Fillable College Of Southern Nevada Paramedic Program Application Packet (CSN)

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College Of Southern Nevada Paramedic Program Application Packet (CSN)

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College of Southern Nevada
Paramedic Medicine Program
Application Packet
Fall 2021
West Charleston Campus
6375 W. Charleston Blvd.
Las Vegas, NV 89146
Room B 205
(702) 651 - 5807
The College of Southern Nevada (CSN) Paramedic Program is accredited by the Commission on
Accreditation of Allied Health Education Programs (www.caahep.org) upon the
recommendation of the Committee on Accreditation of Educational Programs for the
Emergency Medical Services Profession (CoAEMSP)
1
Table of Contents
Paramedic Medicine Overview .............................................................................................................................................. 3
Program Information .......................................................................................................................................................... 3
Program Description ........................................................................................................................................................... 3
Paramedic Job Functions .................................................................................................................................................... 3
Career Opportunities .......................................................................................................................................................... 3
Program Expense Estimate .................................................................................................................................................... 4
Application Process ................................................................................................................................................................ 5
Application Checklist........................................................................................................................................................... 6
Application Form................................................................................................................................................................. 7
Experience Form ................................................................................................................................................................. 9
Sample Letters...................................................................................................................................................................... 10
Intent to Host Paramedic Internship................................................................................................................................. 10
Current Standing in Course ............................................................................................................................................... 11
Paramedic Program Advising Meeting.............................................................................................................................. 12
Required Vaccines & TB Skin Testing................................................................................................................................... 13
Selection Criteria .................................................................................................................................................................. 14
Application Review Process ................................................................................................................................................ 15
2
Paramedic Medicine Program Information
We are dedicated to preparing students with the necessary skills, through both theory and practice, to meet
the needs required of an EMS professional both locally and nationally. The Paramedic Medicine Program at
CSN meets or surpasses all the local and national formal education requirements through a comprehensive
breadth and complex depth of study in advanced life support.
Successful completion of the program can lead to either a Certificate of Achievement (C.O.A) or an Associates
of Applied Science (A.A.S.) in Paramedic Medicine from CSN and concurrent eligibility for professional
certification through the National Registry of Emergency Medical Technicians (NREMT) as well as local
licensure through the Southern Nevada Health District (SNHD) at the paramedic level.
CSN Paramedic Program Description
The CSN Paramedic Program is limited to 24 students per cohort; alternates may be selected and placed on a
waiting list. The selection process ensures unbiased review of all applicant qualifications, with significant
emphasis placed on applicants with prior 911 experience, national AEMT certification, and a confirmed
internship sponsor with a local 911 provider. Complete selection criteria can be reviewed later in this packet.
Upon acceptance into the program, candidates should expect to be in classes 2-3 days a week for nine (9)
hours*, in clinical rotations one day a week for four (4) to twelve (12) hours, and require study time of up to
thirty-six (36) hours per week. This is a rigorous program; maintaining full-time employment throughout the
duration of coursework will prove to be challenging and cannot interfere with required class or clinical time.
Paramedic Job Functions
The paramedic is an important health care worker providing highly skilled care to the patient before he or
she arrives at a hospital facility. In many instances, the care provided for the patient in the pre-hospital
setting means the difference between life and death. The field of emergency medicine is the ideal field for
that individual who is seeking a physically and mentally stimulating occupation and who enjoys helping
people during crisis situations. Some of the responsibilities routinely performed by a paramedic include:
• Demonstrating technical competence in all basic and advanced life support emergency care
interventions within the national scope of practice model
• Analyzing emergency situations and assessing patients utilizing a systematic approach
• Developing and implementing a prehospital patient care plan as the medical leader on a multi-
disciplinary team of public safety personnel
• Displaying values consistent with the professional identity of a paramedic
Paramedics represent the highest nationally recognized level of pre-hospital emergency medical services
provider. They are expected to be capable of performing the same essential functions as all other CSN EMS
students. The full list of essential functions can be reviewed on the CSN EMS website.
Career Opportunities
The CSN Paramedic Medicine Program is designed for those students seeking a career in the pre-hospital
emergency setting. The field has expanded rapidly in recent years and well-qualified technicians are in
demand. Average salary for emergency medical technicians and paramedics in Nevada ranges from $9.17 -
$24.35 per hour, with a median salary of $18.41 per hour. This information was gathered from
nevadaworkforce.com based on 2016 data.
