Emt -i/99 Vs. Emt-p

[Plattsfire2]

Quick question for everyone. I took the NREMT-I99 course about three years ago, and have recently graduated from the Paramedic course. Both courses taken at Creighton University in Omaha NE. I can honestly say that - with the exception of RSI - there are absolutely no differences in both certifications. Now, I have heard that in some states I/99's cannot push Amiodarone, but they are able to substitute Lidocaine. I have also heard some states do not allow I/99's to use Dopamine. Appearantly Nebraska is not one of these states. So I am asking for anybody's thoughts on this subject, good/bad/indifferent.

Mike

[Res343cue]

All I want to say is...

Wow. :rolleyes:

[btroutm]

I'll go with indifferent on this one. EMT-I (99) is shorter than EMT-P, so naturally there will be things a paramedic can do that an intermediate cannot.

[RyanEMVFD]

Texas doesn't even recognize the 99 level.

[BloodNGuts]

Here in WI we recognize the 99 level. My dept. has about 10 and 2 paramedics. we also have IV Techs. Our I's can give:
Adenosine
amiodarone
atropine
calcium
valium
dopamine
IV Epi
furosemide
Lidocaine
Morphine
sodium bicarb

Iv Techs:
D-50
Narcan
Nitroglycerin

Basics
Glucagon
ASA
albuterol
subq Epi
assist with pt. nitro
oral glucose

[gurlmedicff]

In VA the only difference between the 2 are that EMT-I's have to call for orders for Morphine for MI's and deformities and Valium for seizures and EMT-P's don't. Everything else can be done by both.

[tesemt]

Wow, I'm in EMT-I class right now, here in NC, Intermediates can give:
ASA, Albuterol, D50W, Diphenhydramine, Epi, Glucagon, Ipratropium, Levalbuterol, Naloxone, NTG, Oxymetazoline, and Thiamine. Give or take, baed on which county one works in. The NREMT curriculum in the Brady book has almost double the med's. I may want to move to Nebraska, or VA, lol. (I'm actually not too far fom VA)

[LeuitEFDems]

Tesemt,
Definately DON'T come to MA, we're still using the DOT-'85 curriculum for EMT-I's. They updated both the basic and medic training to '99 but for some reason, which after numerous letters and phone calls to OEMS, we still can't get a straight answer as to why the I's didn't get upgraded as well. I am currently an I now, going through medic class, and I found it obsurd the amount of training we had to go through for so little skills. We are only allowed to do IV's, run NS, Ringers for burns, and intubate...on top of nebs for asthmatics, epi-pens and ASA. We just got a memo from the state and I almost collapsed when I saw they are going to allow B's and I's to do glucose monitoring. It was brought up last year when they 1st allowed us to do albuterol, but was shot down...now it just came out of left field.

[parafire81]

Come on out to Iowa, we'll even call you a paramedic. (I-99's are "Iowa Paramedics" and P's are "Paramedic Specialists") For more info on our scope of practice vist http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf

[btroutm]

Don't come to Chicago...Intermediates are treated as Basics in most systems around here. There isn't a level between ALS (paramedics) and BLS (basics/intermediates).

[Ridryder911]

In Ok. we currently use 3 levels. Basic, Intermediate, Paramedic. The EMT/I are allowed to intubate, I.V., assist with NTG, up-drafts etc.. not able to adminster on their own. They are beginnig to wean this level out by most education systems no-longering offering the sole EMT-I program. The push is basic or paramedic.

Most services are not offering much difference in recognition or pay if any.



Be safe..
Ridryder911
R.n.,CCRN,CEN, CCEMT/P, NREMT/P

[chicagoambo]

Thats true in Chicago, emt-a's or emt-p thats it!I've never heard of this 99 deal why not paramedic? Sounds about the same as meds go . Can they intubate?I don't understand why emt-i exists?It sounds like everything the p medics do

[Plattsfire2]

I can try to post our state protocols for the Basic, I-85, I-99 and Paramedic. Really with the exception of Amio and Dopamine (both allowed with appropriate medical direction), there is no difference between the two. I-99's can even needle cric the throat and do plueral decompressions. No RSI though - in fact, very few departments in Nebraska do RSI anyway, even at the Paramedic level.

