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NREMT-PTE - NREMT Paramedic Trauma Exam - Dump Information

Vendor : Medical
Exam Code : NREMT-PTE
Exam Name : NREMT Paramedic Trauma Exam
Questions and Answers : 49 Q & A
Updated On : October 18, 2018
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NREMT-PTE Questions and Answers

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NREMT-PTE NREMT Paramedic Trauma Exam

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NREMT-PTE exam Dumps Source : NREMT Paramedic Trauma Exam

Test Code : NREMT-PTE
Test Name : NREMT Paramedic Trauma Exam
Vendor Name : Medical
Q&A : 49 Real Questions

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Medical Medical NREMT Paramedic Trauma

EMT of the 12 months named | killexams.com Real Questions and Pass4sure dumps

Pete Ghiringhelli of Gwinn, left, shakes arms with Forsyth Township Supervisor Joe Boogren, as Boogren items Ghiringhelli along with his plaque for the 2017 superior Emergency clinical Technician of the yr award from the Michigan department of fitness and Human features’ Bureau of EMS, Trauma and Preparedness at a Forsyth Township Board assembly. (photograph courtesy of Carilyn Froberg, Forsyth Township EMS director)

MARQUETTE — Pete Ghiringhelli of Gwinn was these days diagnosed as considered one of Michigan’s 10 gold standard emergency clinical technicians, receiving a 2017 superior Emergency scientific Technician of the 12 months award from the Michigan branch of fitness and Human services’ Bureau of EMS, Trauma and Preparedness at a Forsyth Township Board meeting.

“It was an honor to get that award,” Ghiringhelli noted.

He said he’s grateful for the state’s acknowledgment of first responders with the award, noting that “it potential a whole lot that the state takes day trip to recognize individuals.”

Ghiringhelli, who served as director of Forsyth Township Volunteer fire department for over twenty years, has served as a volunteer EMT and firefighter with the Forsyth Township Volunteer fire department for over 30 years. He became recognized with Marquette County’s own EMT of the year award in 2001, he said.

Ghiringelli achieved his practicing as a firefighter in 1986 and turned into impressed to pursue EMT education and licensing due to the need for EMTs in his neighborhood.

“Our township needed americans and i become on the hearth branch, they have been hunting for EMTs, so I signed up,” he mentioned.

He got his EMT license in 1988 after finishing EMT training in 1987, he pointed out.

Ghiringhelli went on to pursue practicing as an advanced EMT to expand his skill set and be in a position to offer extra care as a responder, he spoke of.

right through his years of service, Ghiringhelli has spoke back to many calls, even assisting with the beginning of little ones.

“I’ve seen everything, I’ve done every little thing,” he spoke of, noting he has been completely satisfied to serve his community throughout the years.

he is grateful for the help of his wife, Patty, their three infants, as well as the guide of his co-people.

“We work with an excellent community of individuals, that makes it less difficult to do,” he pointed out.


Giants' scientific personnel and EMS group always capable on gameday | killexams.com Real Questions and Pass4sure dumps

It’s the middle of the fourth quarter in a tie video game, fans are screaming, and also you get the signal. It’s go time.

Eli Manning isn’t the just one faced with this class of pressure condition. Jason Emmel may well be thrust into motion on any given Sunday at MetLife Stadium.

whereas Manning’s crew is the new york Giants, Emmel’s is the new Jersey activities Exposition Authority (NJSEA) Emergency medical capabilities. whereas Manning’s alerts come from coaches, Emmel’s come from the Giants’ scientific workforce. If Emmel sees the “all come” sign – a coach miming turning a guidance wheel – he races onto the box in his cart, surroundings off a rehearsed emergency motion plan each viewed and unseen to the general public.

“There are 80,000 americans in the stadium staring at you after which a further million at home looking at you,” mentioned Emmel, EMS special ops supervisor. “however they’re still a affected person and you just go again and you do what you have to do and deal with them the same method we would treat any one. You simply ought to type of be aware that on the end of the day, it’s nevertheless a affected person. They’re an NFL player, they're very typical all over the world with people looking at the NFL, but at the conclusion of the day, they’re still a affected person and you just must center of attention on that.”

this is probably the most seen a part of the job. because of the actual nature of the game, each fan has considered a player carted off the container. What they don’t see is the earlier than and after.

4 container crew members – two on the domestic facet, two on the guests – get to the stadium at 9:30 a.m. for a 1 p.m. kickoff. Ronnie Barnes, senior vice chairman of scientific services and head athletic trainer for the Giants, likes them to be there when the visiting group’s buses arrive. First they put out their machine on the container, together with an oxygen deliver for each benches. Then 60 minutes previous to kickoff, there's a full clinical assembly with trainers, head team physicians from both teams, medical spotters, and referees. They get to grasp every different and discuss where all and sundry could be all through the video game.

and then no one wishes to peer the EMS crew again. sadly, that isn’t all the time the case.

“The doctors depend on Jason’s team because they comprehend they know the players, and they’re used to working on avid gamers,” EMS director Fran Guthrie R.N. pointed out. “The medical doctors are docs, but that doesn’t mean they work with massive football players and their large, extensive necks and different things. There are different things that go into intubation and just coping with a participant and their character. These guys hold a level head whereas everyone else which you can see their adrenaline pumping and that they’re on the scorching seat, to be able to talk, when someone goes down and whether they stroll away or not in the beginning. It’s intense feeling.”

Guthrie directs a crew that contains EMS coordinator Antonio Vagueiro, EMS supervisor Anthony Tremarco, Emmel and the special operations team of Henry Ruiz, Joseph Dyl, Melanie Alberto and Brian Mende.

within the event of a severe damage, a sequence response is decided in motion to get the player to the medical institution. there's an escort from the stadium to the Lincoln Tunnel, which is then picked up via Port Authority and brought through the tunnel, and then the NYPD takes over from there to get them to the clinic.

