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Purpose

The following guidance will be used by TFRD members wishing to become paramedics, and newly hired, probationary employees that have a State of Ohio paramedic certification in good standing to detail the TFRD paramedic internship program.

Policy/Procedure

BEFORE ENTERING A PARAMEDIC PROGRAM:

1. Per the CBA, the City will pay the tuition cost up front rather than on a reimbursement basis (2125.96).

2. Before registering with an accredited paramedic education program, the TFRD Executive Financial Administrator (EFA) Shall be notified by the student of their intent to enter a paramedic education program. The TFRD EFA will provide the prospective paramedic student instructions regarding the City of Toledo’s payment of tuition, or reimbursement if applicable.

3. Understanding that each paramedic program and student may progress at a different pace, the TFRD paramedic student shall make regular contact with the TFRD Training Bureau regarding class status and progression, and to provide any unforeseen changes in graduation date.

AFTER GRADUATING ACCREDITED PARAMEDIC TRAINING PROGRAM:

Paramedic Internship Program consists of 2 phases:

*TFRD Recruits, hired with a State of Ohio paramedic certification will be addressed at the end of this procedure*

Paramedic Internship – Phase 1

1. Once a paramedic has graduated from an accredited program, they are to alert both the Training and EMS Bureaus when they have received their National Registry or State of Ohio paramedic certification and provide copies of their certifications.

2. Once a paramedic is awarded their State of Ohio paramedic certificate, they will be enrolled in the TFRD paramedic internship program that consists of additional ALS transport ride time and education as deemed necessary by the TFRD Medical Director. (Refer to the CBA between the COT and L92, Sections 2125.96 & 2125.100):

3. Per the CBA: All members who furnish the Chief of Training with a valid State of Ohio Paramedic certification shall have their time commitment to the program and their paramedic differential started on the same day they are first used as a paramedic under the terms of the paramedic internship, but no later than thirty (30) days from furnishing their valid State of Ohio Paramedic certification. 2125.100

4. Per the CBA, “members who are denied the ability to complete the 96-hour (ie, 3rd rider) part of the Paramedic internship on duty within twenty (20) working tours of providing proof of State of Ohio Paramedic certification shall have the option of scheduling it on overtime.” (2125.100) During the paramedic internship program, the paramedic will be required to complete the following:

• A minimum of 96 hours of ALS medic ride time and 20 documented patient contacts as a third EMS (ALS) provider. Each electronic health record (EHR) that the intern creates will be reviewed and signed by the PTO assigned to the medic unit during the ride time. The intern will not be documented as the “lead provider,” but will take the opportunity to act as the lead and have their assessment, interview, and intervention skills evaluated by PTO on scene.
  
  
  • Every attempt will be made to allow the intern to complete the ride time in 12-hour blocks, preferably 0700-1900, to better allow for quality hands on training and instruction.
    
    
  • During each of the ride-time blocks, the intern will be responsible for completing an “open book” protocol review quiz, assigned by the TFRD Training Bureau.
    
    
    • During the ride-time, the intern will be required to complete practical skill assessments, evaluated by either the PTO, EMS, or Training Bureau staff.
      • The practical assessments are educational in nature and if the intern requires more instruction, they will be offered additional time to complete the assessments.
        
        
    • Additional Training/education may be offered the intern during their ride-time if available.
      
      
    • Completion of the ALS skill sheet (located in ALS protocol Admin 200; J-2)
      
      
  • After the 96-hour ride time has been completed, the intern will be detailed to the Training Bureau during their regularly scheduled shift to complete a written protocol exam and practical skill test with Training or EMS Bureau staff.
    • The Practical skill challenge will consist of essential skills that all line paramedics must possess, according to TFRD ALS protocol.

• If the intern is unsuccessful in passing any quiz, test, or practical assessment during the TFRD paramedic internship program, they will be allowed additional instruction until they are successfully able to meet the TFRD standard of care.

• Drug test- This will be scheduled by the Health and Wellness Officer after notification from the TFRD EMS Bureau and must be completed before an intern is released from the internship program and permitted to work as a TFRD paramedic.

• Documented ride time with a PTO. The intern may also receive ride-time with a member of the Training Bureau or EMS Bureau; this will not replace PTO ride-time.

• Meet the TFRD Medical Director for expectations of performance and protocol/skill review.

• Education at the TFRD annex, for medication exchange, after-hours access, and emergency procedures.

• Security access to vending machines.

5. Copies of the following must be submitted to the TFRD Training Bureau Supervisor before a member can be added to the TFRD Pharmacy License: refer to ALS protocols Admin 200-J for more information

• Completed paramedic skill sheet

• Valid driver’s license

• AHA BLS cert. card

• Current State of Ohio Paramedic Certification card

• ACLS cert. card

• Meet with TFRD Medical Director (before end of Phase 2).
  • The meeting may include protocol and practical skill review.
  • The Medical Director may elect to do this in person, virtually, or by webinar.

