202 KAR 7:330. Requirements for examination, certification, and recertification of the advanced emergency medical technician.

 

      RELATES TO: KRS 38.030, Chapter 39, 39A.050, 311A.010, 311A.020, 311A.025, 311A.050, 311A.090, 311A.095, 311A.100, 311A.110, 311A.127, 311A.140, 311A.145, 311A.150, 311A.195, 10 U.S.C. 121, 672(b)

      STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation establishes requirements for examination, certification, and recertification of the AEMT.

 

      Section 1. Certification Requirements. (1) An applicant for initial certification as an AEMT shall complete an educational course that:

      (a) Meets or exceeds the National Emergency Medical Services Educational Standards-Instructional Guidelines for an AEMT; and

      (b) Meets all educational standards established in 202 KAR 7:601.

      (2) An applicant for initial certification as an AEMT in Kentucky shall pass the examination required to obtain the National Registry of Emergency Medical Technicians certification for an AEMT.

      (3) An applicant for initial certification as an AEMT shall provide proof that the applicant has:

      (a) Completed a college degree; or

      (b)1. Obtained a high school diploma; or

      2. Successfully taken the General Educational Development (GED) test.

      (4) An applicant for AEMT shall complete and submit a signed EMS Responder Application.

      (5) An applicant for AEMT shall submit valid evidence of completion of the following courses:

      (a) HIV/AIDS training required by KRS 311A.110; and

      (b) Pediatric Abusive Head Trauma required by KRS 311A.127.

      (6) An applicant for AEMT shall pay to KBEMS the fee established in 202 KAR 7:030 for certification as an AEMT.

      (7) An applicant for AEMT shall submit to KBEMS an unexpired cardiopulmonary resuscitation (CPR) card or other current evidence of completion of a CPR course that:

      (a) Meets all standards of the American Heart Association Basic Life Support for Healthcare Provider course; and

      (b) Includes a psychomotor examination component and a cognitive assessment.

      (8) An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check required shall be

      (a) National in scope for an applicant not currently certified at any level in Kentucky;

      (b) Statewide in scope for an applicant with current certification in Kentucky;

      (c) Less than six (6) months old when the applicant submits to KBEMS all requirements for certification; and

      (d) Provided by a vendor that has been contracted through KBEMS or an official federal entity.

      (9) An applicant shall not directly submit a background check. The background check shall be submitted to the Kentucky Board of Emergency Medical Services by the company or federal entity that conducts the background check.

      (10) An applicant shall have two (2) years from the completion date appearing on the course completion form for the applicant’s AEMT course to:

      (a) Pass the National Registry exam for AEMT certification; and

      (b) Fulfill all requirements for certification as an AEMT established in this section.

 

      Section 2. Scope of Practice. (1) An AEMT shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model.

      (2) In addition to the skills and procedures in the National EMS Scope of Practice Model, the scope of practice of a Kentucky AEMT shall include the following procedures:

      (a) Quantitative and qualitative capnography and capnometry;

      (b) Bilevel Positive Airway Pressure and Continuous Positive Airway Pressure (BIPAP/CPAP) devices;

      (c) End tidal Carbon Dioxide (ETCO2) Detection;

      (d) Acquisition of a non-interpretive twelve (12) lead electrocardiogram (ECG);

      (e) Transmission of a non-interpretive twelve (12) lead electrocardiogram (ECG); and

      (f) Establish and maintain adult intraosseous infusion.

      (3) Eligibility to perform the supplemental procedures shall require an AEMT to complete education on and training for the skill performed. The supplemental curriculum required shall consist of:

      (a) Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using a noninvasive monitoring device – Application of 12 lead electrocardiogram electrodes and monitor;

      (b) Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using a noninvasive monitoring device – Application and interpretation of quantitative capnography and end tidal carbon dioxide monitoring;

      (c) Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using Bilevel Positive Airway Pressure and Continuous Positive Airway Pressure Devices; and

      (d) Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using intraosseos infusion in the adult.

