# EMT-B vs. EMT-A



## frdude1000 (Feb 2, 2009)

Hello Everyone.  Before I became involved in EMS, there was a certification called EMT-A, at least in Maryland there was.  What was its scope of practice?  How does it compare to the EMT-B, First responder?  Why did we abandon it and change to EMT-B?


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## rmellish (Feb 2, 2009)

As an Advanced in Indiana, I can say that the AEMT cert is a high level of care than EMT-B. AEMT became far less popular as paramedics, true ALS, became more available and thus less expensive than they had been previously. 

Indiana is slowly phasing the certification out by putting in place strict requirements to be approved to teach an advanced course. I wouldn't expect the cert to last more than 5-6 more years here, the way things are moving.


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## Ridryder911 (Feb 2, 2009)

In the older days EMT-A stood for EMT Ambulance, not EMT Advanced. Even NREMT classified as such. Before one could obtain a patch, you would have to have at the least 6 months Ambulance experience. The rocker (like the EMT/I) had the wording Ambulance. It was an honor to have the ambulance rocker, demonstrating you had experience. 

R/r 911


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## ffemt8978 (Feb 2, 2009)

And if you turn on the Way Back Machine, EMT-A used to stand for EMT-Ambulance....


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## rhan101277 (Feb 2, 2009)

Yeah I like the patches myself, gives you a good feeling.


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## frdude1000 (Feb 2, 2009)

Ok I understand what it means, but how is it different from emt-b?


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## rmellish (Feb 2, 2009)

Ridryder911 said:


> In the older days EMT-A stood for EMT Ambulance, not EMT Advanced. Even NREMT classified as such. Before one could obtain a patch, you would have to have at the least 6 months Ambulance experience. The rocker (like the EMT/I) had the wording Ambulance. It was an honor to have the ambulance rocker, demonstrating you had experience.
> 
> R/r 911



And, I stand corrected....


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## Ridryder911 (Feb 2, 2009)

frdude1000 said:


> Ok I understand what it means, but how is it different from emt-b?



All were considered basics but those without ambulance were considered just EMT's. With the modification of EMT standards, NREMT dropped the rating and lumped them altogether. 
There is no difference in Basic EMT, EMT/B etc. Starting this year NHTSA official titles will  be EMT, EMT Advanced, and Paramedic without the EMT wording.


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## Wee-EMT (Feb 3, 2009)

I'm an EMT-A up here in the cold north, Which is like being an EMT/I in the states. Ours stands for EMT-Ambulance. 

EMR=EMT/B, EMT-A=EMT/I, and then Paramedic. EMR's (EMT-B's) can not get work in the city.


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## JPINFV (Feb 3, 2009)

ffemt8978 said:


> And if you turn on the Way Back Machine, EMT-A used to stand for EMT-Ambulance....


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## Bosco578 (Feb 3, 2009)

Wee-EMT said:


> I'm an EMT-A up here in the cold north, Which is like being an EMT/I in the states. Ours stands for EMT-Ambulance.
> 
> EMR=EMT/B, EMT-A=EMT/I, and then Paramedic. EMR's (EMT-B's) can not get work in the city.


 
Are you not an EMT student?


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## fortsmithman (Feb 6, 2009)

Wee-EMT said:


> I'm an EMT-A up here in the cold north, Which is like being an EMT/I in the states. Ours stands for EMT-Ambulance.
> 
> EMR=EMT/B, EMT-A=EMT/I, and then Paramedic. EMR's (EMT-B's) can not get work in the city.


I thought Edmonton fire was requiring their fire recruits to be EMR's.


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## Bosco578 (Feb 6, 2009)

fortsmithman said:


> I thought Edmonton fire was requiring their fire recruits to be EMR's.


 
They do. They having nothing to do with Edmonton EMS,other than occasionally get in the way.


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## fortsmithman (Feb 6, 2009)

Bosco578 said:


> They do. They having nothing to do with Edmonton EMS,other than occasionally get in the way.



They also get in the way here in the nwt as well.:lol:


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## jochi1543 (Feb 6, 2009)

Wee-EMT said:


> I'm an EMT-A up here in the cold north, Which is like being an EMT/I in the states. Ours stands for EMT-Ambulance.
> 
> EMR=EMT/B, EMT-A=EMT/I, and then Paramedic. EMR's (EMT-B's) can not get work in the city.



They don't call us EMT-As anymore, just EMTs.


I wish we'd finally take on the same titles as the rest of the country (primary/advanced/critical care paramedic).