“we're extraordinarily fortunate to have the very best stadium-based emergency features within the country,” Barnes referred to. “We count on the paramedic group of workers at MetLife Stadium for emergency coverage at our practices and video games. they are highly educated and intensely skilled in activities trauma. Tony Vagueiro and Fran Guthrie demand excellence, and we benefit drastically from their management.”

The same functions are given to the away team, from taking X-rays to deciding upon up drugs to transporting trainers, players and members of the family to the medical institution.

“The Giants are very good with the opposing teams’ avid gamers,” Vagueiro mentioned. “They’ll say, ‘hear, you need to pick up the trainer and player, think you can address that? So we’ll ship a supervisor out to decide upon him up and look ahead to him and you have a aircraft on the tarmac. Now we have to make arrangements with Port Authority – ‘We’re coming during this gate, are you able to meet us, can you support us out, are you able to get us out to the [plane]?’ So now we’ve bought to be cleared, we get cleared, and it’s the equal aspect if we have to take a participant to long island. It’s to the point where we’re a smartly-oiled computer.”

each may additionally, it gets a tune-up.

The EMS crew and the Giants’ full scientific team of workers social gathering for a day on the Quest Diagnostics training core. They go over every state of affairs and deploy mock situations within the fieldhouse with mannequins and game-day device.

“That’s the NFL attempting to make every thing uniform,” Guthrie referred to. “So 5 years ago, people were doing things their personal manner. The Giants had a way. somebody else had a different means. So when whatever thing happens, they wanted every little thing to be uniform all through the complete league, and the training got here into play. They at all times obtained collectively and discussed everything, but now it’s greater formalized. The time to disagree is for those who’re working towards and never when you’re in a true-lifestyles condition. So it does work out because they do argue from side to side to figure out which method is the most fulfilling manner.”

after all, when someone is injured it is not just a depend of ripping off the shoulder pads or helmet. there is an entire process. on the other hand, getting a participant’s machine off is one of the many wonderful variables of the job.

within the EMS toolkit are electric cordless drills for helmet screws and special sheers for shoulder pads. With the quite a lot of sorts of facemasks and helmets, some are push pins whereas others are screws. And what happens if the screw is rusted or stripped? They leave no stone unturned in this practice session. 

“there is definitely not any situation that we haven’t spoke of and long past over,” Emmel mentioned. “The planning is really the important thing to having success if anything occurs.”

And some thing will take place.

“The paramedics are a really essential a part of that practicing,” Barnes referred to. “Our physicians, athletic trainers, paramedics and other simple scientific specialists all teach for serious trauma on the container and for catastrophic backbone injuries. we've relied heavily on the team through the years. they've been instrumental in assisting our clinical workforce in providing instant medical consideration in emergency cases. Their superior working towards in trauma, CPR, intubation, getting rid of injured players from the field, and sanatorium transport has been worthwhile to our gamers and scientific workforce. I have worked with Tony for 39 years and i cannot supply him adequate praise for his knowledgeable advice. Their whole community of paramedics is dedicated to the care of our athletes. they are a vital part of our scientific workforce.”

Barnes, Vagueiro and Guthrie go again to the early days of Giants Stadium. before Barnes got here alongside, the paramedics were local volunteers. He modified that with the NJSEA, a state company with rules, to ensure that every little thing turned into carried out effectively and that ambulances coping with the gamers were smartly-equipped.

“He was completely happy with what we may offer, and we started working with him each football Sunday,” Guthrie talked about. “and then our relationship simply developed from there. What we necessary was EMTs with paramedic background because they needed to be capable of support the physicians and recognize a serious injury on the field.”

Jobs like these are not for the faint of coronary heart.

“You ought to find it irresistible,” observed Guthrie, who began as a registered nurse in a new York city emergency room. “It gets on your blood.”

Vagueiro, in the meantime, received into the container because of own event. He was in a serious vehicle accident when he changed into 17, and the EMS on the scene changed into from Newark like he turned into, in spite of the fact that he became out of town at the time. That led him to college health facility and finally the NJSEA in 1978, the year after Guthrie took over. Vagueiro even designed the backboard that is still used these days in stadiums across the country. The need arose in the aftermath of Jets protecting conclusion Dennis Byrd’s profession-ending neck harm in 1992. The historic boards without difficulty had been no longer massive enough for a football player.

“I still have the receipt that we paid for the mildew and everything,” Vagueiro noted. “Now it’s mandated for each NFL and faculty soccer team. They tried about 5 several types of board, and the one they went with changed into the one I designed. It came from the need with Byrd. That’s after I designed it. When Byrd obtained damage with the Jets, I said, ‘here is now not going to work.’ I suppose that became our first really off-the box-removal, and that’s when we designed the board.

“It appears like that everybody that got here on the group or has been appointed by means of the crew from Fran got here from stress environments – streets of Newark, streets of ny. So there’s now not much you in fact can throw at them that’s going to make them get jittery.”

That’s what makes them so effective.

“The EMS crew are a crucial and essential a part of our scientific team,” referred to Dr. Scott Rodeo, the Giants’ head crew health care professional and activities medicine Surgeon at medical institution for special surgery. “they've provided skilled enter that has aided the creation of our emergency motion plan (EAP) for MetLife Stadium. i am at all times reassured after I see them on the sidelines, realizing that they convey gigantic skills to our emergency clinical response crew.”

but like a backup quarterback, no one desires to see them.

“with a bit of luck we’re just there to monitor a Giants win,” Emmel referred to, “and not must do anything.”


Trauma in EMS | killexams.com Real Questions and Pass4sure dumps

title /content ]]> Editor's notice: here is the primary installment in a 3-half sequence on scientific transportation and EMS. read the 2nd half, "Equipping EMS."

