EMERGENCY MEDICAL TECHNICIAN - ( EMT ) C.C.R.I. COURSE CURRICULUM SPRING 2017

EMERGENCY MEDICAL TECHNICIAN - ( EMT ) C.C.R.I. COURSE CURRICULUM SPRING 2017 FIRE 1130-104 TEXTBOOKS : Emergency Care Textbook 13 th Ed. Revised, Brady TUES/THURS/ 10 - FRI / 6:00 PM 10:00 PM Emergency Care Workbook 13 th Ed., Brady 1 WEDNESDAY; 1 SATURDAY BLS for Healthcare Providers ( A. H. A. ) LECTURES - ROOM # 1156 LABS - ROOM # 1156 WARWICK CAMPUS CCRI EMT Course Approval Number is 17-004E A MINIMUM OF 10 HOURS OF RESCUE OBSERVATION RIDE TIME PLUS A MINIMUM OF 5 PT. CONTACTS Medical Director Herbert J. Brennan, D.O. Department Chairperson of Nursing & Fire Science Jeanne S. McColl, MS, RN, CNE RIEMS Licensed Instructor Coordinator Program Director - Fire Science Ronald K. Gagne, Sr., B.S.B.A., A.A.S., NREMT-P Russell G. McGillivray, Jr.,MPA,LPN,MS,EMS,I/C ---------------------------------------------------------------------- LAB INSTRUCTORS SCOTT D. CARON EMT-C, I/C GABRIEL K. COTE EMT-C JOSEPH DeANGELIS NREMT-P RAYMOND M. MEDEIROS EMT-C, I/C JAMES McLEROY NREMT-P AMANDA McCAUGHEY EMT-B GREGG NOURY EMT-C JOSEPH E. SIMAS EMT-C, I/C WILLIAM SINGLETON EMT-C

-2- Preparatorv Date: January 24, 2017 TUESDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 1, 2 ; Protocols Lesson 1 (4 hours) EMT Course Overview / Introduction to Emergency Medical Care / The Well-Being of the EMT: EMT-Basic Course Orientation to include General Course Information, a review of the required RIEMS Policies and Protocols, a review of the specific course policies and procedures as well as a course overview. This session should also include an Introduction to Emergency Medical Care. Date: January 26, 2017 THURSDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Chapter 3, 4 ; Comfort One Protocol; Protocols Lesson 2 (4 hours) Lifting and Moving Patients, Medical/Legal and Ethical Issues: Explores the scope of practice, ethical responsibilities, advanced directives, consent, refusal, abandonment, negligence, duty to act, confidentiality, and crime scenes. Additional information regarding the Introduction to Emergency Medical Care should be provided during this session, Comfort One Protocol and lifting and moving patients will be included. Date: January 27, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 5, 6, 7, 8 Lesson 3 (4 hours) Medical Terminology, Anatomy & Physiology, Ventilation, Perfusion, and Shock, Understanding Pathophysiology, Life Span Development: A brief overview of the human body systems, anatomy, physiology and topographic anatomy. Include medical terminology specific to the body systems covered in this lesson. It is expected that specific body systems will be reviewed throughout the lectures of this training program. Life Span development. Introduction to Vital signs. Airway / Cardiopulmonary Resuscitation Date: January 31, 2017 TUESDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 9, 10 ; Protocols Lesson 4 (4 hours) QUIZ # 1 Chapters 1, 2, 3, 4 Airway Management, Respiration and Artificial Ventilation: Emphasis on airway anatomy and physiology, how to maintain an open airway, pulmonary resuscitation, and the variations for infants and children. The use of airways, suction equipment, and oxygen equipment to include the use of Ambu Bag, Pocket Mask, King Airway, Nebulizers and delivery systems, and other resuscitation devices will be discussed.

