INSTRUCTOR RESOURCE GUIDE Emergency Medical Response

INSTRUCTOR RESOURCE GUIDE

Emergency Medical Response

For Non-EMS Personnel

For use with Emergency Medical Responder: First on the Scene 11th edition, Pearson Education, Inc.

ISBN 978-1-945991-21-9 PRN2240

Emergency Medical Responsefor Non-EMS PersonnelInstructor Resource Guide, 2019 Release

Purpose of this GuideThis ASHI Emergency Medical Response Instructor Resource Guide is solely intended to give information on the presentation and administration of ASHI Emergency Medical Response certified training classes. The information in this book is furnished for that purpose and is subject to change without notice.

Notice of RightsNo part of this ASHI Emergency Medical Response Instructor Resource Guide may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without written permission from the American Safety & Health Institute.

TrademarksAmerican Safety & Health Institute and the ASHI logo are registered trademarks of the American Safety & Health Institute.

American Safety & Health Institute1450 Westec DriveEugene, OR 97402

800-447-3177 541-344-7099

E-mail: [email protected] our website at emergencycare.hsi.com

Copyright © 2019 American Safety & Health Institute All rights reserved. Printed in the United States of America.

First Edition—2019

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ErSoNNElPrefaceThe American Safety & Health Institute (ASHI) is an association of professional safety and health educators providing nationally recognized training programs across the United States and in several foreign countries. ASHI’s mission is to continually improve safety and health education by promoting high standards for members, principles of sound research for curriculum development, and the professional development of safety and health instructors worldwide. ASHI’s Emer-gency Medical Response Program content as referenced in Emergency Medical Responder: First on Scene, 11th edition, by Pearson Education, Inc. is based upon the following science, treatment recommendations, and guidelines:

• 2015 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science with Treatment Recommendations

• 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, and annual Guidelines Updates.

• National EMS Education Standards and Emergency Medical Responder Instructional Guidelines, NHTSA, https://www.ems.gov/education.html [May 2019].

• National Association of State EMS Officials. National EMS Scope of Practice Model 2019. Washington, DC, NHTSA, https://www.ems.gov/education.html [May 2019].

ASHI offers training and certification programs in emergency care and occupational safety and health for corporate America, government agencies, health care providers, first responders, and other professional rescuers. To learn more about ASHI, visit emergencycare.hsi.com.

Science and technology are constantly creating new knowledge and practice. Like any printed material, this publication may become out of date over time.

Do not use the information in this program as a substitute for professional evaluation, diagnosis, and treatment from an appropriately qualified and licensed physician or other healthcare provider. Local or organizational physician-directed practice protocols may supersede treatment recommendations in this program.

Municipal, state, provincial, national, or federal regulations are governmental orders having the force of law.

In the United States, Canada, and most other industrialized countries, workplace safety regulations and occupational licensing requirements prescribe scope of practice, rules, standards, and conditions with which every training agency, program, instructor, and licensed person must comply. ASHI Training Centers and their authorized instructors must be completely familiar with the regulations and licensing requirements of persons to whom they offer training and cer-tification. Training Centers and authorized instructors must not advertise, represent, or otherwise promote that their programs will meet specific regulations or licensing requirements unless and until such is confirmed with the licensing authority and/or ASHI.

Infection Control TerminologyThe Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard (1910.1030) uses the term “universal precautions” as an approach to infection control. The U.S. Department of Health & Human Services (HHS) Centers for Disease Control and Prevention (CDC) guidelines combine the term “universal precautions” and “body sub-stance isolation” into a single set of precautions termed “Standard Precautions” for the care of patients in hospitals.1 Isolation practices and terminology continue to evolve. For compliance with OSHA Standards, the use of either Universal Precautions or Standard Precautions is acceptable.2

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lPLEASE READ THE FOLLOWING TERMS AND CONDITIONS BEFORE USING THESE ASHI MATERIALS. BY PURCHASING, DOWNLOADING OR OTHERWISE USING OR ACCESSING THESE MATERIALS, YOU ACKNOWLEDGE AND HEREBY AGREE TO BE LEGALLY BOUND BY BOTH THESE TERMS AND CONDITIONS AND THE MOST RECENT HSI TRAINING CENTER ADMINISTRATIVE MANUAL (TCAM) AVAILABLE AT HTTP://WWW.HSI.COM/QUALITYASSURANCE

Unless otherwise indicated in writing by ASHI, ASHI grants you (“recipient”) the limited right to download, print, photocopy and use the electronic materials, subject to the following restrictions:

• The recipient is prohibited from selling electronic or printed versions of the materials.

• The recipient is prohibited from altering, adapting, revising, or modifying the materials.

• The recipient is prohibited from creating any derivative works incorporating, in part or in whole, the content of the materials.

• The recipient is prohibited from downloading the materials and re-posting them to any website without written permission from ASHI.

• Any rights not expressly granted herein are reserved by ASHI.

DISCLAIMERHSI has used reasonable effort to provide up-to-date, accurate information that conforms to generally accepted treatment recommendations at the time of publication. These recommendations supersede recommendations made in previous ASHI programs. Science and technology are constantly creating new knowledge and practice. Like any printed material, this publication may become out of date over time. Guidelines for safety and treatment recommendations cannot be given that will apply in all cases/scenarios as the circumstances of each incident often vary widely. Signs and symptoms may be incomplete and can vary from person to person. Do not use the information in this program as a substitute for professional evaluation, diagnosis, and treatment from an appropri-ately qualified physician or other licensed healthcare provider. Local or organizational physician-directed practice protocols may supersede treatment recommendations in this program. Alert emergency medical services (EMS) or activate your emergency action plan immediately if you are not sure an emergency exists or when any person is unresponsive, badly hurt, looks or acts very ill, or quickly gets worse.

The ASHI logo is a registered trademark of the American Safety & Health Institute, Inc. (ASHI). ASHI is a member of the HSI family of brands.

American Safety & Health Institute 1450 Westec Drive Eugene, OR 97402

800-447-3177 541-344-7099

E-mail: [email protected]

Visit our website at http://www.hsi.com

Copyright © 2019 American Safety & Health Institute ALL RIGHTS RESERVED. Printed in the United States of America.

First Edition—2019

— SUBJECT TO CHANGE WITHOUT NOTICE —

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ErSoNNElAcknowledgmentsStaff/Technical Consultants

Medical DirectorGregory R. Ciottone, MD, FACEP

Production TeamCarolyn Claman, Dana Midles, Carol Perez-Vitier, Jason Williams

Technical ConsultantsCorey Abraham, MEdSr. Account Representative Health & Safety Institute

Craig S Aman, MBA, MICPLeadership Team MD Solutions International Captain/Paramedic Seattle Fire Department Seattle, WA

Steve Barnett, MBAVP, Emergency Care Health & Safety Institute

Brandon Condon, BA, RN, EMT-B (Ret.)Owner Safety Training Professionals, LLC Milwaukee, WI

Dave FinleyDirector of Instructional Systems TrainSmart, Inc Chicago, IL

Christopher J. Le Baudour, MS Ed, NREMTAdjunct Faculty EMS Training Program Santa Rosa Junior College Santa Rosa, CA

Jeffrey Lindsey, PhD, PM, EFOCoordinator/Lecturer University of Florida St. Petersburg, FL

Howard Main, NREMTP, CCEMTPOwner Health Education Services Salinas, CA

W. Daniel Rosenthal, RN, BS, CCHCPresident Workplace Nurses, LLC Gretna, LA

William Rowe, FF/EMT-P (Ret.)VP Business Development, 24/7 Health & Safety Institute

Ralph Shenefelt, FF/EMT-P (Ret.)SVP, Regulatory & Quality Assurance Health & Safety Institute

Zigmund Sawzak, ParamedicDirector of EMS Instruction CPR LifeLine Portland, OR

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ErSoNNElContents

Program Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Program Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Why ASHI Emergency Medical Response? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Relation to EMS Educational Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

State Regulated Licensing and Credentialing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Training and Certification Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Class Administration and Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Program Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Core ContentSupplemental Content

Third-Party Content

Class Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Initial ClassRenewal Class

Challenge

Class Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Initial Class Outline and Time Frame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Initial Class Learning Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4OverviewCognitive Objectives

Psychomotor ObjectivesAffective Objectives

Instructional and Certification Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Instructional Materials from Pearson Education, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Student TextbookLesson Plans

Slide PresentationsChapter Handouts

Instructional Materials From ASHI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9ASHI Emergency Medical Response Resource

GuideClass Attendance RecordScenario Sheets

Certification Materials From ASHI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Class RosterWritten Exam

Performance Evaluation SheetsContinuing Education Record

Initial Class Requirements and Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Class Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Initial Class ScheduleClass SyllabusLearning EnvironmentClassroom Space

Classroom SafetyInstructor and Equipment RatiosMaterials and Equipment Lists

Conducting an Initial Training Class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Getting Ready for ClassIntroducing the ClassConducting Class Sessions

Student Illness and Other EmergenciesClass Instructors

May 2019

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lCertification Requirements and Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Certification Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Challenge MethodPreparing for EvaluationClass Roster Written Exam

Performance EvaluationEnding the Certification ProcessDocumentation and Issuing Certification CardsCertification Process Assistance

Certification Process Time Frame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Renewal of Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Renewal Class Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Continuing Education Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Renewal Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20BLS CertificationLapsed Certification

Challenge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Challenge Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Preparing for a ChallengeConducting a Challenge

Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Summary of Program Documents found Online in Otis

Class Roster with Instructions

Endnotes

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ErSoNNElProgram Design

Program OverviewThe ASHI Emergency Medical Response training program provides a detailed and comprehensive approach for managing out-of-hospital medical emergencies prior to the arrival of EMS.

The program is designed to provide comparable training to that of Emergency Medical Responder, the base level training for EMS providers. However, the program is not intended for training EMS providers or preparing students to be eligible for EMS provider testing and certification.

The ASHI Emergency Medical Response program pro-vides more details, depth, and exposure to standard first aid training topics to provide richer and more advanced training in first aid. It meets workplace first aid training requirements and satisfies the desire to learn more than just basic first aid without the state licensing require-ments associated with EMS provider training, certifi-cation, and credentialing.

