# What Education and Training Certifications can a EMT-Basic take?



## hatsuo (Jan 19, 2012)

What are some certifications a EMT-B get certified in?


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## NomadicMedic (Jan 19, 2012)

There are several advanced level "merit badge classes" you can take, none will provide you any additions to your scope of practice. 

You can also take fire classes, rescue classes and online NIMS classes. 

Your best bet for additional classes is to investigate paramedic school.


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## ethomas4 (Jan 30, 2012)

not much to get "certified" in. but..

take what ever class you can. As mentioned above sometimes taking a class wont give you a right to actually do more things but always push to learn and take advanced classes. Someday it will pay off, you will discover new things, meet new people. I encourage you to take whatever class interests you. Study hard and make the best of it.

I have taken advanced courses as an EMT B before, some people really got on my case about it. I have never said "this is a waste of time." its all about learning and challenging yourself. 

I agree best next certification is P school.

look at vertical rescue, thats a course almost everyone is a beginner in.

good luck


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## JPINFV (Jan 30, 2012)

Someone needs to make a line of basic science courses under the heading of life support. Who wouldn't want to be certified in Advanced Physiology Life Support?


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## EpiEMS (Jan 30, 2012)

ethomas4 said:


> I have taken advanced courses as an EMT B before, some people really got on my case about it. I have never said "this is a waste of time." its all about learning and challenging yourself.



What sort of advanced courses are available? I noticed you mentioned vertical rescue. Is there, say, anything on hazardous materials, trauma, or infectious disease (particular interests)


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## Maine iac (Jan 30, 2012)

There are many courses that you can take. Many of them are typically associated with ALS, but there is always a BLS component which you can test at. Some off the top of my head are GEMS, PEPP, maybe NRP, fire 1, HAZMAT responder (probably not the correct name), PHTLS/ITLS/ATLS, somebody mentioned NIMS, basic life support instructor.

You will find though that anything medical will be lacking in "basic" areas because very quickly it all becomes advanced life support.

Something that I think all basics should know something about is pharmacology. It is not talked about at all in a basic class, but should be as anybody on the streets has to deal with it! There are many good books on prehospital pharma or toxicology, and it would probably help you understand what your pts are on and why they are taking them.


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## EpiEMS (Jan 30, 2012)

Speaking to knowing pharmacology, would it be worthwhile to review commonly prescribed meds or meds that might indicate the cause of a call?


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## Maine iac (Jan 30, 2012)

Totally!!

Just off the top of my head it could be a call for a female complaining of nondescript backpain. Slow onset a little while ago, just an achy feeling in the center of the back, no real other complaints, maybe worse with movement... You guys are dual BLS providers so you can't put her on the monitor but you notice she is rolling deep with cardiac meds. She didn't really tell you much about her cardiac hx because it is just some weird back pain, but hey she could be having an MI.

Or knowing that if a trauma pt is not going to be able to compensate like you or I because they are on rate control drugs might make you react differently or take them to a different hospital.


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## EpiEMS (Jan 30, 2012)

Makes good sense.


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## mycrofft (Jan 30, 2012)

Forget certificates, get some degrees! We need PEMS (prehospital EMS) people who will dig in, go get those master's and doctorates (and baccalaureates too) and start giving back to the patients and their "brethren and sisteren" working with patients every day. 

Decide what part of your EMT-B class either interested you the most, or you still have questions about, then dig in on your own. THInk about what you would like to be able to do, then learn about it, even if you can't use it; learn all about it. Go visit your EMT instructors and ask *them.*


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## DrParasite (Jan 30, 2012)

Maine iac said:


> Just off the top of my head it could be a call for a female complaining of nondescript backpain. Slow onset a little while ago, just an achy feeling in the center of the back, no real other complaints, maybe worse with movement... You guys are dual BLS providers so you can't put her on the monitor but you notice she is rolling deep with cardiac meds. She didn't really tell you much about her cardiac hx because it is just some weird back pain, but hey she could be having an MI.


or she might be having plain old muscular back pain.  when you hear hoofbeats, think horses, not zebras or eagles.





Maine iac said:


> Or knowing that if a trauma pt is not going to be able to compensate like you or I because they are on rate control drugs might make you react differently or take them to a different hospital.


ummm, I'm not a medic, but I thought a trauma patients needs a trauma center?  usually they need blood and/or a trauma surgeon to fix the problem, and if they are going to crash, very little yo can do about it.