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## fortsmithman (Feb 7, 2009)

jochi1543 said:


> I wish we'd finally take on the same titles as the rest of the country (primary/advanced/critical care paramedic).


That change will probably happen.


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## jochi1543 (Feb 7, 2009)

fortsmithman said:


> That change will probably happen.



Would be nice, I find that most people don't even know what an EMT is, and I don't want to misrepresent myself by saying I'm a paramedic (like one of my classmates who said he was "going to medical school" ), so it always comes down to something like, "Well, I work for the ambulance..." "Oh, you are an ambulance driver!? That's so awesome" "....." LOL.


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## RESQ_5_1 (Feb 7, 2009)

We hire EMR's here in the "True Northern Alberta". EMR/Emt= BLS....EMT/Paramedic=ALS. we even have some crews that are EMR/EMR. And, EMT-B is actually just a touch higher than EMR. When I did my equivelancy, all I needed was 12-1 skills and gap training. I actually (at the time) had learned more than EMR's learn in Alberta. The nice thing about the requirements in Alberta to achieve the level of EMT or Paramedic, is that it builds on each level. As opposed to simply going into Paramedic school with no experience or foundation.


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## jochi1543 (Feb 7, 2009)

RESQ_5_1 said:


> We hire EMR's here in the "True Northern Alberta". EMR/Emt= BLS....EMT/Paramedic=ALS. we even have some crews that are EMR/EMR. And, EMT-B is actually just a touch higher than EMR.



Really? I haven't looked too much into it, but I remember reading on this forum that EMT-Bs can't even do BGL testing, at least in some states...


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## mycrofft (Feb 8, 2009)

*We original EMT-A's used to paint our faces and shake rattles...*

In Nebraska when I got mine (1977-78) just needed to pass the basic class (one semester at Metro Technical College, Omaha), and a shift clinical in an ER (mine was  at the old red brick St Joseph/Creighton hospital on the bluffs). That got you the state EMT-A, IAW Dept of Transportation (not NREMT). To work in Lincoln you had to get a city license also. No rockers or anything, just painted A or P on our foreheads with berry juice.


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## Kendall (Feb 19, 2009)

jochi1543 said:


> Really? I haven't looked too much into it, but I remember reading on this forum that EMT-Bs can't even do BGL testing, at least in some states...



The differences in scope balance out in most respects. For instance, EMT-B's in some states can not do BGL monitoring while we EMR's can. EMT-B's are allowed to carry and administer Epi-Pens while we are only able to "assist" our patient in administering it (which I personally don't see much point in; if someone has an Epi-Pen, why would they call an ambulance to give it to them? If you're calling an ambulance for an allergic reaction its likely that you DON'T have an epi-pen...)


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## Kendall (Feb 19, 2009)

jochi1543 said:


> I wish we'd finally take on the same titles as the rest of the country (primary/advanced/critical care paramedic).



I agree 100%... But I wouldn't count on it happening anytime soon, with the Health Disciplines Act and all that coming into force. And then there's the whole problem of the College of Paramedics, but that's a whole new can of worms.


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## bradnovlesky (Feb 19, 2009)

i thought the new nremt ranks dont start until 2015 ( EMR replacing FR/ EMT replacing EMT-B/ AEMT replacing the EMT I /


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## fortsmithman (Feb 20, 2009)

Here in Canada mainly in western Canada we are using EMR which is equal to EMT-B used in the USA.  Our EMT or PCP is equal to EMT-I and paramedic which is the same.


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## bradnovlesky (Feb 22, 2009)

does anyone else herd anything about the new nremt ranks??


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## VentMedic (Feb 22, 2009)

bradnovlesky said:


> does anyone else herd anything about the new nremt ranks??


 
http://www.emtlife.com/showthread.php?t=11348

http://www.emtlife.com/showthread.php?t=9056


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## CAOX3 (Feb 22, 2009)

I think I have you all beat.

When i took my EMT class, a few to many years ago.

We:
Intubated
defib(not AED)
BGL monitoring
pasg

Meds:
ASA
Epi pen
EPi by neb
Racemic Epi
glucagon
tylenol
asa
albuterol
O2
nitro (I believe we carried it, we may have just assisted)

Granted our class wasnt 120 hours either, safe to say I was a little over my head in the begining.


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## CAOX3 (Feb 23, 2009)

Let me just say it was an interesting couple of months.


