EMT-Basic & EMT-Intermediate: What's up w/ That??

[FF McDonald]

I am frustrated. I feel that I am one of the only people that enjoys all aspects of emergency service. I like being an EMT, and I enjoy firefighting as well. In regards to EMS, I would like to seek the highest level of training that is available to me, yet I live in NJ, which is an EMT-Basic state. Although the curriculum is written for the entire country, each individual state can alter it as it see's fit. Which means that I cannot train to Intubate, or start IV's. EVEN THOUGH it is in the curriculum.

However, I feel that this may be more due to the fact that a lot of the policy in NJ is written by practicing Paramedics.

Does anyone feel as frustrated as I do? I would like to hear from you if you are.

[JawOLife]

I am from Wisconsin. Currently, legislation is in the process of changing the cirriculum in the state for levels of training and treatment. Here, EMT-I is where anyone is able to perform IV's, any ALS beyond and above further training.(Obveously) EMT-P or in other states strickly "Paramedic" is where you may administer any life saving intravenus drugs. IN our particular county... any persons other than licensed paramedics..(EMT-B,EMT-I, No first responder groups, they are exempt and separate from this) Are on a casual-call basis. If on scene, and the medics need another hand for advanced treatment - you go, if you are near one of the Ambulance stations and a call comes thru - you may go... just not all day for all calls, unless it is a training day were it was signed off by the director of EMS (embursement purposes) If you are affiliated with a first responder group, but yet you are at a EMT or Paramedic level, you are not allowed to treat at those levels. There are no separate EMT/EMT-I groups, except for in the southern part of our county, and they are all EMT-B or I level, which work for the county, yet are allowed to treat at those levels because they cover the south part of the county for county EMS, and transport if need be. The state requirement, for paramedic level of training has been changed to I believe almost 2000 hours, from the previous (I believe) 1100. What I get out of the whole deal is that the states lets everyone play if certified at that level. Separate ambulance services may require for a minumum level of training to cover the *****. Which there are separate guidelines for those particular services to require their personel to be at such a level, which were adopted from the state. Separate services may set the standard, and allow licenced persons to work for them at that level, but they must be sure that they follow state guidelines. It's a big ..liability thing. Thats what I get out of it. I know they are having problem in Milwaukee because of this in the suburbs, and in the city..... level or training... are they allowed to do the or that...bla,bla,bla.... It should be the same all the way around....

[CptEms]

What a strange way of doing business. In the Commonwealth of Virginia, it doesnt matter if your are an EMT, EMT-ST (shock trauma), EMT-C (cardiac), or EMT-P (paramedic), if you have been thru the approved course and pass all the written, practical tests and orals boards, you are licensed to practice anywhere in the state, and it doesnt matter if you are paid or volunteer. I have heard of several states that dont allow volunteers to practice ALS procedures (I think Delaware is one of them) and I would think that just hampers quick arrival of much needed help.

[hylo]

Hi I am a firefighter/EMT-b, from Dublin Ireland, with much the same fustration as you have.
I have just posted a new topic, emt-b is it really good enough. It could also have been a reply to your post.
Have a read and see what you think, and e-mail me if you want to discuss it more.

Stay safe my friend, and keep up the good work, everything we do makes a difference, to somebody.
Hylo.

[Boothby]

FF McDonald
Partner I feel your pain, I have been there myself. Here are a few things to think about though. If you do start an IV what are you going to do with it? Most IV lines are primarily started to allow access for drug administration. Even in a trauma patient we are getting away from running huge boluses of fluid into people just because they are trauma. Did you know that you could have a life threatening complication from running fluid into a person?

Second is intubation. Did you know that endotrachial intubation is one of the riskiest proceedures that a paramedic can perform? There is a greater chance of having a lethal complication from intubating a patient than anything else we do.

If you look at the differences between a medic and a basic from the standpoint of the proceedures alone, what you will find is that all the proceedures that are reserved for medics have the potential to cause serious harm or death if not done properly. Yes all the skills look really sexy, but there is alot of bookwork and clinicals that go along with doing those proceedures. The MD's who we work under and who are ultimatly responsible for the things we all do are VERY aware of the dangers involved. From their point of view there is enough risk by having medics doing these proceedures without adding basics to the mix. If you get in an look at what drives your laws I think that you will find it's not medics trying to protect their turf, but MD's trying to protect themselves and do what is best for the patient. My recomendation to you is find a really good medic school (look nation wide and do alot of research) and become a paramedic. Then go find a fire department that hires firemedics and go to work (that's what I did). Untill then remember BLS before ALS. Become really good at what you CAN do. There is nothing paramedics love more than having good basics to work with.

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Larry Boothby
Firefighter/Paramedic
Truck 3 A-shift
Local 1784
Memphis.