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Airway Training Form
Airway Training Form
Date of Scenario
*
MM slash DD slash YYYY
Medic Name
*
First
Last
Medic Email
*
Credentialing Level
*
EMTB-1
EMTB-2
AEMT-1
AEMT-2
EMTP-1
EMTP-2
EMTP-3
EMTP-4
Medical Consult
Airway Refresher Type
*
Basic Airway Adjuncts & EGD (EMTB-1, EMTB-2, AEMT-1, EMTP-1)
Advanced Airway Skill Demonstration (AEMT-2, EMTP-2 Attendant)
Advanced RSI & Ventilator Mgmt (EMTP-3, EMTP-4)
Airway Remediation Training
Airway Trimester (for advanced only)
T1 (Jan-Apr)
T2 (May-Aug)
T3 (Sep-Dec)
Scenario Trainer Name
*
First
Last
Scenario Trainer Email
*
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