Emergency scientific technicians, first responders and paramedics—the backbone of emergency medical services—have worked for a long time under a compensation gadget that effectively continues their pay low and gives them an incentive to now not always give efficient, high-quality care. That reimbursement model may well be in for revision, though, a flow that would be welcomed by means of many in the trade.

on the middle of the difficulty is a Sixties-period compensation model that EMS experts say not fits with how the EMS group wants to supply care. below the existing model, which became developed when ambulances have been used for transportation only, an ambulance service receives paid most effective if a affected person is transported to a clinic.

title

abstract study greater >

/content material.1 ]]> An EMT or paramedic who spends the time and energy to appropriately stabilize a affected person in a house or on the scene of an accident gets reimbursed nothing if the patient feels well sufficient to say no a trip to the emergency room. but if that identical affected person—who may no longer need additional care—decides to consult with the ER, then not simplest does the ambulance carrier receives a commission, however the clinic ER does too, unleashing a string of bills that maybe might have been prevented.

That kind of compensation for a provider designed to be able to go at any time makes it complicated to support the infrastructure and overhead of EMS. It also encourages inefficient use of healthcare elements.

“there is a disincentive to no longer take people to the clinic,” says bypass Kirkwood, president of the national EMS management association and chief of the Wake County Emergency clinical capabilities division, Raleigh, N.C. Kirkwood and others say that EMS authorities do their job to the better of their potential, however EMS providers could do extra, saving the healthcare gadget funds by means of providing extra care upfront. however the current reimbursement model effortlessly discourages preventive care by using no longer giving businesses the supplies to deliver it, Kirkwood says.

And while the nation has come to expect the use of tax funds to pay for the readiness of fire coverage, ambulance service isn't always sponsored with taxes. There isn't an automated expectation that the executive should back EMS providers. That capacity ambulance services regularly may also run on a shoestring or may subsidize emergency care with nonemergency care, reminiscent of transferring sufferers between healthcare amenities.

truly, the vogue amongst public ambulance providers is to drag lower back, specialists say.

related content Tenth annual record on the healthcare body of workers

Celebs, professionals to the rescue

study half 2: Equipping EMS

“We're really dropping jobs” within the municipal and county arenas, says Connie Meyer, board president of the national association of Emergency scientific Technicians and EMS captain for Johnson County (Kan.) Med-Act, a public EMS company. “We're making an attempt to make the case that we're a a must have a part of the healthcare device,” she says. “EMS is a security web for the healthcare gadget.”

as a result of the latest compensation mannequin, areas in which emergency scientific capabilities will not have well-backed funding from the community tax base are more likely to pay their EMS personnel less and combat to retain personnel in the container for a long time, business experts say.

Compensation and retention fresh statistics from a federally backed 2010-eleven survey of participants of the national association of State EMS officers, or NASEMSO, suggests that EMS salaries will also be low given their magnitude in the clinical-care spectrum. That survey discovered emergency clinical technicians earned a median of $25,066 to $28,600 a year, while a person with the extra-superior designation of paramedic earned a median of $38,000, according to the survey, which for this element got responses from 26 to 29 states.

A separate report from the U.S. Bureau of Labor facts, which agencies EMTs and paramedics into one classification, estimated their 2010 median pay to be $30,360 a year. EMS people who do double duty as firefighters often earn extra. The median salary in 2010 for a firefighter become $forty five,250 a year, in response to the BLS. each fall short of the median salary of registered nurses, which was $69,one hundred ten as of might also 2011, in response to the BLS.

“there's a retention problem as a result of (EMS) is what individuals trust a low-paying job,” says William Brown Jr., executive director of the country wide Registry of Emergency medical Technicians, which offers expert EMS certification. The repayment should include a element that covers the “readiness” required of EMS, Brown says. “How are you speculated to guide the delivery of EMS to 300 million americans if you happen to don't get paid for lots of the work and readiness that you just do?” Brown asks.

whereas EMS personnel in urban settings commonly get paid a profits, there are still a huge variety of EMS responders who receives a commission little or nothing as volunteers. That creates some anxiety within the industry, with some desirous to boost entry-stage EMS requirements. The U.S.' standards are among the many lowest of English-speaking countries, Kirkwood says, whereas communities relying on volunteers commonly oppose it. Volunteer EMS personnel are already being requested to do a whole lot, and elevating necessities would make it even more problematic to appeal to and retain volunteers, he says.

“people who do it without charge need to do it with minimal investment,” he says.

altering certification The countrywide Registry of Emergency medical Technicians is in the process of reworking or renaming its certification ranges, removing some of the classes and introducing a new one. once the entire alterations are in location by using the end of 2013, the number of certification levels will stand at 4: emergency scientific responder, emergency scientific technician, advanced emergency clinical technician and paramedic.

The emergency scientific responder certification, so we can replace the primary responder designation, allows the holder to deliver entrance-line EMS care notwithstanding they can't look after sufferers within the lower back of an ambulance, in accordance with the NREMT. EMTs can deal with patients in an ambulance the usage of clinical gadget such as automated defibrillators as well as bring trauma care; EMTs are additionally expert in essential find out how to deal with injuries and ailment.

An superior emergency medical technician requires EMT certification plus extra education, allowing the holder to deliver extra superior care. The paramedic certification additionally first requires EMT certification, and that they give the maximum level care of the EMS experts. no longer all EMS programs should be suffering from the adjustments as a result of NREMT certification is not obligatory and some states offer their own examinations or recognize only one of the crucial certification tiers.

Demographics of the country also could be working towards EMS with the aid of perhaps making a scarcity of those staffers. “we'll face increased challenges sooner or later as a result of the entire child boomers getting old,” says Gary Ludwig, deputy fireplace chief for the metropolis of Memphis, Tenn. Memphis is placing a more advantageous volume of emphasis on EMS care and is increasing its group of workers and funding for it, Ludwig says.