Individuals likely to benefit from ASHI Emergency Medical Response training include the following:

• Law enforcement officers

• Correctional officers

• Security personnel

• Event and crowd control staff

• Lifeguards

• Park rangers

• Workplace Emergency Response Team (ERT) members

• Disaster team members

• Community Emergency Response Team (CERT) members

• Athletic trainers

• Outdoor guides

Current certification in healthcare-level CPR training, or Basic Life Support (BLS), is a prerequisite for students taking an ASHI Emergency Medical Response training class. BLS training and certification can also be done concurrently, as part of an ASHI Emergency Medical Response class. The ASHI BLS for Healthcare Providers and Professional Rescuers training program is an ideal choice for meeting the prerequisite. Equivalent courses, with hands-on skill practice included, are acceptable.

BackgroundIn 1966, the U.S. National Academies of Science released a report entitled Accidental Death and Dis-ability: The Neglected Disease of Modern Society. This report detailed the lack of an effective national system to address out-of-hospital medical emergencies. It paved the way for the implementation and development of today’s professional emergency medical services (EMS).

EMS was a big step forward, but over time it became clear that there was still a significant gap between basic first aid training and EMS provider training as an emer-gency medical technician, or EMT. Non-EMS emergency responders, especially law enforcement officers, needed something to fill the gap.

As a result, the Department of Transportation (DOT) established the First Responder training curriculum in 1979 as an advanced training program in first aid tech-niques, modeled after the newly developed EMS training curriculums.

It quickly became popular with law enforcement and other non-EMS providers such as workplace emergency response team members.

It also became popular with EMS agencies and fire departments as a quicker and more affordable option for base-level EMS training (other than EMT or paramedic), especially for smaller departments in rural areas. Over time, this resulted in First Responder training becoming a more formally recognized and regulated EMS provider level, including a name change to Emergency Medical Responder (EMR).

The regulation of EMS providers, including EMR, is done at the state level. Typically, regulations address the process of initial and ongoing training, along with the rules and requirements for EMS provider certification and licensing.

With the move to formalize this level of training into EMS as EMR, traditional non-EMS providers that used the earlier First Responder training have found the more recent EMS-based EMR training more regulated, and more burdensome to find and take.

Why ASHI Emergency Medical Response?The original purpose of First Responder training — filling the knowledge and skill gap between basic first aid training and EMS for non-EMS providers — is the intent of the ASHI Emergency Medical Response program.

The ASHI Emergency Medical Response program is based on the same nationally developed information for training Emergency Medical Responders in EMS. The program uses the same instructional and student mate-rials to provide an effective EMR alternative for non-EMS providers.

From a workplace first aid compliance standpoint, cer-tification in ASHI Emergency Medical Response meets or exceeds the Occupational Safety and Health Admin-istration (OSHA) medical and first aid training require-ments for the workplace.

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lThe required student text for students taking an ASHI Emergency Medical Response class is:

Emergency Medical Responder: First on the Scene, 11th Edition Christopher J. LeBaudour, J. David Bergeron, Keith Wesley, MD Pearson Education, Inc. © 2019 (and future editions)

Instructional materials produced by Pearson Education, Inc. are provided free-of-charge to approved Training Centers who have purchased the ASHI Emergency Medical Response Digital Resource Kit and have at least one Instructor authorized to teach the ASHI Emergency Medical Response program. Instructional resources from Pearson include the following:

• Lesson plans

• Slide presentations

• Lesson handouts

All of the ASHI-produced administrative materials required for the class and Emergency Medical Response certification are included with the ASHI Emergency Medical Response Digital Resource Kit:

• Instructor Resource Guide

• Performance Evaluations

• Written Exam

• Support documents

Class Administration and CertificationASHI is responsible for the rules and requirements for conducting a class, and for the processes used for initial certification and renewal.

Important:THE DISTINCTION BETWEEN A TRAINING CLASS AND CERTIFICATION IN ASHI EMERGENCY MEDICAL RESPONSE IS IMPORTANT BECAUSE THEY BOTH HAVE UNIQUE ADMINISTRATIVE REQUIREMENTS.

This Instructor Resource Guide provides details on how to prepare for and conduct an ASHI Emergency Medical Response training class. Specific learning objectives and class requirements are identified for successful completion.

This Instructor Resource Guide also provides details on how to conduct the certification process, including spe-cific performance evaluations and written exam for ASHI Emergency Medical Response certification.

Relation to EMS Educational GuidelinesIn the United States, educational guidelines for EMRs as EMS providers are established by the National Highway Traffic Safety Administration (NHTSA), an agency within the U.S. Department of Transportation. NHTSA has developed a scope of practice for EMR providers, as well as national EMR education standards and instruc-tional guidelines (www.ems.gov/education.html).

From the EMS perspective, a scope of practice is what a licensed person legally can and cannot do. It helps define the boundaries between healthcare professionals.

A unique feature of the NHTSA EMR Scope of Practice is its extensive overlap and alignment with standardized first aid content. The goal of both trained EMR and first aid providers is to initially manage medical emergencies, using non-invasive techniques, until more highly trained EMS providers can take over care.

The ASHI Emergency Medical Response training program is based on the NHTSA EMS EMR scope of practice, education standards, and guidelines. The program provides more extensive and detailed training in first aid, similar to other advanced first aid training cur-riculums that have been developed.

State Regulated Licensing and CredentialingIt is not the intent of this ASHI Emergency Medical Response program to cross into the state-regulated EMS world.

An individual who has been trained and certified in ASHI Emergency Medical Response will not be licensed or credentialed to practice emergency medical care as an EMS provider within an organized state EMS system.

EMS provider licensing and credentialing are legal activ-ities performed by the state, not ASHI. Individuals who require or desire licensure and credentialing within the state EMS system must complete specific requirements established by the regulating authority — typically, a state EMS agency within the state health department.

The ASHI Emergency Medical Response program is not intended to prepare individuals for national certification, licensure, or credentialing as an EMS provider. Con-sequently, ASHI does not proactively seek state EMS approval of this Emergency Medical Response program.

Training and Certification MaterialsDifferent from other training programs developed and produced by ASHI, the Emergency Medical Response program uses third-party student and instructional materials produced by Pearson Education, Inc. during the training class.


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ErSoNNElProgram Structure The ASHI Emergency Medical Response program iden-tifies both core and supplemental training content to be used during a training class.

Core ContentThe core training content reflects the minimum cognitive knowledge and skill competencies required to be pre-pared for certification as an ASHI Emergency Medical Response provider.

The ASHI Emergency Medical Response program has identified a specific subset of NHTSA EMR content as core content.

Supplemental Content The ASHI Emergency Medical Response program also recognizes the need for additional training to individually address the varying needs of the students taking it.

To help this, the ASHI Emergency Medical Response program has identified additional EMR information from NHTSA as supplemental content. Supplemental content is optional to cover and based on the needs or desires of those being taught and the organizations they represent.

Importantly, for those that desire it, the use of supple-mental content can also offer the ability to provide a unique training class that is consistent with the National EMS Scope of Practice for EMS-based Emergency Medical Responders.

Based on state laws and regulations, supplemental content may require or benefit from the use of medical oversight from a physician or other highly credentialed healthcare provider. Training Centers providing ASHI Emergency Medical Response training classes should investigate and understand the laws and regulations related to supplemental content in the states they do training in.

Third-Party ContentAdditional training materials that are not produced by ASHI or Pearson Education, Inc. may be used to enhance the ASHI Emergency Medical Response training at the discretion of the Training Center director. These addi-tional materials may not be used in lieu of ASHI or Pearson materials and may not be used to shorten or otherwise alter the core training content required for certification.

Training Centers are responsible for the accuracy or legal use of third-party training content.

Class TypesThere are three class types for the ASHI Emergency Response training program:

Initial ClassA face-to-face classroom presentation for individuals who have never been certified or whose previous certifi-cation has lapsed longer than 30 days.

Renewal ClassA face-to-face classroom presentation for current ASHI Emergency Medical Response certified individuals who wish to refresh cognitive knowledge and skill com-petency to prepare for certification renewal.

ChallengeA face-to-face classroom evaluation for individuals who wish to earn certification by demonstrating existing knowledge and skill competency without taking an initial or renewal class.

Class MethodASHI Emergency Medical Response training is only conducted in a face-to-face, classroom-based manner. Separate cognitive/affective and psychomotor class sessions are recommended for the efficient use of Instructors, equipment, and materials.


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lInitial Class Outline and Time Frame

Lesson Lesson Time

1. Introduction to EMS Systems 100–120 minutes

2. Legal and Ethical Principles of Emergency Care 155–165 minutes

3. Wellness and Safety of the Emergency Medical Responder 150–160 minutes

4. Introduction to Medical Terminology, Human Anatomy, and Life Development 170–180 minutes

5. Introduction to Pathophysiology 100–110 minutes

6. Principles of Lifting, Moving, and Positioning of Patients 145–155 minutes

7. Principles of Effective Communications 80–90 minutes

8. Principles of Effective Documentation 45–55 minutes

9. Principles of Airway Management and Ventilation 315–325 minutes

10. Supplemental Lesson: Principles of Oxygen Therapy 85–95 minutes

11. Principles of Resuscitation 185–195 minutes

12. Obtaining a Medical History and Vital Signs 95–105 minutes

13. Principles of Patient Assessment 145–155 minutes

14. Caring for Cardiac Emergencies 85–95 minutes

15. Caring for Respiratory Emergencies 60–70 minutes

16. Caring for Common Medical Emergencies 125–135 minutes

17. Caring for Environmental Emergencies 125–135 minutes

18. Caring for Soft-tissue Injuries and Bleeding 150–160 minutes

19. Recognition and Care of Shock 90–100 minutes

20. Caring for Muscle and Bone Injuries 110–120 minutes

21. Caring for Head and Spine Injuries 105–115 minutes

22. Caring for Chest and Abdominal Emergencies 105–115 minutes

23. Supplemental Lesson: Care During Pregnancy and Childbirth 120–130 minutes

24. Caring for Infants and Children 165–175 minutes

25. Special Considerations for the Geriatric Patient 105–115 minutes

26. Supplemental Lesson: Introduction to EMS Operations and Hazardous Response 120–130 minutes

27. Supplemental Lesson: Introduction to Multiple-Casualty Incidents, the Incident Command System, and Triage

90–100 minutes

Total Course Time (Not Including Supplemental Content): Approx. 47–50 hours

Initial Class Learning ObjectivesOverviewBefore a student can be evaluated for ASHI Emergency Medical Response certification, he or she must meet the learning objectives identified for the class itself. A complete list of cognitive, psychomotor, and affective learning objectives is found in front of each chapter in the Emergency Medical Responder textbook from Pearson, and those objectives are incorporated into the Pearson Lesson plans and slide presentations.

