# Taking the next step...



## silvercat354726 (Aug 19, 2008)

Well I am going to be taking the next step in EMT.  I start class Sept 2, for EMT-I.  I didn't think NY even offered the class anymore.  I found a place about an hour away.  I called to see when they offered it again and they only offer it once a year.  So I figured out a way I could take the class this year, with my husband working until about 8pm.  So I will take this class and maybe in a year or so I will sign up for medic class.  I don't want to jump into medic, so I thought I would start with EMT-I.   So for anyone that has taken the EMT-I do you have any suggestions for me?  Does anyone know what book they use?


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## KEVD18 (Aug 19, 2008)

intermediate isnt a stepping stone. its a bs rank used almost exclusively by companies or departments that cant afford or wont pay for real als. 

my recommendation would be either save your money, keep working as a basic and when you're ready to pull the trigger on your medic, do so; or go to medic school. you have to be a basic before you can be a medic. you DONT have to be an -I. if you go to -I school with the intention of easing the transition to medic, your going to be disappointed.


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## bstone (Aug 20, 2008)

KEVD18 said:


> intermediate isnt a stepping stone. its a bs rank used almost exclusively by companies or departments that cant afford or wont pay for real als.



I take major offense to that. Perhaps you can retract it?


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## silvercat354726 (Aug 20, 2008)

It isn't that my company won't pay for ALS, it is what I want to do and see if I want to take the step into medic.  If it isn't a stepping stone than why is it offered?


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## Ridryder911 (Aug 20, 2008)

Levels between the Basic and Paramedic were and are designed as substitutes for the real thing. Taking small snipits of the curriculum and making them a certification is a cheap, and doing things half arse way of stating you have ALS. 

They were initially designed for areas until the full program could be developed and be put in placed. Never meant to be a free standing certification to stop at. Unfortunately too many took advantage and never progressed upwards as they were supposed to. 

Intermediate (which is supposed to be half way) has become a cheap way of having ALS without the benefits. Administration can charge for ALS rates, and even hire those having the EMTI/99 and pay peanuts for a placebo Paramedic. Which is not fair for the medic, the patient nor the system. 

I am not against the Intermediate level itself, only that one should be able to register only once while they are in Paramedic school. 

R/r 911


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## KEVD18 (Aug 20, 2008)

bstone said:


> I take major offense to that. Perhaps you can retract it?




brad, im sorry that it offends you, but i stand by what i said. the intermediate was created as a half *** attempt to avoid the high cost of paramedics. that doesnt mean your a halfassed emt. it doesnt mean your a bad guy. it doesnt mean anything other than the system is flawed and we have a useless rank.


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## BossyCow (Aug 20, 2008)

KEVD18 said:


> brad, im sorry that it offends you, but i stand by what i said. the intermediate was created as a half *** attempt to avoid the high cost of paramedics. that doesnt mean your a halfassed emt. it doesnt mean your a bad guy. it doesnt mean anything other than the system is flawed and we have a useless rank.



I gotta say that any attempt to learn more and widen a skill set should be applauded. In the rural setting, where we often have to wait for ALS to arrive from a distance, being able to start IVs, maintain an airway and other ILS skills means ALS has a patient to work with when they arrive instead of just a body.


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## Ridryder911 (Aug 20, 2008)

Actually there has been little validation of ILS changing any outcomes in patient care. IV alone does not change outcome without medication being administered. Doubtful that 250 -1000 ml of fluid is going to change the outcome as well. 

Again a band-aid to fix an arterial bleed... never works. 

R/r 911


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## KEVD18 (Aug 20, 2008)

BossyCow said:


> I gotta say that any attempt to learn more and widen a skill set should be applauded. In the rural setting, where we often have to wait for ALS to arrive from a distance, being able to start IVs, maintain an airway and other ILS skills means ALS has a patient to work with when they arrive instead of just a body.



im all for the advancement of education. knowledge is a powerful thing, but a little knowledge is an accident looking for a place to happen.


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## stephenrb81 (Aug 20, 2008)

In my opinion, If you are in EMS short term (Using it for healthier resume, wetting your feet in health care before jumping into medical school, just for the ego boost, etc...) then I suppose Intermediate wouldn't be a bad choice.

Now, if this is actually your chosen career and you see yourself in a paramedic program within the next 2-3 years then why waste the money?  I'm not sure how the long the intermediate program is because my state doesn't fully recognize it but I assume its around 8-12months, and probably around 1500-3000 dollars (again, assuming, no real clue there).  Well, why spend a year having basic skills reinforced, learn IV therapies, and a few drugs then a few months after your done jump in a paramedic program to reinforce basic skills, learn the intermediate stuff all over again and then add the paramedic training on top?  See my point?  You just dumped away a year and a few thousand dollars to learn something you were going to learn anyways.

Advance apologies for any toe-stepping that might've just occured lol


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## Ridryder911 (Aug 20, 2008)

No apologies needed. Intermediate is a dying breed. Most that used such have added the skills into their basic criteria and still do not have to pay for advanced training. 

I know my state still has it but most institutions have abandoned the training due to lack of interest from employers and EMT's. 

We have Intermediates as any Basic has to be at an Intermediate within one year or be terminated. Unfortunately, they do not receive any further benefits other than they can keep their job. 

R/r 911


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## BossyCow (Aug 21, 2008)

Okay.. for instance... I'm called out to a diabetic emergency. Pt has a glucose of 30 something. ALS is 15 minutes out if I can get it. With an EMT-I in my rig, we can present ALS with a pt that has had sugar, is starting to improve. Without it, by the time I rendezvous with ALS the pt is either combative, seizing or unconscious. I've run several of these.

Another instance; traumatic amputation of the leg car vs motorcycle. Two large bore IV's started on scene were done while the pt still had veins. According to our MPD, without it pt would have died. 

I've also had two overdoses, the ability of the EMT-I to give Narcan meant the pt was conscious and breathing on their own when we met up with ALS instead of being bagged enroute. 

I am not yet an EMT-I. We used to have 2 in our district but both have moved away. Our ALS support is dwindling away to nothing and I see the extra skills allowed under EMT-I as an asset. Knowing more and being able to do more has got to be better than nothing. Unfortunately nothing is the alternative here.


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