      (4) An AEMT shall adhere to the protocols the employing service’s medical director submitted to KBEMS for approval. Deviation from the protocols shall only occur if:

      (a) The AEMT’s medical director or designated on-line medical control orders otherwise;

      (b) Compliance with approved protocols is not in the patient’s medical best interest; or

      (c) The AEMT does not have the equipment or medication to adhere to the protocol.

      (5) An AEMT shall document deviation from an approved protocol as part of the patient care report.

      (6) If providing emergency medical services during a disaster or emergency that qualifies as part of the Emergency Management Assistance Compact, pursuant to KRS 39A.050 or if acting pursuant to another agreement made pursuant to KRS Chapter 39, an AEMT certified in another state may perform the skills and procedures approved by the certifying state.

 

      Section 3. Expiration of Certification. (1) Certification periods and expiration dates shall be pursuant to KRS 311A.095.

      (2) If an AEMT’s certification lapses or expires, the AEMT shall cease provision of emergency medical services.

      (3) If the AEMT has chosen to maintain certification at the EMT level, the AEMT shall apply for renewal of EMT certification prior to the expiration date.

      (4) An AEMT who has allowed all levels of certification to lapse or expire shall be required to reinstate certification pursuant to Section 7 of this administrative regulation.

 

      Section 4. Renewal of Certification and Continuing Education Requirements. (1) To be eligible for renewal of certification, an AEMT shall submit to the board:

      (a) A completed and signed EMS Responder Application; and

      (b) The fee established in 202 KAR 7:030.

      (2) The applicant shall maintain written evidence of:

      (a) Current training in HIV/AIDS treatment and recognition required by Section 1(5)(a) of this administrative regulation; and

      (b) Current training in Pediatric Abusive Head Trauma as required by KRS 311A.127.

      (3) An applicant for renewal of certification as an AEMT shall maintain evidence of:

      (a) Current certification by the National Registry of Emergency Medical Technicians as an AEMT; or

      (b) Completion of the AEMT continuing education requirement of forty-eight (48) total instructional hours. The forty-eight (48) instructional hours shall be composed of twelve (12) elective hours in subject areas chosen by the AEMT and thirty-six (36) hours that include the following minimum contact hours for the following subject areas:

      1. Twelve (12) hours in airway, breathing, and cardiology, with a minimum of one (1) hour in each topic;

      2. Six (6) hours in medical emergencies, excluding cardiology;

      3. Five (5) hours in trauma;

      4. Six (6) hours in obstetrics;

      5. Six (6) hours in pediatrics; and

      6. One (1) hour in disaster management.

      (c) The twelve (12) elective hours required for an AEMT to recertify shall not include more than four (4) hours in a single category in the list provided in paragraph (b)1. through 6. of this subsection.

      (4) To be used for renewal of certification, the AEMT’s continuing education hours shall be certified as valid by:

      (a) The course’s instructor, medical director, training officer, coordinator, or provider that offered the hours; or

      (b) A medical director, service director, or training officer of the AEMT’s ambulance service, first response agency, fire department, rescue squad, or other medical employer.

      (5) An applicant for AEMT shall not be eligible for renewal of certification if the applicant does not complete all hours required by the end of the AEMT’s certification period.

      (6) An applicant’s certification that is based upon completion of continuing education hours that are subsequently proven untrue, inaccurate, or fraudulent through a board audit shall be invalid pursuant to KRS 311A.140(4) and 311A.050(2)(b).

      (7) An applicant who is subject to pending administrative action pursuant to KRS 311A.050 through 311A.090 shall be eligible to renew certification unless the applicant:

      (a) Is temporarily suspended pursuant to KRS 311A.075;

      (b) Has failed to perform an action ordered by the board pursuant to KRS 311A.055 or 311A.060; or

      (c) Is delinquent on fines or fees owed to the board pursuant to KRS 311A.055, 311A.060, or 202 KAR 7:030.

