NOTICE OF BACKGROUND CHECK
IMPORTANT -- PLEASE READ CAREFULLY BEFORE CONFIRMING BELOW
Note: Conducting a Social Security Trace does not access the subject’s credit history nor affects the subject’s credit score or credit rating.
Please note that by signing below you are authorizing and instructing an immediate criminal background and driving record reports from a third party (utilizing a Social Security Number trace) as deemed necessary and appropriate. Moreover, you are allowing reports from a third party on an ongoing basis without any additional notice for as long as you are a member.
AUTHORIZATION AND INSTRUCTION
I acknowledge receipt of the NOTICE OF BACKGROUND CHECK and certify that I have read and understand that notice. I hereby authorize and instruct ProAction to obtain criminal background and/or driving record reports from a third party (utilizing a Social Security Number trace) as deemed necessary and appropriate. This authorization and instruction will take immediate effect when I sign below, and will last throughout the duration of my involvement as a volunteer member. Accordingly, you may obtain additional criminal background and/or driving record reports from a third party on an ongoing basis throughout my association with your organization without any further notice or additional warning. To this end, I hereby authorize without reservation any law enforcement agency, administrator, local, state or federal agency, information service bureau and/or the Social Security Administration to furnish any and all background information (including criminal history and/or driving records and not credit history) requested by Backgroundchecks.com, another outside organization acting on your behalf. I agree that a facsimile (“fax”) or photographic copy of this Authorization and Instruction shall be as valid as the original.
To qualify for EMS certification or licensure an individual must successfully complete a State approved course and achieve competency in each of the psychomotor skills. In addition the individual must achieve a passing score on the state written certification or licensure examination. EMS personnel must be at least 18 years of age. Generally, the knowledge and skills required show the need for a high school education or equivalent. EMS personnel must have the:
-Ability to communicate verbally via telephone and radio equipment
-Ability to lift, carry and balance up to 125 pounds (250 pounds with assistance)
-Ability to interpret written, oral and diagnostic form instructions
-Ability to use good judgment and remain calm in high-stress situations
-Ability to work effectively in an environment with loud noises and flashing lights
-Ability to function efficiently throughout an entire work shift
-Ability to calculate weight and volume ratios and read small print, both under life threatening time constraints
-Ability to read and understand English language manuals and road maps
-Ability to accurately discern street signs and address numbers; ability to interview patient, family members and bystanders
-Ability to document, in writing, all relevant information in prescribed format in light of legal ramifications of such
-Ability to converse in English with coworkers and hospital staff as to status of patient.
-EMS personnel should possess good manual dexterity, with ability to perform all tasks related to highest quality patient care. Ability to bend, stoop and crawl on uneven terrain and ability to withstand varied environmental conditions such as extreme heat, cold and moisture is vital. The ability to work in low light, confined spaces and other dangerous environments is required.
Description of Tasks:
-Receives call from dispatcher, responds appropriately to emergency calls, reads maps, may drive ambulance to emergency site, uses most expeditious route and observes traffic ordinances and regulations.
-Determines nature and extent of illness or injury, takes pulse, blood pressure, visually observes changes in skin color, auscultates breath sounds, makes determination regarding patient status, establishes priority for emergency care, renders appropriate emergency care (based on competency level); may administer intravenous drugs or fluid replacement as directed by physician.
-May use equipment (based on competency level) such as but not limited to, defibrillator, electrocardiograph, performs endotracheal intubation to open airway and ventilate patient, inflates pneumatic anti-shock garment to improve patient’s blood circulation or stabilize injuries.
-Assists in lifting, carrying, and transporting patient to ambulance and on to a medical facility.
-Reassures patients and bystanders, avoids mishandling patient and undue haste, searches for medical identification emblem to aid in care.
-Extricates patient from entrapment, assesses extent of injury, uses prescribed techniques and appliances, radios dispatcher for additional assistance or services, provides light rescue service if required, provides additional emergency care following established protocols.
-Complies with regulations in handling deceased, notifies authorities, arranges for protection of property and evidence at scene.
-Determines appropriate facility to which patient will be transported, reports nature and extent of injuries or illness to the facility, asks for direction from hospital physician or emergency department.
-Observes patient in route and administers care as directed by physician or emergency department or according to published protocol.
-Identifies diagnostic signs that require communication with facility.
-Moves the patient into the emergency facility from the ambulance.
-Reports verbally and in writing concerning observations about the patient, patient care at the scene and in route to facility, provides assistance to emergency staff as required.
-Maintains familiarity with all specialized equipment.
-Replaces supplies, sends used supplies for sterilization, checks all equipment for future readiness, maintains ambulance in operable condition, ensures ambulance cleanliness and orderliness of equipment and supplies, decontaminates vehicle interior, determines vehicle readiness by checking oil, gasoline, water in battery and radiator and tire pressure.
If authorization is granted, it shall remain valid until cancelled. The student may cancel this release at anytime by submitting another FERPA release form to ProAction Emergency Services Institute.