Emergency Medical Services (EMS) Working Group JOB TITLES The EMS Working Group determined the following job titles to be the most commonly requested EMS personnel in an interstate, mutual aid-based response: EMS Job Title 1: Air Medical Transport Manager 5 EMS Job Title 2: Air Medical Transport Mechanic 7 EMS Job Title 3: Air Medical Transport Medical Director 9 EMS Job Title 4: Air Medical Transport Paramedic 11 EMS Job Title 5: Air Medical Transport Pilot 4 EMS Job Title 6: Air Medical Transport Registered Nurse 4 EMS Job Title 7: Emergency Medical Responder 4 EMS Job Title 8: Emergency Medical Technician (EMT) 4 EMS Job Title 9: Emergency Vehicle Operator 21 EMS Job Title 10: Emergency Vehicle Operator-Heavy 23 EMS Job Title 11: EMS Physician 4 EMS Job Title 12: EMS Transportation Group Supervisor 27 EMS Job Title 13: EMS Transportation Unit Leader 29 EMS Job Title 14: EMS Treatment Unit Leader 31 EMS Job Title 15: EMS Triage Unit Leader 33 EMS Job Title 16: Medical Branch Director 35 EMS Job Title 17: Medical Group Supervisor 37 EMS Job Title 18: Medical Supply Coordinator 39 EMS Job Title 19: Paramedic 4 REQUISITE AND RECOMMENDED CRITERIA Considering existing, nationally-accepted standards, the Emergency Medical Services (EMS) Working Group extracted relevant education, training, experience, physical/medical fitness, certification, and licensing criteria to define the baseline criteria for each job title listed above. These baseline criteria represent the minimum requirements for EMS personnel to participate in the National Incident Management System (NIMS) Integration Center’s National Emergency Responder Credentialing System. The EMS Working Group identified additional recommended criteria relating to education, training, certification, experience, and physical/ medical fitness where it believed standards and baseline criteria did not exist or were deemed insufficient. These recommended criteria are not required and represent the EMS Working Group’s recommendations for EMS personnel to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. The categories used in Designing a National Emergency Responder Credentialing System are defined as follows: Education Formal instruction based on a curriculum that prepares an individual with the core knowledge and skill for entry into a discipline and for performing a job function   Training1 Instruction and/or activities that enhance an individual’s core knowledge, increase a skill set and proficiency, and strengthen and augment abilities Experience Time required functioning in a job title for an individual to attain proficiency in applying knowledge, skills, and abilities Physical/ Medical Fitness Physical and medical considerations that when applied, help to ensure safe performance in risky environments Certification Designation granted by Authority Having Jurisdiction (AHJ) that an individual has met  requirements and achieved specific knowledge, skills, and abilities Licensing Legal designation granted by AHJ that an individual has met the necessary legal requirements to function in a job title    Where requisite and/or recommended criteria do not apply, that category will not be listed. EMS ACRONYM LIST ADM Aeronautical Decision Making AHJ Authority Having Jurisdiction AMPA Air Medical Physician Association AMRM Air Medical Resource Management AMT Air Medical Technician ATP Airline Transport Pilot CAMTS Commission on Accreditation of Medical Transport Systems CBRNE Chemical, Biological, Radiological, Nuclear, and High-Yield Explosives CCRN Critical Care Registered Nurse CEN Certified Emergency Nurse CEVO Emergency Vehicle Operator’s Course CFRN Certified Flight Registered Nurse CTRN Certified Transport Registered Nurse CRM Crew Resource Management DDC Defensive Driving Course DEA Drug Enforcement Administration EMR Emergency Medical Responder EMS Emergency Medical Services EMT Emergency Medical Technician EVO Emergency Vehicle Operator FAA Federal Aviation Administration FP-C Certified Flight Paramedic GED General Equivalency Diploma GVW Gross Vehicle Weight HazMat Hazardous Materials IAP Incident Action Plan ICS Incident Command System IS Independent Study MCI Mass Casualty Incident NHTSA National Highway Transportation Safety Administration NIMS National Incident Management System NREMT National Registry of Emergency Medical Technicians NRP Neonatal Resuscitation Program OSHA Occupational Safety and Health Administration PIC Pilot in Charge Td Tetanus and Diphtheria Tdap Tetanus, Diphtheria, and Pertussis EMS Job Title 1: Air Medical Transport Manager Description: The primary focus of an Air Medical Transport Manager or administrator is patient and air medical crew safety through the coordination of patient transportation and the maintenance of records relating to patient identification, condition, and destination via rotor-wing or fixed-wing air ambulance. The Air Medical Transport Manager assists in the identification and allocation of resources to support all air medical missions and may facilitate the communication of information between the scene and sending/receiving facilities in conjunction with the Air Medical Transport Medical Director. The Air Medical Transport Manager coordinates aviation activities with the Aviation Coordinator and other transportation team leaders. