EMT Policies (pdf) - UCLA Center for Prehospital Care
EMT Policies (pdf) - UCLA Center for Prehospital Care
EMT Policies (pdf) - UCLA Center for Prehospital Care
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<strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong><br />
<strong>EMT</strong> Education Program<br />
Course Policy Manual<br />
December 2012 – December 2013
Table of Contents<br />
Introduction ................................................................................................................................................... 4<br />
General Philosophy & Mission ..................................................................................................................... 4<br />
Program Staff and Faculty ............................................................................................................................ 5<br />
Documentation of Program Eligibility ......................................................................................................... 6<br />
Accreditations ............................................................................................................................................... 8<br />
Student Services ............................................................................................................................................ 8<br />
Ethics and Standards of Conduct .................................................................................................................. 9<br />
Misconduct ................................................................................................................................................. 11<br />
Program In<strong>for</strong>mation ................................................................................................................................... 15<br />
General Course Description ........................................................................................................................ 15<br />
Required Textbook and Materials .............................................................................................................. 15<br />
Recommended Textbook and Testing Program .......................................................................................... 15<br />
Attendance .................................................................................................................................................. 15<br />
Office Hours and Tutoring .......................................................................................................................... 17<br />
Grading <strong>Policies</strong> and Course Completion ................................................................................................... 17<br />
Verification <strong>for</strong> NR<strong>EMT</strong> and Issuance of Completion Certificates ........................................................... 20<br />
Initial Certification and Background Investigation .................................................................................... 20<br />
Commonly Asked Criminal Background Questions ................................................................................... 21<br />
Recertification............................................................................................................................................. 22<br />
Ride-Along .................................................................................................................................................. 23<br />
Frequently Asked Questions Regarding Ride-alongs ................................................................................. 24<br />
Affiliation with West Los Angeles Community College Credit and Grading Scale .................................. 24<br />
Copies of Course Completion ..................................................................................................................... 26<br />
Classroom Decorum.................................................................................................................................... 26<br />
Disciplinary Action ..................................................................................................................................... 28<br />
Academic Probation .................................................................................................................................... 28<br />
Disciplinary Probation ................................................................................................................................ 28<br />
Termination from the Program ................................................................................................................... 28<br />
Appeal of Disciplinary Termination ........................................................................................................... 29<br />
Condition <strong>for</strong> Re-Enrollment ...................................................................................................................... 29<br />
Voluntary Withdrawal ................................................................................................................................ 30<br />
Refunds and Transfer Policy ...................................................................................................................... 30<br />
Exposure Control Policy ............................................................................................................................. 31<br />
Evaluation of Exposure Occurrences and Follow-up ................................................................................. 33<br />
Frequently Asked Questions Regarding the <strong>EMT</strong> Program ....................................................................... 34<br />
Exposure/Injury Report Form ..................................................................................................................... 36<br />
Policy Certification ..................................................................................................................................... 38<br />
Participation in <strong>Prehospital</strong> <strong>Care</strong> and Education Research ........................................................................ 39<br />
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Introduction<br />
Welcome to the <strong>UCLA</strong> <strong>EMT</strong> Education Program offered in partnership with West Los Angeles<br />
College. This manual will outline various course policies <strong>for</strong> your reference. This manual will<br />
include sections to in<strong>for</strong>m you about the various instructors and contact in<strong>for</strong>mation, course<br />
completion requirements, and course expectations. You will also be asked to sign a certification<br />
at the end of this packet indicating that you have read and understand these policies governing<br />
participation in the program.<br />
General Philosophy & Mission<br />
The <strong>EMT</strong> Education Program is devoted to developing highly skilled and educated prehospital<br />
care providers. The <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> and the <strong>UCLA</strong> <strong>Prehospital</strong> Research<br />
Forum have combined to create a program that is recognized <strong>for</strong> excellence in <strong>EMT</strong> Education.<br />
This basic premise is focused around high academic standards, a commitment to the field of<br />
prehospital emergency care, and a dedication to present and future students and <strong>EMT</strong>s. The<br />
program will strive to be attentive to student needs by creating a stimulating academic<br />
environment where learning will foster future academic growth and challenge preconceived<br />
notions.<br />
With every program we expect our students to commit themselves to success by studying,<br />
participating in class discussions, approaching faculty or staff members concerning extra help or<br />
problems encountered in the program, and being prepared <strong>for</strong> class on a daily basis. In return,<br />
the student can expect that the program faculty will commit to listen to the student’s needs as a<br />
learner, develop quality educational programs, study tips, and classroom presentations, and assist<br />
each learner in becoming successful.<br />
<strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong>: Mission<br />
To advance the systems, enhance the methods, and educate the people who provide prehospital<br />
and emergency care to the ill and injured.<br />
<strong>UCLA</strong> <strong>Prehospital</strong> Research Forum: Mission<br />
To promote, educate and disseminate prehospital research conducted at all provider levels to<br />
advance and challenge the future of EMS.<br />
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Program Staff and Faculty<br />
<strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong><br />
10990 Wilshire Blvd; Suite 1450<br />
Los Angeles, CA 90024<br />
Phone (310) 267-5959<br />
Fax (310) 312-9322<br />
Director<br />
Baxter Larmon, PhD, MICP<br />
Medical Director<br />
Steven J. Rottman, MD, FACEP<br />
Managing Director<br />
Todd LeGassick, MPH<br />
Associate Medical Director<br />
Atilla Uner, MD<br />
<strong>UCLA</strong> <strong>EMT</strong> Education Program<br />
Program Director<br />
Principal Instructor/Senior Educator<br />
Barry Jensen, NR<strong>EMT</strong>-P, NCEE<br />
Jeff Pollakoff, MICP (Retired)<br />
Office (310) 312-9316 Office (310) 312-9317<br />
bjensen@mednet.ucla.edu<br />
jpollakoff@mednet.ucla.edu<br />
EMS Educator<br />
Mark Malonzo, NR<strong>EMT</strong>-P, NCEE<br />
Office (310) 312-9490<br />
mmalonzo@mednet.ucla.edu<br />
Program Coordinator<br />
Program Coordinator<br />
Jessica Evans, <strong>EMT</strong>-B<br />
Joe Kalilikani, <strong>EMT</strong>-B, NCEE<br />
Office (310) 312-9362 Office (310) 312-9310<br />
jessicaevans@mednet.ucla.edu<br />
jkalilikani@mednet.ucla.edu<br />
Other key faculty and skills instructors will be introduced throughout the program.<br />
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Documentation of Program Eligibility<br />
Prior to the Start of the Program:<br />
1. Eligibility <strong>for</strong> <strong>EMT</strong> Training: Students who successfully complete the course will be<br />
issued an academic Course Completion Certificate. Those pursuing professional <strong>EMT</strong><br />
certification must be at least 18 years of age and meet additional requirements at the time of<br />
application <strong>for</strong> local certification. Individuals may enroll in class six months prior to their<br />
18th birthday with the understanding that their certification will be withheld until age<br />
requirements are met. If you are under the age of 17 ½, you may still take this course;<br />
however, you will not be eligible <strong>for</strong> certification as an <strong>EMT</strong> in Cali<strong>for</strong>nia.<br />
2. BLS Certification: Provide a copy of your current Basic Life Support <strong>for</strong> Healthcare<br />
Providers CPR card from the American Heart Association (AHA) or a Professional Rescuer<br />
CPR card from the American Red Cross (ARC). No other card will be accepted by the<br />
certifying agency.<br />
3. Recommended Preparation: Completion of medical terminology and/or <strong>EMT</strong> Preparation<br />
Course.<br />
4. Computer And Technical Recommendations:<br />
Online assignments will be routinely assigned, following a similar <strong>for</strong>mat as the computerbased<br />
National Registry examination required <strong>for</strong> <strong>EMT</strong> professional certification. Other<br />
