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Regional Sanctioning – What is it and how do I get it?

The realm of EMS has continued to evolve and strengthen over the decades, and finding a mechanism to coordinate a diverse group of agencies that involve medical care, fire suppression, hazmat response and technical rescue – all under the umbrella of the U.S. Department of Transportation- can be a challenge to say the least.  It is easy for an agency director or manager to become focused on the microcosm of their own agency or company and lose sight of what challenges, advancements, and innovations the neighboring organization is involved in.  Different goals create different standards, and different standards lead to inconsistent education, unequal training, and discrepancies in provider care.

Mitigation of these differences is where the Tidewater Emergency Medical Services Council (TEMS) comes into play. Through the Office of the Regional Educational Coordinator, TEMS can act as a clearinghouse of knowledge, information, conversation, and standardization.  TEMS functions as an oversight organization that helps to maintain a consistent experience for all prehospital students and interns in the region.

TEMS does not provide the initial training or certification for prehospital providers, but TEMS does provide feedback to for-profit as well as municipal training institutions in the region.  One of the most important mechanisms for region wide standardization is the implementation of a Regional Protocol Exam Process.  Providers that wish to practice prehospital care in TEMS come to the region as a certified provider who has successfully passed a National Registry Exam.  This shows that the provider is proficient in the skills, knowledge and abilities set forth by the National Registry of Emergency Medical Technicians. However, it is the nature of EMS to have specific standards of care set forth by Medical Doctors that reflect the capabilities and expectations of a given region. These standards are written down (and managed by TEMS) into a single document known as the Tidewater Regional Protocols.

The Regional Sanctioning Exam is a means by which we can ensure all providers are knowledgeable and proficient in the standards of care that have been established in the greater Tidewater Virginia region. This exam is the product of a combined input of a Training and Education Committee (managed by TEMS) made up of training officers who develop the question content.

Providers are inducted into the process through their local fire department, rescue squad, private ambulance services or standby company. Each agency training officer submits to TEMS a contract by which all parties agree to set a one-year timetable to complete a demonstration of individual medical skills and a reflection of a cognitive understanding of the TEMS Protocols. 

  • ALS Sanctioning Overview

Providers are able to show their skill proficiencies with their local training officers, and then take the ALS Sanctioning Exam.  This online exam is managed by TEMS, who ensures the integrity of the questions, and manages the hosting platform that allows for a question bank to provide random questions in a multiple choice format.  These questions are created, updated, and approved by the Training and Education Committee. It should be noted that there is a distinct version of the Sanctioning Exam for the Advanced EMT and the Intermediate/Paramedic

Upon successful completion of the Sanctioning exam, the applicant will then be eligible for Oral Boards. The provider must spend time ‘practicing’ this process though trial runs by which the provider is verbally given a likely scenario and must orally explain their assessment, conclusions, and plans of action on how they would provide care in this fictional scenario.  

  • Practice Board Information

Download TEMS Practice Boards Protocol Questions 2023

If the applicant can show they are proficient with the agency training officer, they can schedule the actual Oral Board event with their agency Operational Medical Director, and the TEMS Regional Educational Coordinator. The role of the REC is to ensure the Oral Board Process is fair and consistent with approved standards from the Region’s Medical Directors. 

After passing the Regional Sanctioning Boards, the provider is then considered to be approved to practice their skills anywhere in the Tidewater Region. There is no need to go through the Regional Sanctioning Process again when returning or transferring to another TEMS agency once Regionally Sanctioned.

  • Psychomotor Testing

Candidates for Legal Recognition, Challenge and Reentry in Virginia will need to have their psychomotor competency verified by an Education Coordinator who is affiliated with a fire-based EMS system or accredited training program.  If the provider cannot find a program to affiliate with, TEMS is able to provide this service for a small fee.

Make a Difference by Equipping & Educating EMS Providers

TEMS, a 501(c)(3) non-profit organization, appreciates support for its training events and programs which benefit the EMS system across our region.

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Serving the cities of Chesapeake, Franklin, Norfolk, Portsmouth, Suffolk and Virginia Beach and the counties of Accomack, Isle of Wight, Northampton and Southampton.

TEMS is a 501(c)(3) Non-Profit Corporation.

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