NATS & UCD to train Ireland’s First EMT-As in 2004


The National Ambulance Training School (NATS) in affiliation with University College Dublin (UCD) has successfully submitted a course for the implementation of EMT-training in Ireland. The course has been evaluated by an independent consultant and reviewed by PHECC’s Accreditation Committee and Council. Council at its December meeting gave approval for three development courses to occur in the first year of EMT-A training.


The training and operational costs of EMT-A training have been determined and provided to the Department of Health and Children (DoHC). The Department has agreed that PHECC is the appropriate body to disburse and monitor the training component of the funding. We are awaiting confirmation of informal advice from the Department that the funding is to be made available in early 2004.

In addition PHECC has agreed to fund NATS for two overseas trained paramedic instructors and one additional faculty member to assist in the implementation and development of EMT-A training in the first year.

Revision of S.I.

The DoHC is progressing the revision of the PHECC Statutory Instrument (S.I.) The revised S.I. contains key amendments in relation to the PHECC Register and a Fitness to Practice Committee. These need to be in place before the Medicinal Products and Controlled Substances regulations can be amended to allow the administration of medications by EMT-As and indeed EMTs.

Operational Implementation

PHECC commissioned an external consultant to outline several potential models of EMT-A deployment and these will inform the training during the refinement of the course during the first year. Furthermore, these models have been provided to the Working Group formed by the Health Board CEOs to consider issues such as the selection and deployment of EMT-As. PHECC is represented at the Working Group meetings.

EMT-A is now Government Policy

EMT-A is now Government Policy, and was launched by the Minister at the AAP Conference in Limerick in March last year. The Hanly Report gives clear indications as to the extent that government expects EMT-A to be implemented. It is worth noting that every resolution concerning EMT-A considered by the Council and Committees and Working Group (Clinical Care Committee, Accreditation Committee, Medical Advisory Group) of PHECC has been carried without dissent since Council was established in 2000. This built on the excellent work of the National Ambulance Advisory Council following the Report of the Review of the Ambulance Service, 1993.

This consensus was reflected in the consultations when PHECC visited every ambulance station in Ireland in 2002.

All the best to NATS and UCD in what will be a big year for them and for pre-hospital emergency care in Ireland.

NQEMT Examination

The first NQEMT Examination was held in October 2002 and the most recent in November 2003. In all five examinations have been held with 102 candidates. Unsuccessful candidates are permitted to repeat the NQEMT exam on two more occasions.

The NQEMT Examination consists of four sections;

MCQ (120 test items)
Short answer (6 questions to answer)
Primary skills (six skills)
Secondary skills (eight skills randomly chosen)

Section 1

Section 1 consists of 120 MCQs, to be completed within 1.5 hours, presented to the candidates on a computer programme. Candidates are offered an EMT-Aopportunity to sit a mock MCQ examination to familiarise themselves with the MCQ computer programme.

To date 101 of the total 102 candidates have passed Section 1, 91 on their first attempt, 7 on their second attempt and 3 on their third attempt.

Section 2

Section 2 consists of 6 short answers, to be completed within 2 hours. Question one (cardiac management), question two (airway or trauma management) and question three (medical emergency management) are compulsory. The candidate has then to complete three of six questions which may be from any part of the syllabus.

To date 95 of the total 102 candidates have passed Section 2, 83 on their first attempt, 10 on their second attempt and 2 on their third attempt.


The Medical Advisory Group (MAG) of PHECC are finalising the Clinical Practice Guidelines (Advanced) and Medication Formulary to support the training and implementation of EMT-A.

Section 3

Section 3 consists of 6 primary skills assessments. Each skill to be completed within 8 minutes. The primary skills are as follows;

Automated External Defibrillator (AED) use in cardiac arrest
Airway management
Cardiopulmonary Resuscitation (CPR)
Haemorrhage control
Initial patient assessment
Patient assessment skills

Section 4

Section 4 consists of 8 secondary skills selected at random for each examination from the skills assessments published by PHECC. Section 3 and section 4 are completed together in a circuit, each skill to be completed within 8 minutes.

In general primary and secondary skills assessments have not presented difficulties for candidates and candidates who have been offered resits perform particularly well on the resits.

Examination Review

To mark the first completed year of NQEMT Examinations and to identify and implement opportunities to quality improve the content and conduct of the examination, PHECC is conducting a thorough review of all aspects of the NQEMT Examination. This will build on the external review of the first examination by Professor Paul Finucane, Director of Competence Assurance at the Medical Council, and ensure the integrity of the NQEMT Examination into the future.