# EMT-B vs. EMT-I



## ClarkKent (Apr 5, 2009)

Where I live (Sacramento, Ca), there is only an EMT-B right to EMT-P.  I am not sure if they are combining the two classifications, or doing away with one.  What I am trying to find out what is the main differentness between EMT-B to an EMT-I (If your EMS system does not use the term EMT-B and EMT-I, I am saying the same thing as EMT-I and EMT-II)


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## 8jimi8 (Apr 5, 2009)

From what i read in EMS monthly, they are planning on phasing out EMT-I by 2014?


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## TransportJockey (Apr 5, 2009)

8jimi8 said:


> From what i read in EMS monthly, they are planning on phasing out EMT-I by 2014?



EMT-I should disapear in a few years to be replaced by the EMT-A designator


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## 8jimi8 (Apr 5, 2009)

Sorry, didn't mean to ignore your question.  A few more advanced interventions in your scope than an EMT-B. I haven't read the book, so i cannot list them for you!


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## ClarkKent (Apr 5, 2009)

Then what information am I missing from the EMT-I class?  I want to become an EMT-P some day and I do not want to miss out on any information


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## ClarkKent (Apr 5, 2009)

8jimi8 said:


> Sorry, didn't mean to ignore your question.  A few more advanced interventions in your scope than an EMT-B. I haven't read the book, so i cannot list them for you!



Where can I find the information that I am missing.  Until they have an EMT-A am I stuck as an EMT-B??


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## TransportJockey (Apr 5, 2009)

ClarkKent said:


> Where I live (Sacramento, Ca), there is only an EMT-B right to EMT-P.  I am not sure if they are combining the two classifications, or doing away with one.  What I am trying to find out what is the main differentness between EMT-B to an EMT-I (If your EMS system does not use the term EMT-B and EMT-I, I am saying the same thing as EMT-I and EMT-II)



Here in NM the differences are:
EMT-BASIC (EMT-B): 

(1)  The  following  allowed  skills,  procedures,  and  drugs  may  be  performed  without  medical 
direction: 

a.  Basic airway management 
b.  Use of basic adjunctive airway equipment 
c.  Suctioning 
d.  Cardiopulmonary resuscitation, according to current ECC Guidelines 
e.  Obstructed airway management 
f.  Bleeding control  
g.  Spine immobilization 
h.  Splinting 
i.  Scene assessment, triage, scene safety 
j.  Use of statewide EMS communications system 
k.  Childbirth (Imminent Delivery) 
l.  Glucometry 
m.  Oxygen 
n.  Other  non-invasive  procedures  as  taught  in  EMT-B  courses  adhering  to  DOT 
curricula 
o.  Wound management 

(2)  The following require Service Medical Director Approval 
a.  Allowable Skills: 
1.  Mechanical positive pressure ventilation.  
2.  Use  of  multi-lumen,  supraglottic,  and  laryngeal  airway  devices  (examples: 
PTLA, Combi-tube, King Airway, LMA) 3.  Pneumatic anti-shock garment 
4.  Application and use of semi-automatic defibrillators 
5.  Acupressure 
6.  Transport  of  patients  with  nasogastric  tubes,  urinary  catheters,  heparin/saline 
locks, PEG tubes, or vascular access devices intended for outpatient use 

b.  Administration of approved medications via the following routes: 
1.  Nebulized inhalation 
2.  Subcutaneous 
3.  Intramuscular 
4.  Intranasal 
5.  Oral (PO) 

c.  Allowable Drugs 
1.  Oral glucose preparations 
2.  Aspirin PO for adults with suspected cardiac chest pain 
3.  Activated charcoal PO 
4.  Acetaminophen PO in pediatric patients with fever  
5.  IM auto-injection of the following agents for treatment of chemical and/or nerve 
agent exposure: 
a.  atropine 
b.  pralidoxime 
6.  Albuterol (including isomers), via inhaled administration 
7.  Ipratropium,  via  inhaled  administration,  in  combination with  or  after  albuterol 
administration 
8.  Epinephrine via auto-injection device 
9.  Administration of naloxone by SQ, IM, or IN route 
10.  Administration  of  Epinephrine,  1:1000,  no  single  dose  greater  than  0.3  ml, 
subcutaneous or  intramuscular  injection with a pre-measured  syringe or 0.3 ml 
TB  syringe  for anaphylaxis or  status asthmaticus  refractory  to other  treatments 
under  on-line  medical  control.   When  on-line  medical  control  is  unavailable, 
administration is allowed under off-line medical control if the licensed provider 
is working under medical direction using approved written medical protocols.   