critical course communications including office hours, grade reports, and other course<br />
records will also be delivered via the internet to facilitate student access. There<strong>for</strong>e,<br />
computer and internet access are required <strong>for</strong> current students. Public or on-campus libraries<br />
offer access <strong>for</strong> course work if you do not have normal internet access. The <strong>UCLA</strong> <strong>EMT</strong><br />
Education Program utilizes JB Course Manager (http://ucla.jbcourse.com/). Many of the<br />
documents found on the course site are Adobe <strong>pdf</strong> files and the free reader can be found at<br />
http://get.adobe.com/reader/ The interactive lesson modules are Adobe Flash based.<br />
There<strong>for</strong>e, an iPad or iPhone will NOT run these applications. For the latest Flash player, go<br />
to http://get.adobe.com/flashplayer/ A computer lab is available during lunch, at our<br />
classroom location, if needed. The JBCourse website provides additional the minimum<br />
specifications. These requirements are subject to updates and can be verified at<br />
http://ucla.jbcourse.com/.<br />
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Prior to the Start of the Clinical Rotation(s):<br />
5. Clinical Orientation: Attendance at “Clinical Orientation.”<br />
6. Health Insurance: Students must maintain individual health insurance or worker’s<br />
compensation insurance <strong>for</strong> the clinical / ride-along portion of the program, and furnish proof<br />
of insurance. Students are responsible <strong>for</strong> all payment <strong>for</strong> medical care related to hazardous<br />
exposures injuries and/or illnesses.<br />
7. Proof of successful passage of a basic physical examination conducted within six (6)<br />
months prior to the beginning of the course. The report must be signed by a physician and<br />
specify that you have no physical limitations that would impede your participation in any<br />
phase of the program. The original document is required.<br />
8. Proof of the following immunizations / Examinations:<br />
• Hepatitis B vaccine/immunity. Note: If the Hepatitis B vaccine/immunity series has been<br />
started but not yet completed, proof that you have started the series must be provided when<br />
your application is submitted. Students electing not to receive the HBV vaccination must<br />
sign a waiver or provide documentation of HBV immunity (titer).<br />
• Measles/Mumps/Rubella (MMR): Vaccine or a positive titer is required.<br />
• Tuberculosis: A negative TB test or chest x-ray within six (6) months prior to the beginning<br />
of the Clinical portion of the course.<br />
9. Varicella (Chicken Pox) vaccine or immunity following disease as documented by titer.<br />
Successful completion of Clinical Practice Module on the JB Course Manager.<br />
Ride-along or clinical shifts done without meeting these requirements<br />
or done at locations not authorized by our the <strong>EMT</strong> Program Director<br />
will not be accepted and may subject the student to disciplinary action<br />
up to and including termination from the program.<br />
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Accreditations<br />
This program is approved by the Los Angeles County Department of Health Services EMS<br />
Agency and the State of Cali<strong>for</strong>nia. In addition, the program is approved to train veterans and<br />
eligible persons under the provisions of Title 38, United States Code.<br />
Student Services<br />
Libraries<br />
Students enrolled in the <strong>EMT</strong> Education Program have access to the <strong>UCLA</strong> Biomedical Library<br />
(subject to their policies and procedures). This library has numerous resources regarding all<br />
aspects of the <strong>EMT</strong> and paramedic occupation in the <strong>for</strong>m of books, tapes, and case studies.<br />
Placement Assistance<br />
Known employment vacancies in the field (both local and out-of-county) are posted on the<br />
bulletin board adjacent to the classroom. Some <strong>EMT</strong> service provider agencies contact the<br />
school <strong>for</strong> likely candidates <strong>for</strong> employment, and make scheduled appearances <strong>for</strong> recruitment.<br />
Although the Program may facilitate in<strong>for</strong>mation about known vacancies, the Program does not<br />
offer placement assistance nor is a guarantee <strong>for</strong> employment made.<br />
Housing<br />
The school has no facilities to house students. The responsibility <strong>for</strong> completing the housing<br />
arrangements rests with the student.<br />
Students with Disabilities<br />
The <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> may provide reasonable accommodations during a<br />
program to students with disabilities (including learning disabilities). Reasonable<br />
accommodations are defined as accommodations that do not fundamentally alter the Program.<br />
All students are required to meet the Program's enrollment requirements.<br />
If you require special accommodations, please submit your written request along with your<br />
program registration. Upon receipt, you will be contacted by our Client Services Manager to<br />
discuss your request and obtain your current disability evaluation.<br />
For assistance with any questions concerning special accommodations, please contact Michelle<br />
Jones, Student Services Coordinator, at (310) 312-9307.<br />
Veterans Assistance Benefits<br />
If you are eligible to receive Veterans Benefits and would like in<strong>for</strong>mation on processing your<br />
benefits please call the Department of Veterans Affairs (DVA) nationwide toll free number at<br />
(800) 827-1000.<br />
For assistance with using your Veterans Assistance Benefits <strong>for</strong> the Emergency Medical<br />
Technician Program (only) or related benefits questions, please contact Rosa Calva, <strong>UCLA</strong><br />
Client Services Manager, at (310) 312-9318.<br />
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Ethics and Standards of Conduct<br />
Due to the high standards of the <strong>EMT</strong> Education Program and the EMS Profession, student<br />
conduct must reflect professionalism, integrity and responsibility at all times. The following<br />
section sets <strong>for</strong>th ethical standards, standards of conduct, and examples of misconduct subject to<br />
disciplinary action (including probation or termination from the Program).<br />
Ethical Standards<br />
Students are expected to meet the following ethical standards while in the Program:<br />
• <strong>EMT</strong>s are health care professionals regardless of whether or not they receive monetary<br />
compensation <strong>for</strong> their work. Thus, an <strong>EMT</strong> is bound by the highest standards of<br />
professional conduct and ethics. The <strong>EMT</strong> Education Program will not tolerate a breach of<br />
these standards by its students.<br />
• Students must conduct themselves in an ethical manner throughout the classroom and clinical<br />
phases of the Program. Failure to adhere to these standards may result in termination from<br />
the Program. Violation of these standards includes, but is not limited to, stealing, cheating,<br />
and breach of a patient’s confidentiality.<br />
Professional Behavior<br />
The conduct of the <strong>EMT</strong> student reflects upon the individual, his or her agency, the <strong>UCLA</strong> <strong>EMT</strong><br />
Education Program, and the EMS Profession. There<strong>for</strong>e, the student must conduct him/herself in<br />
a professional and responsible manner at all times, as described below.<br />
Professional Behavior/Attributes include:<br />
• Appearance. Excellent personal grooming and a neat, clean appearance help instill<br />
confidence in patients treated by <strong>EMT</strong>s. Respond to the scene in neat, clean, and complete<br />
uni<strong>for</strong>m or appropriate dress. This will help to effectively portray the positive image you<br />
want to communicate. Remember, you are on a medical team. Your appearance can send the<br />
message that you are competent and can be trusted to make the right decisions.<br />
• Knowledge and skills. To practice as an <strong>EMT</strong>, you need to successfully complete the basic<br />
training we are providing. In addition, you will also need to know:<br />
• How to use and maintain common emergency equipment, such as suction machines,<br />
spinal immobilization equipment, Automatic External Defibrillators, splints, ob kits, and<br />
various tools to gain access to the patient.<br />
• How and when to assist with the administration of medications approved by medical<br />
control.<br />
• How to clean, disinfect and sterilize non-disposable equipment.<br />
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• Safety and security measures <strong>for</strong> yourself, your partner and other rescuers, as well as <strong>for</strong><br />
the patient and bystanders.<br />
• The territory and terrain within the service area to allow expedient response to the scene<br />
and to the appropriate receiving facility.<br />
• State and local traffic laws and ordinances concerning emergency transportation of the<br />
sick and injured.<br />
• Physical Demands. Aptitudes required <strong>for</strong> work of this nature are good physical stamina,<br />
endurance, and body condition that would not be adversely affected by frequently having<br />
to walk, stand, lift, carry and balance at times in excess of 125 pounds. Motor<br />
coordination is necessary because over uneven terrain, the patient’s, the <strong>EMT</strong>’s, and other<br />
workers’ well being must not be jeopardized. Prior to professional employment, all <strong>EMT</strong><br />
candidates must qualify <strong>for</strong> a Medical Examiner’s Certificate by passing the physical<br />
examination specified by U.S. Department of Transportation standards. Individual<br />
employers may have additional requirements.<br />
• Temperament and abilities. In times of crisis, patients will look toward someone to<br />
reestablish order in a suddenly chaotic world. Chances are that someone will be you. It can<br />
bring out the best in you as well as cause you a great deal of stress. To be as effective as you<br />
can be as and <strong>EMT</strong>, you should have the following characteristics:<br />
• A pleasant personality. As an <strong>EMT</strong> you will often be required to per<strong>for</strong>m skills and<br />
procedures while speaking in a reassuring and calming voice to a patient who may be<br />
agitated, in shock or in a great deal of pain.<br />
• Leadership ability. You must be able to assess a situation quickly, step <strong>for</strong>ward to take<br />
control when appropriate, set action priorities, give clear and concise directions, be<br />
confident and persuasive enough to be obeyed, and carry through with what needs to be<br />
done.<br />
• Good judgment. You must be able to make appropriate decisions quickly, often in unsafe<br />
or stressful situations involving human beings in crisis.<br />
• Good moral character. While there are many legal constraints on the profession, you<br />
also have ethical obligations. You are in a position of public trust and that can never by<br />
wholly defined by statute or case law alone.<br />
• Stability and adaptability. Being an <strong>EMT</strong> can be quite stressful. Exhaustion, frustration,<br />
anger and grief are part of the package. You must be able to learn how to delay<br />