Some influential businesses are taking a look at these core issues with how emergency scientific functions are offered and paid for, and alterations may happen given healthcare's shifting of greater center of attention on a affected person's total continuum of care and profitable providers for better great.

Dia Gainor, govt director of the NASEMSO, says there are a few issues that industry stakeholders are working to clear up, together with a group of workers count; creating national definitions for what constitutes an EMS employee—paid or volunteer; and the industry's strategy to repayment, which generally is below the cost of presenting the service.

Work to evaluate the EMS mannequin is below method at organizations such because the U.S. department of Transportation's country wide highway site visitors security Administration, the national EMS Advisory Council and the Medicare fee Advisory commission as well because the NASEMSO.

The NHTSA, which has basic oversight of EMS on account of its background as a transporter of patients, commissioned a series of essential stories on the EMS team of workers. essentially the most fresh of which, launched final year, goals to spotlight the concerns dealing with the business. known as The Emergency scientific capabilities workforce Agenda for the longer term, the report outlines desires involving EMS group of workers: health and protection; training and certification; planning and development; and information and research.

The dearth of information on the EMS group of workers become in the past addressed in a 2008 NHTSA record, and became summarized in the more contemporary file. “the most simple group of workers information, equivalent to team of workers measurement, can not be accurately estimated the use of obtainable data,” the document authors wrote. The BLS does not distinguish between EMTs and paramedics, doesn't determine EMTs go-educated as firefighters, and doesn't capture volunteer EMS people, according to the document. Others word that many EMS people have more than one job, which additionally complicates the calculation of an trade workforce complete.

“or not it's very tough to count number this group of workers,” Susan Chapman, one of the authors of both reviews, says in an interview. There have been diverse makes an attempt to calculate staff totals, but the reviews' consequences produce divergent numbers, says Chapman, director of allied health workforce reviews on the school of California at San Francisco's center for the health Professions and an assistant adjunct professor on the u.s. school of Nursing.

effects of reform one other effort by using the NHTSA-affiliated country wide EMS Advisory Council is discovering the ways the EMS segment might take part within the form of initiatives being carried out because of healthcare reform, akin to pay-for-performance and shared-discounts courses, says Marc Goldstone, a member of the council and vice chairman and affiliate commonplace information for a regional division of neighborhood health systems professional services Corp., Franklin, Tenn., the management features unit of for-earnings clinic chain neighborhood health systems.

“The council has been very lively,” and is addressing a few issues, together with attracting and retaining good employees, Goldstone says.

MedPAC's activity in EMS is pushed by way of an order from Congress that was part of the middle category Tax relief and Job creation Act of 2012, which requires the advisory community to research even if the Medicare ambulance charge agenda—which produced prices of $5.2 billion in 2010—may still be reformed in the long term and for shorter-term issues involving rural Medicare add-on costs that had been carried out in 2008 to are trying to alleviate some repayment problems.

MedPAC individuals predict to get as a minimum an initial draft of a document from personnel participants before the add-on charges expire at 12 months-conclusion, though the ultimate document isn't due until June 15, 2013, based on a transcript of an April MedPAC assembly.

And just ultimate week, a group of industry stakeholders convened by way of the NASEMSO become set to fulfill to move ahead with the NHTSA-funded mission titled EMS team of workers Planning and construction guidelines for State Adoption.

The goal is to produce “an informative document to prepare state EMS places of work to appropriately collect and mixture EMS-certain workforce statistics in a fashion regarded appropriate through the staff building planning industry, and supply the state EMS officers with adequate depth and literacy to be enabled to interact their state department of labor, state staff construction commission, or others to provoke a sector-based strategy for group of workers planning and building,” in line with the assembly invitation.

Already being verified in city and rural settings is the idea of neighborhood paramedicine. The idea is in line with giving above all informed paramedics the ability to work as primary caregivers in chosen instances and settings. The move goals to draw on present knowledge and apply them in new techniques, proposing well being care or performing comply with-up visits for sufferers who could advantage from guidance within the home however may additionally now not require a traditional domestic fitness seek advice from. ( See story from Aug. 22, 2011: "medical professional 911: Rural areas are looking for improved roles for paramedics.")

The approach requires a extra severe reworking of compensation. Minnesota has authorised a kind of that class of care for rural Medicaid contributors and look at various initiatives are in location in a number of different components of the nation.

Some providers have taken it into their own palms to boost EMS care. In components of Kentucky and Tennessee, an Ascension fitness-owned chest-ache network has informed EMS personnel to try to improve outcomes in the regions it serves, says Ranee Curtis, director of regional network services for Nashville-primarily based St. Thomas fitness, which runs the St. Thomas Chest pain community.

In setting up the network, St. Thomas found that there have been quite a lot of protocols and approaches in place among a lot of EMS suppliers, while substances and training were lacking. due to this fact, the network created training programs for EMS worker's and other caregivers to are trying to standardize care in the community, Curtis says.

St. Thomas networks have trained about 1,200 EMTs and paramedics in crucial care, air flow transport and other styles of pre-health facility care, a spokeswoman says. The network additionally has developed the first state-accredited vital-care paramedic route, in line with St. Thomas. EMS performed an fundamental function, Curtis says. “We desire EMS to be a worth to the group.”

TAKEAWAY: Emergency medical services compensation is at its core a damaged system, and the industry has begun efforts to fix it.


NREMT-PTE NREMT Paramedic Trauma Exam

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SWGTC EMT students have 100 percent pass rate | killexams.com real questions and Pass4sure dumps

Southwest Georgia Technical College’s (SWGTC) Emergency Medical Technology (EMT) students recently had 100 percent passage rate on their National Registry of Emergency Medical Technicians — EMT Basic (NREMT EMT-B) exam.

The students in this class, all of which passed the exam, included Bradley Books, Scott Burgess, Clint Chastain, Jon Conner, Lee Davis, John Harper, Daniel Powers, Nathan Powers, Michael Redding, and Corey Thompson.