d.  Patient’s Own Medication that May be Administered 
1.  Bronchodilators using pre-measured or metered dose inhalation device  
2.  Sublingual nitroglycerine for unrelieved chest pain, with on line medical control 
only

EMT-I:
EMT-INTERMEDIATE (EMT-I): 

(1)  The  following  allowed  skills,  procedures,  and  drugs  may  be  performed  without  medical 
direction: 

a.  Basic airway management 
b.  Use of basic adjunctive airway equipment 
c.  Suctioning 
d.  Cardiopulmonary resuscitation, according to ECC Guidelines 
e.  Obstructed airway management 
f.  Bleeding control  
g.  Spine immobilization  
h.  Splinting 
i.  Scene assessment, triage, scene safety 
j.  Use of statewide EMS communications system 
k.  Childbirth (Imminent Delivery) 
l.  Glucometry 
m.  Oxygen 
n.  Wound management 

(2)  The following require Service Medical Director Approval: 

a.  Allowable Skills: 
1.  Mechanical positive pressure ventilation.  
2.  Use of multi-lumen,  supraglottic, and  laryngeal airway devices  (examples: 
PTLA, Combi-tube, King Airway, LMA) 
3.  Pneumatic anti-shock garment 4.  Application and use of semi-automatic defibrillators 
5.  Acupressure 
6.  Transport  of  patients  with  nasogastric  tubes,  urinary  catheters, 
heparin/saline  locks,  PEG  tubes,  or  vascular  access  devices  intended  for 
outpatient use 
7.  Peripheral venous puncture/access 
8.  Blood drawing 
9.  Pediatric intraosseous tibial access 
10.  Adult intraosseous access 

b.  Administration of approved medications via the following routes: 

1.  Intravenous 
2.  Intranasal 
3.  Nebulized inhalation 
4.  Sublingual 
5.  Subcutaneous 
6.  Intradermal 
7.  Intraosseous  
8.  Endotracheal  (for  administration  of  epinephrine  only,  under  the  direct 
supervision of an EMT-Paramedic, or  if  the EMS service has an approved 
special skill for endotracheal intubation) 
9.  Oral (PO) 
10.  Intramuscular 

c.  Allowable Drugs 

1.  Oral glucose preparations.  
2.  Aspirin PO for adults with suspected cardiac chest pain.  
3.  Activated charcoal PO 
4.  Acetaminophen PO in pediatric patients with fever  
5.  IM auto-injection of  the  following agents  for  treatment of chemical and/or 
nerve agent exposure: 
(i)  atropine 
(ii)  pralidoxime 
6.  Albuterol (including isomers) via inhaled administration 
7.  Ipratropium,  via  inhaled  administration,  in  combination  with  or  after 
albuterol administration 
8.  Naloxone 
9.  I.V. fluid therapy (except blood or blood products) 
10.  50% Dextrose – intravenous 
11.  Epinephrine via auto-injection device 
12.  Epinephrine  (1:1000), SQ or  IM  for  anaphylaxis  and known  asthmatics  in 
severe respiratory distress (no single dose greater than 0.3 cc)  
13.  Epinephrine  (1:10,000)  in  pulseless  cardiac  arrest  for  both  adult  and 
pediatric  patients.   Epinephrine may  be  administered  via  the  endotracheal 
tube in accordance with ACLS and PALS guidelines.  
14.  Nitroglycerin  (sublingual)  for  chest  pain  associated  with  suspected  acute 
coronary  syndromes.   Must  have  intravenous  access  established  prior  to 
administration  or  approval  of  online  medical  control  if  IV  access  is 
unavailable. 
15.  Morphine, fentanyl, or dilaudid for use in pain control with approval of on-
line medical control 
16.  Diphenhydramine for allergic reactions or dystonic reactions 
17.  Glucagon,  to  treat  hypoglycemia  in  diabetic  patients  when  intravenous 
access is not obtainable 18.  Promethazine and anti-emetic agents, for use as an anti-emetic 
19.  Methyprednisoline for reactive airway disease/acute asthma exacerbation 
20.  Hydroxycobalamine 

