FG CE Form - OBLS - Sept 18 2024

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EMCT CONTINUING EDUCATION FORM

Name: _______________________________________ Cert #_____________ Exp Date_____________

DATE AND TIME OF PROGRAM

PLACE: ZOOM DATE: 09/18/2024 TIME BEGINNING: 10:00 am TIME ENDING: 11:00 am

2016 National Continued Competency Requirements (NCCR) 2016

_______

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1. National Competency Component (20 hours EMT) (30 hours Paramedic)

a. Airway, Respiration, and Ventilation (1.5 hours EMT) (3.5 hours Paramedic)

b. Cardiovascular (6 hours EMT) (8.5 hours Paramedic)

c. Trauma (1.5 hours EMT) (3 hours Paramedic)

d. Medical (6 hours EMT) (8.5 hours Paramedic)

e. Operations (5 hours EMT) (6.5 hours Paramedic)

2 Local or State Competency Component (10 hours EMT) (15 hours Paramedic)

3 Individual Competency Component (10 hours EMT) (15 hours Paramedic)

4. AzDHS requires a minimum of 5 hours in Pediatric Emergency Care.

Distributive Education

**Maximum Distributive Education (DE) Allowances:

Distributive Education (DE) is a method of delivering EMS education where the educator and student are not able to interact in real time. Examples include: online courses, journal article reviews, and videos.

EMCT-Basic

National Continued Competency max 7 DE hrs. Local Continued Competency max 7 DE hrs. Individual Continued Competency

DESCRIPTION (continue on back if needed)

EMCT-Paramedic

Obstetric Life Support (OBLS)

Andrea Shields, MD, MS

Associate Professor of Obstetrics & Gynecology, Division of Maternal Fetal Medicine

Program Director, Maternal Fetal Medicine Fellowship University of Connecticut School of Medicine

INSTRUCTOR(S)/COORDINATOR

Printed Name: Signature: Date: Peggy Baker, AEMS Peggy Baker September 18, 2024

This is to certify that the information provided above is true to the best of my knowledge.

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