6. When all requirements of the TFRD internship have been satisfied, the member will be added to the pharmacy license and move to Phase 2 of the internship program.

Paramedic Internship – Phase 2

The second phase of the internship program will begin at the time the paramedic has been added onto the TFRD Pharmacy License.

1. A paramedic that has been added to the TFRD pharmacy license will be partnered with a PTO for a minimum of 480 hours on an ALS medic unit as a second (paramedic) EMS provider. At this time, the intern has progressed to a full-fledged paramedic; but will have an opportunity to work together with a PTO, recognizing that this will be a different experience than riding as a third provider. The 480 hour ride-time will be completed as close to consecutively as reasonable.

2. The Training Bureau and/or EMS Bureau will periodically check on the intern’s progress and to assess protocol retention and hands-on skills. These interactions will be scheduled with the intern, and they will have an opportunity to prepare for the assessments. Assessments will not be punitive, and will be completed on duty.

3. 12 months after the intern has been added to the TFRD pharmacy license, the intern will be detailed to the Training Bureau for a final protocol test and physical skill challenge. This will be scheduled through the Senior Battalion Chief of that shift in accordance with the detailing agreement.

• If the intern is unable to pass the protocol review test or skill challenge, the intern will be offered education and/or instruction to assist them in successfully completing the assessments. Additional instruction/education will not be punitive and will not affect the 2400hr commitment, and will be completed on duty.

Newly hired paramedics:

1. Recruits that currently have a State of Ohio paramedic certification are required to complete the paramedic internship program.

2. Every attempt will be made to allow the intern to complete their first phase of the internship while in recruit status.

1. While the recruit class is in EMT-Basic training; assigned to the TFRD Training Bureau, the paramedic recruits will be entered into the TFRD paramedic internship program to begin phase one of the program.

3. When the recruits graduate from the Fire Academy, the paramedic probationary employees will work as paramedics during their 3 rotations.

1. First Rotation – The paramedic probationary employee will be allowed to practice within their certification only while under the guidance of an *experienced TFRD paramedic
   
   
   1. At no time will 1st rotation, paramedic be utilized as the sole paramedic on any rig, or scene.
      
      
   2. Giving the probationary employee an opportunity to work to their certification level will allow them to keep valuable skills up to date.
      
      
   3. 1st round paramedic, probationary employees will not be listed as paramedics in Vector Solutions.
      
      
2. Second Rotation – The paramedic, probationary employees will be listed with a “RED” P in Vector Solutions, and will be allowed to use their paramedic skills only while operating under the supervision of an experienced TFRD paramedic.
   
   
   1. If the paramedic, probationary employee is scheduled to ride a medic unit, they will only act as a paramedic under the direction of an *experienced TFRD paramedic.
      
      
   2. If, due to staffing, the intern is scheduled to ride the medic unit outside of the internship program, they may ride with a paramedic that is not a PTO.
      
      Example: M3 has an experienced, non-PTO paramedic assigned for the day; but no EMT. An intern can be tasked to fill that EMT spot, outside of the internship program.
      1. In this situation, the intern will not receive credit toward their ride-time commitment for their internship.
      2. They can use their ALS skills as if they were assigned to any other first responding rig with an experienced medic, but this is outside of their internship responsibilities.
      3. The experienced paramedic will not be eligible for PTO pay differential.
      4. At no time will a “RED” P intern act as the sole paramedic on any scene.
         
         
3. Third Rotation – The paramedic, probationary employee will continue to be classified with “RED’ P in Vector Scheduling; and only be able to utilize ALS skills while under the direction of an experienced paramedic.
   
   
   1. At the conclusion of the intern’s 3rd rotation, their designation will change to a “YELLOW” P in Target Scheduling and they may act as the sole paramedic on any TFRD rig, as long as the intern has completed their 480-hour phase II internship ride-time..

*Experienced TFRD paramedic is defined as one having at least two (2) years of experience as a TFRD paramedic or is a paramedic officer.

TFRD ALS CE Requirements, refer to TFRD ALS Protocol 200-H

1. Once the paramedic has received their State of Ohio paramedic certification, they shall attend TFRD ALS Continuing Education (CE).

2. TFRD paramedics are responsible for signing up for monthly ALS CE, on their own. CE dates can be scheduled on Target Solutions. The EMS Bureau can assist new paramedics with the scheduling process. 419-245-1275.

3. Students attending in-person CE must sign 2 rosters. The first roster is to be signed at the beginning of class to certify attendance. The Second roster is to be signed upon completion of CE to certify completing that month’s CE, and to declare CTE or OT.

1. TFRD EMS Bureau will enter time into Target Scheduling for compensation, once the rosters are provided by the CE training center.

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