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Air Medical Transport Manager to participate in NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Training2 Completion of the following courses/ curricula: 1. Incident Command System (ICS)-100: Introduction to ICS 2. ICS-200: Basic ICS 3. Federal Emergency Management Agency (FEMA) Independent Study (IS)-700: An Introduction to the National Incident Management System (NIMS) 4. Occupational Safety and Health Administration (OSHA) 1910.120 Hazardous Materials (HazMat) Awareness Training or equivalent basic instruction on responding to and operating in a chemical, biological, radiological nuclear, and high-yield explosives (CBRNE) mass casualty incident (MCI) Experience Ongoing involvement with an established air medical transport service EMS Job Title 1: Air Medical Transport Manager RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Air Medical Transport Manager to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training Ongoing training in operations and management and care of patients involved in MCIs Experience 1. Minimum of 2 years of supervisory, management, or administrative experience 2. Knowledge of Commission on Accreditation of Medical Transport Systems (CAMTS) accreditation standards for patients requiring air medical transport 3. Medical Transport Leadership Institute or equivalent Certification 1. Certified Medical Transport Executive or equivalent college-level education Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that require refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Tetanus and diphtheria (Td) toxoid or Tetanus, diphtheria, and pertussis (Tdap.) Receipt of primary series and booster within 10 years * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 2: Air Medical Transport Mechanic Description: The primary focus of an Air Medical Transport Mechanic is to ensure that aircraft used for medical missions are maintained to airworthiness standards prescribed by applicable regulations. The Air Medical Transport Mechanic is responsible for the direct operation and administration of avionics maintenance and support. The Air Medical Transport Mechanic will ensure compliance with Federal Aviation Administration (FAA) and other related regulations; that aircraft avionics and avionics-related equipment inspection and maintenance records are originated and retained for review as needed; that specific equipment and special tools are made available to accomplish the inspection, maintenance, and repair of avionics-related components on any aircraft in use; and that all appropriate entries have been made and/or transcribed to the aircraft journal and technical logs with respect to the avionics maintenance function and airworthiness status of the aircraft. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Air Medical Transport Mechanic to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education High school diploma or General Equivalency Diploma (GED) Training Completion of FAA-certified mechanic school or equivalent on-the-job training Certification Completion of Airframe & Powerplant Certification Licensing Valid driver’s license EMS Job Title 2: Air Medical Transport Mechanic RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Air Medical Transport Mechanic to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training Completion of the following courses and/or curricula: 1. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Minimum of 2 years of experience working as an aviation mechanic Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 3: Air Medical Transport Medical Director Description: The primary focus of an Air Medical Transport Medical Director is to oversee the care that the air medical transport crew delivers to the patient from the point of initial contact throughout the entire transport and appropriate disposition of the patient to the point of definitive care. The Air Medical Transport Medical Director is a licensed physician with education and experience in areas of medicine and pre-hospital care commensurate with the patient care mission. The Air Medical Transport Medical Director serves as a clinical resource to the air medical transport crew and has the authority over all patient care and clinical aspects of the air medical transport service. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Air Medical Transport Medical Director to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Graduate of an accredited medical school and completion of an accredited residency program Training3 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI 5. Air Medical Physician Association’s (AMPA) Medical Director’s Core Curriculum or equivalent basic training as an aviation medical technician (AMT) medical director Experience Ongoing involvement with an established air medical transport service Certification Completion of the following: 1. Board certification or board-eligible in emergency medicine (or other comparable specialty) 2. Current Drug Enforcement Administration (DEA) Registration Licensing Active status of legal authority to function as a physician granted by a state, the District of Columbia, or U.S. territory EMS Job Title 3: Air Medical Transport Medical Director RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Air Medical Transport Medical Director to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Experience 1. Active involvement in the care of critically ill/injured patients 2. Knowledge of CAMTS Accreditation Standards for patients requiring air medical transport Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 4: Air Medical Transport Paramedic Description: The primary focus of an Air Medical Transport Paramedic is the acute management and transportation of the broad range of patients who access the emergency medical system. The Air Medical Transport Paramedic possesses basic and advanced skills to include invasive and pharmacological interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies. Emergency care is based on an advanced assessment and the formulation of a field impression. The Air Medical Transport Paramedic has education and experience in areas of patient care commensurate with the patient care mission. The Air Medical Transport Paramedic provides care designed to minimize secondary injury and provide comfort to the patient and family while transporting the patient to an appropriate health care facility. Paramedic is the minimum licensure level for patients requiring the full range of advanced out-of-hospital care. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Air Medical Transport Paramedic to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of a state-recognized paramedic program (based on the National Highway Transportation Safety Administration’s [NHTSA’s] National Standard Curriculum) Training4 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRBNE MCI Experience Ongoing involvement with an established air medical transport service Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a paramedic granted by a state, the District of Columbia, or U.S. territory EMS Job Title 4: Air Medical Transport Paramedic RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Air Medical Transport Paramedic to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for Paramedic as defined by NHTSA’s National EMS education standards.5 Training Completion of the following courses and/or curricula: 1. Ongoing training in the management and care of patients involved in MCIs 2. Neonatal Resuscitation Program (NRP) or equivalent, if expected to transport high-risk OB or neonatal patients Experience 1. Minimum of 2 years of emergency and critical care paramedic experience 2. Knowledge of CAMTS Accreditation Standards for patients requiring air medical transport Physical/Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” Certification Certified Flight Paramedic (FP-C) EMS Job Title 5: Air Medical Transport Pilot Description: The primary focus of an Air Medical Transport Pilot is the safe, coordinated transport of air medical personnel and equipment to the location of an incident and subsequent provision of safe, coordinated transport of injured victims to an appropriate destination. The Air Medical Transport Pilot has authority for acceptance of specific missions and will make all decisions concerning suitability of weather conditions, landing areas, condition of the aircraft for flight, loading of the aircraft, and other factors affecting flight safety.  REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Air Medical Transport Pilot to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of required ground school on aeronautical knowledge; pass the required knowledge and practical test that applies to the aircraft type and class certificate sought Training6 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. Instrument Flight Training7 5. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI 6. Risk assessment training and hazard mitigation 7. Air Medical Resource Management/Aeronautical Decision Making (ADM)/Crew Resource Management Experience Pilot is current in aircraft type and pilot rating as determined by the AHJ Completion of the following: 1. 2000 hours of pilot-in-command time (in helicopters for rotorcraft operations) 2. 250 hours of unaided night time 3. 300 hours of turbine time 4. 100 hours of EMS time 5. Fixed wing operations: Pilot in Command (PIC) must be ATP rated, 2000 airplane flight hours with 1000 as PIC, 500 hours multi-engine time as PIC (not required of single-engine turbine aircraft), 100 nighttime hours as PIC Physical/Medical Fitness Completion of the following: 1. Annual flight physical with medical class certificate that corresponds with the pilot certificate/rating Certification 1. Commercial Pilot Certificate with Instrument Rating preferred (Rotor). Military or Public Use pilot equivalent training, documented to the same standard or higher. EMS Job Title 5: Air Medical Transport Pilot RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Air Medical Transport Pilot to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training 1. Ongoing training in operations of management and care of patients involved in MCI incidents. 2. 100 hours night-vision goggles 3. Hoist operations, rappelling operations, mountain operations, desert operations, and over-water operations as applicable to the mission the pilot will be asked to perform Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 6: Air Medical Transport Registered Nurse Description: The primary focus of an Air Medical Transport Registered Nurse is to provide direct care and transportation of critical and emergent patients who access the EMS scene or inter-facility health care system. The Air Medical Transport Registered Nurse possesses the education and experience in areas of patient care commensurate with the patient care mission. The Air Medical Transport Registered Nurse will serve as a functional member of the air medical transport crew, providing critical assessment, treatment, and transportation of patients via rotor-wing or fixed-wing air ambulance. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Air Medical Transport Registered Nurse to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Graduate of an accredited nursing program Training8 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an established air medical transport service Licensing Active status of legal authority to function as a registered nurse granted by a state, the District of Columbia, or U.S. territory EMS Job Title 6: Air Medical Transport Registered Nurse RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Air Medical Transport Registered Nurse to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training Completion of the following courses and/or curricula: 1. Ongoing training in the management and care of patients involved in MCIs 2. Neonatal Resuscitation Program (NRP) or equivalent, if expected to transport high risk OB or neonatal patients Experience 1. Minimum of 2 years of emergency and critical care nursing experience 2. Knowledge of CAMTS Accreditation Standards for patients requiring air medical transport Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that require refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” Certification Completion of at least one of the following: 1. Certified Flight Registered Nurse (CFRN) 2. Certified Transport Registered Nurse (CTRN) 3. Certified Emergency Nurse (CEN) 4. Critical Care Registered Nurse (CCRN) EMS Job Title 7: Emergency Medical Responder Description: The primary focus of the Emergency Medical Responder is to initiate immediate lifesaving care to critical patients who access the emergency medical system. The Emergency Medical Responder possesses the education and experience in areas of patient care commensurate with the patient care mission. Additionally, the Emergency Medical Responder has the basic knowledge and skills necessary to provide lifesaving interventions while awaiting additional EMS response and to assist higher level personnel at the scene and during transport. The Emergency Medical Responder functions as part of a comprehensive EMS response, under medical oversight. He/she performs basic interventions with minimal equipment. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Emergency Medical Responder to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of state-recognized first responder program based on the NHTSA’s National Standard Curriculum Training9 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. FEMA IS-700: NIMS, An Introduction 3. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or National Registry of Emergency Medical Technicians (NREMT) certification at this level Licensing Active status of legal authority to function as a first responder or an emergency medical responder granted by a state, the District of Columbia, or U.S. territory EMS Job Title 7: Emergency Medical Responder RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Emergency Medical Responder to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for Emergency Medical Responder as defined by the NHTSA’s National EMS education standards10 Training Ongoing training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 8: Emergency Medical Technician (EMT) Description: The primary focus of an Emergency Medical Technician is to provide basic, noninvasive interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies. This may occur at an emergency scene until transportation resources arrive, from an emergency scene to a health care facility, between health care facilities, or in other healthcare settings. Additionally, the Emergency Medical Technician possesses the education and experience in areas of patient care that are commensurate with the patient care mission, providing care to minimize secondary injury and provide comfort to the patient and family while transporting the patient to an emergency care facility. The Emergency Medical Technician level is the minimum licensure level for personnel transporting patients in ambulances. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Emergency Medical Technician to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of a state-recognized EMT program based on NHTSA’s National Standard Curriculum Training11 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. FEMA IS-700: NIMS, An Introduction 3. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as an Emergency Medical Technician granted by a state, the District of Columbia, or U.S. territory EMS Job Title 8: Emergency Medical Technician (EMT) RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Emergency Medical Technician to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for Emergency Medical Technician as defined by NHTSA’s National EMS education standards12 Training Ongoing training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 9: Emergency Vehicle Operator Description: The primary focus of an Emergency Vehicle Operator is the safe operation of assigned emergency vehicles less than 26,000 lbs. Gross Vehicle Weight (GVW) used for patient care and/or transport. The Emergency Vehicle Operator is responsible for checking the fuel and oil levels and inspects the vehicle to ensure that the brakes, windshield wipers, and lights are working and that a fire extinguisher, flares, and other safety equipment are aboard and in working order. The Emergency Vehicle Operator ensures cargo is secure and adjusts the mirrors so that both sides of the vehicle are visible from the driver’s seat. Drivers report equipment that is inoperable, missing, or loaded improperly to the Emergency Vehicle Operator Mechanic. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Emergency Vehicle Operator to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Training13 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. FEMA IS-700: NIMS, An Introduction 3. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI 4. Emergency Vehicle Operator’s Course, CEVO, or equivalent 5. Defensive Driving Course (DDC4) or equivalent Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Emergency Vehicle Operator course Licensing Valid driver’s license EMS Job Title 9: Emergency Vehicle Operator RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Emergency Vehicle Operator to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Experience 2 years minimum driving experience plus a minimum of 1 year Emergency Vehicle Operator (EVO) experience Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 10: Emergency Vehicle Operator-Heavy Description: The primary focus of an Emergency Vehicle Operator-Heavy is the safe operation of heavy or large emergency vehicles over 26,000 lbs. GVW with special operating requirement (airbrakes, medium- or heavy-duty chassis) used for patient care and/or transport. The Emergency Vehicle Operator-Heavy is responsible for checking the fuel and oil levels and inspects the vehicle to ensure that the brakes, windshield wipers, and lights are working and that a fire extinguisher, flares, and other safety equipment are aboard and in working order. The Emergency Vehicle Operator--Heavy ensures cargo is secure and adjusts the mirrors so that both sides of the vehicle are visible from the driver’s seat. Drivers report equipment that is inoperable, missing, or loaded improperly to the Emergency Vehicle Mechanic. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an Emergency Vehicle Operator-Heavy to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Training14 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. FEMA IS-700: NIMS, An Introduction 3. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI 4. Emergency Vehicle Operator’s Course, CEVO, (for heavy or large emergency vehicles over 26,000 lbs. GVW), or equivalent 5. DDC4 or equivalent Experience 1. Ongoing involvement with an EMS-providing entity, organization, or agency 2. Demonstrate basic competency of vehicle operation Certification EVO Licensing Valid driver’s license EMS Job Title 10: Emergency Vehicle Operator-Heavy RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an Emergency Vehicle Operator-Heavy to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Experience 2 years minimum driving experience plus a minimum of 1 year EVO and 1 year EVO-Heavy experience Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 11: EMS Physician Description: The primary focus of the EMS Physician is to ensure quality patient care and provide medical oversight of EMS resources within an established command and control system during an incident response. The EMS Physician is a licensed physician who possesses the education and experience in areas of medicine and out-of-hospital care commensurate with the patient care mission. The EMS Physician’s primary responsibilities include the development and initiation of EMS protocols, oversight of EMS resource allocation, and appropriate handling, treatment, and transportation of victims. The EMS Physician has the authority over all patient care and clinical aspects of the EMS service. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an EMS Physician to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Graduate of an accredited medical school and completion of an accredited residency program Training Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. ICS-300: Intermediate ICS 4. FEMA IS-700: NIMS, An Introduction 5. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience 1. Minimum of 2 years of experience or training in out-of-hospital emergency care of the acutely ill or injured patient???? 2. Knowledge of Federal, State, and local MCI and disaster plans 3. Active medical practice Certification Current DEA registration Licensing Active status of legal authority to function as a physician granted by a state, the District of Columbia, or U.S. territory EMS Job Title 11: EMS Physician RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an EMS Physician to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training Completion of the following courses and/or curriculum: 1. Base Station Course or equivalent Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 12: EMS Transportation Group Supervisor Description: The primary focus of an EMS Transportation Group Supervisor is the coordination of patient transportation and maintenance of records relating to the patient’s identification, condition, and destination. He/she designates ambulance Staging Area(s), ensures that patient information and destinations are recorded, requests additional ambulances as required, coordinates requests for air medical transportation through the air medical transport manager, coordinates the establishment of the helipads with the medical branch director and air medical transport manager, and ensures the establishment of communications with hospitals. The EMS Transportation Group Supervisor reports to the medical branch director and supervises the medical communications coordinator and the ambulance coordinator. The EMS Transportation Group Supervisor is responsible for the coordination of patient transportation and maintenance of records relating to the patient’s identification, condition, and destination.15 REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an EMS Transportation Group Supervisor to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Training16 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency EMS Job Title 12: EMS Transportation Group Supervisor RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an EMS Transportation Group Supervisor to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training17 Completion of the following courses/ curricula: 1. ICS-300: Intermediate ICS 2. Unit-specific