      (8) A certified AEMT who is not undergoing disciplinary action with the board and who is a member of a branch of the United States military or a National Guard or military reserve unit shall be eligible for an extension of the time limit to renew certification if the AEMT:

      (a)1. Is called to federal active duty by presidential order pursuant to 10 U.S.C. 121 and 673b during the current certification period; or

      2. Is called to state active duty for an extended period of time by order of the governor pursuant to KRS 38.030;

      (b) Because of the call to active duty, is unable to complete the continuing education hours required for renewal of certification; and

      (c) Submits a written request for an extension within thirty (30) days prior to or sixty (60) days after release from active duty.

      (9) The extension granted pursuant to subsection (8) of this administrative regulation shall not exceed one (1) year beyond the effective date of release from active duty for the AEMT. The AEMT shall be required to provide a DD 214 or other relevant federal documents as proof of the release date.

      (10) If asked by the office of the board to provide the documentation of continuing education hours an AEMT used as a basis for renewal of certification, the AEMT shall submit the documentation within ten (10) business days of receipt of the board’s request.

      (11) The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.

 

      Section 5. AEMT Reciprocity. (1) An individual who is certified by the NREMT as an AEMT shall be eligible for direct reciprocity for initial certification as an AEMT in Kentucky if the applicant submits a completed and signed EMS Responder Application and proof of:

      (a) The applicant’s unrestricted NREMT certification as an AEMT; and

      (b) Completion of current training in:

      1. HIV/AIDS training required by KRS 311A.110;

      2. Pediatric Abusive Head Trauma training required by KRS 311A.127; and

      3. CPR that meets the requirements of Section 1(7) of this administrative regulation; and

      (c) Submission of the Kentucky Required Mandatory Supplemental Curriculum for AEMT Initial Training Verification Report.

      (2) An applicant shall pay the fee required for initial certification through reciprocity pursuant to 202 KAR 7:030.

      (3) An applicant for AEMT direct reciprocity shall undergo a national background check and have the results submitted to the board. Background checks that are older than six (6) months shall not be considered current, and the applicant shall be required to undergo another national background check prior to approval of certification through reciprocity.

      (4) An AEMT certified pursuant to Section 1 of this administrative regulation shall not perform any procedures or skill on which the AEMT has not been trained. An AEMT who performs a skill for which the AEMT does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.060.

      (5) An AEMT certified pursuant to Section 1 of this administrative regulation shall complete the Kentucky supplemental AEMT curricula for the procedures listed in Section 2(3) of this administrative regulation within six (6) months of receiving certification through direct reciprocity.

      (6) Verification of competency on the supplemental curricula procedures in Section 2(3) of this administrative regulation shall be submitted to the board within six (6) months of receiving certification. Failure to submit verification shall result in revocation of AEMT certification, and the board shall issue a new certificate at the level of EMT for the remaining certification period.

      (7) If an AEMT certified pursuant to this section fails to supply verification of competency as required by subsection (6) of this section and the AEMT’s certificate is reissued at the EMT level of certification, the AEMT shall be ineligible to apply for and receive AEMT reciprocity certification until the applicant has submitted verification of competency in the supplemental procedures in Section 2(3) of this administrative regulation.

 

      Section 6. Exemptions from AEMT Administrative Regulations. Certification requirements for an AEMT shall not apply to:

      (1) United States military members, state National Guard personnel, or employees of the United States government if the individual provides emergency medical services:

      (a)1. On land owned by the United States government; or

      2. In facilities owned by the United States government; or

      (b)1. In the performance of official duties under federal law; or

      2. As part of assistance for a mass casualty or disaster incident pursuant to federal law or official state assistance request; or

      (2) An AEMT certified in another state or territory of the United States who:

      (a) Enters Kentucky with a patient being transported to a medical facility or other final destination in Kentucky; or

      (b) Travels through Kentucky during the course of a patient transport from an out-of-state location to a destination outside of Kentucky.