“This was my first time teaching in a structured college environment. The group of guys I had for my first class were awesome and the only thing that could have made it better was them passing their NREMT-Basic on their first attempt, and they did. I am very proud of my first class of students for doing such a great job,” Chuck Lester, advanced EMT instructor.

The 10 students from this program that took the NREMT EMT-B exam passed the first time, when the national average for first time pass rate is about 70 percent. Since this group of students has passed this exam, their next step is to take another semester of classes for the Advanced EMT curriculum and then take the NREMT EMT — Advanced Exam to become certified as an Advanced EMT from the National Registry of Emergency Medical Technicians.

“SWGTC hopes the public will never need the expertise of the graduates of our Emergency Medical Technician-Basic program, but in an emergency situation, the public can be confident in the skills of the graduates responding to the emergency. It is comforting to know that the first persons to render care to you are competent, experienced and skilled. Student successes like this can be attributed to the qualified, credentialed instruction from Chuck Lester. We are proud of our students and Mr. Lester,”Dr. Annie McElroy, Vice President of Academic Affairs.

The EMT certificate program at SWGTC prepares students to provide basic emergency medical care and transportation for critical and emergent patients. Graduates of this program will possess basic knowledge of CPR, bleeding control and wound treatment, how to deliver a baby in the field, and how to manage the following: heart attack patient, severe allergic reactions, diabetics, strokes, and all aspects of trauma victims.

Students can complete this program in one semester if taking the full 16 credit hours required for graduation.

SWGTC offers more than 80 certificate, diploma, and degree programs. Many of these programs provide training for some of the nation’s fastest-growing career fields including Nursing, Automotive Technology, Veterinary Technology, and Criminal Justice Technology.

More information may be obtained by calling 229-225-4096 or by logging onto www.southwestgatech.edu.

Southwest Georgia Technical College is a unit of the Technical College System of Georgia.


Medcomtech : Specialized Training Services - Critical Care and Flight Paramedic Program | killexams.com real questions and Pass4sure dumps

Notice Type: Sources Sought Notice

Posted Date: 29-MAR-18

Office Address: Department of the Army; U.S. Army Medical Command; Center for Health Care Contracting; ATTN: MCAA C BLDG 41972107 17TH Street Fort Sam Houston TX 78234-5015

Subject: Specialized Training Services - Critical Care and Flight Paramedic Program

Classification Code: U - Education & training services

Solicitation Number: W81K0418R0007

Contact: Michael S. Brown, Contract Specialist, Phone 2102954600, Email michael.s.brown132.civ@mail.mil - JoLena M. Perkin, Contracting Officer, Phone 2102214852, Email jolena.m.perkin.civ@mail.mil

Setaside: N/AN/A

Place of Performance (address): Ft Sam HoustonSan Antonio, TX

Place of Performance (zipcode): 78234

Place of Performance Country: US

Description: Department of the Army

U.S. Army Medical Command

Center for Health Care Contracting

THIS IS A REQUEST FOR INFORMATION (RFI) ONLY. This RFI is issued solely for information and planning purposes - it does not constitute a Request for Proposal (RFP) or a promise to issue an RFP in the future. This request for information does not commit the Government to contract for any supply or service whatsoever. Further, the Army Medical Command Health Readiness Contracting Office is not at this time seeking proposals and will not accept unsolicited proposals. Interested parties are advised the U.S. Government will not pay for any information or administrative costs incurred in response to this RFI; all costs associated with responding to this RFI will be solely at the interested party's expense. Not responding to this RFI does not preclude participation in any future RFP, if any is issued. If a solicitation is released, it will be synopsized on the Federal Business Opportunities (FedBizOpps) website. Potential responders are responsible for monitoring this site for additional information pertaining to this requirement. Note: This RFI under W81K04-18-R-0008 is a revised/updated RFI under W81K04-17-R-0012 and does not constitute a new, separate requirement. Changes include an updated North American Industry Classification System (NAICS) code, size standard and language adapted into the performance work statement (PWS). BACKGROUND: The United States Army Medical Command (MEDCOM) is considering a non-personal services requirement to provide specialized training services in support of the U.S Army Critical Care Paramedic Program, Army Medical Department Center and School (AMEDDC&S), U.S. Army Medical Command (MEDCOM). Specialized training services includes, but are not limited to Critical Care and Paramedic training, appropriate clinical rotations, and the cost and scheduling of the Flight Paramedic Certification exam (FP-C) and the National Registry of Emergency Medical Technicians (NREMT) psychomotor and written examinations for the National Registered Paramedic (NRP) certification. The US Government will not exercise any supervision or control over the contract service providers (CSPs) performing the services herein. Such CSPs shall be accountable solely to the Contractor who is, in turn responsible to the US Government.

In 2010, the AMEDDC&S and the US Army School of Aviation Medicine convened a Flight Medic Critical Task selection board which determined that the requisite skill level for a flight medic should be a paramedic with certain additional critical care skills. In 2011, the Journal of Trauma published the paper "Impact of critical care trained flight paramedics on casualty survival during helicopter evacuation in the current war in Afghanistan". The study showed patient survival at 48 hours was 66% higher when patients were transported by critical care trained crews as compared to patients transported by crews who were not trained in critical care. This strongly supported the recommendation that critical care training should become the standard for Medical Evacuation (MEDEVAC) medical providers. Shortly thereafter, The Army Surgeon General, based upon a recommendation from the AMEDDC&S Commanding General, decided that the flight medic would be trained as a paramedic with critical care training. The Army codified this series of decisions in ALARACT 061/2012 which provided notification of the requirement and intent to train 68W Flight Medics to NREMT-P standards with critical care training.