As for merit badge classes to take, you can look at PHTLS, AMLS, GEMS, PEPP, ICS 200 & 300, HazMat Ops, Defensive Driving/EVOC, LSI (awareness and operations) and START.  They can't replace experience, but they can help prepare you for dealing with stuff you may see on the job.


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## JPINFV (Jan 30, 2012)

DrParasite said:


> or she might be having plain old muscular back pain.  when you hear hoofbeats, think horses, not zebras or eagles.


I wouldn't quite call an atypical (non-chest pain) MI presentation a zebra. 



> ummm, I'm not a medic, but I thought a trauma patients needs a trauma center?  usually they need blood and/or a trauma surgeon to fix the problem, and if they are going to crash, very little yo can do about it.


Because all trauma patients go to a trauma center? I mean, if I stub my toe and stupidly call 911, I'm still a trauma patient, just not a patient needing a trauma center. However, what happens when medications interfere with the body's attempt to gain homeostasis? A response that we're supposed to be looking at to help determine the severity of the patient's injuries?


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## Handsome Robb (Jan 30, 2012)

JPINFV said:


> I wouldn't quite call an atypical (non-chest pain) MI presentation a zebra.
> 
> 
> Because all trauma patients go to a trauma center? I mean, if I stub my toe and stupidly call 911, I'm still a trauma patient, just not a patient needing a trauma center. However, what happens when medications interfere with the body's attempt to gain homeostasis? A response that we're supposed to be looking at to help determine the severity of the patient's injuries?



Agreed 100% Extensive cardiac hx with back pain and nothing pointing to trauma? AMI is far from a zebra on that call. High index of suspicion. It takes 2 minutes to rule out cardiac with a 12 lead. As a basic, go with your gut.

Ever heard of trauma criteria DrP?


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## johnrsemt (Jan 31, 2012)

To answer the OP;  as an EMT-B you can take almost all of the classes and certifications that a Paramedic can take;  you just can't always get the certification.
  But it is good training,  and a great way  to get your CE hours done.

  I always thought it was a good idea to take the same courses (esp if your company/dept pays for them)  that way you make a good sounding board for your partner/medic.  I always made sure that my BLS partner knew the ALS protocols;  it is a good way to double check yourself.


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## DrParasite (Jan 31, 2012)

JPINFV said:


> Because all trauma patients go to a trauma center? I mean, if I stub my toe and stupidly call 911, I'm still a trauma patient, just not a patient needing a trauma center. However, what happens when medications interfere with the body's attempt to gain homeostasis? A response that we're supposed to be looking at to help determine the severity of the patient's injuries?


are you serious?  while a stubbed toe IS a traumatic injury, it isn't a trauma patient.  unless you think the stubbed toe is going to decompensate because they are on rate control drugs take them to a different hospital.

we both know the comment I was referring to was not talking about a toe injury, it was a serious traumatic injury.

stop taking what I said out of context.

and yes, multi system trauma (or anything that meeting trauma criteria) should probably go to a trauma center not a local hospital, regardless of what other medications the injured party is on.


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## JPINFV (Jan 31, 2012)

So the stubbed toe is a medical patient? That's admittedly an extreme, so how about a patient in a car accident? When medication has the ability to block the body's response to a tramatic insult, then it has to be taken into account when deciding if a patient suffering from a traumatic insult meets criteria to bypass hospitals for a trauma center. Alternatively, do you take all patients involved in a car accident to a trauma center?


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## Maine iac (Jan 31, 2012)

The greater point is that this guy wants to become a better provider. I have seen many medics ask the question: How can I be better?, but I haven't seen many EMTs wanting to do higher level learning, purely for knowledge sake. The basic class does not even mention the word pharmacology and since it is not directly presented to them I can't expect many to understand it. Knowing what these drugs can do to the patients will make anybody a better provider.

Maybe a toe isn't trauma criteria, but I've seen many substantial ortho injuries go to non trauma hospitals (for this I am classifying a trauma hospital as Level 1). I can loose 1/5 of my circulating volume into my thigh and when my heart can not compensate for this loss because of a medication, I as the provider need to start watching out for more serious signs of shock. Maybe this basic has dealt with a bad ortho injury in an elderly pt, but down played it because the pt. still has normal vitals, when in actuality the pt was in trouble. It could be the difference between running lights and sirens or going with traffic. 

In my opinion all the classes need a solid 50 hours extra (minimum) of pharmacology.