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## tlkennedy5 (Feb 26, 2009)

I'm in my EMT-B class right now in Kentucky and here's what I've gathered:

EMT-B's in Kentucky can use BIADs (King, Combitube) and within the next few months I gather, epi-pens are going to be phased out and epi ampules will be carried instead for injection.  They are also adding some meds I believe, asprin protocol being one of them.  

However, back to the EMT-A thing.  Kentucky doesn't recognize EMT-Intermediates, but they have gotten the ball rolling to recognize EMT-Advanced sometime in the next year.  Once that happens, certain procedures (most likely the ones just added mentioned above) will be taken away and given to the EMT-A's.  They will also have the power to start IV's.  There's still some debate on whether they can intubate using ETs or not and if they will be able to push anything through the lines.


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## nomofica (Mar 11, 2009)

Wee-EMT said:


> I'm an EMT-A up here in the cold north, Which is like being an EMT/I in the states. Ours stands for EMT-Ambulance.
> 
> EMR=EMT/B, EMT-A=EMT/I, and then Paramedic. EMR's (EMT-B's) can not get work in the city.



Nice, a fellow Albertan!


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## fortsmithman (Mar 11, 2009)

The Alberta College of Paramedics dropped the A from EMT-A.  It's now EMT.
http://www.collegeofparamedics.org/pages/home/default.aspx


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## nomofica (Mar 12, 2009)

That is true.

I'm honestly surprised at how little requirements are required to enroll in the EMT programs in Alberta... Only the P level requires Biology/Chemistry/English 30 (Anatomy and Physiology is liked, but not a prerequisite). All you need for EMR and EMT-B/I/A (again, like you've mentioned, now known just as EMT) is CPR/BLS level C and your EMR license respectively.


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## Kendall (Mar 13, 2009)

Not always true; depends on your school. And regardless of what your school's entry requirements are, they WILL expect you to have a basic understanding of biology and chemistry, otherwise your course would take a lot longer... (as it probably should). The reality of it is that in the approx. 400 hours that you are in the classroom you should be building upon past knowledge of physiology as it is a basic requirements for EMR's. 

Btw, EMR's CAN find work in the city if you know where to look!


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## nomofica (Mar 14, 2009)

Kendall said:


> Not always true; depends on your school. And regardless of what your school's entry requirements are, they WILL expect you to have a basic understanding of biology and chemistry, otherwise your course would take a lot longer... (as it probably should). The reality of it is that in the approx. 400 hours that you are in the classroom you should be building upon past knowledge of physiology as it is a basic requirements for EMR's.
> 
> Btw, EMR's CAN find work in the city if you know where to look!



I guess I should have clarified that I've only really looked at NAIT's EMT and EMT-P programs at this point. They don't require A&P, but is considered one of things that will put you ahead of the game.

I could be (and probably am) wrong, as this is only my understanding of NAIT's requirements.

I've also heard (from first hand accounts) that NAIT doesn't teach everything that's on the Alberta College of Paramedics' EMR/EMT/EMT-P exams... Is this correct?


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## fortsmithman (Mar 14, 2009)

nomofica said:


> I guess I should have clarified that I've only really looked at NAIT's EMT and EMT-P programs at this point. They don't require A&P, but is considered one of things that will put you ahead of the game.
> 
> I could be (and probably am) wrong, as this is only my understanding of NAIT's requirements.
> 
> I've also heard (from first hand accounts) that NAIT doesn't teach everything that's on the Alberta College of Paramedics' EMR/EMT/EMT-P exams... Is this correct?



Our service does in house EMR training using NAIT's EMR course.  One of our members is authorized to instruct the NAIT program.  You might want to try the EMT and EMT programs over at Portage College in Lac La Biche. or you could try the EMT program at AHASTI in Calgary.


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## cyclebear (Mar 23, 2009)

*EMT-A Scope of Pratice*

It is really interesting to look back at all of the changes that have taken place in EMS over the years.  When I started in 1979. I was an EMT-A(Ambulance).  Over the years I progressed with the coming changes, and eventually elevated the level of Paramedic Specialist.  Specialist is an Iowa designation.

All of that being said, along the way I became an EMS Instructor.  I taught the EMT-Basic and First Responder classes.

Now then, to give a little perspective to the scope of practice differences, I told my First Responder students how much things had changed over the years.  To emphasize the point I told them that what I had been taught at the EMT-A level in 1979, would not qualify me as one of today's First Responders.

So keep getting up every morning.  There is still an abundance of things to learn!!!


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