[LFD443]

In Ohio, which admittedly usually does everything different than everyone else is doing it EMT-I 99's can use what is approved by each department's medical director. I cannot for instance use any cardiac drugs or morphine which of course was covered in the class. I can use Nubain but not Morphine under any circumstances. I am expected to use a monitor and interpret the rythym but can't do anything about it. We can however intubate as basics in my department.

[7U4Free]

I'm in a county in Northern Va. We have two levels of providers Basics (EMT-B), and Medics (EMT-I and EMT-P). Basics can assist with some pt meds, but no IV's, or meds from our box. The ALS protocols do not draw a distinction between I and P. The med box, such that it is, is open to either level, along with ET, IO, IV, 12-leads, Capnograpy etc. The Protocols are somewhat restrictive for the area, and require med control calls for some of the meds. (Lasix for CHF is an example). As an I, I can run the ACLS protocols for the most part end-to-end.

[mcad64]

Missouri has EMT-P and EMT-B Only NO EMT-I

[taidan]

It seems to me that there is more theory/pharmacology(sp?) taught in Paramedic.

[spc0806]

I am not sure what the difference is between an EMT-I or an EMT-P is in New York State but I know now that we have EMT-CC or Critical Care so I am not exactly sure how they work either. Anyone have any info?

[medic123]

I am not sure what the difference is between an EMT-I or an EMT-P is in New York State but I know now that we have EMT-CC or Critical Care so I am not exactly sure how they work either. Anyone have any info?

NY - EMT I can tube start line no offence to any I's on here but the other name for them is medic helper.

CC- don't get me going here but only some areas rec. them for NY works on a region by region MAC cert besides EMT level.
CC's can start lines and push most drugs but their education level is below Paramedic, you tell me how much diff. there is if you take half the class room time and more then half clic. time to become CC. They are good for Inter. Fac. transports though.

EMTP in NY is highest level on average 12 month colege level training add to that around 800 some odd cli. time.

Hope that helps

[chrnea]

As I understand it, according to the newer scope of practice for EMT's. The Basic level is the same but the I-level is rapidly moving up to becoming what the P level has been. The p level is becoming much more specialized in as much as they are moving to a clinical level. The expanded scope is allowing P's to do more and giving them a place to move up to.
It has always been that once you made paramedic you were essentially done in the career field. Unless you went on to nursing or PA then there was nowhere else to go. Now with the expanded scope the paramedic can move higher within their profession of emergency medicine.
The Emt-I will be what the p has been in the past. So if all you want to do is ride in the rig then eventually I level is all the further you will need to go.
This is not in full effect yet but it is beginning to take shape with the expanded cirriculum for emt-p. It is now a 1000 hr plus program and the EMt I program is up to near 700hrs.

[SDparamed]

I work for a rural service that is VERY busy. We are located on an indian reservation in South Dakota. Since we are on a rez we are a "soverign nation" so we can kind of set our own rules with minimal state intervention. Here is what we can do:
EMT-B's: Blood glucose and combitube
EMT-I85: combitube, IV's, and they carry nitro, albuterol, ASA, D50 D5W, NS, LR, and thiamin.
EMT-99: all of the above plus use of ET tubes and they also carry first line cardiac meds
EMT-P: everything else most medics can do- except we do not do RSI or surgical crichs.

[FireMedic138]

In Arizona the only difference between I-99 and Paramedic is that as a paramedic I can start central lines (subclavian, internal jugular, and possibly femoral depending on which region you work in). I think this is silly, since I've been a paramedic for over thirteen years and never needed to start a central line. There is even less reason now that we have sternal IO. Arizona paramedics can do surgical chrics, but not RSI. Amiodarone is allowed, but no one in the area I work in carries it.

Arizona hasn't really had a niche for intermediates for a long time. None of the big city fire departments have ever used them, only EMT's and Paramedics. The state has done a good job of getting paramedics into rural areas, so even the rural areas have paramedics and not much need for intermediates. Few, if any training courses for intermediates exist anymore here.