expressing your feelings until the emergency is over. Just as important, you must also be<br />
able to understand that intense emotional reactions are normal and that seeking support<br />
from coworkers, counselors, friends, and family are important aspects of keeping yourself<br />
mentally and physically fit.<br />
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Misconduct<br />
Students are subject to disciplinary action up to and including termination from the Program <strong>for</strong><br />
misconduct, including but not limited to:<br />
• Academic Dishonesty. All <strong>for</strong>ms of academic misconduct, including but not limited to<br />
cheating, fabrication, plagiarism, multiple submissions, or facilitating academic dishonesty.<br />
For the purposes of this policy, the following definitions apply:<br />
Cheating. Cheating includes, but is not limited to, the use of unauthorized materials, leaving<br />
the testing area without permission or a prolonged period of time, in<strong>for</strong>mation, or study aids<br />
in any academic exercise; or helping another student commit an act of academic fraud; or the<br />
failure to observe the expressed procedures or instructions of an academic exercise (e.g.,<br />
examination instructions regarding alternate seating or conversation during an examination).<br />
Fabrication. Fabrication includes, but is not limited to, falsification or invention of any<br />
in<strong>for</strong>mation or citation in an academic exercise.<br />
Plagiarism. Plagiarism includes, but is not limited to, the use of another's words or ideas<br />
as if they were one's own; including but not limited to representing, either with the intent<br />
to deceive or by the omission of the true source, part of or an entire work produced by<br />
someone other than the student, obtained by purchase or otherwise, as the student's<br />
original work; or representing the identifiable but altered ideas, data, or writing of another<br />
person as if those ideas, data, or writing were the student's original work.<br />
Multiple Submissions. Multiple submissions includes, but is not limited to, the<br />
resubmission by a student of any work which has been previously submitted <strong>for</strong> credit in<br />
identical or similar <strong>for</strong>m in one course to fulfill the requirements of a second course,<br />
without the in<strong>for</strong>med permission/consent of the instructor of the second course; or the<br />
submission by a student of any work submitted <strong>for</strong> credit in identical or similar <strong>for</strong>m in<br />
one course to fulfill the requirements of a concurrent course, without the<br />
permission/consent of the instructors of both courses.<br />
Other Forms of Dishonesty. Other <strong>for</strong>ms of dishonesty, including but not limited to<br />
fabricating in<strong>for</strong>mation or knowingly furnishing false in<strong>for</strong>mation or reporting a false<br />
emergency to the program or to program officials acting in the per<strong>for</strong>mance of their<br />
duties.<br />
• Forgery. Forgery, alteration, or misuse of any Program document, record, key, electronic<br />
device, or identification. This policy applies to any individual <strong>for</strong> whom the Program<br />
maintains records, regardless of current student status.<br />
• Theft. Theft of, conversion of, misappropriation of, or damage to or destruction of any<br />
property of the Program or University or property of others while on Program or University<br />
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premises or at official Program functions; or possession of any property of the Program or<br />
others stolen while on Program premises or at official Program functions.<br />
• Computers. Theft or other abuse of computing facilities or computer time, including but not<br />
limited to unauthorized entry into a file to use, read, or change the contents or <strong>for</strong> any other<br />
purpose; unauthorized transfer of a file; unauthorized use of another individual's<br />
identification or password; use of computing facilities to interfere with the work of another<br />
student, faculty member, or Program official; use of computing facilities to interfere with a<br />
Program computing system.<br />
• Unauthorized Conduct. Unauthorized possession of, receipt of, duplication of, or use of the<br />
Program's name, insignia, or seal. Unauthorized entry to, possession of, receipt of, or use of<br />
any Program properties, equipment, resources, or services. Selling or distributing course<br />
lecture notes, handouts, readers, or other in<strong>for</strong>mation provided by an instructor, or using them<br />
<strong>for</strong> any commercial purpose, without the express permission of the instructor.<br />
• Physical Abuse. Physical abuse, including but not limited to rape, sexual assault, sex<br />
offenses, and other physical assault; threats of violence; or conduct that threatens the health<br />
or safety of any person.<br />
• Rape. Rape refers to "rape" as defined by the Cali<strong>for</strong>nia Penal Code (as it may be amended<br />
from time to time). Among other acts, the Penal Code prohibits the following acts:<br />
Sexual intercourse against a person's will accomplished by <strong>for</strong>ce or threats of<br />
bodily injury.<br />
Sexual intercourse against a person's will where the person has reasonable fear<br />
that she (or he) or another will be injured if she (or he) does not submit to the<br />
intercourse.<br />
Sexual intercourse where the person is incapable of giving consent, or is<br />
prevented from resisting, due to alcohol or drugs, and this condition was known,<br />
or reasonably should have been known by the accused.<br />
Sexual intercourse where the person is incapable of resisting because she (or he),<br />
at the time, is unconscious or asleep, and this is known to the accused.<br />
• Sexual Assault. The act of sexual assault includes <strong>for</strong>ced sodomy (anal intercourse); <strong>for</strong>ced<br />
oral copulation (oral-genital contact); rape by <strong>for</strong>eign object (<strong>for</strong>ced penetration by a <strong>for</strong>eign<br />
object, including a finger); and sexual battery (the unwanted touching of an intimate part of<br />
another person <strong>for</strong> the purpose of sexual arousal). These also include situations when the<br />
accused sexually assaults a complainant incapable of giving consent, including where the<br />
complainant is prevented from resisting due to alcohol or drugs and this condition was<br />
known, or reasonably should have been known by the accused.<br />
Note: For the purpose of this regulation, students should understand that:<br />
Forced intercourse or other unwanted sexual contact is defined as rape or sexual<br />
assault whether the assailant is a stranger or an acquaintance of the complainant.<br />
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Intoxication of the assailant shall not diminish the assailant's responsibility <strong>for</strong><br />
sexual assault.<br />
• Sexual Harassment. Unwelcome sexual advances, requests <strong>for</strong> sexual favors, and other<br />
verbal or physical conduct of a sexual nature constitute sexual harassment when:<br />
Submission to such conduct is made either explicitly or implicitly a term or<br />
condition of instruction, employment, or participation in other Program activity;<br />
Submission to or rejection of such conduct by an individual is used as a basis <strong>for</strong><br />
evaluation in making academic or personnel decisions affecting an individual; or<br />
Such conduct has the purpose or effect of unreasonably interfering with an<br />
individual's per<strong>for</strong>mance or creating an intimidating, hostile, or offensive Program<br />
environment.<br />
In determining whether the alleged conduct constitutes sexual harassment, consideration<br />
shall be given to the record of the incident as a whole and to the totality of the<br />
circumstances, including the context in which the alleged incidents occurred.<br />
• Stalking. Stalking is behavior in which an individual willfully, maliciously, and repeatedly<br />
engages in a knowing course of conduct directed at a specific person which reasonably and<br />
seriously alarms, torments, or terrorizes the person, and which serves no legitimate purpose.<br />
• "Fighting Words." The use of "fighting words" by students to harass any person(s) on<br />
Program property, on other property to which these policies apply, or in connection with<br />
official Program functions or Program-sponsored programs. "Fighting words" are those<br />
personally abusive epithets which, when directly addressed to any ordinary person are, in the<br />
context used and as a matter of common knowledge, inherently likely to provoke a violent<br />
reaction whether or not they actually do so. Such words include, but are not limited to, those<br />
terms widely recognized to be derogatory references to race, ethnicity, religion, sex, sexual<br />
orientation, disability, and other personal characteristics. "Fighting words" constitute<br />
"harassment" when the circumstances of their utterance create a hostile and intimidating<br />
environment which the student uttering them should reasonably know will interfere with the<br />
victim's ability to pursue effectively his or her education or otherwise to participate fully in<br />
Program programs and activities.<br />
• Hazing. Hazing or any method of initiation or pre-initiation activity which causes, or is<br />
likely to cause, bodily danger, physical harm, or personal degradation or disgrace resulting in<br />
physical or mental harm to any student or other person.<br />
• Obstruction or Disruption. Obstruction or disruption of teaching, research, administration,<br />
disciplinary procedures, or other Program activities.<br />
• Disorderly Conduct. Disorderly or lewd conduct.<br />
• Disturbing the Peace. Participation in a disturbance of the peace or unlawful assembly.<br />
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<strong>UCLA</strong> CPC Revised 12/10/2012
• Failure to Comply. Failure to identify oneself to, or comply with directions of, a Program<br />
official or other public official acting in the per<strong>for</strong>mance of their duties while on Program<br />
property or at official Program functions, or resisting or obstructing such Program or other<br />
public officials in the per<strong>for</strong>mance of or the attempt to per<strong>for</strong>m their duties.<br />
• Controlled Substances. Unlawful manufacture, distribution, dispensing, possession, use, or<br />
sale of, or the attempted manufacture, distribution, dispensing, or sale of controlled<br />
substances, identified in Federal and State laws or regulations.<br />
• Alcohol. Manufacture, distribution, dispensing, possession, use, or sale of, or the attempted<br />
manufacture, distribution, dispensing, or sale of alcohol which is unlawful or otherwise<br />
prohibited by, or not in compliance with, Program policy or campus regulations.<br />
• Destructive Devices. Possession, use, storage, or manufacture of explosives, firebombs, or<br />
other destructive devices.<br />
• Weapons. Except as expressly permitted by law, possession, use, storage, or manufacture of<br />
a firearm or other weapon capable of causing bodily injury. Students with special permits to<br />
carry weapons must receive clearance from the <strong>UCLA</strong> Police Department prior to bringing<br />
that weapon into any course-sponsored settings.<br />
• Program Properties. Using Program properties <strong>for</strong> the purpose of organizing or carrying<br />