The development of the institutional training model started with the creation of the Critical Care Flight Paramedic Program (CCFPP) at AMEDDC&S in late 2011. The first pilot course was from February to August of 2012. The curriculum, taught by the faculty at the contractor's site followed the National Emergency Medical Services Education Standards, as established by the National Highway Traffic Safety Administration (NHTSA). Successful completion of the course enables the military student to attempt National Registry of Emergency Medical Technicians (NREMT) Paramedic level cognitive and psychomotor examinations, as well as the critical care level FP-C exam.

The NREMT-P Certified military students transition directly to the critical care course, with the didactic portion conducted at a contractor site, and critical care clinical rotations at a government selected facility when available. Each military student will complete 176 hours of appropriate clinical rotations during the critical care course. This amount significantly exceeded the number of hours required in civilian paramedic critical care courses. The justification for this increased number of hours is that flight paramedics in the civilian air ambulance community will generally have 3-5 years of full time experience as a ground paramedic prior to being hired. Given the potential for an Army Medic to not have nearly that level of experience, a substantial number of clinical hours was added to the critical care flight paramedic program to provide a reasonable clinical baseline for each medic. Completing the critical care course prepares the military students to attempt the International Board of Specialty Certification (IBSC), Board for Critical Care Transport Paramedic Certification (BCCTPC), Flight Paramedic-Certified (FP-C) cognitive examination.

As the institutional model was created for only 210 authorizations to train per year, it became apparent it would not be possible to meet the throughput necessary to meet the FY13 NDAA directive.

The Army created the Home Station Training option to supplement the throughput of military students. This option, outlined in ALARACT 028/2013 and updated in ALARACT 301/2013, allowed MEDEVAC units to send Soldiers to an accredited civilian paramedic training program. This option provides flexibility for units and Soldiers to obtain the training without having to change duty stations. This is extremely beneficial to Soldiers assigned to air ambulance units that may be pending a deployment cycle. Additionally, this option is advantageous for National Guard and Reserve unit Soldiers whose civilian employment would be severely disrupted for an individual training event.

Through HQDA EXORD 149-17, The Office of the Surgeon General (OTSG), The United States Army Medical Command (USAMEDCOM) and the United States Army notified members of the Aeromedical Evacuation communities with guidance and direction for manning the operational use of ASI F2 Critical Care Flight Paramedics. This EXORD, unless formally rescinded or suspended, remains in effect until 01 October 2024.

The current institutional model consists of contracted services to provide Paramedic and Critical Care courses. The Paramedic Course is 26 weeks in duration. The Critical Care Course is 8 weeks in duration including 176 hours of patient contact clinical rotations conducted at the contractor's medical facilities under a Medical Training Agreement maintained by the contractor. Currently it is not feasible for the government to provide this training internally, requiring the need for external outsourcing to conduct classes until such time as the government is capable of performing some or all of this task itself. The NAICS code assigned to the acquisition is 611519, Other Technical and Trade Schools. The associated size standard is $15 million.Other Technical and Trade Schools. A draft Performance Work Statement (PWS) is attached to this announcement for reference.

PURPOSE: 1) To request information on capabilities of potential offerors to provide the services described in the draft PWS in order to determine if this will be set-aside. Please note, decision to set-aside this requirement for a small business program or to compete it through full and open procedures has not yet been made.

RESPONSES REGARDING POTENTIAL SOURCES STATEMENT OF CAPABILITIES: Interested parties should provide feedback/input to this RFI by submitting the following information via email to Mr. Michael S. Brown, michael.s.brown132.civ@mail.mil, not later than 4 April 2018, 12:00 pm, Central Standard Time:

1. Name of the firm, point of contact, phone number, email address, DUNS number, CAGE code, a statement regarding small business status (including small business type(s)/certifications(s) such as SDB, 8(a), HUBZone, SDVOSB, WOSB, etc.) and the corresponding NAICS code.

2. If the vendor is not physically located within the 25 mile geographical criteria of Ft Sam Houston, San Antonio, TX, would the vendor be willing to facilitate a means to perform these courses with the 25 mile geographical criteria If so, please include how you could meet these geographical restrictions. (Satellite campus, partnerships, teaming agreements, etc. ) Only the course itself must meet the geographical limitations, not the vendor location.

3. Identify whether your firm is interested in competing for this requirement as a prime contractor or not. Identify subcontracting, joint ventures or teaming arrangement that will be pursued, if any.

4. Small Business Participation Plan. Pursuant to FAR 19.702(a)(1), unless waivered, offerors will be required to submit a Subcontracting Plan IAW FAR 19.704 to meet the following subcontracting goals:

Type of Business % Small Business Concerns 33% Small Disadvantaged Business* 5% Woman-Owned Small Business 5% HUBZone Small Business. 3% Service-Disabled Veteran-Owned Small Business 3%

Please describe how your company would meet this requirements, or if you feel your company would be eligible to waiver this requirement, please describe those terms.

5. Does your company currently have Medical Training Agreements (MTA) / Memorandums of Understanding (MOU) with medical facilities The facilities shall have current accreditation as a Chest Pain Center, Stroke Center, Trauma Center, and /or have Pediatric Intensive Care Unit or Neonatal Intensive Care Unit.

YOUR RESPONSE TO THE SYNOPSIS: Please limit your documentation to the following Page Size, Font Type and Size, Spacing and Page Numbering. Responses shall be submitted using a Microsoft Word document with page size 8.5 by 11 inches. Font type shall be Times New Roman, size 10-12 using standard tabs and indent software features with no less than single spacing between lines. Responses are limited to no more than ten (10) pages for the entire RFI response statement.