ASHI has identified these learning objectives as either core or supplemental for Emergency Medical Response

training. Competency in the core learning objec-tives is necessary preparation for being evaluated for certification.

Developing competency in supplemental learning objectives is optional at the discretion of the Training Center responsible for the class. Supplemental objec-tives provide the flexibility to meet the unique needs of the students being taught without burdening them with information on content that has no application in the context of their job/role.


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ErSoNNElCognitive ObjectivesCognitive learning objectives are those that focus on conceptual or factual knowledge of a given topic. They are focused on changing what a student should know after completing training.

All chapter-by-chapter cognitive learning objectives identified in the Pearson Emergency Medical Responder textbook are considered core objectives for ASHI Emer-gency Medical Responder training, except for those in chapters and appendices identified by ASHI as supple-mental. The supplemental chapters and appendices are the following:

• Chapter 10 — Principles of Oxygen Therapy

• Chapter 23 — Care During Pregnancy and Childbirth

• Chapter 26 — Introduction to EMS Operations and Hazardous Response

• Chapter 27 — Introduction to Multiple-Casualty Incidents, The Incident Command System, and Triage

• Appendix 1 — Patient Monitoring Devices

• Appendix 2 — Principles of Pharmacology

• Appendix 3 — Air Medical Transport Operations

• Appendix 4 — Introduction to Terrorism Response and Weapons of Mass Destruction

Instructor Note:TO COMPLY WITH UPDATES TO THE EMS EDUCATIONAL GUIDELINES, THE USE OF NALOXONE FOR A SUSPECTED OPIOID OVERDOSE (APPENDIX 2, PAGE 575) HAS BEEN INCLUDED AS A REQUIRED CORE COGNITIVE LEARNING OBJECTIVE. IT IS RECOMMENDED TO INCLUDE THIS ALONG WITH THE DRUG ABUSE/OVERDOSE TOPIC IN CHAPTER 16, CARING FOR COMMON MEDICAL EMERGENCIES.

If you are wanting to provide a comparable training class to the National Scope of Practice for EMS-based Emer-gency Medical Responders, identify and include all cog-nitive learning objectives from the supplemental content.

Meeting Cognitive Learning Objectives

Cognitive learning objectives can be met through various means, such as the following:

• Textbook reading assignments

• Class lecture

• Class discussion

• Slide presentations

• Videos

• Handouts

• Worksheets

Psychomotor ObjectivesPsychomotor learning objectives are those that focus on the ability to perform specific skills and treatment sequences. They are focused on changing what a student should be able to physically do after completing training.

The psychomotor learning objectives identified for classroom training in ASHI Emergency Medical Response are heavily based on those found in the Emer-gency Medical Responder textbook from Pearson. In some cases, learning objectives from the textbook may have been expanded to reflect more specific information or slightly modified for clarification.

The core psychomotor learning objectives for classroom training are as follows:

1. Participate in simple research activities facili-tated by the instructor. (Chapter 1)

2. Demonstrate and describe proper handwashing technique. (Chapter 3)

3. Demonstrate and describe the proper appli-cation and removal of PPE. (Chapter 3)

4. Given an illustration of the human body, properly describe the location of random injuries as presented by the instructor. (Chapter 4)

5. Demonstrate the use of proper body mechanics while performing a patient lift. (Chapter 6)

6. Demonstrate the proper technique for the fol-lowing moves: (Chapter 6)

a. Clothes drag

b. Blanket drag

c. Direct ground lift

d. Extremity lift

7. Demonstrate the proper technique for placing a supine patient into the recovery position. (Chapter 6)

8. Demonstrate the proper technique for log-rolling a patient. (Chapter 6)

9. Demonstrate effective communication strat-egies when dealing with instructional staff, classmates, and simulated patients. (Chapter 7)

10. Use therapeutic communication strategies to establish effective relationships with classmates and simulated patients. (Chapter 7)

11. Deliver an appropriate verbal transfer of care following a simulated patient encounter. (Chapter 7)

12. Demonstrate the ability to accurately document a simulated patient encounter. (Chapter 8)

13. Properly correct an error made during docu-mentation. (Chapter 8)

14. Demonstrate the proper technique for the head-tilt, chin-lift maneuver. (Chapter 9)


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l15. Demonstrate the proper technique for the jaw-

thrust maneuver with and without a CPR mask. (Chapter 9)

16. Demonstrate the proper technique for the use of a bag-mask device on an adult, child, and infant. (Chapter 9)

17. Demonstrate the proper technique for providing positive pressure ventilations for an adult, child, and infant patient with inadequate respirations. (Chapter 9)

18. Demonstrate the proper technique for removal of a foreign body airway obstruction on an adult, child, and infant. (Chapter 9)

19. Demonstrate the proper technique for per-forming single-rescuer CPR on a simulated patient in cardiac arrest. (Chapter 11)

20. With another student or instructor, demonstrate the proper technique for performing two-rescuer CPR on a simulated patient in cardiac arrest. (Chapter 11)

21. Demonstrate the proper use of an AED on a simulated patient in cardiac arrest. (Chapter 11)

22. Demonstrate the ability to properly obtain and accurately trend and document the following vital signs: (Chapter 12)

a. Mental status

b. Respirations

c. Pulse

d. Skin signs

e. Capillary refill

f. Pupils

23. Demonstrate the ability to identify immediate and potential hazards to safety. (Chapter 13)

24. Demonstrate the ability to properly perform a scene size-up. (Chapter 13)

25. Demonstrate the ability to properly perform a primary assessment. (Chapter 13)

26. Demonstrate the ability to properly perform a secondary assessment. (Chapter 13)

27. Demonstrate the ability to properly perform a reassessment. (Chapter 13)

28. Demonstrate the ability to properly identify and perform appropriate interventions during a patient assessment. (Chapter 13)

29. Demonstrate the ability to appropriately assess and care for a patient experiencing cardiac compromise. (Chapter 14)

30. Demonstrate the ability to appropriately assess and care for a patient experiencing respiratory compromise. (Chapter 15)

31. Demonstrate the ability to appropriately assess and care for a patient experiencing an altered mental status. (Chapter 16)

32. Demonstrate the ability to properly administer naloxone for a suspected opioid overdose. (Appendix 2)

33. Demonstrate the ability to appropriately assess and care for a patient experiencing a heat-re-lated emergency. (Chapter 17)

34. Demonstrate the ability to appropriately assess and care for a patient experiencing a cold-re-lated emergency. (Chapter 17)

35. Demonstrate the ability to appropriately assess and care for a patient experiencing an emer-gency secondary to a bite or sting. (Chapter 17)

36. Demonstrate the proper care for a patient with suspected internal bleeding. (Chapter 18)

37. Demonstrate the proper techniques for con-trolling external bleeding using direct pressure, elevation, commercial or improvised tour-niquets, and packed hemostatic dressings. (Chapter 18)

38. Demonstrate the proper care for a patient with an impaled object. (Chapter 18)

39. Demonstrate the proper care for a patient with an amputation injury. (Chapter 18)

40. Demonstrate the proper care of a patient with a burn injury. (Chapter 18)

41. Demonstrate the proper techniques for caring for a patient at risk for shock. (Chapter 19)

42. Demonstrate the appropriate assessment of a skeletal injury. (Chapter 20)

43. Demonstrate the appropriate technique for manual stabilization of a skeletal injury. (Chapter 20)

44. Demonstrate the appropriate assessment and care of a patient with a head injury. (Chapter 21)

45. Demonstrate the appropriate assessment and care of a patient with a suspected spinal injury. (Chapter 21)

46. Demonstrate the appropriate airway man-agement for a patient with a suspected cervi-cal-spine injury. (Chapter 21)

47. Demonstrate the appropriate technique for manual stabilization of the cervical spine. (Chapter 21)

48. Demonstrate the proper technique for log-rolling a patient with a suspected spinal injury. (Chapter 21)

49. Demonstrate the proper technique for spinal motion restriction of a supine patient. (Chapter 21)

50. Demonstrate the proper technique for spinal motion restriction of a seated patient. (Chapter 21)

51. Demonstrate the proper technique for removal of a helmet for a patient with suspected spinal injury. (Chapter 21)


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accurately trend and document auscultated and palpated blood pressures. (Chapter 12)

14. Demonstrate the appropriate splinting care for a patient with a long bone injury. (Chapter 20)

15. Demonstrate the appropriate splinting care for a patient with a joint injury. (Chapter 20)

16. Demonstrate the appropriate sizing and appli-cation of a cervical collar. (Chapter 21)

17. Demonstrate the ability to identify the signs of an imminent delivery of a baby. (Chapter 23)

18. Demonstrate the steps for preparing for and assisting with a field delivery. (Chapter 23)

19. Demonstrate the proper care of the infant fol-lowing a field delivery. (Chapter 23)

20. Demonstrate the proper care of the mother following a field delivery. (Chapter 23)

21. Demonstrate the ability to identify a compli-cated delivery. (Chapter 23)

22. Demonstrate the proper assessment and care for a complicated field delivery. (Chapter 23)

23. Demonstrate the ability to identify and manage common hazards at a simulated emergency response. (Chapter 26)

24. Demonstrate the process for proper cleaning and decontamination of equipment following a simulated emergency response. (Chapter 26)

25. Demonstrate how to use the Emergency Response Guidebook appropriately to identify a suspected hazardous material. (Chapter 26)

26. Demonstrate the ability to properly categorize patients of a simulated multiple-casualty situ-ation. (Chapter 27)

27. Demonstrate the proper method for attaching a three- and four-lead monitor to a simulated patient. (Appendix 1)

28. Demonstrate the proper method for attaching a pulse oximeter to a simulated patient. (Appendix 1)

29. Demonstrate the proper method for using an end-tidal CO2 detector when ventilating a simu-lated patient. (Appendix 1)

30. Demonstrate the ability to properly assist a patient with the self-administration of the fol-lowing prescribed medications: (Appendix 2)

a. Prescribed inhaler

b. Epinephrine auto-injector

31. Demonstrate the ability to properly administer the following medications: (Appendix 2)

a. Activated charcoal

b. Oral glucose

c. Naloxone

d. Nitroglycerin

e. Epinephrine auto-injector

f. Nerve agent auto-injector

52. Demonstrate the appropriate assessment and care of a patient with a chest injury. (Chapter 22)

53. Demonstrate the appropriate assessment and care of the patient with abdominal pain. (Chapter 22)

54. Demonstrate the appropriate assessment and care of an open abdominal injury. (Chapter 22)

55. Demonstrate the ability to properly assess and care for the pediatric patient. (Chapter 24)

56. Demonstrate various techniques that can be employed to maximize successful assessment of the pediatric patient. (Chapter 24)