-3- Patient Assessment Date: February 2, 2017 THURSDAY Chapters 11, 12, 13 Lesson 5 (4 hours) Name & Level of Instructor: Ronald Gagne, NREMT-P Scene Size-Up, The Primary Assessment, Vital Signs & Monitoring Devices: Emphasizes scene size up, primary assessment of the patient, and obtaining and maintaining vital signs as well as the use of monitoring devices. Discussions pertaining to base line vital signs and a sample history taking are to be included in this session. Date: February 3, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 14, 15 Lesson 6 (4 hours) The Secondary Assessment, Critical Decision Making, Communication and Documentation: Emphasizes the knowledge and skills to perform the initial assessment, discuss the priorities of patient care, a detailed physical examination versus a formal physical examination and the ongoing assessment of trauma and medical patients. NOTE: February 5, 2017 NO REFUNDS OF TUITION OR FEES AFTER THIS DATE. Date: February 7, 2017 TUESDAY Name & Level of Instructors: Lesson 7 (4 hours) QUIZ # 2 Chapters 5, 6, 7, 8 Airway Management, Respiration and Artificial Ventilation Practical Skills - LAB: Provides supervised practice for students to develop psychomotor skills of airway management. Emphasis will be placed on the principles and use of airways, suction equipment, and oxygen equipment to include Ambu Bag, Pocket Mask, King airway, Nebulizer and delivery systems, and other resuscitation devices will be included in this session. These skills are to be reinforced throughout this training program.

-4- Mecical Emergencies & Trauma Date: February 9, 2017 THURSDAY Chapters 16, 17, 18 ; Protocols Lesson 8 (4 hours) Name & Level of Instructor: Ronald Gagne, NREMT-P Medical Emergencies Part I - General Pharmacology, Respiratory and Cardiac Emergencies: Review of the respiratory anatomy and physiology to include assessment of respiratory difficulty and emergency medical care of respiratory emergencies. Includes instruction in RIEMS protocols and medications. A review of the cardiovascular system, to include assessment of cardiovascular diseases. Includes the emergency medical care of cardiovascular emergencies, RIEMS protocols and medication administration with an emphasis on Aspirin, Nitroglycerin. Review of the nervous system and cerebral vascular accidents to include assessment of stroke, emergency medical care for stroke patients, and RIEMS protocols and medication administration. Date: February 10, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 19, 20, 21 Protocols Lesson 9 (4 hours) Medical Emergencies Part II - Diabetic Emergencies and Altered Mental Status, Allergic Reaction, Poisoning and Overdose Emergencies: Review of the respiratory anatomy and physiology to include assessment of respiratory difficulty and emergency medical care of respiratory emergencies. Includes instruction in RIEMS protocols and medications. A review of the cardiovascular system, to include assessment of cardiovascular diseases. Includes the emergency medical care of cardiovascular emergencies, RIEMS protocols and medication administration with an emphasis on Aspirin, Nitroglycerin. Review of the nervous system and cerebral vascular accidents to include assessment of stroke, emergency medical care for stroke patients, and RIEMS protocols and medication administration. Date: February 14, 2017 TUESDAY Name & Level of Instructors: Lesson 10 (4 hours) QUIZ # 3 Chapters 9, 10 Patient Assessment Practical Skills - LAB: Re-emphasizes the knowledge and skills learned thus far to assure that the student has the knowledge and the skills of assessment necessary to continue with the management of all patients with specific medical conditions and traumatic injuries.

-5- Date: February 16, 2017 THURSDAY Name & Level of Instructor: Ronald Gagne, NREMT-P AHA-BLS for Healthcare Providers Lesson 11 (4 hours) MANDATORY CLASS Cardiopulmonary Resuscitation & Automated External Defibrillation (AED) - Manikin Practice: Knowledge and skill development lecture - demonstration to include one-man CPR - 2-man CPR, infant and child resuscitation, obstructed airway for adult, child and infant - risk factors - warning signs of heart attack, stroke, and use of the Automated External Defibrillator. Date: February 17, 2017 ( FRIDAY NIGHT ) SNOW MAKE UP DATE OR FOR A CANCELLED CLASS DATE ONLY IF NEEDED Date: February 21, 2017 TUESDAY Name & Level of Instructors: Lesson 12 (4 hours) MANDATORY CLASS C.P.R. PRACTICAL AND WRITTEN EXAM + STROKE Cardiopulmonary Resuscitation and Automated External Defibrillation (A.E.D.) - LAB Manikin Practice. One-man CPR (adult, child, and infant), 2-person CPR (adult and child), obstructed airway (adult, child, and infant) and Automated External Defibrillation (AED). These skills need to be reinforced throughout the training program, with a written and psychomotor skills evaluation, and successfully completed prior to the end of the training program.

