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Emergency Care Attendant 24 lessons, final examination, state skills test. Approved by the Texas Department of Health as an alternative method of completing the training required to be eligible to take the state certification examination for Emergency Care Attendant. Covers the DOT first-responder curriculum plus the additional skills needed for ECA certification in Texas. Requires a minimum of 20 hours of skills instruction in addition to the independent study component. Stoy, W. A. and Ctr. for Emerg.