57. Demonstrate the application of the pediatric assessment triangle. (Chapter 24)

58. Demonstrate the ability to properly assess and care for the geriatric patient. (Chapter 25)

59. Demonstrate various techniques that can be employed to maximize successful assessment of the geriatric patient. (Chapter 25)

The supplemental psychomotor learning objectives for classroom training are as follows:

1. Demonstrate the proper technique for the fol-lowing moves: (Chapter 6)

a. Direct carry method

b. Draw sheet method

2. Demonstrate the proper use of equipment used to transport patients. (Chapter 6)

3. Demonstrate proper technique when communi-cating via radio. (Chapter 7)

4. Demonstrate the proper technique for the insertion of an oropharyngeal airway (OPA). (Chapter 9)

5. Demonstrate the proper technique for the insertion of a nasopharyngeal airway (NPA). (Chapter 9)

6. Demonstrate the proper technique for oral suctioning using an electric or hand-operated suction device. (Chapter 9)

7. Demonstrate the proper technique for nasal suctioning using an electric or hand-operated suctioning device. (Chapter 9)

8. Demonstrate the proper use of a non-rebreather mask. (Chapter 10)

9. Demonstrate the proper use of a nasal cannula. (Chapter 10)

10. Demonstrate the ability to add supplemental oxygen to a CPR mask and a bag-mask device. (Chapter 10)

11. Demonstrate the proper technique for attaching a regulator to a cylinder. (Chapter 10)

12. Demonstrate the ability to identify and trou-bleshoot a leaky oxygen cylinder/regulator. (Chapter 10)


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l• Scenario practices should be monitored and

evaluated, but not guided, interrupted, or corrected. When concluded, an Instructor can use debriefing techniques to allow students to identify things that went well and things that could be improved. A repeat practice can allow students to make changes in approach based on the debriefing discussion.

• ASHI provides scenario practice sheets for use in preparing students for the performance evalu-ation required for certification. These scenario sheets provide an example of what Instructors could create for group scenario practices within the class.

• Class Exercises are interactive sessions used during class to reinforce a key point or non-physical task. Instructors may use short video clips, still images, worksheets, or group discus-sions when conducting a class exercise.

Affective ObjectivesAffective learning objectives are those that focus on the emotional, ethical, and moral aspects of a topic. They are focused on changing how a student feels after com-pleting training.

All chapter-by-chapter affective learning objectives identified in the Pearson Emergency Medical Responder textbook are considered core objectives, except for those in chapters and appendices identified by ASHI as supplemental. The supplemental chapters and appen-dices are as follows:

• Chapter 10 — Principles of Oxygen Therapy

• Chapter 23 — Care During Pregnancy and Childbirth

• Chapter 26 — Introduction to EMS Operations and Hazardous Response

• Chapter 27 — Introduction to Multiple-Casualty Incidents, The Incident Command System, and Triage

• Appendix 1 — Patient Monitoring Devices

• Appendix 2 — Principles of Pharmacology

• Appendix 3 — Air Medical Transport Operations

• Appendix 4 — Introduction to Terrorism Response and Weapons of Mass Destruction

If you are wanting to provide a comparable training class to the National Scope of Practice for EMS-based Emergency Medical Responders, identify and include all affective learning objectives from the supplemental content.

Meeting Affective Learning Objectives

Affective learning objectives can be met through var-ious means, such as the following:

• Group discussion

• Case studies

• Survivor/victim stories

• Guest speakers

32. Demonstrate and discuss the ability to establish an appropriate helicopter landing zone. (Appendix 3)

33. Demonstrate the procedure for administering a chemical antidote auto-injector to yourself and a fellow EMS provider. (Appendix 4)

The split between core and supplemental objectives is different between the cognitive and psychomotor objec-tives. A number of topics are required to be covered cognitively as core content but have a related supple-mental psychomotor objective.

If you are wanting to provide a comparable training class to the National Scope of Practice for EMS-based Emergency Medical Responders, identify and include all psychomotor learning objectives from the supplemental content.

Meeting Psychomotor Learning Objectives

Psychomotor learning objectives can be met through a number of classroom methods. Instructors are en-couraged to use an effective approach within the classroom to meet them.

• Small Group Practices use hands-on practice in small groups of 2–4 students to focus on developing competency in a skill or a sequence of care. Small group practices are best suited for skills that require a high degree of quality or treatment sequences that have a very specific order.

• A demonstration of a skill or sequence, in real-time and prior to student practice, can be very helpful in developing student competency. When demonstrating skills, a high-quality perfor-mance is essential because students will tend to copy it.

• The Emergency Medical Responder textbook from Pearson provides step-by-step skill guides, described as photo scans. These scans can be used by students in small group practices to help guide and reinforce proper technique.

• Self-instruction within the small groups is a very effective approach. Assign a provider, patient, or coaching role to each student and have the student coach facilitate the practice using a skill guide. Have students switch until each has assumed each role. Experiencing the multiple perspectives of provider, patient, and coach, and the repetition of the skill practice provides a solid foundation in developing skill competency.

• Scenario-based group practices allow students to experience the realistic decision-making pro-cesses that occur in a real emergency. Student groups are provided a simulated patient and a backstory of limited information about what is occurring, and then left on their own to manage the situation.


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ErSoNNElInstructional and Certification Materials

OverviewConducting ASHI Emergency Medical Response classes for ASHI certification requires the use of a combination of instructional and certification materials from both Pearson Education, Inc. and ASHI. The bulk of the mate-rials used during the classroom portion are produced by Pearson. The bulk of the materials used during the certi-fication process are produced by ASHI.

The required student Pearson textbook is available for purchase directly from ASHI.

The required ASHI Emergency Medical Response Digital Resource Kit contains all of the ASHI materials needed to conduct the class and the ASHI certification process. All of the digital instructional materials from Pearson are provided free of charge with the purchase of the ASHI Digital Resource Kit.

Besides the student textbook, all instructional and cer-tification materials are provided in digital form online through the Training Center portal in Otis. Please see Otis for the most up-to-date information. Log in to Otis at otis.hsi.com/login. If you need assistance logging into Otis, call 800-447-3177 to speak with technical support.

Instructional Materials from Pearson Education, Inc. Student TextbookThe required student textbook for ASHI Emergency Medical Response classes is Emergency Medical Responder: First on the Scene, 11th Edition. This textbook identifies the cognitive, psychomotor, and affective learning objectives for the class and all of the relevant content a student needs to learn. The textbook also provides scans, or skill guides, for use in hands-on psychomotor skills practices.

Lesson PlansIntegrated lesson plans are provided for each student textbook chapter. Lesson plans provide guidance on lesson timing, an outline of the content covered, and Master Teaching Notes in regard to student textbook features:

• Teaching Tips

• Discussion Topics

• First on Scene Discussions

• Critical Thinking Discussions

• Class Activities

• Media Links

• Knowledge Applications

Lesson plans are provided in digital form online through the Training Center portal in Otis after purchase of the ASHI Emergency Medical Response Digital Resource Kit.

Slide PresentationsIntegrated slide presentations are provided for each student textbook chapter. Slide presentations review the learning objectives for the chapter, present an outline of content along with appropriate still images, and provide a summary of key content points.

Slide presentations are provided in digital form online through the Training Center portal in Otis after pur-chase of the ASHI Emergency Medical Response Digital Resource Kit.

Chapter Handouts

Integrated interactive handouts are provided for each student textbook chapter. These handouts are inter-active, using multiple-choice questions, scenario case-studies, fill-in-the-blank review questions, and listing exercises to reinforce student learning.

Chapter handouts are provided in digital form online through the Training Center portal in Otis after pur-chase of the ASHI Emergency Medical Response Digital Resource Kit.

Instructional Materials from ASHIASHI Emergency Medical Response Instructor

Resource Guide This Instructor Resource Guide provides all of the key administrative information for conducting an ASHI Emergency Medical Response training class and for the ASHI certification process after training is completed. It also provides detailed information on the process for renewal.

IMPORTANT:THIS ASHI EMERGENCY MEDICAL RESPONSE RESOURCE GUIDE PROVIDES ALL OF THE ADMINISTRATIVE INFORMATION NECESSARY FOR CONDUCTING ASHI EMERGENCY MEDICAL RESPONSE TRAINING AND CERTIFICATION.


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lPerformance Evaluation SheetsA student must take and pass a performance evalu-ation for certification as an ASHI Emergency Medical Response provider. Performance evaluation is made up of five distinct skill evaluations:

• Respiratory Arrest (Bag-Mask)

• Cardiac Arrest — Adult

• Cardiac Arrest — Infant

• Traumatic Injury (Responsive or Unresponsive)

• Medical Emergency (Responsive or Unresponsive)

An optional performance evaluation sheet for emergency oxygen administration is also provided.

Instructors check off skill performance on performance evaluation sheets. These sheets can also be used to help with any needed remediation. Performance evalu-ation sheets and instructions for their use are provided with the Digital Resource Kit.

Continuing Education RecordThe continuing education record is a form that allows a currently certified ASHI Emergency Medical Response provider to keep track of continuing education during a certification period for use in renewal.

The continuing education method for renewal of certifi-cation requires the exclusive use of the ASHI Emergency Medical Response CE Library. Individual memberships for access to the library are available for purchase. No other continuing education courses are accepted for use in renewal of certification.

The Continuing Education Record and instructions for its use are included with the Digital Resource Kit.

Class Attendance RecordAn ASHI Emergency Medical Response training class will be a multi-session, multi-day course. Student atten-dance or designated make-up work is required for all sessions. For ease in the documentation of attendance, an optional class attendance record form is included in the ASHI instructional materials for use. The class attendance record provides details of the class, enrolled students, session dates, and session topics. Instructors may use an alternative attendance record if desired, col-lecting the same information. A class attendance record and instructions for its use are included with the Digital Resource Kit.

Scenario SheetsScenario sheets are student practice tools used to help students learn how to apply skills and make reasoned judgments and decisions in a realistic, simulated setting, working as either a single rescuer or as the lead provider in a team. These scenario sheets are related to perfor-mance evaluation sheets and are an ideal way to help students prepare for performance evaluation. Scenario sheets and instructions for their use are included with the Digital Resource Kit.