training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 13: EMS Transportation Unit Leader Description: The primary focus of an EMS Transportation Unit Leader is the coordination of patient transportation and maintenance of records relating to the patient’s identification, condition, and destination. He/she designates ambulance Staging Area(s), ensures that patient information and destinations are recorded, requests additional ambulances as required, coordinates requests for air medical transportation through the transportation group supervisor or air medical transport manager, coordinates the establishment of the helipads with the medical branch director and air medical transport manager, and ensures the establishment of communications with hospitals. The EMS Transportation Unit Leader reports to the medical group supervisor and supervises the medical communications coordinator and the ambulance coordinator.18 REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an EMS Transportation Unit Leader to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Training19 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency EMS Job Title 13: EMS Transportation Unit Leader RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an EMS Transportation Unit Leader to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Training20 Completion of the following courses/ curricula: 1. ICS-300: Intermediate ICS 2. Ongoing training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability”. EMS Job Title 14: EMS Treatment Unit Leader Description: The primary focus of the EMS Treatment Unit Leader is the coordination of treatment, preparation for transport, directing movement of patients to loading location(s), and coordinating movement of patients from the Triage Area to Treatment Areas with the triage unit leader. The EMS Treatment Unit Leader requests sufficient medical reserves and supplies, establishes communications and coordination with the transportation unit leader, ensures continual triage of patients throughout Treatment Areas, and directs movement of patients to ambulance loading area(s). The EMS Treatment Unit Leader possesses the education and experience in areas of patient care that are commensurate with the patient care mission. The EMS Treatment Unit Leader reports to the medical group supervisor and supervises treatment managers and the treatment dispatch manager. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an EMS Treatment Unit Leader to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of state recognized First Responder program based on NHTSA’s National Standard Curriculum Training21 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a first responder or an EMR granted by a state, the District of Columbia, or U.S. territory EMS Job Title 14: EMS Treatment Unit Leader RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an EMS Treatment Unit Leader to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for Emergency Medical Responder as defined by NHTSA’s National EMS Education Standards22 Training Ongoing training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments), and * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 15: EMS Triage Unit Leader Description: The primary focus of the EMS Triage Unit Leader is to provide triage management and movement of patients from the Triage Area. The EMS Triage Unit Leader informs the medical group supervisor of resource needs, implements the triage process, coordinates movement of patients from the Triage Area to the appropriate Treatment Area, maintains security and control of the Triage Area, and establishes the morgue. The EMS Triage Unit Leader possesses the education and experience in areas of patient care that are commensurate with the patient care mission. The EMS Triage Unit Leader reports to the medical group supervisor and supervises triage personnel, litter bearers, and the morgue. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for an EMS Triage Unit Leader to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of state recognized First Responder program based on NHTSA’s National Standard Curriculum Training23 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a first responder or an EMR granted by a state, the District of Columbia, or U.S. territory EMS Job Title 15: EMS Triage Unit Leader RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for an EMS Triage Unit Leader to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for EMR as defined by NHTSA’s National EMS Education Standards24 Training Completion of the following courses/ curricula: 1. ICS-300: Intermediate ICS 2. Ongoing training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments), and * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 16: Medical Branch Director Description: The primary focus of a Medical Branch Director is the implementation of the Incident Command System (ICS) Incident Action Plan (IAP) within the medical branch. The Medical Branch Director reports to the Operations Section Chief and supervises the medical group(s) and the patient transport function (unit or group). The Medical Branch Director possesses the education and experience in areas of patient care commensurate with the patient care mission and manages all medical group/branch functions to safely and quickly extricate, triage, treat, and transport all patients according to the IAP’s medical objectives. The Medical Branch Director reviews group assignments for effectiveness of current operations and provides input to Operations Section Chief for the IAP, supervises branch activities, reports to the Operations Section Chief on branch activities, and maintains the unit/activity log.25 REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for a Medical Branch Director to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of state-recognized first responder program based on NHTSA’s National Standard Curriculum Training26 Completion of the following courses/ curricula: 1. ICS-100: An Introduction to ICS 2. ICS-200: Basic ICS 3. ICS-300: Intermediate ICS 4. FEMA IS-700: NIMS, An Introduction 5. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a first responder or an EMR granted by a state, the District of Columbia, or U.S. territoryEMS Job Title 16: Medical Branch Director RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for a Medical Branch Director to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for EMR as defined by NHTSA’s National EMS education standards27 Training Completion of the following courses/ curricula: 1. Unit-specific training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 17: Medical Group Supervisor Description: The primary focus of the Medical Group Supervisor is to implement all medical group/branch functions to safely and quickly extricate, triage, treat, and transport all patients according to the incident medical objectives. The Medical Group Supervisor possesses the education and experience in areas of patient care commensurate with the patient care mission. The Medical Group Supervisor establishes command and control of the activities within a medical group, establishes the medical group with assigned personnel, and requests additional personnel and resources sufficient to respond to the magnitude of the incident. The Medical Group Supervisor reports to the medical branch director and supervises the triage unit leader, treatment unit leader, patient transport unit leader, and medical supply coordinator.28 REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for a Medical Group Supervisor to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of state-recognized first responder program based on NHTSA’s National Standard Curriculum Training29 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. ICS-300: Intermediate ICS 4. FEMA IS-700: NIMS, An Introduction 5. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a first responder or an EMR granted by a state, the District of Columbia, or U.S. territory EMS Job Title 17: Medical Group Supervisor RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for a Medical Group Supervisor to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for EMR as defined by NHTSA’s National EMS education standards30 Training31 Completion of the following courses/curricula: 1. Unit-specific training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 18: Medical Supply Coordinator Description: The primary focus of the Medical Supply Coordinator is to acquire and maintain control of appropriate medical equipment and supplies from units assigned to the medical group. The Medical Supply Coordinator requests additional medical supplies and distributes medical supplies to treatment and triage units. The Medical Supply Coordinator reports to the medical group supervisor. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for a Medical Supply Coordinator to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of state recognized First Responder program based on NHTSA’s National Standard Curriculum Training32 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. ICS-200: Basic ICS 3. FEMA IS-700: NIMS, An Introduction 4. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a first responder or an EMR granted by a state, the District of Columbia, or U.S. territory EMS Job Title 18: Medical Supply Coordinator RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for a Medical Supply Coordinator to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for EMR as defined by NHTSA’s National EMS education standards33 Training Completion of the following courses/ curricula: 1. ICS-300: Intermediate ICS 2. Ongoing training in the management and care of patients involved in MCIs Physical/ Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments), and * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” EMS Job Title 19: Paramedic Description: The primary focus of a Paramedic is to provide emergency care based on an advanced assessment and the formulation of a field impression, including basic and advanced skills focusing on the acute management and transportation of the broad range of patients who access the emergency medical system. The Paramedic possesses the education and experience in areas of medicine and pre-hospital care commensurate with the patient care mission. The Paramedic’s skills include invasive and pharmacological interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies. The Paramedic provides care designed to minimize secondary injury and provide comfort to the patient and family while transporting the patient to an appropriate health care facility. The Paramedic is the minimum licensure level for patients requiring the full range of advanced out-of-hospital care. REQUISITE CRITERIA The table below lists minimum requisite criteria, based on existing protocols and standards, for a Paramedic to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. Category Criteria Education Completion of a state-recognized paramedic program based on NHTSA’s National Standard Curriculum Training34 Completion of the following courses/ curricula: 1. ICS-100: Introduction to ICS 2. FEMA IS-700: NIMS, An Introduction 3. OSHA 1910.120 HazMat Awareness Training or equivalent basic instruction on responding to and