# Difference between EMR and EMT-B?



## nomofica (Apr 2, 2009)

I know they're "equivalent" to one another, but are EMT-B's taught more than EMRs in Alberta?

From what I've noticed, EMT-B's find more work in their states than an EMR does in Alberta. I know somebody can shed some light on this for me.


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## AJ Hidell (Apr 2, 2009)

The answer is simple.  Your educational standards are twice what ours are in the U.S.

The reason for the job disparity is two-fold.  Primarily it is because there are a LOT more private, non-emergency ambulance driver jobs in a free society than in Communist Canada.  That means there are a lot more employers and a lot more jobs here.  Second, it is because EMT is our established entry level for those jobs.  EMR is not.

Trust me, there is no advantage to being an EMT-B here over being an EMR there.  It just overqualifies you for a transfer job, or it underqualifies you for an emergency job.  Either way, it doesn't pay squat.


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## nomofica (Apr 2, 2009)

So in a simple-termed comparison, EMR > EMT-B?


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## AJ Hidell (Apr 2, 2009)

nomofica said:


> So in a simple-termed comparison, EMR > EMT-B?


In what respect?  Training?  Scope of practice?  Job prospects?


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## nomofica (Apr 2, 2009)

AJ Hidell said:


> In what respect?  Training?  Scope of practice?  Job prospects?



Training/scope of practice


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## jochi1543 (Apr 2, 2009)

I think EMR/EMT-B scope of practice is actually different, and the differences vary state-to-state. I have no idea what the national competencies are for EMT-B, but from reading this forum, I've found instances where the EMT-B scope was below EMR (e.g. not allowed to take BGL) and where it was above (i.e. using Combitubes, King LTs, and LMAs). We are similar in some aspects (length of training, inability to do IVs, whatever), but you can't say that EMR > EMT-B, or vice versa. Just like EMTs/PCPs have slightly different scopes across the provinces....say, an Alberta EMT can administer Atrovent and a BC PCP can't, but a BC PCP can administer Narcan, while an AB EMT can't. Doesn't mean one is better than the other, there are just some differences. Now, PCP vs. ACP? That's a HUGE difference in training and scope of practice. But country vs. country or province vs. province comparisons don't amount to much when the levels are roughly the same.


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## AJ Hidell (Apr 2, 2009)

I agree with Jochi.  There are comparisons and differences to be noted, but no overall proclamation of superiority of either over the other.  The variations in the quality of EMT training in the US, which varies from as little as 110 hours to almost three times that much, are just too great to generalize.  The only thing I would say with certainty is that an EMT-B is better prepared for working in an ambulance environment than an EMR.  Not really a superiority thing.  Just a difference in focus between the two programs.


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## nomofica (Apr 2, 2009)

Okay, that clears some things up for me.
Thanks, guys!


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## jochi1543 (Apr 2, 2009)

AJ Hidell said:


> The only thing I would say with certainty is that an EMT-B is better prepared for working in an ambulance environment than an EMR.  Not really a superiority thing.  Just a difference in focus between the two programs.



You guys have clinicals for EMT-Bs, correct? Or does that vary state to state, too? Because we don't have any clinical requirements for EMRs...so that aspect of training would definitely allow EMT-Bs to be better prepared for working than EMRs. Just thinking of my EMT-A/I practicum, I had worked as an EMR for a bit prior, did maybe 20 calls, nothing special, mostly transfers. But compared to my classmates who had absolutely no experience prior to EMT-A/I practicum, I was lightyears ahead. I may not have gotten to ever give a med, restrain a combative patient, or dress a wound as an EMR, but I had taken vitals many times, including in a moving ambulance, I learned to work with a partner (big transition for some, from the "I do everything" scenarios to suddenly having a 2nd person jump in and often try to take over), I became comfortable talking to patients, touching them, etc. One of my partners often says that one must do at least 15 calls before they finally feel at ease working. Even a little bit of practical experience makes a HUGE difference, so having required clinical time would be a major advantage to EMT-Bs over EMRs. I don't think ride-alongs can compare to actual clinicals, because you usually don't do anything - and if you do, it's because the crew tells you to.


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## fortsmithman (Apr 3, 2009)

I asked some of my services senior members about what the USA equivalent of EMR is and they all said that EMR is a cross between CFR and EMT-B.


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## scottyb (Apr 3, 2009)

jochi1543 said:


> You guys have clinicals for EMT-Bs, correct? Or does that vary state to state, too?



I can only speak to NY and NREMT (and with limited experience), but both of those require Practical Examination.  And in NY, there is a required 10 ER/Ride along "internship"for lack of a better word, at least when I took my class.


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## xlq771 (Apr 4, 2009)

I don't think there is much difference between the US EMT-Basic and Canadian EMR levels.  I have done both programs - the Alberta EMR program at the now defunct Western College of EMS in Hinton, and the US/NYS EMT-Basic program at the Erie County Fire Academy outside Buffalo. 

Both programs were taught in the same format, both for lectures, and for practical skills labs.  While the EMT-Basic program was supposed to be 127 hours on paper, there were days that class was dismissed early, so it was closer to 110 hours.  The EMR program, while only 80 hours in class, required more self study, and gave more homework.  It also used Mosby's book The Basic EMT, as its course book.  The EMR program was the only program that taught the use and loading of an ambulance cot - the EMT program was geared to firefighters.


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