# Accelerated EMT B to EMT I courses



## Earthen (Nov 19, 2010)

Hi all, I need a quick way to upgrade my EMT-B to an EMT-I so that I can find a job in Georgia... because apparently you cant really get employed as a basic down there.

I had found a 2 week EMT-I85 course slated for January, but it got cancelled :sad:


Do any of you know of anything similar taking place in december, jan, or feb? wilderness or tactical courses are fine with me as long as i can get a NREMT approved emt I out of it.
thanks much

Earthen


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## Harbeezy (Nov 19, 2010)

From what our instructor told us, it takes atleast 3 months to take in all the information and skills for Emt-I. Down here in Griffin, they might have a class starting in january that is in 3rd quarter, which is when our Emt-I stuff begins. Might wanna check it out. Southern Crescent Technical College.


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## MrBrown (Nov 19, 2010)

... and here Brown was thinking six months to a year to complete our old IV/cardiac course was too short


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## goodgrief (Nov 19, 2010)

Georgia is a different beast then other states because we only have EMT-I and paramedics. If you are already in Georgia the only thing you can do is sit through a EMT-I class.  Some schools will let you skip the first month which is the basic class, but you will be required to do everything else.

If you are in Metro Atlanta you wont be able to get into a class starting in Jan. because the schools around here usually are full for EMT-I. and it normally takes 1 full quarter to get all your paperwork together before the quarter you want to attend. 

You may want to try Medix, although the school is often made fun of, because its not a college they might be able to work wtih you on this. 
In metro atlanta your EMT schools are Dekalb Tech, Lanier Tech and Gwinnett Tech. I cant think of any others. 

A friend of mine has the same problem, he cant work here because he is only a basic in his state, but has all the skills of an I-85

This is the exact reason I say get rid of basic, have a First responder, an EMT-I and a Paramedic

Ok jumped off my soap box. Good luck, and welcome to Georgia


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## reaper (Nov 20, 2010)

See, I say get rid of Intermediate! Should have Basic and medic. No need for watered down certs.


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## goodgrief (Nov 20, 2010)

As long as a basic can start iv's,  give o2, and maybe d50, I'm ok with losing emt I. I don't understand the need for 4 levels of care, and each state picking what a basic or I level means for them. My friend who works in a diff state as a B can do all that I can do minus king airway, 
Have a first responder level, ie basic first aid
A emt level ie iv, basic airway, 
And a  paramedic, 

But simple is to much to ask for these days.


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## reaper (Nov 20, 2010)

While a lot of basics can do IVs. Why need it, if they are with a medic? Why need D50, if they are with a medic?

King is a BIAD, just like a combi or LMA. Should be no reason a Basic cannot drop one.


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## goodgrief (Nov 20, 2010)

They need those skills because emts are not always with a medic, and a lot of areas run bls trucks,


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## reaper (Nov 20, 2010)

If they are a BLS truck, then they don't need those skills.


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## Earthen (Nov 24, 2010)

ah, thats so frustrating.   Its not exactly easy finding an EMT-I course outside of Georgia either, since so many states are phasing it out...

Do any ambulance companies hire B's and train them in-house to an I?


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## EMT11KDL (Nov 25, 2010)

Earthen said:


> ah, thats so frustrating.   Its not exactly easy finding an EMT-I course outside of Georgia either, since so many states are phasing it out...
> 
> Do any ambulance companies hire B's and train them in-house to an I?



some do, i know in my area they train up to I/A and P level.. where are you at?


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## Earthen (Nov 25, 2010)

EMT11KDL said:


> some do, i know in my area they train up to I/A and P level.. where are you at?




Michigan, though I'm pretty much free to move anywhere i want at the moment.


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## 8jimi8 (Nov 25, 2010)

from what i've noticed on this site, most professionals take offense to people begging for fast track short cuts.  Slow down and educate yourself.


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## Earthen (Nov 25, 2010)

8jimi8 said:


> from what i've noticed on this site, most professionals take offense to people begging for fast track short cuts.  Slow down and educate yourself.




I'm looking to do this before grad school starts, or I wouldn't have any issue taking a semester long course.

Thanks for the advice, but you can sometimes get more hours of good training in class 12 hours/day than you can 6 hours/week.  I take offense that you're implying I'm not professional, and that I am begging.  I've been riding on a rig for years, and I'm simply asking for good, helpful information.  

I'm hanging just fine with my 4 week basic from WMI; admittedly, a lot of that might be because my major made the didactic portion of the course 90% review.