3
*see proposed schedule
CSN Paramedic Program Expense Estimate
CSN General Expenses
Application Fee
For CSN admission
$20.00
New Student Fee
First-time CSN students
$20.00
Non-Resident Fee
Non-Nevada residents
$3843.00/semester
Excess Credit Fee
Students with more than 91 credits, no degree
$54.88/credit
E-learning Fee
Online course fee
$10.00/online course
Pre-Program Expenses
Clinical Scheduler/Tracker
Information provided at orientation
$84.00
Drug Screen
To be completed upon acceptance
$35.00
Background Check
To be completed upon acceptance
$49.50
CPR Card
AHA BLS Provider
$00.00 - $80.00
Uniforms
CSN EMS Uniform or Sponsor Uniform
$00.00 - $150.00
Equipment
Watch, Stethoscope, Trauma Shears, Calipers
$10.00 - $250.00
Medical Insurance
Maintained throughout program
$0.00 - $500.00/month
Physical Exam
Completed on CSN form; good for 1 year
$0.00 - $75.00
†
†
†
†
†
†
†
†
Immunizations
See Vaccines (page 13)
$0.00 - $600.00
†
Core Course Expenses
Textbooks
Tuition & Fees FA21
Tuition & Fees SP22
Tuition & Fees SU22
Tuition & Fees FA22
Available at CSN Charleston Campus Bookstore
15 credits in CSN tuition & fees / *EMS lab fees
15 credits in CSN tuition & fees / EMS lab fees
7 credits in CSN tuition & fees / EMS lab fees
3 credits in CSN tuition & fees / EMS lab fees
$79.20 - $1356.15
$1993.75
$2018.75
$914.75
$387.75
$
Additional Course Expenses
Pre/Corequisite Courses
6 credits in CSN tuition & fees
C.O.A. Additional Course
3-5 credits in CSN tuition & fees
A.A.S. Additional Courses
19-21 credits in CSN tuition & fees
$805.50
$378.75 - $646.25
$2455.75 - $2714.25
$$
$$
$$
Professional Expenses
NREMT Psychomotor Exam
SNHD Provisional Licensure
SNHD Fingerprinting
NREMT Cognitive Exam
SNHD Licensure
Completed at end of summer semester
Completed before beginning an internship
For new SNHD EMS providers
Completed after Passing EMS 173
For local 911 paramedics
$300.00
$61.00
$71.25
$152.00
$99.00
†
†
†
†
† Paid to a third-party vendor, not the College of Southern Nevada
$
Cost may vary if renting texts, buying used texts, or buying from other vendors
$$
Does not include any additional course-specific fees, equipment, or textbooks
4
Paramedic Program Applicant Process
1. Obtain an Emergency Medical Technician (EMT) certificate
a. Local, State, and National certifications/licenses are all accepted
b. Preference will be given to applicants with a NREMT Advanced EMT certificate
2. Apply to the College of Southern Nevada as a student
a. Transfer in all credits from outside institutions and
b. Verify if prerequisite course(s) requirements are met
3. Schedule an advising meeting
a. With the EMS Program Director or
b. With an EMS full-time faculty member
4. Complete the application packet
a. Attach all requested forms, transcripts, letters, & copies then
b. Seal all materials in ONE envelope, put your name and NSHE ID on the outside
5. Turn the completed application into the EMS offices: Fall 2021 Due Date = July 1!
a. Administrative Assistant or
b. Program Director or
c. Full-time Faculty Member
6. Check your provided email for important updates
a. Notification of an incomplete application packet or your calculated selection criteria score will
be sent within three (3) weeks of application submission
b. Notification of your admission status will be sent within three (3) weeks after the application
deadline
7. Confirm or deny your acceptance by submitting the completed form: ONE week to accept!
a. Electronically or
b. Physically
8. Prepare
a. Mark the orientation date on your calendar! Be there!!! and
b. Rearrange employment schedules and
c. Save for tuition, fees, books, uniforms, & equipment and
d. Obtain proof of required vaccines
5
Paramedic Application Checklist
A completed application will contain ALL the following documents. Illegible copies, unofficial transcripts, and
incomplete documents will not be accepted. Notification of an incomplete application will be emailed to the
applicant within three (3) weeks of submission.
☐ Paramedic Medicine Program Application Form
☐ Proof of Advising Meeting
☐ Copy of current, valid EMT/AEMT certificate/licensure
☐ Copy of AHA BLS Provider CPR Card
☐ Official College Transcripts* (unofficial transcripts acceptable from CSN only)
☐ EMS/Healthcare Experience Form
☐ Letter(s) of Recommendation
*Applicants with additional coursework still in progress at the time of application will need to
submit
☐ Proof of Registration and Expected End Date
☐ Faculty letter of current standing in course(s)**
Additional documents (optional) which will be used to boost selection criteria score.