Certification Materials from ASHIClass RosterThe Class Roster is the principal record of ASHI Emer-gency Medical Response certification. The roster verifies successful student completion of the written exam and performance evaluation required for ASHI certification or renewal. It also documents any remediation, if used during evaluation. A complete, accurate, and legible roster signed by the authorized instructor or submitted online through Otis is required for every student certified as an ASHI Emergency Medical Response provider. The roster must be delivered to the Training Center responsible for the class or submitted online through Otis within 30 days of the certification process. The Training Center is required to keep a copy of the roster (paper or digital) for no less than 3 years. The Class Roster and instructions for its use are included with the Digital Resource Kit.

Written ExamA student must take and pass the Written Exam for cer-tification as an ASHI Emergency Medical Response pro-vider. The written exam for the certification process is made up of 100 multiple-choice questions.

Two versions of the Written Exam, answer keys, and annotated answer keys, along with an answer sheet, are provided with the Digital Resource Kit.

Annotated answer keys can be used for help with any needed remediation.


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ErSoNNElInitial Class Requirements and Administration

Class PreparationUnderstanding the class requirements will help Training Centers and Instructors adequately prepare for an ASHI Emergency Medical Response training class and prevent unintended complications.

IMPORTANT: COMPLETE STANDARDS AND GUIDELINES FOR QUALITY ASSURANCE, INCLUDING PROGRAM STANDARDS, CERTIFICATION STANDARDS, AND THE TERMS AND CONDITIONS FOR INSTRUCTOR AND INSTRUCTOR TRAINER AUTHORIZATION, ARE LOCATED IN THE MOST RECENT VERSION OF THE HSI TRAINING CENTER ADMINISTRATION MANUAL (TCAM) AVAILABLE AT HTTPS://EMERGENCYCARE.HSI.COM/QUALITY-ASSURANCE-COMPLIANCE.

ALL INSTRUCTORS HAVE AGREED TO COMPLY WITH THESE STANDARDS BY SUBMITTING A SIGNED APPLICATION FOR INSTRUCTOR AUTHORIZATION.

Initial Class ScheduleUnlike other ASHI emergency care training programs, in which classes are usually done in a single session over a few hours, ASHI Emergency Medical Response training is typically done in multiple sessions over multiple days. Developing an effective class schedule is important for efficiently conducting the class.

Identify the overall class hours required for the content being covered. Suggested times per lesson are available in the lesson outline provided earlier in this resource guide.

Identify how quickly the training needs be completed. Keep in mind that there is a significant amount of infor-mation being covered and that adequate time should be given for students to comprehend the information, develop skill competence, and prepare for evaluation.

Consider splitting cognitive and psychomotor skills training into separate sessions. This will help when arranging for the materials and equipment required for skills practice.

Identify convenient and available times for the indi-viduals who are being trained and develop a schedule to accommodate all of the class needs.

Class SyllabusClear and frequent communication about the class is beneficial for students. Creating a class syllabus is an excellent way of making sure students always have access to important class information such as the following:

• Instructor name and qualifications

• Instructor contact information

• Class description

• Class prerequisites

• Class textbook and other required materials

• Class location(s)

• Class schedule

• Teaching-learning methods (e.g. lecture, dis-cussion, case studies, hands-on practice, etc.)

• Learning objectives

• Successful class completion and certification requirements

• Class attendance policy

• Student behavior requirements

• Attire and appearance requirements

• Class policies (e.g. academic dishonesty)

A sample class syllabus is provided with the digital support materials in Otis.

Learning Environment The ideal learning environment is comfortable, effi-cient, and distraction-free with sufficient space, seating, resources, and equipment. Instructors should make a reasonable effort to ensure a physically safe, com-fortable, and appropriate learning environment. The room should be well lit, well ventilated, and comfortable in temperature. Avoid cramped classroom setups where possible.

Classroom Space The training location should be large enough to accom-modate chairs, tables, and skill practice space for the maximum number of students anticipated for your class. Separate locations for cognitive and skill learning is rea-sonable to consider.

For cognitive learning sessions, ensure students have comfortable seating with tables to accommodate text-books, laptops, and notepads. Make sure all students have clear visual access to whiteboards, media presen-tation screens, and demonstration surfaces. Ensure all students can hear instruction clearly.


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l• ASHI

o Emergency Medical Response Instructor Resource Guide, 1 for each class

o Class Attendance Record (optional), 1 for each class

o Scenario sheets (set of 5), 1 for each student o Class Roster, 1 for each class o Written Exam (2 versions), 1 for each student o Written Exam Answer Sheet,

1 for each student o Written Exam Answer Keys (2 versions),

1 for each class o Written Exam Annotated Answer Keys

(2 versions), 1 for each class o Performance evaluations (set of 5),

1 for each student o Rate Your Program course evaluation form,

1 for each student o ASHI Emergency Medical Response

certification card, 1 for each student

Minimum Core Skill Practice Equipment

• Handwashing soap and running water, acces-sible to all students

• Waterless hand cleaner, enough for all students

• Disposable gloves, multiple pairs per student

• Human body illustration or prop, 1 for each class

• Blankets, 1 for each practice group

• Simulated patient care report sheets, multiple copies for each student

• CPR masks, 1 for each practice groups with sep-arate one-way valves for each student

• Bag-mask devices (adult, child, and infant), 1 set for each practice group

• CPR manikins (adult, child, and infant), 1 set for each practice group

• AED training devices and pads, 1 for each practice group

• Penlights, 1 for each practice group

• Medical alert necklaces or bracelets, 1 for each practice group

• Timing device with second hand for vital signs (e.g. watch, phone), 1 for each practice group

• Dressings, multiple numbers

• Bandages, multiple numbers

• Tape, multiple numbers

• Commercial tourniquets, 1 for each practice group

• Improvised tourniquet supplies, 1 set for each practice group

• Packed dressing supplies, 1 set for each practice group

• Simulated impaled objects, 1 for each practice group

Hands-on skill practice requires adequate space to be effective. Allow 15 to 17 square feet per student whenever possible. Avoid lecture hall type of arrange-ments for skill practice sessions.

Classroom Safety Make sure there are no obvious hazards in the classroom, such as extension cords that can be tripped over. Dis-courage students from smoking, eating, or engaging in disruptive or inappropriate behavior. Have an emer-gency response plan in case of serious injury or illness, including evacuation routes from the classroom. Be aware of and share with students the location of the nearest bathrooms, exit, phone, first aid kit, AED, fire alarm pull station, and fire extinguisher.

Instructor and Equipment RatiosASHI Emergency Medical Response training classes have a maximum limit of 24 students.

During cognitive learning sessions, the maximum stu-dent-to-instructor ratio is 24:1.

During psychomotor skill practice sessions, a higher level of supervision is necessary to ensure effective skill facilitation, practice, and guidance. For skill sessions, the maximum student-to-instructor ratio is 12:1 with a recommended ratio of 6:1.

In general, the maximum student-to-equipment ratio for individual skill development is 6:1, with a recommended ratio of 3:1. For team-based skill practices the minimum group size is at least 4 students, with a recommended cap of 6 students.

Materials and Equipment Lists Use the lists below to prepare the right materials and equipment for the training you are delivering. All mate-rials and equipment are required unless noted. The numbers below are the minimum requirements. Having more equipment to increase the hands-on practice time per student is encouraged.

Classroom Equipment

• Slide presentation delivery device

• Large television, monitor, or projection screen

• Whiteboard or equivalent for spontaneous notes or visuals

• Video presentation device (optional)

• Audio set-up for video presentations (optional)

Training and Evaluation Materials

• Pearson Education, Inc.

o Emergency Medical Responder (EMR) student textbook, 1 for each student

o EMR chapter handouts (optional, set of 27), 1 for each student

o EMR lesson plans, 1 for each class o EMR slide presentations, 1 for each class


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multiple numbers

• Adjustable cervical collars, 1 for each practice group

• Helmets (bicycle, motorcycle, or football), 1 for each practice group

• Commercial OB kits, 1 for each practice group

• Childbirth simulation trainers, 1 for each practice group

• U.S. Department of Transportation Emergency Response Guidebooks, 1 for each practice group

• START Triage training package, 1 for each class

• Three- or four-lead cardiac monitor, 1 for each practice group

• Disposable leads used with a cardiac monitor, multiple numbers

• End-tidal CO2 detectors, 1 for each practice group

• Nerve agent auto-injector trainer, 1 for each practice group (type available to students for real use following training)

Optional Items for Showing/Recognition/Awareness (1 for each class)

• Nitroglycerin spray

• Nitroglycerin tablets

• Baby aspirin

• Asthma inhaler

• Inhaler spacer device

• Oral glucose

• Activated charcoal

• Naloxone

• Epinephrine auto-injector

• Electrolyte or sport drink

• Commercial pressure bandage

• Commercial hemostatic dressing

• Commercial burn-gel dressing

• Commercial occlusive dressing

• Triage tag

• Glucometer

• Commercial nerve-agent auto-injector

Optional Items for Consideration

• Pens and pencils, 1 for each student when taking written exam

• Blankets or mats for uncarpeted floors

• Name tags or tents for each student

• Spare projector bulb (as needed)

• Extension cord (as needed)

• Bulky dressings, multiple numbers

• Simulated amputated parts, 1 for each practice group

• Plastic bags for amputated parts, 1 for each practice group

• Triangular bandages, multiple numbers

• Occlusive dressing material, 1 for each practice group

• Alcohol/cleaning wipes, multiple numbers

Minimum Supplemental Practice Equipment (required if covered)

• Draw sheets, 1 for each practice group

• Simulated bed, 1 for each class

• Simulated stretcher, 1 for each class

• Long backboards and straps, 1 set for each practice group

• Commercial stretchers (type available to students for real use following training)

• Simulated portable radios, 1 for each practice group

• Extrication devices (type available to students for real use following training)

• Oropharyngeal airways (OPAs), 1 set for each practice group

• Nasopharyngeal airways (NPAs), 1 set for each practice group

• OPA and NPA insertion training device, 1 for each practice group

• Electric suctioning devices, 1 for each practice group

• Hand-operated suction devices, 1 for each practice group

• Blood pressure cuffs and stethoscopes, 1 for each practice group

• Non-rebreather masks, 1 for each practice group (on manikins)

• Nasal cannulas, 1 for each practice group (on manikins)

• Oxygen delivery tubes (for use with CPR mask or bag-mask), 1 for each practice group

• Non-rebreather and nasal cannula training manikin, 1 for each practice group

• Oxygen delivery systems (filled tank and regu-lator), 1 for each practice group

• Pulse oximeter, 1 for each practice group

• Naloxone delivery training kits, 1 for each practice group (type available to students for real use following training)

• Epinephrine auto-injector trainers, 1 for each practice group (type available to students for real use following training)

• Commercial long bone/joint splints (type available to students for real use following training)


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lConducting Class Sessions ASHI Emergency Medical Response training will require multiple class sessions over multiple days. Take the fol-lowing steps to ensure effective learning:

• Review the related lesson plan and learning objectives prior to the class session.