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## seperrybasic-iv (Nov 26, 2010)

goodgrief said:


> As long as a basic can start iv's,  give o2, and maybe d50, I'm ok with losing emt I. I don't understand the need for 4 levels of care, and each state picking what a basic or I level means for them. My friend who works in a diff state as a B can do all that I can do minus king airway,
> Have a first responder level, ie basic first aid
> A emt level ie iv, basic airway,
> And a  paramedic,
> ...



seperrybasic-iv
I know i got my cert. in TN and they do the EMT-IV and now that ive moved to GA I cant seem to get a job, even in the Hospitals because i my IV skills do not transfer over. Now i have to look into schools that i can get my EMT-I Cert. If you know of any good schools in the metro atlanta?


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## MrBrown (Nov 26, 2010)

Until you can answer me the following, Brown does not think you should be starting IVs on people.

*Fluid Balance*
• Define the boundaries of each of the three fluid compartments and state the proportional volumes typically found in each

• Define the terms: electrolytes, ions, cations, anions. Give examples of each found in the body, and state their physiological functions. (half page)

• Define the term non-electrolyte and give three examples 

• Give a brief explanation of the following electrolyte disorders. Include signs and symptoms that may manifest as a result of these.
o Hyponatremia
o Hypernatremia
o Hypokalemia
o Hyperkalemia

• Explain the initial fluid shift that would occur if the if the patients blood volume was suddenly reduced under Starlings Law.

• Define the following terms and explain the role each process plays in human fluid dynamics.
o Diffusion
o Osmosis
o Active Transport
o Facilitated Diffusion

• Define the following terms 
o Shock
o Perfusion
o Inotropic
o Chronotropic
o Pulse Pressure
o Mean arterial pressure (MAP)

• Explain these complications of irreversible shock and how we may pre• vent and help treat them.
o Renal Failure
o Acute Respiratory Distress Syndrome (ARDS)
o Disseminated Intravascular Coagulation (IDC)

• Describe the pathophysiology, common presentation and briefly outline the management of distributive, cardiogenic and hypovolaemic shiock

• Discuss the differences between how children and adults (particularly the aged) maintain and respond to blood pressure changes

• Provide a definition of the peripheral resistance and stroke volume

• What factors about a blood vessel determine its peripheral resistance?

• During exercise stroke volume will increase. How is that achieved?

• Explain why fluid tends to shift from the interstitial to intravascular space in the early stages of shock.

• Blood transports a number of substances around the body. What are those substances and how are they transported in the blood

• Pulse Oxymetry measures the oxygenation of the blood flowing through the capillary beds and peripheral tissues. Explain how this concept works and when the use of pulse oxymetry is not indicated and why?

• Define isotonicity, hypertonicity and hypotonicitiy

List the constituent of various IV fluids and there respective tonicity.
o normal saline
o 0.45% NaCl
o 5% Dextrose
o Hartmanns

*Homeostasis Regulation*

• Explain the Renin-angiotensin pathway and explain how homeostasis of blood pressure and volume is maintained.

• Describe how the kidneys regulate the excretion of water in urine, and the role of the hormones ADH, and Aldosterone

*Acid / Base Balance*

• What is the normal pH range of body fluids?

• Define the term buffer system and list the 3 major buffer systems involved in acid / base balance

• Briefly describe the renal and respiratory compensatory mechanisms of acid/base balance

• A person presents with hyperventilation syndrome, classic signs of carpopedal spasm, peri-oral parasthesia. Explain the physiology that results in these signs and symptoms.

*Trauma*

• Explain the difference between blunt trauma and penetrating trauma, the difference in the types of injuries commonly encountered and their MOI (mechanism of injury) and the difference in the management of shock occuring as a result of each.

• Describe causes of shock, other than hypovolaemia, in trauma patients, and how to recognize and manage them.
o Tension pneumothorax
o Myocardial contusion
o Acute Myocardial Infarction
o Spinal injury

• Explain the shock management of this patient (on your 20min ride to hospital) with this head injury?
o B.P - 80/30
o Pulse – 128
o Resps – 28
o GCS - 13

*IV Cannulation and Complications*

• Indicate the anatomical location of common cannulation sites

• Discuss and explain factors that influence choice of vein for cannulation

• Intravenous cannulas are colour coded. List the colour, gauge and flow ware of various sized IV cannulas.

• Define ‘aseptic technique’ and explain universal safety measures taken while cannulating.

• Describe and discuss the concept of ‘informed and implied consent’.

• When gaining informed consent. List the information that you would inform the patient. (6234 – P.C 3.4)

• Prior to the administration of I.V fluids to a patient what checks should you perform? (6231 – P.C 4.4)

• State the clinical procedure for administering IV fluids to the shocked patient.