☐ Letter of Intent to Host a Paramedic Internship upon Program Completion**
☐ Copy of military ID card
**Sample letter(s) follows in packet, though any official letter from an instructor/agency representative
will be accepted.
6
Paramedic Medicine Program Application Form
APPLICANT INFO
Name:
Home Address:
City:
Email:
Date of Birth:
State:
Phone:
Zipcode:
SSN:
NSHE ID:
EMERGENCY CONTACT
Name: Relationship: Phone:
EDUCATION (complete all that apply; proof of highest graduation must be attached)
High School: City: Graduation Date:
College: City:
Highest Degree Awarded: Completion Date:
EMPLOYMENT (last 5 years, most recent first)
Employer:
From: Until:
Supervisor:
Status: Full Time Part Time Per Diem
Employer:
From: Until:
Supervisor:
Status: Full Time Part Time Per Diem
Employer:
From: Until:
Supervisor:
Status: Full Time Part Time Per Diem
PERSONAL STATEMENT
The reason I want to attend the CSN Paramedic Medicine Program is:
7
No Degree
Employer/CSN Communications
While enrolled in the paramedic program, do you plan on maintaining employment? ☐ Yes ☐ No
If you are accepted into the program and are employed with an EMS or fire agency - do you give the CSN EMS
faculty permission to discuss your progress with your agency’s Clinical Director/Manager or Chief of EMS as it
relates to your cognitive, psychomotor, or affective domain? ☐ Yes ☐ No
Criminal History
If you have been convicted of any type of felony crime, it is strongly advised you immediately contact the
Southern Nevada Health District Office of EMS Training and/or the National Registry of EMTs. Some felony
convictions will result in denial of licensure or certification as a paramedic or the ability to sit for these
examinations.
I have read the above statement and understand that both clinical placements and professional
certification/licensure is privilege not a right, which may be affected by my criminal background.
☐ Yes ☐ No
Program Expenses
I have reviewed the expected program expenses and understand that these are the responsibility of myself or
my sponsor. I realize that certain program activities, such as clinical rotations or internship placement, cannot
be started until all requirements have been met. It is my responsibility to ensure timely completion of all
program requirements and failure to do so may result in my removal from the paramedic medicine program.
☐ Yes ☐ No
Attestation
I attest that all the information on the application is accurate and complete to the best of my knowledge. I also
understand that falsification of any part of the paramedic medicine program application will result in
denial/removal from the paramedic medicine program and/or the College of Southern Nevada.
☐ Yes ☐ No
Printed Name
Signature
Date
8
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Paramedic Medicine Program Experience Form
APPLICATION INFORMATION
Applicant Name:
NSHE ID:
Program Track:
☐
Regular
☐
Academy
Program Year:
PAID 911 EMS EXPERIENCE
How many months have you worked as a paid, full-time, 911 EMS provider?
How many months have you worked as a paid, part-time, 911 EMS provider?
Agency:
Contact Person:
Your Position:
Phone:
Agency:
Contact Person:
Your Position:
Phone:
OTHER PRE-HOSPITAL EXPERIENCE
How many months have you spent as a pre-hospital EMS provider (not included above)?
(non-911 ambulance service, volunteer EMS agency, casino EMT, etc.)
Agency:
Contact Person:
Your Position:
Phone:
OTHER MEDICAL EXERIENCE
How many months have you spent as any other type of healthcare provider?
(non-EMS = ER tech, scribe, medical assistant, etc.)
Agency:
Contact Person:
Your Position:
Phone:
With my signature below, I attest that the above information is accurate and complete to the best of my
knowledge. I also understand that falsification of any part of the paramedic medicine program application will
result in denial/removal from the paramedic medicine program and/or the College of Southern Nevada.
Printed Name
Signature
Date
9
Fall 2021
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signature
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Intent to Host a Paramedic Internship
From:
Agency:
Phone:
Email:
To: CSN Paramedic Medicine Program Admissions
6375 W. Charleston Blvd.
Las Vegas, NV 89131
(702) 651 – 5807
ems@csn.edu
Dir Sir or Madam,
I am submitting this letter of intent to host a paramedic internship for ,
who is applying to your Paramedic Medicine Program in . With this letter the agency listed
above agrees to host the paramedic candidate upon successful completion of all CSN paramedic courses
except EMS 173 – which is the paramedic internship.