out unlawful activity.<br />
• Violations of Law. Violation of Federal, State, or local laws.<br />
Students subjected to disciplinary action <strong>for</strong> misconduct may appeal the sanction as provided in<br />
the appeal policy set <strong>for</strong>th in this manual.<br />
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Program In<strong>for</strong>mation<br />
General Course Description<br />
This program is broken down into three phases: Didactic (Lecture), Practical (Hands-on Skills)<br />
and Clinical Observation (Ambulance Ride-along Shifts). The course is comprised of a total of<br />
130 hours broken down as follows: Didactic/Practical - 120 hours, Clinical– a minimum of 24<br />
hours of total observation with a minimum of 10 patient contacts. In addition, 4-8 hours will be<br />
needed <strong>for</strong> testing.<br />
Successful completion of this program requires completion of all course pre- and co- requisites,<br />
affective domain evaluation completed with a minimum of 80%, a minimum overall average of<br />
80% on all exams and homework assignments, a minimum score of 80% on the written final<br />
exam and successful completion of all skills evaluations. In addition, the ride-along observation<br />
must be started within 14 days of course completion.<br />
Required Textbook and Materials<br />
The textbook is Emergency <strong>Care</strong> and Transportation of the Sick and Injured, 10 th Edition, by<br />
AAOS. The <strong>EMT</strong> Supplement 2012 accompanies the text. Students are expected to have the<br />
text and supplements with them during class. Books and apparel can be purchased at<br />
http://emt.uclacpcbooks.org or http://www.jblearning.com/uclacpc /. In addition, access to the<br />
course companion website, via http://ucla.jbcourse.com/, will be distributed.<br />
Recommended Textbook and Testing Program<br />
As an optional textbook, the American Heart Association’s, Fundamentals of BLS <strong>for</strong><br />
Healthcare Providers, is available and should have been given to you when you took your CPR<br />
course. A test preparation package will be distributed to our students during the course. The<br />
testing site is available, from our textbook publisher, at no additional charge to the students.<br />
Attendance<br />
Attendance during all phases of the Program is extremely important because of the nature of the<br />
material to be presented. During the Program, all lectures and skills are based on material from<br />
prior lectures and skills sessions. Without having a strong foundation in this prior material, it is<br />
extremely difficult to attain and master the new material or skill. In addition, the Los Angeles<br />
County Department of Health Services has determined that <strong>EMT</strong>-1 training shall consist of<br />
no less than 120 hours of instruction including skills sessions and ten hours of supervised<br />
emergency room clinical or ambulance patient care experience. There<strong>for</strong>e, attendance is<br />
mandatory, not optional. The following are the attendance requirements expected <strong>for</strong> students<br />
while in attendance of the program:<br />
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1. Students failing to sign the session attendance sheet will be recorded as absent,<br />
regardless if they attended the class. If a student signs <strong>for</strong> another student, they<br />
may be terminated from the <strong>EMT</strong> Program immediately.<br />
2. Any absence requires advance notification of the Program Director, Program Coordinator<br />
and / or the Principal Instructor, in writing or by phone. Absences must only be in the<br />
event of severe medical illness, family emergency or comparable occurrence. Students<br />
who miss more than 8 hours of class will be required to make-up these missed hours. If<br />
applicable, students missing between 1 and 7 hours, who choose not to make up these<br />
hours, will promptly be reported to Veterans Affairs (VA). Students missing more than<br />
16 hours of class, without verifiable and appropriate reasons, will not be eligible <strong>for</strong> <strong>EMT</strong><br />
certification and may be dropped from the course. Documentation of emergency or<br />
illness will be required if more than 16 hours of class is missed.<br />
3. It is the responsibility of the student to obtain the in<strong>for</strong>mation from any session missed.<br />
This may be accomplished by attending one of our other <strong>EMT</strong> Programs or, if no other<br />
class is in session, by a make up assignment, arranged through the Program Director or<br />
Principal Instructor. Additionally, the Program Director may require the student to<br />
per<strong>for</strong>m additional assignments to cover in<strong>for</strong>mation missed. If a student wishes to attend<br />
another <strong>EMT</strong> program to make-up hours (or <strong>for</strong> purposes of reviewing material), prior<br />
approval must be obtained from the Program Director. Further, make-up <strong>for</strong> any missed<br />
sessions in another <strong>EMT</strong> Program may only occur while the course you are enrolled is not<br />
in session.<br />
4. Students arriving more than one hour late to class will be considered absent. This will<br />
count as a missed session <strong>for</strong> the purposes of the attendance policy set <strong>for</strong>th in item<br />
number 1, listed above.<br />
5. Students who sleep in class may be recorded as absent. If you are having trouble staying<br />
awake, you are encouraged to stand in the back of the classroom, without obstructing or<br />
interfering with other students or the course instruction.<br />
6. If an exam is missed due to tardiness or absence, the exam grade will be a zero (0) and<br />
the student will then still need to pass the exam in order to progress through the Program.<br />
This will count toward the maximum allowable failure requirements.<br />
7. Students who have medical illnesses will be required to show proof from a Cali<strong>for</strong>nia<br />
licensed physician of said illness.<br />
8. In an emergency a class may be canceled by the Program Director. Confirmation of<br />
classes can be made by calling (310) 267-5959.<br />
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Office Hours and Tutoring<br />
Office hours are during the lunch break and after class, as scheduled, <strong>for</strong> the Accelerated and<br />
weekend programs and one hour be<strong>for</strong>e class <strong>for</strong> the evening programs. Students can receive<br />
assistance or make-up quizzes during this time. If you wish to meet with an individual<br />
instructor, contact him/her directly to schedule an appointment. It is the responsibility of the<br />
student to seek assistance in a timely manner. Following the last day of class, during the 30 day<br />
completion period, students may come to scheduled office hours <strong>for</strong> tutoring<br />
(http://uclacpctutoring.eventbrite.com/ ) or exam re-takes<br />
(http://retesting2013.eventbrite.com) if an appointment is made via the eventbrite ticketing<br />
system.<br />
Grading <strong>Policies</strong> and Course Completion<br />
Successful completion of the <strong>EMT</strong> Program will be contingent upon completion of the<br />
following:<br />
a) The student successfully passes the final written examination with a minimum score of<br />
80%.<br />
b) The student adheres to the attendance policy, completes and submits all course<br />
assignments.<br />
c) The student successfully passes all final practical skill evaluation stations.<br />
d) The student successfully completes clinical or field observation time.<br />
e) The student obtains a successful affective domain evaluation.<br />
f) The student completes all pending course requirements within 30 days from the last<br />
day of the Didactic/Practical phases of the Program.<br />
g) Requests <strong>for</strong> exceptions must be made in writing and may only be granted by the Program<br />
Director.<br />
The breakdowns <strong>for</strong> grading in the Program are as follows:<br />
10% Average of online quizzes (Block homework assignments)<br />
20%<br />
40%<br />
Online Interactive Modules<br />
Average of Six Block Exams (5 in-class, 1 online)<br />
30% Final Written Exam Average (in-class)<br />
100% Total<br />
Additionally, in order to complete the course, students must also complete the<br />
following Pass / Fail (P/F) items:<br />
P/F Course Participation (attendance)<br />
P/F Professional Behavior Evaluation<br />
P/F All Practical (Skills) Exams<br />
P/F Attendance at mandatory clinical orientation day<br />
P/F Ride-Along Observation (minimum 24 hours, 10 patient contact<br />
minimum)<br />
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The grading policy is as follows:<br />
• 93-100% A<br />
• 86-92% B<br />
• 80-85% C<br />
• 65-79 D (not recommended <strong>for</strong> certification)<br />
A minimum score of 80% is required to complete the program and be recommended <strong>for</strong><br />
certification. A score of 64% or less will be recorded as an “F” (also, not recommended <strong>for</strong><br />
certification).<br />
1. Online Block Homework Assignments (10% total grade)<br />
Block Homework Assignments are posted on the Course Manager website. In order to<br />
take the written final, these assignments must be completed with an overall average of<br />
80%. Please refer to your class syllabus <strong>for</strong> the due dates of these assignments.<br />
2. Online Interactive Modules (20% total grade)<br />
Some essential content is not covered in class and must be completed online via the JB<br />
Course Manager. In order to take the written final, these modules must be completed<br />
with an overall average of 80%. Please refer to your class syllabus <strong>for</strong> the due dates of<br />
these assignments.<br />
3. Block Exams (40% total grade, based on overall average of exams x 400pts)<br />
A series of six exams will be given on a regularly scheduled basis. They are multiple<br />
choice and vary in length. All students must maintain an overall average of 80% on<br />
these exams. One retest will be allowed <strong>for</strong> up to three separate block exams. Retakes<br />
are only allowed <strong>for</strong> exams in which the original score was below an 80%. All exam<br />
retakes must be scheduled at the convenience of the instructor. Students are not allowed<br />
to see their actual exams, once they have been scored. Grades will be posted on the<br />
student website, as soon as possible. Do not call the office <strong>for</strong> grades.<br />
4. Extra Credit<br />
Extra Credit is offered as an opportunity to raise your course grade. These are optional<br />
assignments but highly recommended. Once the final exam has been passed with a<br />
minimum score of 80%, each assignment completed will add points to total course<br />
score. Complete the “extra credit” assignments in each module of JB Course. A few<br />
modules do not have assignments. One (1) point of extra credit will be awarded to the<br />
extra credit total <strong>for</strong> each section completed. It is strongly suggested that the extra credit<br />
is completed prior to the block exam of the relevant materials. These must be<br />
completed no later than 30 days following the last day of the class. In addition to<br />
these assignments, other opportunities <strong>for</strong> extra credit may be announced in class, such as<br />
extracurricular assignments <strong>for</strong> other CPC program areas (1 point per hour assigned,<br />