• List the signs and symptoms of the three IV complications below.
o Infiltration
o Phlebitis
o Extravasation

• For the following complications of IV cannulation describe the signs and symptoms and management of each.
o Fluid Overload
o Air Embolism
o Catheter Shear 

Oh and yes, this was taken out of our IV/Cardiac course.


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## Shishkabob (Nov 26, 2010)

I'm telling you right now, 8 months out of Paramedic school, that I wouldn't get half that crap right.  Does that make me a bad medic, or that that make me a realist saying that theory is all good, but realistically very little of that plays in to my decision of starting an IV, and the stuff that DOES matter is the stuff I remember.


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## MrBrown (Nov 26, 2010)

It may not be important in your decision to physically put a drip into somebody but it should play a part in your decisions to administer IV fluid and/or the amount you give.


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## TransportJockey (Nov 26, 2010)

What is hartmans fluid? I've never heard of that one, honestly.


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## MrBrown (Nov 26, 2010)

Hartmans is ringers lactate


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## TransportJockey (Nov 26, 2010)

Thank you. In that case I've not only heard of it, I've administered it. 





MrBrown said:


> Hartmans is ringers lactate


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## goodgrief (Nov 28, 2010)

seperrybasic-iv said:


> seperrybasic-iv
> I know i got my cert. in TN and they do the EMT-IV and now that ive moved to GA I cant seem to get a job, even in the Hospitals because i my IV skills do not transfer over. Now i have to look into schools that i can get my EMT-I Cert. If you know of any good schools in the metro atlanta?



Honestly if you are comng to georgia, I would just go to paramedic school. Why spend 6 months getting your emt when you can get your paramedic in 18?


In Metro Atlanta you have Lanier Tech, Gwinnett Tech, and Dekalb Tech. . There is Medix also. Depends on what side of the 285 you are on, Im not sure what school are south of 285 like down in Henry.


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## goodgrief (Nov 28, 2010)

Earthen said:


> ah, thats so frustrating.   Its not exactly easy finding an EMT-I course outside of Georgia either, since so many states are phasing it out...
> 
> Do any ambulance companies hire B's and train them in-house to an I?



Not that I know of because you cant work as a B on a truck here. Your best thing would be to come and go straight through paramedic. Every company I have seen in metro atlanta says the same thing. You have to be a NREMT I and a state of Georgia EMT I. 

The only other way I can think to do it and I DO NOT KNOW IF THIS WOULD WORK. 

But could you challenge the NREMT for the I85? then present that to the state office for your 85 license? I have no idea honestly. Just a thought


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## goodgrief (Nov 28, 2010)

MrBrown said:


> Until you can answer me the following, Brown does not think you should be starting IVs on people.
> 
> ........./QUOTE]
> 
> Brown you crack me up with  that. It looked just like my last fluid test.


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## seperrybasic-iv (Nov 29, 2010)

Who are you to say that just because you dont know every detail to the perfact IV, and what EXACTLY needs to be administered that you shouldn't start an IV. I was educated in the basics of IV administration; that is why BASIC is behind EMT in my Certification. Not Paramedic. I had to do my clinicals, state, and national certification just like everybody else and not once did the EMT-IV start jabbering about special fluids or maneuvers.


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## usalsfyre (Nov 29, 2010)

seperrybasic-iv said:


> Who are you to say that just because you dont know every detail to the perfact IV, and what EXACTLY needs to be administered that you shouldn't start an IV. I was educated in the basics of IV administration; that is why BASIC is behind EMT in my Certification. Not Paramedic. I had to do my clinicals, state, and national certification just like everybody else and not once did the EMT-IV start jabbering about special fluids or maneuvers.



Your saying you should administer fluid NOT KNOWING what needs to be administered because your "just a basic"!? Do you not realize you are performing an invasive, potentially harmful treatment? What's the "basic" amount of knowledge needed to start an IV? Because Brown gives a pretty good list of considerations when starting fluid resucitation. 

Please don't skill monkey this. Your patients deserve better.


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## Level1pedstech (Nov 29, 2010)

Earthen said:


> I'm looking to do this before grad school starts, or I wouldn't have any issue taking a semester long course.
> 
> Thanks for the advice, but you can sometimes get more hours of good training in class 12 hours/day than you can 6 hours/week.  I take offense that you're implying I'm not professional, and that I am begging.  I've been riding on a rig for years, and I'm simply asking for good, helpful information.
> 
> I'm hanging just fine with my 4 week basic from WMI; admittedly, a lot of that might be because my major made the didactic portion of the course 90% review.



 I don't think you should take offense,8jimi8 is just giving you a little friendly advice,maybe you have not seen how rough it can get when the words accelerated or short cut appear in a post by someone seeking advice on advancing thier education.  