Date: February 23, 2017 THURSDAY Name & Level of Instructors: Lesson 13 (4 hours) QUIZ # 4 Chapters 11, 12, 13-6- A. McCaughey EMT-B Trauma Practical Skills - LAB I: All skills learned thus far with an emphasis on the knowledge required and the skills needed to perform a Trauma & Medical Patient Assessment, CPR, and Airway Management. RI EMS Protocols, and the appropriate medications i.e. Ana-Kit, Epi-pen, Subcutaneous Injections, Inter Muscular Injections, and Intra Nasal. Date: February 24, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapter 27, 28, 29 ; Protocol Lesson 14 (4 hours) Chest and Abdominal Trauma, Musculoskeletal Trauma, Trauma to the Head, Neck, and Spine: Reviews the musculoskeletal system to include definitions of types of fractures and dislocations, signs and symptoms of fractures, dislocations and sprains, principles and techniques of immobilizing injuries of the upper extremities using splints, sling and swart. Emergency medical care, including the use of cervical immobilization devices, KED, short and long boards, helmet removal, and infant and child considerations will also be discussed. Date: February 28, 2017 TUESDAY Name & Level of Instructors: Lesson 15 ( 4 hours) QUIZ # 5 Chapters 14, 15, 16, 17, 18 Head and Spine - LAB: Review anatomy of the nervous system and the skeletal system. Injuries to the spine and head will include mechanism-of-injury, signs and symptoms of injury, and assessment. Emergency medical care, including the use of cervical immobilization devices, KED, long boards, helmet removal, and infant and child immobilizations will also be demonstrated.

-7- Date: March 2, 2017 THURSDAY Lesson 16 (4 hours) Name & Level of Instructors: Musculoskeletal Care Part I - LAB: Discusses the signs and symptoms of fractures and dislocations of the pelvis, hips, and lower extremities, and also the principles and techniques of immobilizing injuries of the pelvis, hips, and lower extremities including the use of the Traction Splint Date: March 3, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 25, 26 ; Protocols Lesson 17 (4 hours) QUIZ # 6 Chapters 18, 19, 20, 21 Bleeding and Shock, Soft Tissue Trauma / Burns: Review the cardiovascular system, describe the care of a patient with either internal and/or external bleeding, the signs and symptoms of shock are to include the recognition of the signs and symptoms and the emergency care for an allergic reaction, and the emergency medical care for shock. Students are introduced to the Pneumatic Anti-Shock Garment (P.A.S.G.) and also called the Military Anti-Shock Trousers (M.A.S.T.). RI EMS Protocols. Reviewing the anatomy and physiology of the skin and the management of soft tissues injuries and burns. Techniques of dressing and bandaging are to be taught in this lesson. Date: March 7, 2017 TUESDAY Lesson 18 (4 hours) Name & Level of Instructors: Trauma Practical Skills Lab I - LAB: Can be used as practice or to evaluate the psychomotor skill development of a student. This includes an emphasis on the knowledge and skills required of all practical skill stations covered to date.

-8- Date: March 9, 2017 THURSDAY Chapters 22, 23, 24 ; Protocols Lesson 19 (4 hours) Name & Level of Instructor: Ronald Gagne, NREMT-P Abdominal Emergencies, Behavioral and Psychiatric Emergencies and Suicide, Hematologic and Renal Emergencies: Review the anatomy and physiology of the chest, abdomen, digestive system, and genitourinary system including the mechanism of injury, signs and symptoms of injury, and assessment; to include dressing and bandaging of the chest and abdomen. Date: March 10, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 30, 31 ; Protocol Lesson 20 (4 hours) Multisystem Trauma, Environmental Emergencies: Covers the emotional aspects of emergency care, stress management, introduction to Critical Incident Stress Management (CISM). Consideration when dealing with special patients; elderly, handicapped, psychologically distressed patients displaying abnormal behavior, and substance abuse patients. Explores dealing with death and dying and the emotional aspects of SIDS patients. Emphasizes the assessment and emergency medical care of heat and cold exposure. Information on aquatic emergencies and bites and stings will be included. MARCH 11 20, 2017 - SPRING VACATION NO CLASSES