This letter is contingent on the paramedic candidate continuing to abide by all agency-specific rules,
regulations, policies, and procedures. It does not guarantee a specific time frame for the hosting of such an
internship, or dictate the financial circumstances under which the internship may be conducted.
While this letter may be revoked at any time by the sponsoring agency, at this time, the applicant listed above
has met or exceeded any internal agency requirements for a paramedic internship, and is therefore currently
extended the offer a future paramedic internship.
Sincerely,
Printed Name
Signature
Date
10
Fall 2021
Current Standing in Course
From:
Title:
Phone:
Email:
To: CSN Paramedic Medicine Program Admissions
6375 W. Charleston Blvd.
Las Vegas, NV 89131
(702) 651 – 5807
ems@csn.edu
Dir Sir or Madam,
I am submitting this letter on behalf of , who is applying to your
Paramedic Medicine Program in . They are a current student in my course:
, which will end by
.
Right now, this student has a
grade in this course, which I
believe will be the same at the end of the course.
Sincerely,
Printed Name
Signature
Date
11
Fall 2021
HHP 123
Passing
Do
Paramedic Program Advising Meeting
From:
Title:
Phone:
Email:
To: CSN Paramedic Medicine Program Admissions
6375 W. Charleston Blvd.
Las Vegas, NV 89131
(702) 651 – 5807
ems@csn.edu
Dir Sir or Madam,
I am submitting this letter on behalf of , who is applying to your Paramedic
Medicine Program in .
I have reviewed with them the program structure, time requirements, associated costs, and application
requirements and deadlines. At the time of our meeting, the applicant demonstrated completion of the
following requirements (initial all applicable boxes):
☐ Application ☐ EMT ☐ AHA CPR ☐ Transcripts ☐ Experience Form ☐ Reference Letter ☐ Internship Letter
They understand all application requirements are solely their responsibility, and that incomplete applications
may delay or prevent admission to the program. They have been instructed to contact me with any additional
questions they may have regarding their application to the program.
Sincerely,
Printed Name
Signature
Date
12
Fall 2021
Vaccinations
ALL students are required to complete immunizations or provide in writing a written exemption to the
vaccination policy. A student claiming medical or religious exemption may not be able to complete clinical
portions of a health sciences program required for graduation. A consultation with the program director
PRIOR to enrolling in a health sciences program is required of any student claiming either exemption.
Required Vaccines
Documentation of all immunity requires health records which show specific dates of the disease on medical
diagnosis or specific dates when the vaccine(s) were administered. Health records may be in the form of
original vaccination records or the required information may be provided by the original treating physician on
official letterhead/prescription form or similar with a legal signature. School records, baby books, or family
testimonials are not official documentation.
VACCINE
REQUIRED DOSAGE
ALTERNATIVE
Hepatitis
B
3 Doses
1
st
initial dose administered
2
nd
administered 28 or more days after initial dose
3
rd
administered 8 or more weeks after dose 2
(3
rd
dose should be separated from 1
st
does by at
least 16 weeks)
History of the
disease based on
diagnosis or
verification of the
disease by a
Measles,
2 Doses
Mumps, 1
st
initial dose administered
healthcare provider
Rubella 2
nd
administered 28 or more days after initial dose
through laboratory
(MMR)
blood testing
affirming serologic
evidence of
immunity.
Varicella
2 Doses
1
st
initial dose administered
2
nd
administered 28 or more days after initial dose
TDaP
1 Dose
Administered within the last ten years
TB Skin Test
ALL students must have a two-step TB Skin Test (TST) maintained throughout the duration of the program. The
Centers for Disease Control and Prevention recommends: Administer Step One - Read results 48-72 hours
later; Then, Administer Step Two a minimum of seven (7) days after administration of the first step - Read the
results 48-72 hours after administration. A Two-step TB test consists of TWO injections and TWO readings.
Two single TB skin Tests performed within 365 days is acceptable regardless of the time interval between the
two steps.
If a student has a documented history of positive TB Skin Tests, or has a newly positive TST, they should
consult the Engelstad School of Health Sciences (ESHS) TB Skin Test policy for further direction. The policy can
be located on the CSN ESHS website.
13
Selection Criteria
Selection for the Paramedic program will be accomplished by the EMS Committee using the following criteria.