• Arrive early to give yourself plenty of time to get set up and organized.

• Start on time.

• Take attendance, using the class attendance record or similar.

• Use the lesson plan as a guide to adequately conduct the class session and meet the listed learning objectives.

IMPORTANT: DURING SKILL PRACTICE SESSIONS, WARN STUDENTS TO AVOID AWKWARD OR EXTREME POSTURES OF THE BODY. IMPROPER LIFTING AND MOVING IS A LEADING CAUSE OF BACK INJURY.

Student Illness and Other Emergencies Advise students to not attend class if they have an illness such as influenza or a fever. Provide reasonable accom-modation to students to make up class time or skill ses-sions. If a student has a medical emergency, instructors should provide the appropriate care and activate the emergency response plan appropriate for the setting.

Class InstructorsIt is allowable to use other ASHI authorized Emergency Medical Response Instructors to conduct class sessions without the presence of the primary instructor. At least one ASHI authorized Emergency Medical Response instructor must be present for all class sessions. The primary authorized instructor who signs the class roster is responsible for the overall administration of the class.

It is also allowable to invite guest instructors who have expertise in a specific content topic. An ASHI autho-rized Emergency Medical Response Instructor must be present during guest instruction to ensure all learning objectives are met.

Conducting an Initial Training ClassGetting Ready for ClassA successful ASHI Emergency Medical Response training class begins with adequate preparation. Steps to take in preparation include:

• Finalizing a class schedule and class syllabus

• Verifying room availability

• Verifying adequate material and equipment avail-ability (see the materials and equipment list for detailed information)

• Reviewing lesson plans and learning objectives

Introducing the Class When meeting for the first time, begin the class with a short introduction to help everyone to relax, feel less inhibited, and be at ease. A good introduction can set the tone for the entire class:

Greet Students

• Greet students as they arrive and informally introduce yourself.

• Be friendly, considerate, respectful, and professional.

• Have students complete a name tag or tent card and have a seat.

Introduce Class

• More formally introduce yourself, your back-ground, and your experience.

• Establish a connection with the students. Ask about previous training. Connect the students’ experiences and knowledge to this class.

• Consider using an appropriate icebreaker as a warm-up exercise. FYI: Great ideas for these activities can be found on the internet by searching with the key word “icebreakers.”

• Briefly cover facility and classroom safety. Know and share the locations of the following:

o Bathrooms

o Emergency exits and evacuation routes

o Fire alarm pull stations

o First aid kits, emergency oxygen, and AEDs

• Hand out and review the class schedule and class syllabus.

• Distribute any other materials you are providing for the class.


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ErSoNNElCertification Requirements and Administration

Certification ProcessSuccessful completion of a written exam and desig-nated performance evaluations is required for initial cer-tification and renewal as an ASHI Emergency Medical Response provider. This evaluation process documents both the successful completion of the class and the awarding of certification for it.

Challenge Method If a person is attempting to become certified as an ASHI Emergency Medical Response provider using a Chal-lenge, the certification process is different. In a Challenge attempt, a person must be fully prepared for evaluation, receive no prior review, and pass on a single attempt. There is no opportunity for remediation or reevaluation. A person who fails a Challenge must take an initial training class in order to become ASHI certified.

More information on Challenge can be found later in this resource guide.

Preparing for EvaluationIt is essential that students actively prepare for both the written exam and performance evaluation. All evalu-ation is done in a pass/fail format. Instructor coaching or instruction is not allowed during the evaluation process.

To prepare for the written exam, advise students to review textbook content, using the learning objectives at the beginning of each covered chapter in the text and the summary information at the end of each covered chapter to help.

If you are using the interactive chapter handouts pro-vided by Pearson, advise students to review those as well.

To prepare for performance evaluation, provide students with the related scenario sheets for review and practice. These scenario sheets are identical to the performance evaluation sheets used in evaluation.

Encourage students to spend time doing hands-on skill practice with other students to prepare. Schedule and offer skill practice sessions with the appropriate equipment to help.

Class RosterThe class roster is the principal record of training and certification.

When students arrive to the class session in which evaluation will be conducted, have each of them fill out personal information on a class roster, making sure it is complete, accurate, and legible.

Written Exam To become eligible for certification, students must receive a passing score on the ASHI Emergency Medical Response Written Exam. The written exam contains 100 multiple-choice questions. Each student must get at least 74 questions correct (74%) to pass the exam.

Provide at least 100 minutes for the class to complete the exam. Two versions of the exam are provided using the same questions. An optional exam answer sheet is provided for use, or students can answer directly on the exam itself. There is only one answer per question. Instruct students to circle the answer choice that reflects the best answer for the question provided.

The ASHI Emergency Medical Response written exam is an open-book exam. An open-book exam empha-sizes critical thinking and problem solving over recall of memorized facts and decreases test anxiety. Open-book exams mean that students may use reference materials to take exams. Reference materials include any notes taken during the class as well as the Pearson Emergency Medical Responder: First on the Scene (11th Edition) text.

Although students may use reference materials while taking the exam, they should not be allowed to openly discuss the exam with other students or the instructor. Their answers should be their own.

If reading comprehension is an issue, Instructors may read aloud the exam to the students as necessary without providing the answers.

It is essential that all ASHI-authorized Instructors take reasonable steps to ensure the security of the ASHI Emergency Medical Response Written Exam. Please follow these reasonable security guidelines:

1. Don’t broadly share digital files of the exams or answer keys.

2. Store printed exam and answer key copies in a secure location.

3. Do not over-print copies of the exam or answer keys.


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l4. Traumatic Injury (Responsive or Unresponsive)

5. Medical Emergency (Responsive or Unresponsive)

An optional performance evaluation sheet for emergency oxygen administration is also available.

For the first three performance evaluations (respiratory arrest, adult cardiac arrest, and infant cardiac arrest), the student being evaluated plays more of an individual role in performing hands-on skills.

For the other two performance evaluations (traumatic injury, medical emergency) the student being evaluated will act as the lead responder in a team response. As a lead responder, the student will effectively direct the assessment and care of the simulated patient, assigning necessary tasks to other team members (e.g., airway management, bleeding control, manual stabilization, vital signs, etc.) and ensure they are adequately performed.

Keep in mind, the lead responder is the person being evaluated, not the other students playing the role of additional team members. The extent of other team member’s actions can be limited by the evaluator to help manage evaluation time. When a student is being eval-uated by his or herself, verbal directions to simulated team members can be used.

The evaluator can participate in a limited manner such as providing an arriving AED or giving the results of a vital signs measurement. These actions should not interfere with the ability to evaluate the student.

A manikin is used to play the role of the patient when per-forming chest compressions or giving rescue breaths. Another person can be used as a patient in the traumatic injury or medical emergency scenarios. An evaluator should not play the role of the patient in any scenario.

Performance evaluation sheets are used during per-formance evaluation. They are designed to guide an Instructor in conducting the evaluations. Become familiar with using these sheets prior to doing any performance evaluation.

The steps for conducting performance evaluation include the following:

• Conduct the evaluation in a location away from other students to ensure the privacy of the pro-cedure and results.

• Select the appropriate performance evaluation sheet and print/write the student name and eval-uation date on it.

• Inform the student being evaluated of the unique circumstances to be used, such as real or simu-lated team members.

• Start by reading the scenario on the performance evaluation sheet. When completed, have the student being evaluated take immediate action to begin care.

Consider the following tips to prevent cheating when students are taking the exam:

1. Before distributing the exams, remind students that those who are caught cheating will not be eligible for certification.

2. Request a photo ID if you suspect someone may be taking the test in place of a student.

3. Inform students there is to be no talking during the exam. If a student has a question during the exam, ask that student to raise a hand and you will go to him or her.

4. For extra precaution, use both versions of the exam, alternating them between students to make copying from another student more difficult.

5. Walk around the room throughout the exam. Do not do other work while monitoring the exam.

To help correct the completed exams, there are two versions of the Answer Key that correspond to the two versions of the exam. Annotated answer keys are also provided.

If the student achieves a passing score on the written exam, he or she can be marked as completed on the class roster.

If the student has not achieved a passing score, he or she cannot be marked as completed on the class roster.

Students who have not achieved a passing score on the written exam can be provided additional opportunities to pass it. Before doing so, students should be given the opportunity for remediation. A student may also choose to take the written exam again using the alternative version, as soon as possible, without remediation.

When possible, remediation should be separated from the current testing and conducted at another time. Use the annotated answer key, student text, and chapter handouts to review the content related to the missed questions. Refrain from simply identifying the correct answer. Encourage the student to review the content on their own before retesting. Be polite, considerate, encouraging, and professional when remediating skills.

When a student is retaking the written exam, use the alternate exam version from the one that was used previously.

Performance EvaluationPerformance evaluation is a scenario-based assessment process that provides sound, fair, consistent, uniform, objective, and reliable documentation of a student’s competency according to the skill criteria.

To become eligible for certification, students are required to demonstrate skill competency in 5 specific skill areas:

1. Respiratory Arrest (Bag-Mask)

2. Adult Cardiac Arrest

3. Infant Cardiac Arrest


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ErSoNNElDocumentation and Issuing Certification CardsTo complete the administrative requirements for the training class and certification, do the following:

• Distribute Rate Your Program Course Evaluation Forms

o The Rate Your Program course evaluation form, along with instructions for its use, can be found in Otis.

o Allow adequate time to complete and collect.

o Inform students they may also provide Rate Your Program feedback directly to HSI using a web-based form at www.hsi.com/rateyourprogram.