maximum of 10 points). Another such opportunity is a Literature Review (max of 10<br />
points). Please see either Jeff Pollakoff (Principal Instructor) or Barry Jensen (Program<br />
Director) regarding these assignments.<br />
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5. Final Examinations (Written Exam is 30% total grade, based on average of final x 300pts)<br />
The final exam will be given at the end of the Program and include all subject areas from<br />
the entire program. The exam will be multiple choice and the minimum passing score is<br />
an 80%. One retake is available <strong>for</strong> the final written examination. Failure of the final<br />
written examination <strong>for</strong> the second time will result in termination from the course. Once<br />
a student has taken the final exam(s), other exams cannot be retaken or made-up.<br />
In addition, students must pass all Final Practical Skills Stations. All retakes must be<br />
scheduled at the convenience of the instructor. Only one retake is allowed daily. Failure<br />
to pass final practical skills stations on the second re-take will be grounds <strong>for</strong> termination<br />
(a total of 3 attempts are allowed on practical exams).<br />
6. Pass / Fail Assignments<br />
All skills exams are counted as Pass / Fail items and must be successfully completed. A<br />
“professional behavior evaluation”, successfully completed by the faculty, assessing your<br />
competence in the affective domain must be documented as satisfactory. For course<br />
participation, the course attendance requirements must be met. In addition, the clinical<br />
orientation day must have been attended and 24 hours of ride-along observation with a<br />
minimum of 10 patient contacts must be completed.<br />
7. NO ELECTRONIC DEVICES ARE ALLOWED DURING TESTING. Any student caught<br />
engaging in any <strong>for</strong>m of academic dishonesty on an exam or the final exam will be<br />
immediately terminated from the program. In addition, students must request permission<br />
from the proctor to leave the testing area and are only permitted to do so <strong>for</strong> a restroom break<br />
not exceeding 5 minutes. No items are allowed on the desk during testing, including water<br />
bottles. Hats with visors must be reversed so the visor is not visible.<br />
8. Students will be allowed to sit <strong>for</strong> the final examinations (written and practical) only upon the<br />
following conditions:<br />
a) All online assignments have been successfully completed.<br />
b) All exams have been passed with a cumulative average of 80%.<br />
c) A complete and satisfactory “Professional Behavior Evaluation” document has been<br />
submitted.<br />
d) All practical skill labs have been completed.<br />
e) The student has no more than 8 hours of approved absences<br />
Students who successfully complete all aspects of the course will be recommended <strong>for</strong><br />
certification. The <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> will issue one course completion<br />
certificate. This is not an <strong>EMT</strong> certificate, but an acknowledgment of course completion.<br />
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Verification <strong>for</strong> NR<strong>EMT</strong> and Issuance of Completion Certificates<br />
Students completing the course and submitting all required paperwork on or be<strong>for</strong>e the last day<br />
of the course will have their course completion verified <strong>for</strong> the NR<strong>EMT</strong> and Certificates of<br />
Completion issued within one week. The second batch of course completions will be made two<br />
weeks following the initial processing and the last batch of course completions will be made two<br />
weeks after the second batch. NR<strong>EMT</strong> Verifications are normally done once a week. If a delay<br />
occurs in your verification, ensure all your course requirements have been met, including the<br />
clinical component.<br />
Initial Certification and Background Investigation<br />
After a student successfully completes our <strong>EMT</strong> program, the student receives an <strong>EMT</strong> Course<br />
Completion Certificate. In order to become certified as a professional <strong>EMT</strong>, applicants will be<br />
required to:<br />
- successfully complete a certified <strong>EMT</strong> training course within two years of<br />
application <strong>for</strong> professional <strong>EMT</strong> certification,<br />
- successfully complete the final practical exam within 12 months of the last day of<br />
class,<br />
- pass the National Registry of <strong>EMT</strong>s computer adaptive test within 12 months of<br />
the last day of class (it is STRONGLY recommended to complete this exam<br />
within 60 days of course completion),<br />
- undergo and pass a background investigation, and<br />
- meet all requirement as set <strong>for</strong>th by the local certifying agency <strong>for</strong> Cali<strong>for</strong>nia.<br />
Students will need to complete the online application <strong>for</strong> the National Registry certifying exam.<br />
This may be done upon successful course completion by going to www.nremt.org. Upon<br />
passing this examination, a National Registry certification card will be issued, qualifying the<br />
graduate <strong>for</strong> State of Cali<strong>for</strong>nia certification. The instructions <strong>for</strong> this certifying process will be<br />
included with the Course Completion Certificate. Students must be certified by the State of<br />
Cali<strong>for</strong>nia to work as an <strong>EMT</strong> in Cali<strong>for</strong>nia. National Registry certification alone does not<br />
allow you to work in the State of Cali<strong>for</strong>nia.<br />
The certifying process <strong>for</strong> <strong>EMT</strong>s in the State of Cali<strong>for</strong>nia is completed through the local<br />
certifying agency. Our Local Emergency Medical Services Agency (LEMSA) is the County of<br />
Los Angeles Department of Health, Emergency Medical Services Agency. Applications and<br />
instructions <strong>for</strong> certification in Los Angeles County will be distributed in class and are available<br />
<strong>for</strong> download at http://ems.dhs.lacounty.gov/Certification/Cert.htm<br />
The background investigation begins upon application <strong>for</strong> local certification. Applicants will be<br />
required to describe on their application <strong>for</strong> certification any misdemeanor or felony convictions<br />
over one’s lifetime (including juvenile, expunged or sealed violations). Failure to disclose the<br />
required in<strong>for</strong>mation may result in refusal of certification due to falsification. Conviction of a<br />
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crime does not automatically mean an applicant is ineligible <strong>for</strong> certification. The County<br />
Medical Director individually evaluates each case.<br />
Commonly Asked Criminal Background Questions<br />
1. Which criminal offenses WILL exclude an applicant from being eligible <strong>for</strong> <strong>EMT</strong> Certificati<br />
on?<br />
a) Has been convicted of any sexually related offense specified under Section 290 of the<br />
Penal Code<br />
b) Has been convicted of murder, attempted murder, or murder <strong>for</strong> hire<br />
c) Has been convicted of two (2) or more felonies<br />
d) Is on parole or probation <strong>for</strong> any felony<br />
e) Has been convicted and released from incarceration <strong>for</strong> offenses during the preceding<br />
fifteen (15) years <strong>for</strong> the crime of manslaughter or involuntary manslaughter<br />
f) Has been convicted and released from incarceration during the preceding ten (10) years fo<br />
r any offense punishable as a felony<br />
g) Has been convicted of two (2) or more misdemeanors within the preceding five (5) years<br />
<strong>for</strong> any offense relating to the use, sales, possession, or transportation of narcotics or<br />
addictive or dangerous drugs.<br />
h) Has been convicted of two (2) or more misdemeanors within the preceding five (5) years<br />
<strong>for</strong> any offense relating to <strong>for</strong>ce, threat, violence, or intimidation<br />
i) Has been convicted within the preceding five (5) years of any theft related misdemeanor<br />
2. Which criminal offenses MAY exclude an applicant from being eligible <strong>for</strong> <strong>EMT</strong><br />
Certification?<br />
a) Has committed any act involving fraud, intentional dishonesty <strong>for</strong> personal gain within<br />
the preceding seven (7) years<br />
b) Is required to register pursuant to Section 11590 (Controlled Substance Offender) of the<br />
Health and Safety Code<br />
c) Conviction of one (1) misdemeanor within the last five (5) years <strong>for</strong> a related offense<br />
listed within the Health and Safety Code, Section 1798.200<br />
Health and Safety Code Violations 1798.200<br />
Any of the following actions shall be considered evidence of a threat to public health and safety<br />
and may result in denial, suspension, or revocation of a certificate or license, or in the<br />
placement on probation of a certificate or license holder under this division:<br />
1. Fraud in the procurement of any certificate or license.<br />
2. Gross negligence.<br />
3. Repeated negligent acts.<br />
4. Incompetence.<br />
5. The commission of any fraudulent, dishonest, or corrupt act that is substantially related to<br />
the qualifications, functions, and duties of prehospital personnel.<br />
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6. Conviction of any crime that is substantially related to the qualifications, functions, and<br />
duties of prehospital personnel. The record of conviction or a certified copy of the record<br />
of conviction shall be considered conclusive evidence of the conviction.<br />
7. Violating or attempting to violate, directly or indirectly, or assisting in or abetting the viol<br />
ation of, or conspiring to violate, any provision of this division or the regulations adopted<br />
by the authority pertaining to prehospital personnel.<br />
8. Violating or attempting to violate any federal or state statute or regulation that regulates<br />
narcotics, dangerous drugs, or controlled substances.<br />
9. Addiction to, the excessive use of, or the misuse of, alcoholic beverages, narcotics,<br />
dangerous drugs, or controlled substances.<br />
10. Functioning outside the supervision of medical control in the field care system operating<br />
at the local level, except as authorized by any other license or certification.<br />
11. Demonstration of irrational behavior or occurrence of a physical disability to the extent<br />
that a reasonable and prudent person would have reasonable cause to believe that the<br />
ability to per<strong>for</strong>m the duties normally expected may be impaired<br />
12. Unprofessional conduct exhibited by any of the followings:<br />
a. Mistreatment or physical abuse of any patient resulting from excess <strong>for</strong>ce in<br />
excess of what a reasonable and prudent person trained in a similar capacity<br />
would use<br />
b. Failure to maintain confidentiality<br />
c. The commission of any sexually related offense under Section 290 PC<br />
Questions related to this process should be directed to the County of Los Angeles EMS<br />
Agency at (562) 347-1500. Additional background screening measures may be taken by<br />
individual employers as well.<br />
Recertification<br />