Date: March 21, 2017 TUESDAY Name & Level of Instructors: Lesson 21 (4 hours) QUIZ # 7 Chapters 22, 24, 25, 26, 27-9- Evaluation Skills LAB I: Emphasizes the principles of immobilization, the knowledge to conduct an assessment and manage patients with traumatic injuries to include bandaging, splinting, use of traction splint, wire splint, padded board and pneumatic air splints. YOU CAN START YOUR RESCUE OBSERVATION RIDE TIME NOW Infants & Children & Geriatric Patients Date: March 23, 2017 THURSDAY Chapters 33, 34, 35 ; Protocols Lesson 22 (4 hours) Name & Level of Instructor: Ronald K. Gagne, Sr. NREMT-P MIDTERM REVIEW Pediatric Emergencies, Geriatric Emergencies, Emergencies for Patients with Special Challenges: Presents information concerning the development and anatomical differences in infants and children, discuss common medical and trauma situations. Discuss special needs of Geriatric patients. Also discuss patients with special challenges. Date: March 24, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapter 32 ; Protocol Lesson 28 (4 hours) Obstetrics & Gynecology Emergencies: Review the anatomy and physiological changes that occur during pregnancy differentiate between normal and abnormal deliveries, care of the neonate, review signs and symptoms of common gynecological emergencies. SIDS

-10- Evaluations I Date: March 28, 2017 TUESDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Midterm I Lesson 23 (4 hours) Midterm Written Exam: 6:00 pm - 7:00 pm Midterm Practical I: 7:00 pm - 10:00 pm MIDTERM EVALUATIONS PART I On Chapters 1-21 Name & Level of Instructors: Midterm Written and Practical Evaluations Part I: This is to evaluate the knowledge and psychomotor skill development of the students. This includes an emphasis on the knowledge and skill of all practical skill stations covered to date. -------------------------------------------------------------------------------------- Date: March 30, 2017 THURSDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Midterm II Lesson 24 (4 hours) Midterm Practical II: 6:00 pm - 10:00 pm MIDTERM EVALUATIONS PART II Name & Level of Instructors: Midterm Written and Practical Evaluations Part II: A continuation of the psychomotor skills from Midterm I testing. This is to evaluate the psychomotor skill development of students. This includes an emphasis on the knowledge and skill of all practical skill stations covered to date.

-11- Date: March 31, 2017 ( FRIDAY NIGHT ) Name & Level of Instructor: Ronald Gagne, NREMT-P Chapters 36, 37 Lesson 25 (4 hours) EMS Operations, Hazard Materials, Multiple-Casualty Incidents and Incident Management: Overview of the knowledge needed to function in the pre-hospital environment to include responding to a call, emergency vehicle operations, transferring patients, and the phases of an ambulance call. Documentation of RIEMS Ambulance Rescue Run Report Form, and the components of a communication system, radio communication, communications with medical direction, verbal communication, interpersonal communication, and quality improvement will be discussed. Also discussed are mass casualty incidents and Incident Management. Date: April 4, 2017 TUESDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Chapter 39 ; RI Protocol Appendix I Lesson 26 (4 hours) MANDATORY CLASS EMS Response to Terrorism: Introduces the major WMD agents and describes situation/scenarios where these agents could be encountered. Introduce the RI Major Incident Protocol. Discuss management of major incident scenes and the EMT s role in patient triage, evacuation, decontamination, care, and transportation. Discuss medical management of patients exposed to various types of WMD agents. Introduce BLS Major Incident medications, including administration of the Duo-Dote antidote auto injector with atropine and Pam 2. Date: April 6, 2017 THURSDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Chapter 39 ; RI Protocol Appendix I Lesson 27 (4 hours) MANDATORY CLASS Name & Level of Instructors: EMS Response to Terrorism Practical Skills Lab, PPE and Auto-Injectors: Demonstrate appropriate donning and doffing Level C PPE, including use of Positive Air-Purifying Respirator (PARR), Class III Bio-hazard suit. Cover limitations of Level C PPE. Practice in the practical skills of administration of the Duo-Dote antidote auto injector with atropine and Pam 2.