• Issue Certification Card

o Confirm the person’s personal information is on the class roster.

o If earned, fill out and issue an ASHI Emergency Medical Response certification card, marking the appropriate type of certification (initial or renewal).

o A filled-in certification card must be complete, accurate, and legible.

o Card expiration may not exceed 2 years from month of certification requirements being met.

o Congratulate the person for successfully becoming certified as an ASHI Emergency Medical Response provider.

• Complete and Sign a Class Roster

o Document class attendance, successful completion of the written exam, and successful completion of performance evaluation on the class roster.

o The roster must be complete, accurate, and legible.

o Sign the roster and return it within 30 days, along with any other identified class documents, to the training center responsible for the class, or submit a class roster electronically through Otis.

o Signing or electronically submitting the Class Roster for an ASHI EMR training class is confirmation that all participants listed met the terms and conditions for certification.

Certification Process AssistanceThe primary authorized Emergency Medical Response instructor who signs the Class Roster is responsible for the certification process and must be present at all times during the process.

It is allowable to use other ASHI-authorized Emergency Medical Response Instructors to assist in conducting the written exam and performance evaluation during the certification process.

• Tables on the evaluation sheets provide a simple procedure, action, and prompt format for guidance. Allow the student being evaluated to move though the listed procedures in the tables.

o Students should generally complete the procedures in the order on the sheet. Some variance is okay, as long as it does not result in a non-recoverable error.

o Carefully watch the actions taken for each procedure to make sure they are competently performed. Check off the actions as they are completed.

o When an action requires feedback in order to move on, provide the indicated Instructor prompt.

o Continue this process to the end of the table.

If the student being evaluated has competently per-formed the listed actions for all of the procedures, the student can be marked as completed on the class roster.

If the student has incorrectly performed any of the listed actions, the student cannot be marked as completed on the class roster.

Students who have performed incorrect actions can be provided additional chances for performance evaluation. Before doing so, students should be given the oppor-tunity for remediation. A student may also choose to be reevaluated as soon as possible, without remediation.

When possible, remediation should be separated from the current certification process and conducted at another time. Use the performance evaluation sheet that was filled out during the student’s initial evalu-ation to point out errors and suggestions for correction. Most importantly, allow time for hands-on practice and demonstration of correct skills before being evaluated again. Be polite, considerate, encouraging, and profes-sional when remediating skills.

An optional performance evaluation on emergency oxygen administration is included for use when covering the supplemental learning objectives from Chapter 10: Principles of Oxygen Therapy.

Instructors will formally document the successful com-pletion of performance evaluation on the class roster. However, it is highly recommended to keep signed per-formance evaluation sheets as secondary documen-tation of student skill competency or when required by regulation or organizational policy.

Performance evaluation sheets and instructions for their use are included with the Digital Resource Kit.

Ending the Certification ProcessThe effective use of remediation and additional oppor-tunities to complete the written exam and performance evaluation should result in certification for most stu-dents. When an Instructor and Training Center feel they have exhausted the ability for a student to successfully complete the certification process, it is recommended that the student take another class.


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lCertification Process Time FrameAllow adequate time, separate from the training class, for the certification process.

Evaluation Time

Written Exam 100 minutes

Performance Evaluation a,b 80–240 minutesc

Total Evaluation Time Approx. 3–6 hours

a Based on a class size of 12 students.b Total time from student perspective will be approximately 20 minutes.c Evaluation time can be decreased significantly by the use of multiple stations and evaluators.

IMPORTANT:COMPLETE STANDARDS AND GUIDELINES FOR ADMINISTRATION OF THE ASHI EMERGENCY MEDICAL RESPONSE TRAINING CLASS AND CERTIFICATION PROCESS ARE LOCATED IN THE MOST RECENT VERSION OF THE HSI TRAINING CENTER ADMINISTRATION MANUAL (TCAM) AVAILABLE AT HTTP://WWW.HSI.COM/QUALITYASSURANCE.


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ErSoNNElRenewal of Certification

OverviewOnce initially certified, ASHI Emergency Medical Response providers need to renew certification every two years. Renewal as an ASHI Emergency Medical Response provider must be completed before the previous certification ends. It can be accomplished in two ways, through a renewal class or by continuing education.

Renewal Class MethodRenewal of certification can be accomplished by com-pleting a renewal class that focuses on psychomotor skills. A renewal class is 16 hours in length, much shorter than an initial training class.

Instructors can customize the renewal class to reflect the needs of the students within the guidelines established in the table below. All indicated psychomotor objectives must be met in the renewal class.

A renewal class can be conducted over time, including over the entire 2-year certification period. Students are required to complete 100% of the hours through atten-dance at class sessions or through make-up work when a class session is missed.

When using the Renewal Class method for renewal of certification, instructors should document each class session, using a class attendance record or similar method.

Topic / Lesson Chapter(s) Hours Psychomotor Objectives

Airway/Respiratory/Ventilation 9 1.0 1. Demonstrate the proper technique for the use of a bag-mask device on an adult patient in respiratory arrest.

Cardiovascular (separate from BLS renewal hours) 11 2.5 1. Demonstrate the proper technique for performing single-rescuer CPR and use of an AED on a simulated adult patient in cardiac arrest.

2. Demonstrate the proper technique for performing single-rescuer CPR on a simulated infant patient in cardiac arrest.

3. With another student or instructor, demonstrate the proper technique for performing two-rescuer CPR on a simulated patient in cardiac arrest.

Medical Emergencies 14, 15, 16, 17

3.0 1. Demonstrate the ability to appropriately assess and care for a patient experiencing a medical emergency.

Traumatic Injuries 18, 19, 20, 21, 22

1.5 1. Demonstrate the proper techniques for controlling external bleeding using direct pressure, commercial or improvised tourniquets, and packed hemostatic dressings.

2. Demonstrate the appropriate assessment and care of a patient with a suspected spinal injury.

3. Demonstrate the ability to appropriately assess and care for a patient experiencing a traumatic injury.

Electivesa Any Core 8.0 None

a Elective hours can be made up of training that covers any of the core content in the ASHI Emergency Medical Response initial training class.


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lContinuing Education MethodThe continuing education method for renewal of certifi-cation requires the exclusive use of the ASHI Emergency Medical Response CE Library. Individual memberships for access to the library are available for purchase. No other continuing education courses are accepted for use in renewal of certification.

The continuing education record is a form that allows a currently certified ASHI Emergency Medical Response provider to keep track of continuing education for use in renewing certification.

A total of 16 hours of continuing education is required during the 2-year certification period. Defined CE hours in the following categories are required:

Airway/Respiration/Ventilation 1.0 hourCardiovascular 2.5 hoursMedical Emergencies 3.0 hoursTrauma 1.5 hoursElectives (any topic) 8.0 hours

Users can self-select CE courses from the library to meet the listed renewal hours. Each course provides a down-loadable completion certificate for the documentation of training. Those using the CE method for renewal of certification must submit a Continuing Education Record form to the Training Center providing the evaluation, attesting to completion of the required CE hours. The Continuing Education Record form, and instructions on its use, are included in the digital support materials in Otis.

Renewal CertificationSuccessful completion of the ASHI Emergency Medical Response Written Exam and performance evaluation is still required for certification when using either the Renewal Class or CE methods for renewal. Details on the certification process can be found earlier in this guide. An ASHI Emergency Medical Response Class Roster is completed as the primary record of certification for renewal.

BLS CertificationRegardless of the renewal method used, a person must have current certification in ASHI Basic Life Support, or equivalent BLS training, to become renewed as an ASHI Emergency Medical Response provider. Time spent for BLS renewal training cannot be used for required renewal hours specified in the table above.

Lapsed CertificationWhen an ASHI Emergency Medical Response provider certification has lapsed, a 30-day grace period is allowed for entry into a renewal class or use of the CE renewal method. However, this grace period does not extend the certification period.


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ErSoNNElChallenge

OverviewThe Challenge is a face-to-face evaluation of an individual who wishes to earn ASHI Emergency Medical Response certification by demonstrating knowledge and skill com-petency without taking an initial class, renewal class, or continuing education. The person requesting the chal-lenge is solely responsible for being prepared for it.

A challenge uses the same performance evaluation and written exam process used for certification after initial or renewal training.

Challenge ProcessUse the following guidelines when conducting a chal-lenge for certification:

Preparing for a Challenge• Arrive early to give yourself plenty of time to get

set up and organized.

• Greet the person doing the challenge and introduce yourself.

• Have the person fill in personal information on a Class Roster.

• Be friendly, considerate, respectful, and professional.

• Start on time.

• Briefly review the challenge process:

o Anyone can choose to do a challenge, but it can only be attempted once.

o There is no teaching or coaching provided prior to evaluation.

o Performance evaluation is required and must be passed on a single attempt.

o The written exam is required and must be passed on a single attempt.

o If the challenge is unsuccessful, certification must be earned by taking and successfully completing an initial training class.

Conducting a Challenge• Distribute Written Exam

o The written exam for a challenge does not use an open-book format.

o If necessary, an instructor can read the exam aloud without indicating the correct answers.

o Allow at least 100 minutes for the person to take the written exam.

• Grade Written Exam

o If the person does not get at least 74%, or 74 correct out of the 100 questions provided, the challenge is over.

• Conduct Performance Evaluation o Evaluate the person’s skill competency using

the ASHI Emergency Medical Response performance evaluation sheets.

o The person must demonstrate competency of skills as defined by the skill criteria on the performance evaluation sheets.

o When appropriate, the person being evaluated should perform and not just verbalize skills.

o If a person cannot demonstrate competency of any of the skills being evaluated, the challenge is over.

• Issue Certification Card o Confirm the person’s personal information is

on the Class Roster. o If earned, fill out and issue an ASHI

Emergency Medical Response certification card, marking the appropriate type of certification (initial or renewal).

o A filled-in certification card must be complete, accurate, and legible.

o Card expiration may not exceed 2 years from month of a successfully completed challenge.

o Congratulate the person for successfully renewing his or her certification.

• Complete and Sign a Class Roster o Document successful completion of the

written exam and performance evaluation on the Class Roster.

o The roster must be complete, accurate, and legible.

o Sign the roster and return it within 30 days to the training center responsible for the challenge or submit a class roster electronically through Otis.

o Signing or electronically submitting the Class Roster for an ASHI EMR training class is confirmation that all participants listed met the terms and conditions for certification.

