Can someone from California clarify this for me

[Putrid Existence]

So, as far as I've known, the levels of EMS have been EMT-B, EMT-I, and EMT-P. But according to Wikipedia (I know, not the most reliable source), they have this:

- First Responder
- EMT
- Advanced EMT
- Paramedic

So what's the difference between a "first responder" and an "EMT" and an "Advanced EMT"?

 

[Aprz]

Why would this be specific to California? This almost looks like the new setup with the NREMT except I thought they retitled First Responder to Emergency Medical Responder (EMR). A more specific Californian question would be what's the difference between an EMT-I and EMT-II, which EMT-I is an EMT, and EMT-II is an Advance EMT (AEMT). EMT used to be EMT-Basic, AEMT used to be EMT-Intermediate. I am guessing this changed to the setup you said because we finally switched to a state license instead of a county license (or cert, or whatever anybody wants to call it *shrugs*).

I like to think of it like this, an EMR knows how to execute most of the skills an EMT does, and even though an EMT doesn't know much about medicine (sorry guys, don't wanna hate), the EMR knows less about medicine compared to the EMT.

As EMR is to EMT, AEMT is to Paramedic. An AEMT knows how to execute some of the skills the paramedic can do, however, they know less about medicine than the paramedic does.

Even though both the EMR and AEMT can do some of the same skills as the level above, since they know less, they can only half-ish (or less) execute it like an AEMT won't be able to administer all of the same drugs as a Paramedic.

 

[harryb714]

I think it might be safer differentiate between the levels of ems by stating EMR scope of practice and required knowledge is smaller than an EMT-B. EMT-B scope and required knowledge is smaller than AEMT. AEMT is smaller than paramedic.

 

[Akulahawk]

So, as far as I've known, the levels of EMS have been EMT-B, EMT-I, and EMT-P. But according to Wikipedia (I know, not the most reliable source), they have this:

- First Responder
- EMT
- Advanced EMT
- Paramedic

So what's the difference between a "first responder" and an "EMT" and an "Advanced EMT"?

Essentially, a "First Responder" is someone who is trained to a level similar to the Red Cross "Advanced First Aid" level of care. It's literally the minimum level of training that a Firefighter or (much more likely these days) a Police Officer must have.
EMT is your basic level of ambulance care, so to speak. Someone trained/certified to this level meets the minimum requirements for Firefighter or Police Officer training for first aid, and then some, actually.

An Advanced EMT is essentially the "old" EMT-II, or more about that of an NREMT-Intermediate. This level of care is considered "Limited ALS" or another way of putting it, Paramedic Lite. They can do some of the things that a Paramedic can do, but they're going to have to call in a LOT more for orders or permission to do a procedure than a Paramedic does because their education is less than a Paramedic's.

There's more to it, but this is probably a good start to get your head wrapped around it. There weren't that many EMT-IIs around... and if companies can get away with using EMTs instead of AEMTs.... they'll do it.

As a medic, I'd rather have a good EMT than a poor AEMT as a partner, but if both are "good"... I'd rather have an AEMT than an EMT partner. Why? I can delegate certain other tasks to the AEMT that I can't to the EMT. I'd still be responsible for both...

 

[DesertMedic66]

first responder is basically advanced first aid. EMT-Basic is the minimum for firefighters and ambulance personal. In California however we dont use EMT-I. EMT-I is now just EMT-Basics with a class for an expanded scope of practice.

 

[usafmedic45]

first responder is basically advanced first aid.

So is a basic EMT if you really want to split hairs about it. LOL

 

[DesertMedic66]

So is a basic EMT if you really want to split hairs about it. LOL

yep. we just know more words haha

 

[JPINFV]

One thing, though, that muddies the water is that the local systems (LEMSAs or "counties") that used the old EMT-II designation (of which, you can count on one hand) are grandfathered in and can continue using the old EMT-II scope, which is slightly larger than the AEMT scope.

 

[Putrid Existence]

first responder is basically advanced first aid. EMT-Basic is the minimum for firefighters and ambulance personal. In California however we dont use EMT-I. EMT-I is now just EMT-Basics with a class for an expanded scope of practice.