-12- NOTE: April 6, 2017 LAST DAY TO WITHDRAW FROM A CLASS TO RECEIVE A GRADE OF W. Date: April 7, 2017 ( FRIDAY NIGHT ) SNOW MAKE UP DATE OR FOR A CANCELLED CLASS DATE ONLY IF NEEDED Date: April 11, 2017 TUESDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Lesson 28 (4 hours) MANDATORY CLASS STATE PROTOCOLS CPR QUIZ Trauma Score Training / Patient Assessment / Situation Review: Discusses the Revised Trauma Score and allow for student practice. Review Mass casualty and Triage criteria to include the use of the triage tag systems. Emphasis on knowledge and skills required to perform Patient Assessment, CPR, Airway management, or any other skills identified by the instructor as needing re-emphasis. Date: April 13, 2017 THURSDAY Name & Level of Instructors: Lesson 29 (4 hours) Trauma Practical Skills LAB II: Practice of all skills learned to date with emphasis on the knowledge required and the skills to perform: KED, Long board, CPR, Airway Management, Traction Splint, Pneumatic Anti Shock Garment (P.A.S.G.), and both Medical and Trauma Patient Assessments.

-13- APRIL 14 17, 2017 - EASTER RECESS NO CLASSES Extrication / Gaining Access / Multi System Trauma / Highway Safety Date: April 18, 2017 TUESDAY Name & Level of Instructor: Ronald Gagne, NREMT-P Chapter 38 Lesson 30 (4 hours) MANDATORY CLASS QUIZ # 9B on Chapter 32 Highway Safety & Vehicle Extrication: Provides the EMT-Basic student with an overview of rescue operations to include the roles and responsibilities at a crash scene, equipment, gaining access, and removing the patient. Reinforces information on hazardous materials, incident management systems, mass casualty, and basic triage. Date: April 20, 2017 THURSDAY Name & Level of Instructors: Lesson 31 (4 hours) QUIZ # 9 Chapters 32, 33, 34 Lifting and Moving Patients Practical Skills - LAB: Emphasis on the knowledge of body mechanics, lifting and carrying techniques, principles of moving patients, and an overview of equipment. Practical skills of lifting and moving are required during this session. Date: April 21, 2017 ( FRIDAY NIGHT ) SNOW MAKE UP DATE OR FOR A CANCELLED CLASS DATE ONLY IF NEEDED

-14- Date: April 22, 2017 ( SATURDAY ) Name & Level of Instructors: Lesson 32 (4 hours) MANDATORY CLASS AFTERNOON SESSION - 12:00 NOON - 4:00 PM J. Deangelis, NREMT-P GLOVES AND EYE PROTECTION RECOMENDED NO OPEN TOE FOOTWEAR ALLOWED Extrication Practical Skills Auto Extrication - LAB: Emphasizes the knowledge and skills required to perform Patient Assessment, CPR, Airway Management, Pneumatic Anti-Shock Garment (P.A.S.G.), Traction Splint, spinal immobilization (KED and Long board), bandaging and splinting. Can be used as situation review or practical lab sessions. Students should be given the opportunity to perform these skills, including the actual removal of patients from vehicles. Date: April 25, 2017 TUESDAY Name & Level of Instructors: Lesson 33 (4 hours) QUIZ # 8 Chapters 27, 28, 29, 30, 31 J. Deangelis, NREMT-P Musculoskeletal Care Part II - LAB: Completion of the overview of the human body systems, anatomy physiology, and topographic anatomy. Include medical terminology specific to the body systems covered in this lesson. As previously stated, it is expected that specific body systems will be reviewed throughout the lectures of this training program. Date: April 27, 2017 THURSDAY Name & Level of Instructors: Lesson 34 (4 hours) QUIZ # 10 Chapters 33, 34, 35, 36, 37, 38, 39 Medical Emergencies Part II - LAB: Review the assessment of altered level of consciousness, emergency medical care of a patient with altered mental status, diabetes, RIEMS protocols and medication administration for altered mental status, and diabetes with an emphasis on Glucagon. Recognition of the signs and symptoms of poisoning and overdose. Emergency medical care for poison or overdose to include RIEMS protocols and medication administration with an emphasis on activated charcoal.

