculum recommendations.

The National Standard Curriculum for training EMTs identifies immunizations that are recommended for EMT-Basics. The hospitals that NWTC utilizes as clinical training sites for the EMT-Basic Program also require certain immunizations and health standards.

NWTC is committed to protecting its students. The college is also obligated to protect people when students encounter the general public in the course of performing clinical training. Further, NWTC is committed to preparing entry-level EMTs who are ready to function in the field upon completion of their training. When EMT-Basics go to work in the field after their training course, health and safety become important concerns for the emergency agency that they serve. Since NWTC students have already obtained their immunizations, they are prepared to safely perform their job as an EMT in this regard.

Why is CPR a prerequisite for the EMT-Basic program and not part of the training itself?

The current curriculum is the "Emergency Medical Technician - Basic: National Standard Curriculum" , published in 1994. All Wisconsin-approved EMT courses adopted and began using this curriculum in 1995. CPR is not included in this curriculum because CPR is designated as a program prerequisite. Prerequisites for the EMT-Basic Program are discussed on page 19 of the National Standard Curriculum (NSC). It states the following:

"Cardiopulmonary Resuscitation (CPR) -- To meet the time requirements of this revised EMT-Basic Curriculum, CPR should be a prerequisite. Basic life support (CPR) is an essential component of any EMS educational experience and this class should be successfully completed prior to entering the EMT-Basic program. This may be accomplished by various alternatives:

•  Assure that the EMT-Basic candidates have a current card prior to entering the program.

•  Offer one or several programs of CPR prior to the start of the EMT-Basic Program.

•  Set a time prior to the beginning of the EMT-Basic Program and require all students seeking to enter that program to participate or test out.

Note: Although CPR is a prerequisite, it should be routinely practiced and integrated throughout the entire instruction of the EMT-Basic Program. Skill stations should be created to reinforce knowledge and skills."

At NWTC a decision was made in approximately the year 1999 to try re-inserting CPR back into the program, despite the CPR prerequisite. This was done in part for the following reasons:

• A few ambulance services complained about the CPR prerequisite and wanted it to be part of the Program.
• A few adjunct instructors requested that CPR be included in the program.
• Many students were being admitted to the program without appropriate and current CPR cards despite the prerequisite. In other words, they weren't meeting the CPR prerequisite anyway.
• On the whole, most students were demonstrating very poor CPR knowledge and skills when they arrived at EMT class. In many cases it was hard to believe that they had ever taken a CPR course based upon their poor performance in EMT class.

After this, CPR skills seemed to improve but another problem emerged - other skills suffered . CPR for Health Care Providers (HCP) takes eight (8) hours so other topic-hours had to be removed in order to insert CPR into the course. Time at the end of the course formerly used as practice time preparing for the NREMT exam was sacrificed to accommodate CPR. The overall practical skill performance on the NREMT exam seemed to decline because of this.

Other Wisconsin Technical Colleges have experimented in similar ways at one time or another with inserting and removing CPR from their EMT-Basic Program. However, please consider the following points.

• At the present time, none of the WTCS colleges include CPR in their EMT-Basic Program. CPR is a prerequisite for program entry at all 16 colleges statewide.
• The Wisconsin-approved curriculum (the National Standard Curriculum) states that CPR should be a prerequisite to the EMT-Basic Program.
• The WTCS EMS Consultant (Steve Teale) recommends that CPR be a prerequisite to the EMT-Basic Program.
• The DHFS EMS Section (the state agency that approves all Wisconsin EMT-Basic training) recommends that CPR be a prerequisite to the EMT-Basic Program.

Based on all of these factors, a decision was made in early 2004 to remove CPR from the NWTC EMT-Basic Program, making it a prerequisite again.

EMTs must be ready to perform CPR as an expert. The public expects an EMT (or an EMT student) arriving at the scene of an emergency to execute CPR with alacrity, in accordance with current standards, with keen attention to detail and with exemplary competence. The public watches and evaluates what EMTs do and many people in the general public have taken CPR themselves so they know good or poor CPR when they see it . CPR is a cornerstone skill for handling resuscitation situations. Many other aspects of care delivered by an EMT rely on principles learned in CPR class. During the EMT-Basic Program, students benefit by having fresh CPR skills and a recent CPR class, in fact these are essential.

Clinical sites used by the NWTC EMT-Basic Program require that students have a current CPR card. In order to help EMT students be ready to spontaneously and appropriately perform CPR in their clinical experience, we require that their CPR card be issued no more than six (6) months prior to the beginning of their EMT course. This serves as a reasonable and conscientious standard for all NWTC EMT-Basic Program students. This helps students have very good CPR skills and knowledge when they enter the EMT-Basic program.

Questions? Contact Sarah Deuchert at 920-498-6240 or 1-800-422-6982, Ext. 6240