Section 515.940  Aeromedical Crew Member Education Requirements

a)         Except as provided for by subsection (b), each aeromedical crew member assigned to a helicopter or fixed-wing aircraft shall be approved by the SEMSV MD and shall meet the following requirements:

1)         Be a Paramedic, RN or a physician.

2)         Each crew member shall be current in, or obtain within six months of hire:

A)        Advanced Cardiac Life Support (ACLS);

B)        Pre-Hospital Trauma Life Support (PHTLS) or International Trauma Life Support (ITLS);

C)        Pediatric Advanced Life Support (PALS) or Emergency Nursing Pediatric Course (ENPC) or Pediatric Education for Prehospital Professionals (PEPP) Advanced;

D)        TNS or Trauma Nurse Core Course (TNCC);

E)        Neonatal Resuscitation Program (NRP) or an equivalent as approved by the EMS MD.

3)         Initial education program requirements for full-time and part-time critical care and ALS providers.  Each critical care and ALS provider shall successfully complete a comprehensive education program or show proof of recent experience, education and competency in the categories listed in subsections (a)(3)(A) and (B) prior to assuming independent responsibility.

A)        Didactic Component − Shall be specified and appropriate for the mission statement and scope of the medical transport service:

i)          Advanced airway management;

ii)         Altitude physiology/stressors of flight if involved in rotor wing or fixed wing operations;

iii)        Anatomy, physiology and assessment for adult, pediatric and neonatal patients;

iv)        Aviation − aircraft orientation/safety and in-flight procedures/general aircraft safety, including depressurization procedures for fixed wing (as appropriate). Ambulance orientation/safety and procedures as appropriate;

v)         Cardiac emergencies and advanced cardiac critical care;

vi)        Hemodynamic monitoring, pacemakers, implantable cardiac defibrillator (ICD), intra-aortic balloon pump, and central lines, pulmonary artery and arterial catheters;

vii)       Multiple patient incidents;

viii)      EMS radio communications;

ix)        Environmental emergencies;

x)         Hazardous materials recognition and response (all hazards recognition and response);

xi)        High risk obstetric emergencies (bleeding, medical, and trauma);

xii)       Infectious disease prevention, mitigation and treatment;

xiii)      Metabolic/endocrine emergencies;

xiv)      Multi-trauma (chest, abdomen, facial);

xv)       Neonatal emergencies (respiratory distress, surgical, cardiac);

xvi)      Oxygen therapy in the medical transport environment −  mechanical ventilation and respiratory physiology for adult, pediatric and neonatal patients as appropriate to the mission statement and scope of care of the medical transport service;

xvii)     Pediatric medical emergencies;

xviii)    Pediatric trauma;

xix)      Pharmacology;

xx)       Quality Management −  didactic education that supports the medical transport service mission statement and scope of care (e.g., adult, pediatric, neonatal);

xxi)      Respiratory emergencies;

xxii)     Scene management/rescue/extrication (rotor wing and ground ambulance);

xxiii)    Stress recognition and management;

xxiv)    Survival education;

xxv)     Record keeping;

xxvi)    Thermal, chemical, inhalation, radiation and electrical burns;

xxvii)   Legal aspects; and

xxviii)  Toxicology.

B)        Clinical Component − clinical experiences shall include, but not be limited to, the following (experiences shall be specific and appropriate for the mission statement and scope of care of the medical transport service):

i)          Critical care;

ii)         Emergency care;

iii)        Invasive procedures or simulations equivalent for practicing invasive procedures;

iv)        Neonatal intensive care;

v)         Obstetrics − five deliveries;

vi)        Pediatric critical care;

vii)       Pre-hospital care, for rotor wing programs only; and

viii)      Tracheal intubations − 10 performed on live patients either in the field or in the hospital setting when in the presence of and under the direct supervision of a licensed physician or Certified Registered Nurse Anesthetist (CRNA); or performed on cadavers or a human patient simulator (HPS) while under direct supervision; or when in the presence of and under the direct and immediate supervision of the EMS MD or SEMSV MD or designee.

4)         CE /staff development shall be provided and documented for all full-time and part-time critical care and ALS providers. These shall be specific and appropriate for the mission statement and scope of care of the medical transport service.

A)        Didactic CE shall include:

i)          Aviation − safety issues (if involved in rotor wing or fixed wing operations);

ii)         Requirements of this Part regarding ground and air transport;

iii)        Altitude physiology/stressors of flight (if involved in both rotor wing and fixed wing operations);

iv)        Critical care courses;

v)         Emergency care courses;

vi)        Hazardous materials recognition and response;

vii)       Infection control;

viii)      Stress recognition and management;

ix)        Survival education; and

x)         Equipment reviews consistent with program scope and mission.

B)        Clinical and laboratory CE shall include:

i)          Emergency/trauma care;

ii)         Critical care (adult, pediatric, neonatal);

iii)        Invasive procedure labs;

iv)        Labor and delivery;

v)         Pre-hospital experience, for rotor wing programs only;

vi)        Skills maintenance program documented to comply with number of skills required in a set period of time according to policy of the medical transport service (i.e., endotracheal intubations, chest tubes);

vii)       No fewer than five successful intubations per year are required for each Critical Care or ALS provider.  These intubations may be on live patients, either in the field or in the hospital setting, when in the presence of and under the direct supervision of a licensed physician or CRNA; or cadavers or HPS while under direct supervision; or when in the presence of and under the direct and immediate supervision of the EMS MD or SEMSV MD.  Success rates for all live intubations are documented and monitored through the quality management process; and

viii)      Live, HPS or cadaver intubation experience within the following age ranges if served by the air medical/ground inter-facility service: birth to 28 days; 28 days to 12 months; 12 months to 2 years; 2 years to 8 years; and 8 years and older.

5)         Yearly completion of the CE requirements as described in Section 515.930(d).

b)         In addition to at least one aeromedical crew member for BLS  who has met the requirements of subsection (a), and two aeromedical crew members, one of whom must be an RN or licensed physician, for ALS or CCT missions who have met the requirements of subsection (a), the EMS MD or SEMSV MD  may approve and assign additional crew members to a helicopter or fixed-wing aircraft.  The additional crew members shall meet the following requirements:

1)         Provide documentation of completion of education that includes, but is not limited to, the following:

A)        General patient care in-flight;

B)        Aircraft emergencies;

C)        Flight safety;

D)        EMS System and SEMSV Program communications;

E)        Use of all patient care equipment and

F)         Rescue and survival techniques.

2)         Yearly completion of the CE requirements as described in Section 515.930(d).

(Source:  Amended at 42 Ill. Reg. 17632, effective September 20, 2018)