 For the benefit of you and others that may be following along may I offer the following. Most clear thinking individuals know that each persons learning experience is different and that some preform better in an accelerated learning environment while others need more time to absorb even the most basic material.

 Having sat through my fair share of lectures by well meaning educators over a ten year period I came to the conclusion at least for me that roughly two thirds of any given didactic session is made up of fluff,dribble,war stories and other utterly useless information that faded away after a short time in the field. In a conventional learning environment students need to have the ability to sift the core material out of the mix. Those of us that struggle in the conventional setting excel when we are offered just the core material in a no non sense presentation. Those that disagree don't look at the individual and stand firmly on what they believe is best for all students which to me only shows ignorance and intolerance to others needs.

  I can think of many times where during a lecture my ADD would kick in and I would get distracted by a shiny object and get completely side tracked for a few seconds. I have always had to struggle to stay attentive during lectures and have come to the realization that short and to the point is what works for me. Cut the dribble fluff and war stories and just give me the hard information so I can move on. That's what works for me but like I said every one's education needs are different and students need to learn what works best for them.


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## seperrybasic-iv (Dec 1, 2010)

Thats not what i meant. What i meant by it is that im not going to start something without the approval of a paramedic. When doing my clinicals, the paramedic told the EMT what to start. I was able to start multiple IV's on patients, but nothing was given without consult. Im not just going to grab a bag off the shelf and start pushing fluid.


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## Cohn (Dec 1, 2010)

reaper said:


> If they are a BLS truck, then they don't need those skills.



Not every place has a ALS rig. Stop being ignorant to the fact that not every where is like the big city you might work in.


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## usalsfyre (Dec 1, 2010)

Cohn said:


> Not every place has a ALS rig. Stop being ignorant to the fact that not every where is like the big city you might work in.



Cohn, what is an IV going to do to actually TREAT someone? Except for simple hypovolemia, the fluid itself is not theraputic.


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## usalsfyre (Dec 1, 2010)

seperrybasic-iv said:


> Thats not what i meant. What i meant by it is that im not going to start something without the approval of a paramedic. When doing my clinicals, the paramedic told the EMT what to start. I was able to start multiple IV's on patients, but nothing was given without consult. Im not just going to grab a bag off the shelf and start pushing fluid.



If your starting lines for your paramedic, that's one thing. However, if your allowed independently place lines, that's another entirely...


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## TransportJockey (Dec 1, 2010)

Cohn said:


> Not every place has a ALS rig. Stop being ignorant to the fact that not every where is like the big city you might work in.



You don't need to be in a big city to actually have an organization that cares about what's best for the patient. I work in one of the poorest counties, in a poor small town, in Texas. Yet we have 24/7 paid ALS. It can be done everywhere, it just matters what your municipality considers important.


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## Cohn (Dec 1, 2010)

usalsfyre said:


> Cohn, what is an IV going to do to actually TREAT someone? Except for simple hypovolemia, the fluid itself is not theraputic.







<-------

Ask one of the desert walkers if they feel even the slightest better after coming to us.


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## usalsfyre (Dec 1, 2010)

Cohn said:


> <-------
> 
> Ask one of the desert walkers if they feel even the slightest better after coming to us.



Still unconvinced. Are these folks that can't orally rehydrate? If so, wouldn't further investigation as to why they can't be called for? Resulting in the need for something more than an EMT with a merit badge?

Just because we can, doesn't mean we should.


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## jjesusfreak01 (Dec 2, 2010)

MrBrown said:


> Hartmans is ringers lactate



Google Translate

Kiwi --> English


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## TransportJockey (Dec 2, 2010)

jjesusfreak01 said:


> Google Translate
> 
> Kiwi --> English



I've said several time that the Kiwi's and Aussies on here and when they appear on podcasts need to have a translator standing by for those of us who speak American.. Hell, even the Brits we need one for at times.


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## goodgrief (Dec 2, 2010)

usalsfyre said:


> Cohn, what is an IV going to do to actually TREAT someone? Except for simple hypovolemia, the fluid itself is not theraputic.



D50

My thought is this, if something goes bad regardless if the paramedic told me to or not, it is my butt and license on the line. Therefore I am not going to any skill that I dont know the reason behind and the how to do it right.

starting an IV is more then just here is a needle hit the vein.  I know personally I dont want someone who hasnt had the training to start even an INT on me. Maybe my ex and feel free to go 12 gauge in the back of the hand.


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## Earthen (Dec 6, 2010)

Can we get a moderator to shut down this thread?   It's ridiculously off-topic at this point.


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