Certification as an <strong>EMT</strong> is valid <strong>for</strong> two years throughout the State of Cali<strong>for</strong>nia. Each<br />
certification card will indicate an expiration date. It is the responsibility of the “practicing” <strong>EMT</strong><br />
to recertify be<strong>for</strong>e this two-year period has ended.<br />
In order to recertify, students must successfully complete a prescribed Refresher Course or obtain<br />
(24) twenty-four hours of approved continuing education (CE) <strong>for</strong> the <strong>EMT</strong>. In addition to<br />
completing a refresher course every two years or meeting the continuing education requirements,<br />
<strong>EMT</strong>s must take the standardized State of Cali<strong>for</strong>nia skills exam every two years.<br />
Should the <strong>EMT</strong> fail to recertify be<strong>for</strong>e the expiration date, a two-year grace period is extended<br />
<strong>for</strong> recertification, with additional requirements based upon the length of lapse. During this twoyear<br />
period, an <strong>EMT</strong> may NOT work as an <strong>EMT</strong> until the recertification process is completed.<br />
Should the two years lapse without successful recertification, the <strong>EMT</strong> must take the entire<br />
primary training program again.<br />
Any questions regarding certification should be directed to:<br />
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Los Angeles County EMS Agency<br />
10100 Pioneer Blvd, Suite 200<br />
Santa Fe Springs, CA 90670<br />
(562) 347-1500<br />
(562) 941-5835 Fax<br />
http://ems.dhs.lacounty.gov/<br />
For in<strong>for</strong>mation regarding upcoming refresher courses contact our office at (310) 267-5959 or<br />
visit our web site at www.cpc.mednet.ucla.edu<br />
Ride-Along<br />
In order to successfully complete the <strong>EMT</strong> training and be eligible <strong>for</strong> certification, the student<br />
must complete a minimum of 24 hours of ride along observation. In addition students must have<br />
ten patient contacts during the cumulative 24 hours. Students may need to do several ride-alongs<br />
to meet the patient contact requirement. Students must complete their ride along(s) and return<br />
their check off <strong>for</strong>ms to the office no later than 14 days following the last day of class.<br />
Exceptions must be approved by the Program Director or Program Coordinator.<br />
Students must attend a clinical orientation and meet the clinical requirements to be eligible <strong>for</strong><br />
the ride-along component of the course.<br />
SCHEDULING: You will need to contact the ambulance company you wish to ride along with<br />
directly to schedule your shift(s). A list of providers will be provided once all<br />
clinical requirements have been met.<br />
Completed Ride along <strong>for</strong>ms should be given to the Program Coordinator via email or faxed to<br />
the office. Do not mail <strong>for</strong>ms.<br />
Students who deviate from these policies will not be permitted to obtain their ride along<br />
experience and may be dismissed from the course.<br />
UNIFORM REQUIREMENTS:<br />
<strong>EMT</strong> students must wear<br />
1. Plain white, collared, button-down shirt<br />
or golf shirt<br />
2. Black or dark-blue slacks<br />
3. Closed-toe, black or dark shoes<br />
4. Wristwatch<br />
5. Picture ID with birth date<br />
6. Hair must be tied-up or cut-above the<br />
collar<br />
7. Mustaches and beards must be neatlytrimmed<br />
The following is NOT permitted<br />
1. T-shirts<br />
2. Shorts or cut-off pants<br />
3. Opened-toe shoes or sandals<br />
4. Clothing that is torn, in disrepair, or<br />
unlaundered<br />
5. Jeans of any color<br />
6. Excessive jewelry or hoop-type earrings<br />
(<strong>for</strong> your protection)<br />
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Frequently Asked Questions Regarding Ride-alongs<br />
1. Can I do more than one ride along shift?<br />
a. You are welcome to do as many ride along shifts as you wish within 30 days of<br />
the class ending.<br />
b. The more hours you do and the more contacts you obtain, the better you will<br />
master the material in this course.<br />
2. What if I do not get 10 patient contacts within the 24 hour minimum??<br />
a. You will have to go on another ride along.<br />
b. No exceptions are possible; this is a state certification requirement.<br />
3. If I go on another ride along and reach my 10 total patient contacts do I have to stay <strong>for</strong><br />
the whole shift?<br />
a. Yes, once you start a shift you have to stay <strong>for</strong> the duration.<br />
b. On occasion, a shift will be longer due to the nature of the shift work.<br />
Affiliation with West Los Angeles Community College Credit and<br />
Grading Scale<br />
Through a relationship between the <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> (CPC) and the West Los<br />
Angeles College (WLAC), students enrolled in the <strong>EMT</strong> Program are eligible to receive<br />
academic credit.<br />
To be eligible <strong>for</strong> academic credit, each student must be enrolled into WLAC. For CPC students,<br />
enrollment is accomplished by completing a WLAC Enrollment Application and Add Permit.<br />
CPC students are enrolled into WLAC while in attendance of their regular CPC course (not at the<br />
WLAC campus).<br />
Designated enrollment dates will be announced in each class. Students must not miss the<br />
enrollment date, as students have only one opportunity to complete the Enrollment Application<br />
and Course Card in class.<br />
Unit In<strong>for</strong>mation<br />
Students successfully completing a program are eligible <strong>for</strong> 7.0 units under WLAC Progam<br />
Number Allied Health 52.<br />
For questions regarding enrollment, please contact the Administrative Assistant <strong>for</strong> the West Los<br />
Angeles College Allied Health Division by telephone at 310.287.4464 or by e-mail at<br />
alliedhealth@wlac.edu<br />
Enrollment Issues<br />
Any student that previously enrolled in any of the Los Angeles Community College District 9<br />
colleges and has a “Fees Due” designation on their record, will not have the application <strong>for</strong><br />
academic units processed by WLAC until any accounting issues are resolved. In the event of<br />
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such circumstance, the student will be notified by the WLAC Administrative Assistant via<br />
telephone or email. Any discrepancy must be resolved in within 10 business days of notification<br />
in order to maintain a student’s eligibility <strong>for</strong> academic units.<br />
Fees<br />
The cost <strong>for</strong> WLAC <strong>for</strong> this service is $35, which is in addition to the course fees you have<br />
already paid. The fees represent WLAC’s cost to offer this academic service to students.<br />
Withrawal Policy<br />
Students may withdraw from a course by completing a <strong>for</strong>m at West Los Angeles College<br />
Admissions Office by the published date in the Schedule of Classes or online at www.wlac.edu.<br />
Students withdrawing from a course prior to this date will receive a full refund <strong>for</strong> the service fee<br />
<strong>for</strong> the course(s). Students who stop attending class and fail to withdraw will receive a grade of<br />
“F” at West Los Angeles College.<br />
Transcript In<strong>for</strong>mation<br />
Upon the successful completion of an eligible program, <strong>UCLA</strong> will submit a student’s grade<br />
in<strong>for</strong>mation to WLAC. Official transcripts will be available from WLAC approximately 60 days<br />
after the completion of the course. Eligible students can request their official WLAC transcripts<br />
by submitting an official request to WLAC.<br />
• Via Web Site: www.wlac.edu (Under Student Services, Grades/Transcripts)<br />
• Via Telephone: 310.287.4385<br />
• Via Mail: Admissions and Records, Attn: Transcripts<br />
West Los Angeles College<br />
9000 Overland Avenue<br />
Culver City, CA 90230<br />
The grading policy is as follows:<br />
• 93-100% A<br />
• 86-92% B<br />
• 80-85% C<br />
• 65-79 D (not recommended <strong>for</strong> certification)<br />
A minimum score of 80% is required to complete the program and be recommended <strong>for</strong><br />
certification. A score of 64% or less will be recorded as an “F” (also, not recommended <strong>for</strong><br />
certification).<br />
Grading Criteria <strong>for</strong> the Course:<br />
10% Online Quizzes<br />
20% Online Lesson Modules<br />
40% Block Exams<br />
30% Final Written Exam<br />
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P/F<br />
P/F<br />
P/F<br />
P/F<br />
P/F<br />
Professional Behavioral Evaluation<br />
Practical (Skills) Exams<br />
Attendance<br />
Clinical Orientation<br />
Clinical / Ride-along Observation<br />
Copies of Course Completion<br />
The original copy of your course completion certificate is provided without cost. Persons<br />
requesting duplicates will be charged $15.00 per copy. Make sure that your current mailing<br />
address is on file. Certificates mailed to previous addresses may not be <strong>for</strong>warded.<br />
Classroom Decorum<br />
The following regulations concern classroom decorum:<br />
1. No open toed shoes are allowed in the practical skills labs.<br />
2. Students should wear clothing that is appropriate <strong>for</strong> the practical lab setting. This includes<br />
properly fitting clothing that provides a full range of body movement without exposing the<br />
chest, torso, or buttocks or requiring frequent and/or untimely adjustments.<br />
3. Minimal jewelry worn in the practical labs. Jewelry that may pose a significant risk of<br />
snagging or otherwise endangering the wearer or others should not be worn in during skills<br />
practice.<br />
4. All personal electronic devices (pagers, cellular phones, PDAs, etc.) need to be turned to<br />
silent alert mode or turned off during class.<br />
5. Internet access is not allowed during instructional periods. Access is permissible during<br />
breaks.<br />
6. All electronic devices must be powered off and stored during exams and exam review<br />
sessions. Nothing will be allowed on the desks and hats must be taken off or turned so the<br />
visor is not visible from the front.<br />
7. Regularly scheduled breaks will be given throughout the class period. These breaks should<br />
be used <strong>for</strong> returning pages or phone calls, using the restrooms, obtaining snacks or<br />
beverages, or smoking. Disrupting the class <strong>for</strong> any reason other than an emergency will not<br />
be tolerated.<br />
8. Smoking is not permitted in the building or near its entrances. Smoking is only permitted in<br />
assigned areas and proper disposal of cigarette butts should occur. At the Westwood Village<br />
<strong>Center</strong>, smoking is only allowed on the other side of the alley, away from all entrances<br />
to the building and not obstructing traffic.<br />
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9. Students are not permitted to use facility equipment, including phones, fax machines,<br />
computers, or copiers. Students should not enter any faculty office or area without faculty<br />
permission. Certain areas of the facility are off limits.<br />
10. While on breaks, students should respect other students, faculty, and staff with their<br />
activities. The facility is used <strong>for</strong> many other classes and activities. Please be respectful.<br />
11. Students should respect the physical property of the facility and its cleanliness. All student<br />