IMPORTANT:THE CLASS ROSTER IS THE PRINCIPAL RECORD OF TRAINING. SIGNING OR ELECTRONICALLY SUBMITTING A CLASS ROSTER IS CONFIRMATION THAT A PARTICIPANT LISTED MET THE TERMS AND CONDITION FOR CERTIFICATION. COMPLETE TERMS AND CONDITIONS FOR CERTIFICATION ARE LOCATED IN THE MOST RECENT VERSION OF THE HSI TRAINING CENTER ADMINISTRATION MANUAL (TCAM), HTTPS://EMERGENCYCARE.HSI.COM/QUALITY-ASSURANCE-COMPLIANCE


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ErSoNNElAppendix

Support Documents

✓ Sample Class Syllabus

✓ Class Attendance Record

✓ Class Roster

✓ Rate Your Program Course Evaluation

✓ Continuing Education Record

✓ Written Exam A

✓ Written Exam A — Answer Key

✓ Written Exam A — Annotated Answer Key

✓ Written Exam B

✓ Written Exam B — Answer Key

✓ Written Exam B — Annotated Answer Key

✓ Written Exam Answer Sheet

✓ Performance Evaluation Instructions

✓ Performance Evaluations

– Respiratory Arrest (Bag-Mask)

– Cardiac Arrest — Adult

– Cardiac Arrest — Infant

– Traumatic Injury (Responsive or Unresponsive)

– Medical Emergency (Responsive or Unresponsive)

– Emergency Oxygen (Optional)

✓ Scenario Sheet Instructions

✓ Scenario Sheets

– Respiratory Arrest (Bag-Mask)

– Cardiac Arrest – Adult

– Cardiac Arrest – Infant

– Traumatic Injury (Responsive or Unresponsive)

– Medical Emergency (Responsive or Unresponsive)

– Emergency Oxygen (Optional)


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Using a Class RosterThe Class Roster is the principal record of training. A complete, accurate, and legible Class Roster signed by the authorized instructor or submitted online through Otis is required for every training class.

Return the completed Class Roster to the training center responsible for the class within 30 days.

There are four roster pages. The first page documents information regarding the type and makeup of the class. This information is filled out by the training center and/or instructor.

Class Information — Check a single box to identify the class type. Fill in the location the class was conduct-ed, the start and completion dates of the class, the total class hours, and the evaluation/certification date that the final evaluation was done on.

Instructor Information — Fill in the first name, last name, and registry number of the primary instructor for the class. When the class is completed and the information required for the Class Roster has been added, the primary instructor must sign and date the roster, acknowledging the attesting statement provided. If any other ASHI Emergency Medical Response Instructors were used in conducting the written exam or perfor-mance evaluation for certification, fill in the first name, last name, and registry number of each.

The second page of the roster documents personal information about the student and the minimum information required about completion of the class.

Student Information — Circulate the roster among the students and have each fill in first name, last name, and email address.

AttendanceCheck each student off if he or she has met the 100% attendance requirements (or make-up work) for class sessions.

Written Exam ColumnThe Written Exam for the ASHI Emergency Medical Response training program is required for certification.

Write the exam score in the column provided. If an exam score is below the passing score, the student has not completed the class.

Performance EvaluationPerformance evaluation for the ASHI Emergency Medical Response program is required for certification. Check each student off if he or she has shown competence in all of the required performance evaluation skills.

Remediation Column If a student does not receive a passing score on the Written Exam or has not shown competency on any of the required performance evaluation skills, the student should have an opportunity for remediation.

When remediation is provided, check the box in the remediation column for any student requiring it. If re-mediation is not successful, the student has not completed the class.

Completed ColumnCompletion of the class requires the following:

1. Attendance at all class sessions, or completion of make-up work for any sessions not attended

2. Demonstration of minimum skill competency as defined by the skill criteria on the required performance evaluation sheets

3. A passing score on the Written Exam

4. If provided, successful remediation of the Written Exam or Performance Evaluation

Check the “yes” box in the completed column for each student who has met these requirements. Check the “no” box for students who have not. Only students who have completed the class are eligible for certification.

Class Roster InstructionsEmergency Medical Response for Non-EMS Personnel


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lThe third page of the roster is the Performance Evaluation Record. It is filled out by the instructor. Use of the Per-formance Evaluation Record is optional, but highly recommended in order to provide more detailed information on student performance evaluation.

Student Information — Fill in the last name of each student for identification. Include a first name initial if there are multiple students with the same last name.

Required Performance Evaluation Documentation — After completing performance evaluation, check off the students who have correctly demonstrated the skills defined by the skill criteria on the performance evaluation sheets.

The last page of the roster documents the supplemental learning objectives covered in the class sessions. Its use is optional, but highly recommended to accurately document the content covered in training, especially when medical oversight is used.

Check all of the topics or learning objectives covered in class sessions. If none were covered within the objec-tive area, check the “None covered” box.

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Class RosterEm

ergency Medical Response for Non-EM

S Personnel

Prim

ary Instructor ________________________________________________________________________ E

valuation/certification date _____________________________________________

First Nam

eLast N

ame

Email

Attendance

Written

Exam

(Pass ≥74%

)

Performance

EvaluationR

emediation

Given

Completed

1 3

3 3

Y 3

N

3

2 3

3 3

Y 3

N

3

3 3

3 3

Y 3

N

3

4 3

3 3

Y 3

N

3

5 3

3 3

Y 3

N

3

6 3

3 3

Y 3

N

3

7 3

3 3

Y 3

N

3

8 3

3 3

Y 3

N

3

9 3

3 3

Y 3

N

3

10 3

3 3

Y 3

N

3

11 3

3 3

Y 3

N

3

12 3

3 3

Y 3

N

3

13 3

3 3

Y 3

N

3

14 3

3 3

Y 3

N

3

15 3

3 3

Y 3

N

3

16 3

3 3

Y 3

N

3

17 3

3 3

Y 3

N

3

18 3

3 3

Y 3

N

3

19 3

3 3

Y 3

N

3

20 3

3 3

Y 3

N

3

21 3

3 3

Y 3

N

3

22 3

3 3

Y 3

N

3

23 3

3 3

Y 3

N

3

24 3

3 3

Y 3

N

3

Assistant Instructor Required

P

age 2 o

f 4

Perf

orm

ance

Eva

luat

ion

Reco

rdEm

erge

ncy

Med

ical

Res

pons

e fo

r Non

-EM

S Pe

rson

nel

Prim

ary

Inst

ruct

or __

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

__

Eva

luat

ion/

cert

ifica

tion

dat

e _

____

____

____

____

____

____

____

____

____

____

____

P

age

3 o

f 4

The

stud

ents

list

ed a

bov

e ha

ve d

emon

stra

ted

com

pet

ent

per

form

ance

, with

out

assi

stan

ce, f

or t

he p

erfo

rman

ce e

valu

atio

n sk

ills

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natu

re o

f Prim

ary

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ruct

or _

____

____

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____

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_

Last

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e o

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tud

ent

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pira

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A

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genc

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Emer

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(O

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33

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318

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33

320

33

33

33

213

33

33

322

33

33

33

233

33

33

324

33

33

33

Supplemental Topics Record

Emergency M

edical Response for Non-EMS Personnel

Prim

ary Instructor ________________________________________________________________________ E

valuation/certification date _____________________________________________

Check o

ff all of the sup

plem

ental top

ics or learning

ob

jectives covered

in the AS

HI E

merg

ency Med

ical Resp

onse class sessio

ns.

Supplemental Cognitive Topics —

3 None Covered

3

Princip

les of Oxygen Therap

y

3

Care D

uring Pregnancy and

Child

birth

3

Introduction to E

MS

Op

erations and

Hazard

ous Resp

onse

3

Introduction to M

ultiple-C

asualty Incidents,

the ICS

, and Triage

3

Patient M

onitoring Devices

3

Princip

les of Pharm

acology

3

Air M

edical Transp

ort Op

erations

3

Introduction to Terrorism

Resp

onse and W

MD

Supplemental Psychom

otor Learning Objectives — 3

None Covered

3D

irect carry and d

raw sheet m

oves

3

Eq

uipm

ent to transport p

atients

3

Com

municate via rad

io

3

Insert an OP

A

3

Insert an NP

A

3

Oral suctioning

3

Nasal suctioning

3

Non-reb

reather mask

3

Nasal cannula

3

Sup

plem

ental oxygen

3

Oxygen regulator

3

Oxygen eq

uipm

ent

3

Measure b

lood p

ressure

3

Sp

lint long bones

3

Sp

lint joints

3

Cervical collar

3

Identify im

minent child

birth signs

3

Child

birth d

elivery

3

New

born infant care

3

Post-b

irth mother care

3

Com

plicated

deliveries

3

Identify/m

anage comm

on hazards

3

Eq

uipm

ent decontam

ination

3

Em

ergency Resp

onse Guid

ebook

3

Triage

3

Three- and four-lead

monitor

3

Pulse oxim

eter

3

End

-tidal C

O2 d

etector

3

Prescrib

ed inhaler

3

Auto-injector

3

Activated

charcoal

3

Oral glucose

3

Naloxone

3

Nitroglycerin

3

Helicop

ter landing zone

Supplemental Affective Topics —

3 None Covered

3

Princip

les of Oxygen Therap

y

3

Care D

uring Pregnancy and

Child

birth

3

Introduction to E

MS

Op

erations and

Hazard

ous Resp

onse

3

Introduction to M

ultiple-C

asualty Incidents,

the ICS

, and Triage

3

Patient M

onitoring Devices

3

Princip

les of Pharm

acology

3

Air M

edical Transp

ort Op

erations

3

Introduction to Terrorism

Resp

onse and W

MD

P

age 4 o

f 4


Em

ErgEncy mEdical r

EsponsE for N

oN-EMS P

ErSoNNElEndnotes

1. Guideline for Isolation Precautions in Hospitals. Julia S. Garner, RN, MN, and the Hospital Infection Control Practices Advisory Com-mittee. From the Public Health Service, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, Georgia. Garner JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hop Epidemiol 1996; 17:53-80, and Am J Infect Control 1996; 24:24-52. Available: http://www.cdc.gov/ncidod/dhqp/gl_isolation_ptl.html [May 2019]

2. Occupational Safety & Health Administration. Hospital eTool — HealthCare Wide Hazards Module, (Lack of) Universal Precautions. Available: http://www.osha.gov/SLTC/etools/hospital/hazards/univprec/univ.html [May 2019]

INSTRUCTOR RESOURCE GUIDE

ISBN 978-1-945991-21-9© 2019 American Safety & Health Institute PRN2240

Emergency Medical Responsefor Non-EMS Personnel

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