Command Authorization Testing (CAT) 1999
Summary of Information

Why?

Yearly Command Authorization Testing is required by the State.

When/Where?

Testing to begin in October.  The location has been moved to UPMC Southside.  Please call EMS training for the room 255-2450

Who?

In order to provide patient care a paramedic must have command authorization. All paramedics, field supervisors and training personnel are required to successfully complete CAT.

Exceptions will be made in the case of unforeseen emergencies, disasters, and where the medical condition of the employee does not permit full participation in training or testing.

What

CAT for 1999 will consist of the following:

* Skills Testing

    1. Skills
      1. Oral endotracheal intubation
      2. Combitube
      3. Defibrillation/Cardioversion
      4. External pacing
    2. Criteria for successful completion
      1. Medics will be provided with a skills check sheet prior to testing
      2. A passing score for each element of the skills check sheet will be required to pass the skills exam.
      3. Errors will be ranked as follows:



 
Error level
Example
Remediation Required
Command 

Authorization
1
Failure to verbalize universal precautions
Immediate retest
Granted, if retest is passed
2
Poor performance of skill but adequate knowledge of procedure. Unable to intubate mannequin but medic follows the proper sequence.
Retest the same day
Granted, if retest is passed
3
Poor performance of skill and poor knowledge of procedure. Unable to initiate pacing and little knowledge of pacer use
Retest within 3 weeks, remediation at Training may be required.
Provisional command authorization granted for 3 weeks. Failure to remediate with in 3 weeks will result in loss of command authorization
4
Critical error that could jeopardize the life of a patient or the safety of the paramedic or crew.
Retest within 3 weeks, remediation at Training will be required.
Immediate loss of command authorization until remediation occurs
Notes: 

Failure on retest of level 1 or 2 errors will require remediation as per a level 3 error.  Failure on retest of level 3 or 4 errors will result in loss of command authorization until remediation is successfully completed.

* Written Testing (by training Staff)

    1. Open book protocol review test to include Adult and Pediatric Protocols
    2. Criteria for successful completion
      1. A minimum score of 80% required to pass
      2. A score of less than 80% will require a retest within 3 weeks to maintain command authorization
 

* CME Review (by training Staff)

1. Successful completion of all monographs for 1998-99

 2. Review of State required CME hours

3.  Review of Status of ACLS, BTLS, PALS courses

Criteria for successful completion

All monographs must be completed within 3 weeks of testing to maintain command authorization

A plan for successful completion of CME and course will be discussed with the individual medic

Adequate numbers of CME hours are required by the State

 

* Skills review - This is strictly a review, there are no minimum requirements, i.e., number of IVs, intubations, etc. 

1. Review Skills performed in 1999 as per EMMA trip sheet program
 


The term MDOC refers to the Medical Direction Committee for the City of Pittsburgh EMS. The members of the Medical Direction Committee include MD numbers 1-5, Devon Davis, Scott Harrington and Paul Beck.