Why Refresher Training Matters
EMT refresher courses serve a dual purpose: fulfilling recertification requirements and updating your knowledge with current evidence-based practices. Emergency medicine evolves rapidly, and protocols that were standard when you first certified may have changed significantly. A refresher course is your opportunity to close knowledge gaps, practice skills that have declined from infrequent use, and learn about new equipment and medications that have entered the EMS formulary.
Whether you are taking a formal refresher course or self-studying for recertification, focusing your review on high-yield topics maximizes the benefit of your study time. This guide highlights the areas most likely to have changed and the topics where knowledge decay is most common.
Areas of Significant Protocol Evolution
Cardiac Arrest Management
CPR guidelines are updated every five years by the American Heart Association, and recent updates have emphasized minimizing interruptions in chest compressions, using quantitative waveform capnography to monitor CPR quality and detect ROSC, and early epinephrine administration in non-shockable rhythms. Review the current algorithm, including the timing of drug administration, when to consider termination of resuscitation, and post-cardiac arrest care priorities.
Spinal Motion Restriction
The shift from routine backboard immobilization to selective spinal motion restriction is one of the most significant changes in EMS in recent years. Review the current criteria for spinal motion restriction, including the NEXUS criteria and Canadian C-Spine Rule. Understand when a cervical collar alone is sufficient versus when full backboard immobilization is indicated. Practice applying these criteria to clinical scenarios.
Tourniquet Use
Tourniquet use has expanded dramatically based on military evidence. Current guidelines support early tourniquet application for life-threatening extremity hemorrhage. Review proper tourniquet placement (2 to 3 inches above the wound, over a single bone when possible), documentation requirements (time of application), and the circumstances under which a tourniquet should not be removed in the field.
Skills Prone to Decay
Certain skills deteriorate quickly without regular practice:
- Airway management: BVM ventilation technique, particularly maintaining an adequate mask seal and delivering appropriate tidal volumes. Practice on a manikin until you can consistently achieve visible chest rise.
- Patient assessment: The systematic approach (scene size-up, primary assessment, secondary assessment) tends to become disorganized without regular practice. Walk through the steps verbally or with a partner.
- Medication administration: Review the medications in your scope of practice, including indications, contraindications, doses, and routes. Pay special attention to medications you administer infrequently.
- Pediatric care: Pediatric patients represent a small percentage of EMS calls, making skill decay particularly problematic. Review pediatric vital sign ranges, medication dosing, and equipment sizing.
Making the Most of Your Refresher
Approach your refresher course with an open mind. Even experienced providers learn something new in refresher training. Come prepared by reviewing your weak areas beforehand. Ask questions about protocols that confuse you. Practice skills hands-on whenever the opportunity is provided. Take notes on changes from your previous training and update your personal reference materials. Consider the refresher course the beginning of your next two-year learning cycle, not just a box to check for recertification.