Thanks for the info. Also, I live near Riverside, and I'm going to be attending the Moreno Valley College EMT-B class next week, if I can get in.

 

[Sandog]

In San Diego there are plenty of EMT classes offered, rumor is that SWC will be going from 2 P classes to 1 due to the saturation in the market. No advanced or I classes are around that I could find.

 

[Markhk]

Just to give you a state regulation reference...the four levels ("EMR", EMT, AEMT and Paramedic) are regulated by Title 22 regulations.

There is a minimum first aid training standard for public safety personnel (non-EMT Firefighter, Peace Officer/LEO, state/city Lifeguard) under Title 22 Chapter 1.5 called the "First Aid Standards for Public Safety Personnel". These standards can be fulfilled in a variety of ways, but taking a "First Responder" course (such as the "Emergency Response" American Red Cross course) would meet (and exceed) this requirement. California has generally acknowledged these types of personnel as "First Responders", but CAEMSA will formalize a scope of practice and minimum training hours under the new terminology, "Emergency Medical Responder". Training will most likely be in the 60 hour range (and increase from before). Although this new training level has not been formalized as of yet, it is assumed the provider will be a "non transporting emergency medical provider" (ultimately having skills very similar to an EMT) and will be a distinct medical provider level instead of being associated with the vague ""First Aid Standards for Public Safety Personnel" standard.

The EMT is regulated by Title 22 Chapter 2. This was formerly known as the EMT-I (the I being the number 1, which believe me has caused no shortage of confusion).

The AEMT is regulated by Title 22 Chapter 3. The new scope of practice from the old EMT-II was significantly reduced, including the removal of needle decompression, EKG interpretation and intubation. Because so few providers are AEMTs, we run into some confusion because no one says "Woah woah woah!" ...for example, EMSA's interpretation of scope of practice says AEMTs cannot do 3-lead EKG interpretation, yet give the option for synchronized cardioversion and manual defibrillation as an optional scope of practice (Soo... providers just use the quick look function but have no 3-lead?) Strangely while 3-lead EKG interpretation is not in scope, it is optional scope to use ACLS medications like Lidocaine and Atropine which most people would agree need cardiac monitoring to use properly. (You can see EMSA's interpretation that AEMTs can't use EKGs here: http://www.emsa.ca.gov/personnel/Local_Scope/Position_Statements/files/EKG (July 2010).pdf but can sync cardiovert here as optional scope: http://www.emsa.ca.gov/personnel/Local_Scope/Position_Statements/files/Cardioversion (July 2010).pdf )

The Paramedic is regulated by Title 22 Chapter 4.

 

[Monkey]

FYI: EMSTA has just opened a Advanced EMT registration.

EDIT: I was told they are still working out details with County regarding hours... mainly for intern and clinical before setting dates.

In San Diego there are plenty of EMT classes offered, rumor is that SWC will be going from 2 P classes to 1 due to the saturation in the market. No advanced or I classes are around that I could find.

 

[Handsome Robb]

So as an NREMT-I/85, I am trying to register for an Alameda County EMT card. Would I be an AEMT or an EMT? I love how Nevada is 10 bucks to register and Cali is up near 170$ after all the livescan and background checks.

Everything had to be overcomplicated.

 

[Akulahawk]

So as an NREMT-I/85, I am trying to register for an Alameda County EMT card. Would I be an AEMT or an EMT? I love how Nevada is 10 bucks to register and Cali is up near 170$ after all the livescan and background checks.

Everything had to be overcomplicated.

Chances are you'll get an EMT card, unless the County recognizes the AEMT. If they issue you an AEMT card, you'll likely still function as an EMT as Alameda County's Protocols likely do not recognize the AEMT/EMT-II standards... I know that about 10 years ago they didn't recognize the EMT-II, however they'd give a -II an EMT recognition card authorizing work in the County as an EMT.

 

[Sandog]

FYI: EMSTA has just opened a Advanced EMT registration.

EDIT: I was told they are still working out details with County regarding hours... mainly for intern and clinical before setting dates.

That's good to know, thanks.