All responses shall be received no later than 4 April 2018, 12:00 pm, Central Standard Time. Please respond via electronic mail (e-mail) to the Contracting Officer, JoLena M Perkins, at the following address: jolena.m.perkins.civ@mail.mil and Contract Specialist: Michael S. Brown, at the following address michael.s.brown132.civ@mail.mil. All questions MUST be in writing and should also be directed to Michael Brown and JoLena Perkins. In all responses, please reference in the subject line RFI-W81K04-18-R-0008. Verbal questions will not be accepted. This synopsis is for information and planning purposes only and is not to be construed as a commitment by the Government nor will the Government pay for information solicited. Respondents will not be notified of the results of the evaluation. No telephonic responses will be accepted. No solicitation exists; therefore, do not request a copy of the solicitation. All transmitted information marked proprietary shall be treated as such. Therefore, businesses should identify any proprietary information in their responses. Proprietary materials will neither be distributed, nor discussed with, any other organization. Information submitted in response to this will be used at the discretion of the Government. Further, the information submitted will remain confidential insofar as permitted by law, including the Freedom of Information and Privacy Acts.

Link/URL: https://www.fbo.gov/spg/USA/MEDCOM/DADA10/W81K0418R0007/listing.html

Copyright (c) 2018 Federal Information & News Dispatch, Inc., source Federal Documents


Trauma in EMS | killexams.com real questions and Pass4sure dumps

{{title}} {{/content}} ]]> Editor's Note: This is the first installment in a three-part series on medical transportation and EMS. Read the second part, "Equipping EMS."

Emergency medical technicians, first responders and paramedics—the backbone of emergency medical services—have worked for decades under a reimbursement system that effectively keeps their pay low and gives them an incentive to not always provide efficient, quality care. That reimbursement model may be in for revision, though, a move that would be welcomed by many in the industry.

At the center of the problem is a 1960s-era reimbursement model that EMS experts say no longer fits with how the EMS community wants to provide care. Under the current model, which was developed when ambulances were used for transportation only, an ambulance service gets paid only if a patient is transported to a hospital.

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{{/content.1}} ]]> An EMT or paramedic who spends the time and effort to appropriately stabilize a patient in a home or at the scene of an accident gets reimbursed nothing if the patient feels well enough to decline a trip to the emergency room. But if that same patient—who may not need additional care—decides to visit the ER, then not only does the ambulance service get paid, but the hospital ER does too, unleashing a string of bills that possibly could have been avoided.

That kind of reimbursement for a service designed to be ready to go at any time makes it difficult to support the infrastructure and overhead of EMS. It also encourages inefficient use of healthcare resources.

“There's a disincentive to not take people to the hospital,” says Skip Kirkwood, president of the National EMS Management Association and chief of the Wake County Emergency Medical Services division, Raleigh, N.C. Kirkwood and others say that EMS professionals do their job to the best of their ability, but EMS providers could do more, saving the healthcare system money by providing additional care upfront. But the current reimbursement model effectively discourages preventive care by not giving agencies the resources to provide it, Kirkwood says.

And while the country has come to expect the use of tax money to pay for the readiness of fire protection, ambulance service is not always subsidized with taxes. There isn't an automatic expectation that the government should back EMS providers. That means ambulance services often may run on a shoestring or may subsidize emergency care with nonemergency care, such as transferring patients between healthcare facilities.

In fact, the trend among public ambulance providers is to pull back, experts say.

Related Content Tenth annual report on the healthcare workforce

Celebs, execs to the rescue

Read Part 2: Equipping EMS

“We're actually losing jobs” in the municipal and county arenas, says Connie Meyer, board president of the National Association of Emergency Medical Technicians and EMS captain for Johnson County (Kan.) Med-Act, a public EMS provider. “We're trying to make the case that we're a vital part of the healthcare system,” she says. “EMS is a safety net for the healthcare system.”

As a result of the current reimbursement model, regions in which emergency medical services don't have well-subsidized funding from the community tax base are more likely to pay their EMS personnel less and struggle to keep personnel in the field for a long time, industry experts say.

Compensation and retention Recent data from a federally backed 2010-11 survey of members of the National Association of State EMS Officials, or NASEMSO, shows that EMS salaries can be low given their importance in the clinical-care spectrum. That survey found emergency medical technicians earned a median of $25,066 to $28,600 a year, while someone with the more-advanced designation of paramedic earned a median of $38,000, according to the survey, which for this portion received responses from 26 to 29 states.

A separate report from the U.S. Bureau of Labor Statistics, which groups EMTs and paramedics into one classification, estimated their 2010 median pay to be $30,360 a year. EMS workers who do double duty as firefighters generally earn more. The median salary in 2010 for a firefighter was $45,250 a year, according to the BLS. Both fall short of the median salary of registered nurses, which was $69,110 as of May 2011, according to the BLS.

“There is a retention problem because (EMS) is what people consider a low-paying job,” says William Brown Jr., executive director of the National Registry of Emergency Medical Technicians, which offers professional EMS certification. The reimbursement needs to include a component that covers the “readiness” required of EMS, Brown says. “How are you supposed to support the delivery of EMS to 300 million Americans when you do not get paid for a lot of the work and readiness that you do?” Brown asks.

While EMS personnel in urban settings generally get paid a salary, there are still a large number of EMS responders who get paid little or nothing as volunteers. That creates some tension in the industry, with some wanting to boost entry-level EMS standards. The U.S.' standards are among the lowest of English-speaking countries, Kirkwood says, while communities relying on volunteers often oppose it. Volunteer EMS personnel are already being asked to do a lot, and raising standards would make it even more difficult to attract and retain volunteers, he says.

“People who do it for free want to do it with minimal investment,” he says.

Changing certification The National Registry of Emergency Medical Technicians is in the process of reworking or renaming its certification levels, eliminating some of the categories and introducing a new one. Once all of the changes are in place by the end of 2013, the number of certification levels will stand at four: emergency medical responder, emergency medical technician, advanced emergency medical technician and paramedic.

