America?

[bled12345]

I'm a Canadian EMT-A (EMT-I equivilant in the states) It took me about a year and a half of school and practicums to finally be certified and licensed to work.

In Canada, the "EMT-B" is called an Emergency Medical Responder. The only work EMR's are able to find in alberta canada, is medical standby on the oil rigs, or in *VERY* rural townships of like 500 people only, and even then there is never typically 2 EMR's on an ambulance by themselves, there is usually at least always an EMT-A riding on truck.


From reading this website, I keep getting the feeling that EMT-B's actually work in urban settings on BLS trucks independent of the ALS trucks, are EMT-B's able to work in major metropolitan areas? Or like Canada, are you only able to get jobs in very small communities, or doing medical standby's for construction. I'm confused. And where do the EMT-I's fall in to place down there? is EMT-I manditory on your way to becoming an EMT-P? Here in canada you HAVE to have your EMR before you can get your EMT-A, just like you HAVE to have your EMT-A before you can even think of applying to a paramedic school.

Anyone care to fill me in?

 

[uscgk9]

Some schools that have a paramedic program start with EMT-B and go straight through Paramedic. Those schools usually require successful completion of the B portion prior to continuing on. Whether or not you test out at the I level is up to you most of the time. The students that are not affiliated with an agency yet usually just wait to test P so they don't have to pay the testing fees.

As for employment, it varies depending on where you are. At the last 2 states I lived in EMT-Bs did perform patient care in the back all by themselves. Some agencies have a Paramedic and a Basic running as a team and depending on the level of care needed the B could run the back with the P driving. Again it is different all over the country.

I hope that helped answer your question.

 

[Sapphyre]

Here, in Southern California, almost everything is metropolitian. And yes, it is possible to have BLS only ambulances with two EMT-Bs on board, providing care without direct supervision, Basics are also often found on dedicated interfacility transport ambulances. It's also becoming a requirement of several fire academies that you be an EMT-B before they admit you to the fire academy.

Here, there are no EMT-I schools, if your agency wants you to have the skills they are supposed to train you themselves (according to an EMSA document I found once, but can not find again). Again, here in California, EMT-I is not a stepping stone to paramedic. The rule here is, work as an EMT-B for one year, or at least 2000 hours, then you can apply to medic school.

 

[Pittsburgh Proud]

Here in our city we have BLS trucks working side beside our ALS trucks. They run emergency calls that we can say are bls if there are als then they call for als to arrive.

 

[piranah]

i run on a BLS truck...and i work in a major city along with the whole state....it RI so its a lil state

 

[Outbac1]

Bled1234
From what I can understand a US EMT-B has more or less equivelent training to a Can EMR (aka MFR). They work everywhere and can be the only level of care.

Their EMT-I's are being phased out in many places much the same as our P2's, (aka ICP), are. Here in the east there is no requirement to be an EMR before going to PCP school. You do need your PCP before going on to ACP school. Most of Canada has switched over to the newer designations and corosponding National Occupational Competency Profiles, (NOCP)

PCP = Primary Care Paramedic, $12,000.00 and 10 months
ACP = Advanced Care Paramedic, $15,000.00 and 13 more months
CCP = Critical Care Paramedic, $ ??? and ??? more months

 

[JPINFV]

Here, there are no EMT-I schools, if your agency wants you to have the skills they are supposed to train you themselves (according to an EMSA document I found once, but can not find again). Again, here in California, EMT-I is not a stepping stone to paramedic. The rule here is, work as an EMT-B for one year, or at least 2000 hours, then you can apply to medic school.

There is a EMT-Intermediate [EMT-II (2)] program in California apparently at Porterville College in Tulare County. EMT-Intermediate programs and providers are rare in California because, under state law, such an area can't provide ILS services (termed "Limited ALS") as an alternative to paramedics. Essentially, if an area is able to provide paramedic services, then they are not allowed to use intermediates.

Now there is a list of optional skills that include procedures and medications. Some of the procedures [e.g. manual defibrillation] require the EMT-Basic to be directly observed when performing the procedure, but the list is there (http://www.emsa.ca.gov/legislation/FinalApprovedChapter3242007.pdf starts on page 11). Now most [probably all] of the optional skills require providers to demonstrate competency every 6 months, as well, all of the optional skills must be monitored for effectiveness and a reason why EMT-Basics should be allowed to perform them has to be provided. I highly doubt that a simple "We want our Basics to be giving ASA, Narcan, albuterol, glucagon, sub-cutaneous epi, nitro, and activated charcoal and do d-sticks" [subsection (f) of "Optional Skills" is an all or nothing section involving those. You can't pick, say, training for Narcan and ASA and call it a day] is going to get you approval from State EMSA. In the end, it's probably easier to just run paramedics than provide ILS or a truly expanded (as compared to the "We let out EMT-Bs monitor existing IVs and foley caths for interfacility transports" expanded scope. See LA County) scope of practice for EMT-Basics.

As far as working for an EMT-B prior to becoming a paramedic, no specific amount of time is required by the state. Different programs vary from nothing (e.g. NCTI), to 6 months (e.g. UCLA's program) to a year (e.g. Riverside Community College).

 

[Sapphyre]

Thank you JP, for correcting me. I had a feeling, as soon as I hit post, that something was going to be wrong.

< files the information away for further reference >

 

[JPINFV]

Thank you JP, for correcting me. I had a feeling, as soon as I hit post, that something was going to be wrong.

< files the information away for further reference >

No sweat. I'm one of those strange people that have no problem going through government documents for almost useless information. Out of 16 counties, only 5 have EMT-II programs with less than 200 certified EMT-II providers state wide per this report (looks like it was last updated in 2007 per title page, not the cover).
http://www.emsa.ca.gov/aboutemsa/ems_prog.pdf

 

[paramedix]

Where can I find out about your EMT protocols? I think there is a huge difference about our EMT's and the States.

In SA I'm an EMT-I but called an AEA (Ambulance Emergency Assistant), but I can work independently without contacting medical control - within protocol.

Our Critical Care Paramedics are equivalent to the EMT-P/A??? No medical direction needed for any drugs given.

Sorry this might be a bit off topic, but it would be interesting to know the difference in protocols...

 

[bled12345]

In Alberta, EMT-A's are being utilized to help fill the lack of paramedics. In the city of Edmonton and Calgary, they desire running ALS trucks with 2 paramedics, but the lack of paramedics province wide has resulted in using EMT-A's to support the ALS trucks. In edmonton, EMT-A's *ALWAYS* ride with a medic, its an ALS rig, but I guess the EMT-A's are used in the same way as EMT-B's in the states are with the exception that EMT-A's have a wider scope of practise and are more in tune with ALS procedures.

 

[firecoins]

Where can I find out about your EMT protocols? I think there is a huge difference about our EMT's and the States.

NYC protocols
http://www.nycremsco.org/

 

[Outbac1]

Information on Nova Scotia's Emergency Health Service can be found here
http://www.gov.ns.ca/ehs/

Lots of information on ground and air ambulance, essential competencies, comparison templates, protocols etc.

 

[fortsmithman]

My agency currently has on the roster
1 Paramedic who is also a nurse
2 EMT-A
3 EMR one of who is a nurse
5 EVO (Emergency Vehicle Operator)
5 Student On Board one of whom is a nurse

The Northwest Territories currently does not have a licensing body for EMS. My agency also maintains registration with the Alberta College Of Paramedics For the EMT's, EMR's, Paramedic.