areas should be neat and clean prior to leaving the facility at the end of class. At the end of<br />
all session, desks and equipment must be wiped down with the provided disinfectant. Please<br />
notify the faculty or staff with any facility issues so that timely maintenance or repair can<br />
occur.<br />
12. After all breaks, students should return to the classroom or skills groups in a timely fashion.<br />
13. No food will be permitted in the classroom. Drinks are permitted, as long as they are not a<br />
distraction. All spills must be immediately cleaned up with provided supplies. Instructors<br />
will provide breaks <strong>for</strong> the class as needed.<br />
14. The sinks in the classrooms (A660 and A670) may not be used. If a sink is needed, please use<br />
those found in the adjacent bathrooms.<br />
15. Do not prop, and leave unattended, outside doors. The Rehab building is locked at 9pm, be<br />
careful not to be locked out.<br />
16. Classrooms and equipment are to be put back in their original configuration after skills as<br />
directed by the Skills Coordinator or Instructor.<br />
17. Bicycles and other similar devices are not permitted in the classroom or building. You may<br />
utilize the bicycle racks provided on campus and in Westwood. Skate boards must be stored<br />
in the area provided. No exceptions.<br />
18. Students must wear their name tags at all times.<br />
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Disciplinary Action<br />
Students placed on Academic or Disciplinary Probation will be notified in writing. Departments<br />
that are sponsoring students in the program will also be notified if one of their students is placed<br />
on probation. A student who fails to comply with the terms of probation will be terminated from<br />
the Program.<br />
Academic Probation<br />
Students may be placed on probation on academic grounds at the discretion of the Program. A<br />
student on academic probation may be required to attend weekly tutoring sessions as a condition<br />
of his/her probation status. Grounds <strong>for</strong> academic probation include, but are not limited to:<br />
• Failure of two or more quizzes or exams<br />
• Failure to maintain an overall average of 80% on exams<br />
• Failure of four or more practical skills stations<br />
Disciplinary Probation<br />
Students may be placed on probation on disciplinary grounds at the discretion of the Program.<br />
Grounds <strong>for</strong> disciplinary probation include, but are not limited to:<br />
• Failure to comply with the standards of ethics, professional behavior and conduct<br />
set <strong>for</strong>th in this Manual<br />
• Failure to comply with the attendance policy<br />
• Failure to comply with the dress codes during the clinical / Ride-along phase of<br />
training<br />
• Failure to comply with the rules of classroom, clinical site or field station<br />
decorum<br />
• Failure to comply with the exposure control policy<br />
• Failure to meet the documentation requirements of course requisites prior to start<br />
of clinical rotations<br />
Termination from the Program<br />
A student may be terminated from the Program <strong>for</strong> not satisfying the academic or disciplinary<br />
policies and rules outlined in the Course Policy Manual, with or without being placed on<br />
probation, as follows:<br />
Academic Grounds<br />
• Failure to meet academic standards as outlined in the grading policy<br />
• Continued academic failures after being placed on academic probation<br />
• Failure to meet all conditions of a remediation program<br />
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• Failure to meet course requirements during any phase of the Program<br />
Disciplinary Grounds<br />
• Substantial or repeated violation of the standards of ethics, professional behavior<br />
and conduct set <strong>for</strong>th in this Manual<br />
• Repeated absences, tardiness or early departure as outlined in the Attendance<br />
Policy<br />
• Repeated or substantial failure to comply with the rules of classroom, clinical site<br />
or field station decorum<br />
• Continued administrative violations after being placed on administrative<br />
probation<br />
• Repeated or substantial failure to comply with the exposure control policy<br />
• Failure to meet the documentation requirements of course requisites prior to start<br />
of clinical rotations<br />
Upon termination, the student (and his/her sponsoring agency, if applicable) will be notified in<br />
writing of the reasons <strong>for</strong> the termination. This documentation will also be placed in the<br />
student’s file. The Program Director may require an exit interview at the time of termination.<br />
Appeal of Disciplinary Termination<br />
If a student is terminated on disciplinary grounds, he or she may file a written appeal with the<br />
Managing Director of the <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong>. The appeal must be filed within<br />
(10) ten days of the effective date of the termination. It must include an explanation of the<br />
circumstances of the termination, and specific and detailed reasons why the student believes the<br />
termination was unjustified. The student may also submit any relevant witness statements. An<br />
appeal lacking this in<strong>for</strong>mation will be summarily denied without further action.<br />
The Managing Director (or his or her designee) will review the appeal and take any action<br />
reasonably necessary to reach a decision, including interviewing the student and any relevant<br />
witnesses. The Managing Director will issue a decision on the appeal within 45 days of the date<br />
it is filed. The decision will be final and binding.<br />
If applicable, students are counseled by the Program’s Veterans Certifying Official regarding the<br />
program’s probation policy and its repercussions on the payment of benefits.<br />
Condition <strong>for</strong> Re-Enrollment<br />
Re-enrollment or re-entrance will be approved only after evidence is shown to the satisfaction of<br />
the Program’s faculty that the conditions that caused the student’s probation and/or termination<br />
have been rectified. A student is not guaranteed re-enrollment into his/her original enrollment<br />
program, but if re-enrollment is granted, he/she may have to enroll in the next available program.<br />
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Voluntary Withdrawal<br />
1. A student wishing to voluntarily withdraw from the Program must discuss his/her<br />
decision with the Principal Instructor or the Program Director in the <strong>for</strong>m of an exit<br />
interview.<br />
2. All requests <strong>for</strong> withdrawal must be made in writing and signed with an original<br />
signature.<br />
Refunds and Transfer Policy<br />
Refund or transfer requests must be made in writing and faxed or postmarked no less than 14<br />
days prior to the start of the course. A $50 administrative fee will be assessed on these requests.<br />
A full refund will be made in the event a course is cancelled or rescheduled.<br />
Textbooks and certification fees are non-refundable.<br />
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Exposure Control Policy<br />
Students are at risk of exposure to infectious disease during the Program because they may:<br />
1. Have direct physical contact with patients<br />
2. Work with blood (i.e. venipuncture) and other body fluids<br />
3. Potentially have any contact with blood or other bodily fluids<br />
UNIVERSAL OR STANDARD PRECAUTIONS<br />
Universal or standard precautions must be taken when in contact with patients and where there is<br />
a potential <strong>for</strong> contact with body fluids. Appropriate barrier precautions must be used to prevent<br />
skin and mucus membrane exposure to blood and other body fluids.<br />
1. Gloves must be worn <strong>for</strong>:<br />
• Touching blood and/or body fluids, mucus membranes or non-intact skin of all patients;<br />
• Protection of cuts or open lesions on the hands (of health the care provider);<br />
• Gloves must be changed when soiled, torn, or punctured and after contact with each<br />
patient.<br />
2. Protective eyewear and face masks must be worn during tasks that are likely to generate<br />
droplets of blood, saliva, sputum or other body fluids.<br />
3. Protective barriers must be used to minimize the need <strong>for</strong> emergency mouth-to-mouth<br />
resuscitation, such as pocket masks or BVM.<br />
4. Puncture-resistant sharps containers must be used to dispose of needles and other disposable<br />
sharp implements.<br />
CLEAN UP OF BLOOD OR OTHER BODY FLUID SPILL<br />
Prior to initiating clean up of any bodily fluids or other potentially hazardous substance, students<br />
must report the incident to an instructor during class or practical skills lab or to their direct<br />
supervisor during clinical/ride-along sessions. Any potentially hazardous exposure where such a<br />
substance enters the body must be immediately reported to the Administrator on call (see<br />
“Evaluation of Exposure Occurrences and Follow-up” section on page 32. .<br />
1. Gloves must be worn.<br />
2. Wipe up spill with a clean, dry absorbent material, and then discard in biohazard<br />
container.<br />
3. Vigorously wipe contaminated surface with 10% alcohol, a 1:1000 hypochlorite [bleach]<br />
solution, or an equivalent disinfectant, <strong>for</strong> a minimum of 30 seconds.<br />
4. Solutions <strong>for</strong> cleaning must be mixed fresh on a daily basis, following manufacturer’s<br />
instructions or by mixing 1/4 cup bleach with a gallon of water.<br />
SAFE WORK PRACTICES<br />
Students must use safe work practices designed to minimize the chance of exposure to<br />
bloodborne diseases:<br />
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1. Students who have, or recently have had, any type of infectious disease should refrain from<br />
participatory skills until they are considered well. Examples of diseases include, but not<br />
limited to:<br />
• Open cuts, weeping skin lesions, or sores on face, mouth, or hands<br />
• Respiratory infection<br />
• Flu-like symptoms, cough, sore throat, fever<br />
• Active, acute hepatitis<br />
• Mononucleosis<br />
• Tuberculosis<br />
• Active infections, i.e. herpes, shingles, fungi, conjunctivitis<br />
2. Hands and other skin surfaces (as applicable) must be washed:<br />
• Be<strong>for</strong>e and after direct patient contact.<br />
• After removal of gloves.<br />
• After any accidental contamination with blood or other body fluids.<br />
3. Students must wear appropriate personal protective equipment according to guidelines set<br />
<strong>for</strong>th by <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong>, the individual hospital clinical site, or the<br />
Fire/EMS agency.<br />
4. Procedures must be per<strong>for</strong>med in such a manner as to decrease the chance of splashing or<br />
spraying of blood or other body fluids.<br />
5. Reusable instruments contaminated by blood or other body fluids (such as Stethoscopes)<br />
must be placed in designated containers containing disinfectant, <strong>for</strong> a minimum of 10<br />
minutes.<br />
INFECTION CONTROL EDUCATION AND TRAINING<br />
Students must attend an education and training program on Infectious Disease Control. This<br />
program provides in<strong>for</strong>mation on:<br />
1. Epidemiology – modes of transmission of HBV and HIV, symptoms;<br />
2. Infection control methods including universal precautions, work practices, and personal<br />
protective equipment;<br />