The emergency medical responder certification, which will replace the first responder designation, allows the holder to provide front-line EMS care though they cannot care for patients in the back of an ambulance, according to the NREMT. EMTs can treat patients in an ambulance using medical equipment such as automatic defibrillators as well as deliver trauma care; EMTs are also educated in simple methods to treat injuries and disease.

An advanced emergency medical technician requires EMT certification plus additional education, allowing the holder to provide more advanced care. The paramedic certification also first requires EMT certification, and they provide the highest level care of the EMS professionals. Not all EMS systems will be affected by the changes because NREMT certification is optional and some states offer their own examinations or recognize only some of the certification levels.

Demographics of the country also may be working against EMS by possibly creating a shortage of these staffers. “We're going to face increased challenges in the future because of all of the baby boomers growing older,” says Gary Ludwig, deputy fire chief for the city of Memphis, Tenn. Memphis is putting a greater amount of emphasis on EMS care and is increasing its workforce and funding for it, Ludwig says.

Some influential groups are taking a look at these core problems with how emergency medical services are provided and paid for, and changes could occur given healthcare's shifting of more focus on a patient's entire continuum of care and rewarding providers for improved quality.

Dia Gainor, executive director of the NASEMSO, says there are a number of issues that industry stakeholders are working to solve, including a workforce count; creating national definitions for what constitutes an EMS worker—paid or volunteer; and the industry's approach to reimbursement, which generally is below the cost of providing the service.

Work to review the EMS model is under way at organizations such as the U.S. Department of Transportation's National Highway Traffic Safety Administration, the National EMS Advisory Council and the Medicare Payment Advisory Commission as well as the NASEMSO.

The NHTSA, which has primary oversight of EMS as a result of its history as a transporter of patients, commissioned a series of major reports on the EMS workforce. The most recent of which, released last year, aims to highlight the issues facing the industry. Called The Emergency Medical Services Workforce Agenda for the Future, the report outlines goals regarding EMS workforce: health and safety; education and certification; planning and development; and data and research.

The dearth of data on the EMS workforce was previously addressed in a 2008 NHTSA report, and was summarized in the more recent report. “The most basic workforce statistics, such as workforce size, cannot be accurately estimated using available data,” the report authors wrote. The BLS doesn't distinguish between EMTs and paramedics, does not identify EMTs cross-trained as firefighters, and does not capture volunteer EMS workers, according to the report. Others note that many EMS workers have more than one job, which also complicates the calculation of an industry workforce total.

“It's very hard to count this workforce,” Susan Chapman, one of the authors of both reports, says in an interview. There have been different attempts to calculate workforce totals, but the studies' results produce divergent numbers, says Chapman, director of allied health workforce studies at the University of California at San Francisco's Center for the Health Professions and an assistant adjunct professor at the UCSF School of Nursing.

Effects of reform Another effort by the NHTSA-affiliated National EMS Advisory Council is studying the ways the EMS segment could participate in the kind of initiatives being implemented as a result of healthcare reform, such as pay-for-performance and shared-savings programs, says Marc Goldstone, a member of the council and vice president and associate general counsel for a regional division of Community Health Systems Professional Services Corp., Franklin, Tenn., the management services unit of for-profit hospital chain Community Health Systems.

“The council has been very active,” and is addressing a number of issues, including attracting and retaining good employees, Goldstone says.

MedPAC's interest in EMS is driven by an order from Congress that was part of the Middle Class Tax Relief and Job Creation Act of 2012, which calls for the advisory group to research whether the Medicare ambulance fee schedule—which produced fees of $5.2 billion in 2010—should be reformed in the long term and for shorter-term issues related to rural Medicare add-on fees that were implemented in 2008 to try to alleviate some reimbursement problems.

MedPAC members expect to get at least an initial draft of a report from staff members before the add-on fees expire at year-end, though the final report isn't due until June 15, 2013, according to a transcript of an April MedPAC meeting.

And just last week, a group of industry stakeholders convened by the NASEMSO was set to meet to move forward with the NHTSA-funded project titled EMS Workforce Planning and Development Guidelines for State Adoption.

The goal is to produce “an informative document to prepare state EMS offices to properly collect and aggregate EMS-specific workforce data in a manner considered appropriate by the workforce development planning industry, and provide the state EMS officials with enough depth and literacy to be enabled to engage their state department of labor, state workforce development commission, or others to initiate a sector-based strategy for workforce planning and development,” according to the meeting invitation.

Already being tested in urban and rural settings is the concept of community paramedicine. The concept is based on giving specially trained paramedics the ability to work as primary caregivers in selected situations and settings. The movement aims to draw on existing skills and apply them in new ways, providing wellness care or performing follow-up visits for patients who could benefit from assistance in the home but may not require a traditional home health visit. ( See story from Aug. 22, 2011: "Doctor 911: Rural areas seek expanded roles for paramedics.")

The approach requires a more extreme reworking of reimbursement. Minnesota has approved a form of that type of care for rural Medicaid participants and test projects are in place in several other parts of the country.

Some providers have taken it into their own hands to boost EMS care. In parts of Kentucky and Tennessee, an Ascension Health-owned chest-pain network has trained EMS personnel to try to improve outcomes in the regions it serves, says Ranee Curtis, director of regional network services for Nashville-based St. Thomas Health, which runs the St. Thomas Chest Pain Network.

In developing the network, St. Thomas found that there were a variety of protocols and procedures in place among various EMS providers, while resources and education were lacking. As a result, the network created training programs for EMS workers and other caregivers to try to standardize care within the network, Curtis says.

St. Thomas networks have trained about 1,200 EMTs and paramedics in critical care, ventilation transport and other types of pre-hospital care, a spokeswoman says. The network also has developed the first state-approved critical-care paramedic course, according to St. Thomas. EMS played an integral role, Curtis says. “We want EMS to be a value to the community.”

TAKEAWAY: Emergency medical services reimbursement is at its core a broken system, and the industry has begun efforts to fix it.



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