GPA*
X Credit Hours
x 0.10
/20 max
Internship
Agreement
☐ No (0) ☐ Yes (12)
/12 max
Paid, FT 911
months
x 0.083
/4 max
Paid, PT 911
months
x 0.041
/4 max
Other Exp.
months
x 0.041
/2 max
Letter(s) of
Reference
1 point each /3 max
Preferred
Certs.
☐ CSN EMT (1) ☐ NR-EMT (1) ☐ CSN AEMT (1) ☐ NR-AEMT (2)
/4 max
Military/Veteran (2)
Total
/ 51 max
*GPA will be based on a 4.0 GPA scale and include all prior coursework for the highest degree attempted.
Selection criteria score will determine the applicant’s rank in the program admission process. In the event of a
tie in accumulated points, the priority will be given to the applicant:
1. First to the applicant which has a documented EMS agency sponsorship agreement for the internship
2. Second, to the applicant seeking the Associate in Applied Sciences degree of Paramedicine
3. Finally, by the EMS committee consensus decision based on a full review of all tied applicants
Tied accumulated selection criteria points, and subsequent program candidate selection, only becomes a
factor when there are more applicants than seats available in the program.
Calculating EMS Faculty
Signature
DateReviewing EMS Faculty
Date
Signature
14
Paramedic Application Review Process
Initial Review
Upon receipt of an application, a member of the EMS committee will begin initial review of the application.
This review will be completed within three (3) weeks of application submission or application deadline
(whichever occurs first). The primary selection criteria score will be determined based on submitted
documentation, and the score will be sent to the applicant by email no later than twenty-two (22) days after
application submission. In that same initial review timeframe, if an application is deemed to be incomplete,
notification of the incomplete application will also be sent to the applicant via email.
Complete Applications
Complete applications will include at a MINIMUM the following documents:
Paramedic Program Application (with active NSHE ID and valid email address)
Copies of current/valid EMT/AEMT certificates/licensures
Copy of the American Heart Association BLS Provider CPR Card
EMS/Healthcare Experience Form
Letter of Advising Meeting
One Letter of Recommendation
Official College Transcripts (demonstrating completion of pre-requisite course(s))
Additional form(s) and letter(s) may/must be submitted along with these minimum requirements as outlined
for consideration on the application checklist and in under selection criteria.
Incomplete Applications
Applications missing one or more of the minimum forms above, will be marked incomplete. Notification of an
incomplete application will be sent to the applicant via email within twenty two (22) days of application
submission, or application deadline (whichever comes first). Incomplete applications will not be considered for
Paramedic Program candidate selection unless there are less applicants than seats available in the program
Applicant Ranking/Candidate Selection
Once the application deadline has occurred, the EMS committee will schedule a meeting to review all
applications. The review meeting will occur no more than three (3) weeks after the application deadline. At
the review meeting, the EMS committee will review all initial selection criteria calculations for accuracy and
rank applicants based on cumulative score. All ranking of applicants will be done according to the selection
criteria outlined, no additional/subjective/anecdotal information about applicants will be used to determine
the rank/admission of an applicant.
The highest ranked applicants will be selected for acceptance first, with all other complete applications being
considered in rank order until all available positions in the program have been filled. Incomplete applications
will only be considered after review and ranking of all complete applications. Applications which have
outstanding pre-requisite coursework/certification will be scored based on submitted complete requirements,
possibly resulting in a lower total selection criteria score.
At the conclusion of the EMS committee meeting, all accepted applicants will be notified by email of their
acceptance, the program orientation date, and the courses in which to enroll. Applicants with outstanding pre-
15
requisite coursework/certification will be awarded contingent acceptance and will be required to provide
proof of all in-progress requirements by the program orientation date.
Any applicants that were not selected for acceptance, will be notified of either the reason for their rejection or
their rank and standing on the program waiting list should an accepted student decline admission. Any
candidate who wishes to review their applicant selection documents and ranking, must submit a request in
writing to the program director within three (3) weeks of their admission/rejection from the program.
Admission Acceptance
Once acceptance has been granted, candidates will notify the program director of their intent to enroll within
one (1) week of the acceptance notification being sent. After one (1) week, the program director will assume a
declination of acceptance has occurred, and will begin offering the program seat to the highest ranked
applicants on the waiting list.
If all program seats have not been filled, additional applications will be considered on a first-come, first-served
basis up until the program orientation date. Applications not received by the program orientation date, will
only be considered if program seats remain, and at the explicit discretion of the Program Director.
16
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College Of Southern Nevada Paramedic Program Application Packet (CSN)

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