d.   Patient’s Own Medication that May be Administered 
1.  Bronchodilators using pre-measured or metered dose inhalation device  
2.  Sublingual nitroglycerine for unrelieved chest pain. Must have  intravenous 
access established prior to administration or approval of online medical 
control if IV access is unavailable.


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## 8jimi8 (Apr 5, 2009)

depending on your school / state you can skip I and go to P.  
I'm sure you will learn everything in P that you would in I.  I think it is more advanced pharmacology, insertion of IVs, assisting with ECG, i'm pretty sure you are allowed to intubate w/ ETT.  You will learn some arrythmias... i can't remember, i was looking at the EMT-B board while the EMT-I was in a classroom behind us.  

you won't miss anything if you get into paramedic school (if you go to an accredited school!)


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## ClarkKent (Apr 5, 2009)

8jimi8 said:


> if you go to an accredited school



I have done my homework around my area and from what I have found by talking to different EMS personal and web searches, the instructors (both Cap that every fire fighter and EMT-P knows) are very good.  That is why I am passing up two other colleges just to have them at instructors.  

Thank you jtpaintball70 that is a lot of information that is not being covered in my EMT class so now I know that when I pass my NREMT test, it is for an EMT-B and not an EMT-I and now I know how to post my correct training classifications on this board.  I will be an EMT-B (or EMT-1). Thank you for every one helps.


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## TransportJockey (Apr 5, 2009)

ClarkKent said:


> I have done my homework around my area and from what I have found by talking to different EMS personal and web searches, the instructors (both Cap that every fire fighter and EMT-P knows) are very good.  That is why I am passing up two other colleges just to have them at instructors.
> 
> Thank you jtpaintball70 that is a lot of information that is not being covered in my EMT class so now I know that when I pass my NREMT test, it is for an EMT-B and not an EMT-I and now I know how to post my correct training classifications on this board.  I will be an EMT-B (or EMT-1). Thank you for every one helps.



Your welcome. Keep in mind that that is NM scope and not NR. In some parts it's a bit broader than NR.


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## ClarkKent (Apr 5, 2009)

jtpaintball70 said:


> Your welcome. Keep in mind that that is NM scope and not NR. In some parts it's a bit broader than NR.



"NM" and "NR" stand for???


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## TransportJockey (Apr 5, 2009)

ClarkKent said:


> "NM" and "NR" stand for???



NM is New Mexico
NR is National Registry


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## ClarkKent (Apr 5, 2009)

jtpaintball70 said:


> NM is New Mexico
> NR is National Registry



Thank you for making that clear for this newbi


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## Ms.Medic (Apr 6, 2009)

ClarkKent said:


> Where I live (Sacramento, Ca), there is only an EMT-B right to EMT-P.  I am not sure if they are combining the two classifications, or doing away with one.  What I am trying to find out what is the main differentness between EMT-B to an EMT-I (If your EMS system does not use the term EMT-B and EMT-I, I am saying the same thing as EMT-I and EMT-II)



According to all of the post that I have read from you, I would highly suggest that you do some more research on this field before you go into it. Just my opinion.


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## bstone (Apr 7, 2009)

I'm an EMT-I. They keep adding things to our protocls. We just got CPAP, LMAs, King, 12-leads and DuoNeb HHN.


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## AJ Hidell (Apr 7, 2009)

Nevermind..


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