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## EpiEMS (Jan 31, 2012)

Maine iac said:


> In my opinion all the classes need a solid 50 hours extra (minimum) of pharmacology.



There are mid-level practitioners who can legally prescribe with less than 50 hours of pharmacology training, oddly. I can't imagine that more education would hurt.


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## Tigger (Feb 1, 2012)

DrParasite said:


> or she might be having plain old muscular back pain.  when you hear hoofbeats, think horses, not zebras or eagles.ummm, I'm not a medic, but I thought a trauma patients needs a trauma center?  usually they need blood and/or a trauma surgeon to fix the problem, and if they are going to crash, very little yo can do about it.



Just some food for thought but myy understanding is that the presentation given my Maine Iac 


> Just off the top of my head it could be a call for a female complaining of nondescript backpain. Slow onset a little while ago, just an achy feeling in the center of the back, no real other complaints, maybe worse with movement"


is a rather common presentation in females for MIs. So much so that the AHA is starting to roll out commercials for the main stream media. This one was shared in my refresher class:
[YOUTUBE]http://www.youtube.com/watch?feature=player_embedded&v=t7wmPWTnDbE[/YOUTUBE]

If that link does not work try: http://www.youtube.com/watch?feature=player_embedded&v=t7wmPWTnDbE

Not every trauma patient needs a trauma center either. If a stubbed toe isn't a trauma patient, what is it exactly? (Besides BS that is...)

Incidentally, I hit a tree skiing two days ago and was transported by ambulance. I was not initially transported to a trauma center, nor was I transferred to one. I was in a lot of pain to be sure and couldn't move on my own, but I did not have injuries that made it necessary to be seen at a an ACS verified trauma center.


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## EpiEMS (Feb 1, 2012)

Speaking of trauma, what (if any) criteria distinguish which level of trauma center you should go to, if there are multiple ACS verified trauma centers of varying levels around?


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## Tigger (Feb 1, 2012)

EpiEMS said:


> Speaking of trauma, what (if any) criteria distinguish which level of trauma center you should go to, if there are multiple ACS verified trauma centers of varying levels around?



Here is the Massachusetts trauma point of entry plan, which is to be followed by all agencies operating in the Commonwealth. It is slowly starting to come into use, but it is a bit impractical given the lack of ACS verified facilities outside of major population centers.


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## EpiEMS (Feb 1, 2012)

Tigger said:


> Here is the Massachusetts trauma point of entry plan, which is to be followed by all agencies operating in the Commonwealth. It is slowly starting to come into use, but it is a bit impractical given the lack of ACS verified facilities outside of major population centers.



It makes good sense in urban and near-urban areas, I suppose. It's logical in a normal situation (i.e. not an overwhelming MCI) a patient is very critical, then bring to the highest level.

Can't help but wonder what would happen in a massive MCI scenario — with overwhelmed urban trauma centers. Oy vey...


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## Tigger (Feb 1, 2012)

EpiEMS said:


> It makes good sense in urban and near-urban areas, I suppose. It's logical in a normal situation (i.e. not an overwhelming MCI) a patient is very critical, then bring to the highest level.
> 
> Can't help but wonder what would happen in a massive MCI scenario — with overwhelmed urban trauma centers. Oy vey...



I worry more about MCIs in areas that are served exclusively by community hospitals that have limited bed space in both the ER and the rest of the facility.


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## EpiEMS (Feb 1, 2012)

Tigger said:


> I worry more about MCIs in areas that are served exclusively by community hospitals that have limited bed space in both the ER and the rest of the facility.



Oy vey. Now I'm even more frightened.

Now add CBRN and that's just...oy veys mir...


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## JPINFV (Feb 1, 2012)

EpiEMS said:


> Speaking of trauma, what (if any) criteria distinguish which level of trauma center you should go to, if there are multiple ACS verified trauma centers of varying levels around?



There's very little difference between a level 1 and level 2 (mostly being the presence of a residency and production of research), hence we don't differentiate between them. The area of the country I'm most knowledgeable about does not utilize anything beyond level 2.


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## paradoqs (Feb 1, 2012)

If your pt is critical wouldnt you want to go to the closest available facility with a trauma designation to stabilize the pt and let that facility decide if they want to transfer? Thats what my med dir wants us to do.


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## mycrofft (Feb 1, 2012)

OP, you get your answer before we went to Alpha Centauri?


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## EpiEMS (Feb 2, 2012)

mycrofft said:


> OP, you get your answer before we went to Alpha Centauri?



It's only ~4 lightyears away...


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