operating in a CBRNE MCI Experience Ongoing involvement with an EMS-providing entity, organization, or agency Certification Successful completion of a state-approved program at this level or NREMT certification at this level Licensing Active status of legal authority to function as a paramedic granted by a state, the District of Columbia, or U.S. territory EMS Job Title 19: Paramedic RECOMMENDED CRITERIA The recommended criteria that follow are intended to supplement previously listed requisite criteria for the NIMS Integration Center’s consideration and referral to organizations, as appropriate. The table below lists the EMS Working Group’s recommended criteria for a Paramedic to participate in the NIMS Integration Center’s National Emergency Responder Credentialing System. These criteria incorporate and/or modify existing protocols and standards and/or propose their development where they do not exist. Category Criteria Education Successful completion of the minimum terminal learning objectives for paramedic as defined by NHTSA’s National EMS education standards.35 Training Completion of the following courses/ curricula: 1. ICS-200: Basic ICS 2. Ongoing training in the management and care of patients involved in MCIs Physical/Medical Fitness 1. Individuals must be healthy enough to function under field conditions, which may include all or some of the following: * 12-hour shifts, austere conditions (possibly no showers, housing in tents, portable toilets) * Extreme weather conditions (long exposure to heat and humidity, lack of air conditioning, extreme cold, or wet environments) * Long periods of standing 2. Individuals should not require personal medications that need refrigeration of any kind 3. Individuals should not have any physical conditions, impairments, or restrictions that would preclude them from participating in the moving and lifting of patients and/or equipment and supplies 4. Immunizations: * Td toxoid or Tdap. Receipt of primary series and booster within 10 years. * Documentation of Hepatitis B Vaccination Series and documentation of a positive titer (antibody to HBsAg) OR completion of a “waiver of liability” 1 Per National Incident Management System (NIMS) compliance at the time of publication, Incident Command System (ICS)- and Federal Emergency Management Agency (FEMA) Independent Study (IS)- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 2 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 3 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 4 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 5 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education, and greater competency of the entry level EMS provider. Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), and paramedic job titles should be expected to transition to these educational standards as they are implemented. 6 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 7 Does not require current certificate; individuals will have successfully completed training. 8 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 9 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 10 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 11 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 12 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 13 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 14 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 15 The patient transport function may initially be established as a unit and upgraded to a group based on incident size and complexity. 16 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 17 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 18 The patient transport function may initially be established as a Unit and upgraded to a group based on incident size and complexity. 19 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 20 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 21 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 22 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 23 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 24 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 25 The medical function may be initially established as a group and upgraded to a branch based on incident size or complexity. 26 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 27 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 28 The medical function may be initially established as a group and upgraded to a branch based on incident size or complexity. 29 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 30 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 31 Per NIMS Compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 32 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 33 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education, and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. 34 Per NIMS compliance at the time of publication, ICS- and FEMA IS- training courses are listed. Equivalent courses must meet the NIMS National Standard Curriculum. 35 NHTSA’s National EMS education standards are a component of the EMS Education Agenda for the Future: A System Approach, a comprehensive plan for a national EMS education system that will result in improved efficiency in the education process, enhanced consistency in the quality of the EMS education and greater competency of the entry level EMS provider. EMR, EMT, and paramedic job titles should be expected to transition to these educational standards as they are implemented. ?? ?? ?? ?? Working Group Guidelines DESIGNING A NATIONAL EMERGENCY RESPONDER CREDENTIALING SYSTEM B-2 November 2005 DRAFT 2 of 42