3. Vaccinations;<br />
4. Method of reporting an exposure incident and follow-up<br />
HEPATITIS B VACCINATION<br />
1. Students must submit proof of having received the HBV vaccine series, which must be<br />
completed prior to the start of the clinical phase.<br />
2. Students electing not to receive HBV vaccination must sign a waiver or provide<br />
documentation of HBV immunity (titer).<br />
3. The student will be responsible <strong>for</strong> the cost of the vaccine.<br />
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Evaluation of Exposure Occurrences and Follow-up<br />
POLICY<br />
1. It is the student’s responsibility to follow safe work practices and infection control<br />
guidelines.<br />
• Should a student be exposed, he or she must report it immediately to the Administrator on<br />
call at pager number 800-233-7231 ID# 96400. The student must also contact or leave a<br />
message <strong>for</strong> the Program Director at the following voice-mailbox: (310) 312-9316.<br />
• Appropriate medical evaluation and testing will be done according to current <strong>Center</strong>s <strong>for</strong><br />
Disease Control Guidelines, current medical standard of care <strong>for</strong> infectious disease<br />
exposure, or hospital policy.<br />
2. Students are responsible <strong>for</strong> maintaining medical health coverage, and <strong>for</strong> any and all<br />
physical examinations, laboratory testing, and treatment due to exposure, illness, or injury.<br />
PROCEDURE<br />
An in-house unusual occurrence report must be written by the exposed student.<br />
1. This report should document the route of exposure, the circumstances of exposure, and, if<br />
known, the HBV and HIV status of the patient.<br />
2. This report must be given to the Program Director or designee within 24 hours or as soon<br />
as possible after the occurrence.<br />
LIABILITY<br />
Students of the <strong>EMT</strong> program are covered by the University’s general and professional liability<br />
policy to the extent that the student is acting in the course and scope of his or her education or<br />
training. Additional coverage, and uninsurable events including gross negligence, are the<br />
responsibility of the student. The student’s employer may provide an additional insurance policy<br />
<strong>for</strong> the student as well. The student can purchase private supplemental insurance at his/her own<br />
cost.<br />
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Frequently Asked Questions Regarding the <strong>EMT</strong> Program<br />
1. How much studying do I need to do? The amount of studying required will depend<br />
completely upon the individual. Those who have some medical knowledge or<br />
background may grasp material easier than those who do not. The most common<br />
hindrance is terminology. If you are having difficulty, please contact us to schedule an<br />
appointment. Anywhere from 1 to 4 hours per lecture session may be needed.<br />
2. When will my phone call or email be answered? All student correspondence is<br />
important to us. We will make every ef<strong>for</strong>t possible to answer your email or phone<br />
message within 24 hours of receiving them, Monday through Friday, not including<br />
holidays.<br />
3. Are there dumb questions? Yes. If the answer has already been given or is readily<br />
available in a resource at your disposal, the question is not appropriate. As EMS<br />
professionals, you must be resourceful and able to work independently. If you cannot<br />
find an answer to a question, you must ask at least two classmates during class breaks,<br />
be<strong>for</strong>e asking an instructor.<br />
4. How much time do I have to complete my ride-along? You have two weeks from the<br />
last day of class to start your ride-along observation. Students requesting an extension<br />
must do so in writing to the Principal Instructor and / or Program Director. Extensions<br />
may be granted only under exceptional circumstances.<br />
5. When can I get my <strong>UCLA</strong> course completion certificate? After you complete the<br />
course, including submission of your clinical or ride along, we will begin processing your<br />
<strong>UCLA</strong> <strong>EMT</strong> Course Completion Certificate. (See section: Verification of NR<strong>EMT</strong> and<br />
Issuance of Certificates of Completion <strong>for</strong> further details.) Course Completions can<br />
only be generated on a bi-weekly basis. You must submit a copy of your Course<br />
Completion <strong>for</strong> certification in the State of Cali<strong>for</strong>nia. You may take the National<br />
Registry exam prior to receiving your copy of the Course Completion Certificate.<br />
6. When can I take the certifying test? You may schedule the certifying examination<br />
after you have successfully completed our program. You may apply <strong>for</strong> certification<br />
testing by completing the online application at www.nremt.org. This application will be<br />
verified within one week, if all course completion requirements are met.<br />
7. Can I certify out of Los Angeles County? With a <strong>UCLA</strong> <strong>EMT</strong> course completion<br />
certificate in hand, a student may attempt to attain State certification anywhere in<br />
Cali<strong>for</strong>nia, through a local certifying agency, normally the county Department of Health<br />
Services.<br />
8. Is my county certification good throughout Cali<strong>for</strong>nia? Yes. Individual counties are<br />
only allowed to request an additional background investigation above and beyond the one<br />
conducted upon initial certification. This practice will vary from county to county.<br />
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9. Is my certification good in other states? <strong>EMT</strong>s must be certified within the state that<br />
they take the initial <strong>EMT</strong> course. Upon becoming Cali<strong>for</strong>nia State certified, an <strong>EMT</strong> may<br />
apply <strong>for</strong> certification in another state. Approximately half of all states are under the<br />
National Registry of <strong>EMT</strong>. These states require that an <strong>EMT</strong> is Nationally registered<br />
upon entering the state. A student may request in<strong>for</strong>mation regarding National Registry<br />
certification by calling the National Registry at (614) 888-4484 or visiting<br />
www.nremt.org .<br />
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<strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong><br />
Exposure/Injury Report Form<br />
Student Name: ______________________________<br />
Date: ___________________<br />
Clinical site and address: ________________________________________________<br />
Clinical site telephone #: _________________________________________________<br />
Incident occurred under the supervision of: ___________________________________<br />
Source of exposure or injury: _____________________________________________<br />
Activity being per<strong>for</strong>med: ________________________________________________<br />
Briefly describe what occurred: ___________________________________________<br />
<br />
Blood exposures only: Sent <strong>for</strong> follow-up testing/counseling? Yes No<br />
Injury only: Sent to ED/private physician <strong>for</strong> treatment? Yes No<br />
Location of follow-up: __________________________________________________<br />
If excused from clinical/field rotation(s), date released to return: _________________<br />
What might be done to prevent similar incidents from occurring in the future?<br />
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Witnesses names, including address and telephone:<br />
Student address and telephone:<br />
Additional in<strong>for</strong>mation:<br />
____________________________<br />
Student signature and date<br />
______________________________<br />
Program Director signature and date<br />
<strong>UCLA</strong> CPC use only<br />
CC:<br />
student file<br />
Call (310) 825-6301, pager ID 96400, ASAP to report potential exposure.<br />
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Policy Certification<br />
I ____________________________________ have read and understand the expectations<br />
and requirements to participate in the <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> <strong>EMT</strong> Education<br />
Program and the <strong>EMT</strong> Program Course <strong>Policies</strong>. I understand that failure to meet the<br />
requirements as described in the Course <strong>Policies</strong> Manual, Clinical Packet and Course Schedule<br />
may result in my termination from the Program. I also agree to conduct myself as a professional<br />
and in a manner consistent with the Course <strong>Policies</strong> Manual, Clinical Packet and Course<br />
Schedule.<br />
Student Signature:_______________________ Date:______________________<br />
Student Name: ______________________________<br />
Course ID:__________________________________<br />
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Participation in <strong>Prehospital</strong> <strong>Care</strong> and Education Research<br />
The <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> is committed to prehospital care and educational<br />
research. During your tenure at <strong>UCLA</strong> we would be interested in using data that has been<br />
collected about your experience in our course(s). This data is meant to help measure your<br />
learning and provide your instructors with better tools to assist you and future students in<br />
improving the didactic, clinical and field experiences. Currently, your data is confidential and can<br />
only be viewed by your instructor(s).<br />
The <strong>UCLA</strong> <strong>Center</strong> <strong>for</strong> <strong>Prehospital</strong> <strong>Care</strong> would like your permission to confidentially use your<br />
data <strong>for</strong> research purposes. Only the computer programmer(s) and your instructor(s) will have<br />
any student identified in<strong>for</strong>mation, and by accreditation rules are not permitted to share any<br />
in<strong>for</strong>mation about you without your expressed, in<strong>for</strong>med consent.<br />
Your participation in prehospital research is entirely voluntary; it will not cost you anything and<br />
does not pose any risk to your physical or psychological safety, but will be critical in the<br />
improvement of EMS education programs. There is a pressing need <strong>for</strong> more research in EMS<br />
education. Instructors are making decisions about yours and future EMS education programs<br />
without having evidence to substantiate those choices.<br />
Your consent to allow us to use your confidential data in this research is voluntary. Your refusal<br />
to allow us to use your data will involve no penalty or loss of any privileges/benefits to which<br />
you are currently entitled. You are free to withdraw your consent at any time.<br />
____ I DO consent to having my confidential data used <strong>for</strong> research purposes.<br />
____ I do NOT consent to having my confidential data used <strong>for</strong> research purposes.<br />
Student Name: ______________________________<br />
Date:_______________________<br />
<strong>UCLA</strong> Student ID Number: ____________________<br />
Student Signature: __________________________________________________________<br />
Course ID:__________________________________<br />
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<strong>UCLA</strong> CPC Revised <strong>UCLA</strong> CPC Revised 12/10/2012