 

      Section 7. Reinstatement of Certification. (1) An AEMT whose Kentucky certification has lapsed shall be eligible for reinstatement of certification if:

      (a) The lapse in certification has not exceeded a period of three (3) years; and

      (b) The applicant submits:

      1. A completed and signed EMS Responder Application; and

      2. Evidence of:

      a. Current certification at the AEMT level or higher with the National Registry; or

      b. Current training in:

      (i) HIV/AIDS training required by KRS 311A.110;

      (ii) Pediatric Abusive Head Trauma as required by KRS 311A.127; and

      (iii) Healthcare CPR as required by Section 1(7) of this administrative regulation.

      (2) The applicant shall pay the fee pursuant to 202 KAR 7:030.

      (3) The applicant shall undergo a national background check and have the results presented to the office of the board. If the background check is older than six (6) months, the applicant shall be required to undergo and have new results submitted to the board.

      (4) The applicant for reinstatement of certification shall bear the burden of proof of previous certification in Kentucky if the previous certification is in issue or dispute.

      (5) An applicant for reinstatement of an AEMT certification shall submit evidence of formal completion of continuing education hours as required in Section 4 of this administrative regulation. Completion of the hours shall have occurred within the twelve (12) months preceding application for reinstatement of the AEMT.

      (6) An applicant for reinstatement of a lapsed certification shall provide evidence of current skills by completing and submitting validation of those skills on the Kentucky Advanced EMT Skills Verification Report.

      (7) An AEMT whose certification has lapsed for longer than three (3) years shall not be eligible for reinstatement but shall be considered an initial certification and shall meet all requirements in Section 1 of this administrative regulation.

      (8) An applicant ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.

 

      Section 8. AEMT certification through previous pilot projects. (1) An AEMT who obtained certification as an AEMT through training in a pilot project previously approved by the board shall maintain certification until the end of the current certification period without the completion of additional requirements.

      (2) An AEMT certified through a previously approved pilot project who applies for renewal at the end of the current certification period shall meet all requirements for renewal of certification in Section 4 of this administrative regulation.

      (3) An applicant certified as an AEMT in a previously approved pilot project and who meets the requirements for renewal of certification as an AEMT in Section 4 of this administrative regulation shall not be limited to the geographic boundaries established in the original pilot project but shall be considered fully certified and geographically unrestricted to practice as an AEMT in the state of Kentucky.

 

      Section 9. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) "National Emergency Medical Services Education Standards-Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077A, January 2009;

      (b) "EMS Responder Application", KBEMS E-1, September 2012;

      (c) "American Heart Association’s Basic Life Support for Healthcare Providers Course", American Heart Association, 2011;

      (d) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;

      (e) "Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using a noninvasive monitoring device – Application of 12 lead electrocardiogram electrodes and monitor", KBEMS E-29, March 2013;

      (f) "Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using a noninvasive monitoring device – Application and interpretation of quantitative capnography and end tidal carbon dioxide monitoring", KBEMS E-30, March 2013;

      (g) "Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using Bilevel Positive Airway Pressure and Continuous Positive Airway Pressure Devices", KBEMS E-32, March 2013;

      (h) "Kentucky Ambulance Service Specific Supplemental Curriculum for the AEMT using intraosseous infusion in the adult", KBEMS E-31, March 2013;

      (i) "Kentucky Required Mandatory Supplemental Curriculum for AEMT Initial Training Verification Report", KBEMS E-26, March 2013; and

      (j) "Kentucky Advanced EMT Skills Verification Report", KBEMS E-28, March 2013.

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, KCTCS, 300 N. Main Street, Versailles, Kentucky 40383, Monday through Friday, 8 a.m. to 4:30 p.m. (35 Ky.R. 467, 1153, eff. 12-5-2008; 39 Ky.R.2050; 40 Ky.R. 25; 273; eff. 8-21-2013.)