Should EMT-I even exist?

[FCDave]

I know that some states do not recognize the EMT-I level of certification. I can see the many benefits of having this level, but others disagree. What do you think?

[First-Due]

Dave, Hello from Cape Cod, MA http://www.firehouse.com/forums/biggrin.gif
Being only an EMT and working with 21 Paramedics in my Dept. (we have 44 career) and running 3 ALS rigs I wish we had I's for the Medics sake. Mass. does recognize I's as pratice but not every dept. or agency pays a siphen for I. Some do though. On the Cape all the Fulltime FF's have to be least an EMT due to the F.D.'s providing Ambulance service. Also the EMT's are trained in what Mass OEMS calls Paramedic Assist. Trained. Basically Spiking IV Bags,getting monitor ready,IV set up etc. But from the Medic side I can see the benefit of having an I there if another Medic is not available.

[FFCode3EMT]

As an Intermediate and Paramedic student, I think that I's are important. I belong to a combination department (32 B's, 13 I's, 7 P's), and sometimes I'm the only ALS provider when our career staff are on other calls. That patient gets a higher level of care and benefits from it. In the worst case scenario working with a Paramedic, an I can get the tube, or IV while the Paramedic is getting the other, again benefiting the patient in the care they receive.

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**The preceding comments in no way represent the views of my department, its members, or associations that it may belong to.**

[ReRunFFEMTCC]

i do both paid ems and im a volunteer firefighter/emt-cc. where i work they either recognize emt's or medics no in between like an "i" or what we call "cc". but where i volunteer paramedics only have 2 more protocols than us which is a needle decompression and a neddle crochestomy but the druga are the samei even can use narcs where i voli so its goos in a sence where a medic out here goes to school for like a year but if u want to do more on a volunteer level u go t cc which is like 6mthsso it pays a lil to be the "in between" provider.

[medic1488]

As a past Intermediate and now as a medic I definetly see where I's can be benefical, especially when put with the combination Medic/Intermediate crew. What scares me is when intermediates and EMT-cardiacs are relied upon as soul ALS providers, I know as a past Intermediate there was no way I should be carrying more then just your basic cardiac resuscitation meds, you just arent prepared for it in a national I program. As for the more than Intermediate, less then medics cardiacs, the service I work for employs quite a few of them as standard EMT's or I's (my state doesnt recgonize there level) and its been my expierence with alot of them (not all of them because I have met some excellent ones who I would trust my life to before about half the paramedics I know) that they can follow protocols very well. They dont understand why and how this drug that they just is working, they just know the protocol says to give it if the patient presents like so, to give this. Yes, its better than nothing, but should it really be used as a replacement for medics with the more in depth knowledge (and yes I know before people think it, there are some medics out there that do the same cookbook paramedicine)

[engineone2611]

In Ga. there is no recognition of EMT-B. The lowest level of training allowed on a squad is NREMT-I. Our Interm. scope of practice includes D-50 and epi for anaphalaxis and nebulizers. This applies for BLS squads. If you run ALS you must have a Medic or CT(cardiac technician) on board. Our Interm can also use combitube intubation but by state standards are not allowed to use cardiac monitors or ET intubations as of yet even though it is in the national standards. Georgia is extending scope of practice on Interm, and medics over the next couple of years to include 12-leads and rapid sequence intubation for medics along with a few other things. Intermediates will be doing what medics are doing now and medics will be
EMT-P expanded scope. There are uses for EMT-I if the national protocols are allowed to be performed. In these situations they are very useful and can make a dramatic difference in patient care over a basic. So yes there should be and EMT-I in the field and there usefulness is only as limited as your dept regulations.

[HR314]

Hi, I am a Basic from Mississippi, currently attending P-school in Iowa. The outlook on the Inter. level is very unique between these two states. In Mississippi as of July 1, 2001, they will no longer acknowledge the Inter. level, you will either attend P-school or return back to the basic level. Their motive behind this is great in it will raise pay for the medics of this state but detrimental in the fact that they are taking an ACLS assistant out of the rig. I will respond back to you and let ya know how this is working out!!
As for Iowa, they have totally redefined levels of certifications in this state. They have created the level of Paramedic Specialist which is a NREMT-P with 12 lead, RSI, NG tubes & Foley's amongst other things. They have given the title of Paramedic to NREMT-I's. Their motive behind this is that more community's can have a "paramedic" service, also these "medics" have a higher skills list than normal Inter.'s do.
I personally would rather work with a Inter. partner than I would a basic for the simple fact that he/she could offer a plan B if I cannot start an IV or fail at any other Inter. skills.


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Will Roberts
Firefighter II/ EMT-B
Heucks Retreat Fire Department
Brookhaven, MS

[WFDFFEMTI]

It is easy to argue for or against EMT-I level. Being one I prefer to argue for it.
In a perfect world we would all be paramedics and not worry about any other level. Not the world we live in.
The EMT-I level (educationaly) provides for a stepping stone. It allows providers to start at the bottom and work their way up with baby steps. It seems to work well.
In Maine an EMS license is good for three years. If one were to stay at the lower level until it was time to renew, it provides for good experiance and helps providers get good with the basics. And the basics are the most important.