-15- Date: April 28, 2017 ( FRIDAY NIGHT ) Name & Level of Instructors: Lesson 35 (4 hours)? Open LAB: This class includes all materials discussed to date. Date: May 2, 2017 TUESDAY Name & Level of Instructors: Lesson 36 (4 hours) Evaluation LAB: Can be used as practice or to evaluate the psychomotor skill development of a student. This includes an emphasis on the knowledge and skills required of all practical skill stations covered to date. Date: May 4, 2017 THURSDAY Name & Level of Instructors: Lesson 37 (4 hours) Evaluation LAB: Can be used as practice or to evaluate the psychomotor skill development of a student. This includes an emphasis on the knowledge and skills required of all practical skill stations covered to date.

-16- YOUR 10 HOURS OF RESCUE OBSERVATION RIDE TIME YOUR MEDICAL FORMS YOUR I.C.S. 100.b, 200.b & 700.a YOUR BLUE SHEETS YOUR WHITE VITAL SIGNS SHEETS MUST BE COMPLETED AND TURNED IN TO ME BEFORE YOU CAN TAKE YOUR FINAL PRACTICALS Date: May 5, 2017 ( FRIDAY NIGHT ) Name & Level of Instructors: Lesson 38 (4 hours) MAKE UP NIGHT Evaluation II Date: May 9, 2017 TUESDAY Name & Level of Instructors: Lesson 39 (4 hours) Course Review - LAB: Review the course contents by either group discussion or situation review.

-17- Date: May 10, 2017 ( WEDNESDAY ) Name & Level of Instructors: Lesson 40 (4 hours) 10 10 10 10 10 Date: May 11, 2017 ( THURSDAY ) 11 Lesson 41 (4 hours) 11 11 11 11 11 11 FINAL PRACTICAL SKILLS EXAMINATION A comprehensive examination to include all aspects of the practical skills required too function as an EMT. Date: May 16, 2017 TUESDAY Lesson 42 (4 hours) START TIME FINAL WRITTEN Name & Level of Instructor: Ronald Gagne, NREMT-P 5:00 PM EXAMINATION A comprehensive written examination to include all the aspects of the National EMT Curriculum.

-18- MINIMUM OF THREE REQUIRED ON-LINE ICS COURSES THAT MUST BE COMPLETED BEFORE THE END OF THE SEMESTER ICS - 100.b ICS - 200.b ICS - 700.a On-line Course Completion Due Dates: ICS-100.b - On-Line Certificate completed and turned in by February 28, 2017 ICS-200.b - On-Line Certificate completed and turned in by March 31, 2017 ICS-700.a - On-Line Certificate completed and turned in by April 30, 2017 EXTRA CREDIT will be given upon the completion of: ICS - 200.b - Add 5 Points onto your Midterm Exam grade if completed by March 30, 2017 Complete ALL of the Chapters in the Workbook. 5 Points will be added to your final exam grade if completed by May 16, 2017 RESCUE RIDE TIME REQUIREMENTS Students will not be able to do their observation ride time until Midterm Evaluations. You will need to have completed and turned in your CCRI Immunization Paperwork. NOTE: It will take a minimum of at least two weeks to complete all of your required documentations including your proof of immunizations, all titer bloodwork, two separate PPD testing s at least two weeks apart, color blind testing, and a physician s physical examination stating that you are both mentally and physically able to participate in both classroom and observation ride time activities. It is recommended that you begin your medical paperwork process very early on in this program, because you will not be able to complete this program until your medical paperwork and your Rescue ride time are completed and turned in to me.