# Is a EMT-B higher then a CNA?



## codethree (Sep 29, 2012)

I want to apply for a job as a Emergency Department Tech, they say you must be at least a CNA. I am a nationaly certified EMT Basic. Anyone know?


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## STXmedic (Sep 29, 2012)

EMT-B isn't necessarily higher. They are different types of training. However, most EDs will take basics as techs. Best thing to do is call the ER you want to work at and ask them if EMT-B is acceptable.


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## hogwiley (Sep 29, 2012)

Youre comparing apples to oranges. Both have about the same amount of training. Whether or not an EMT or CNA got hired in an ED would probably depend more on work experience than whether someone went through a short EMT or CNA class. 

I think its a toss up personally. Ive worked as both a hospital CNA and an EMT, and I find a good experienced CNA is invaluable to Nurses regardless of the setting. EMTs not so much, it really depends on the EMT, many EMTs have little to no patient care skills. 

Neither can start IVs or do blood draws or EKGs without additional training, so its kind of a pointless that an EMT knows how to spine board people or practiced putting on a tourniquet(like thats a hard skilly anyway). Those skills are almost useless in a hospital ER and easily learned if it matters.


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## hogwiley (Sep 29, 2012)

One more thing. CNAs arent really taught to do these structured head to toe patient assessments the way EMTs are, and that is probably the one area EMTs have a "higher" level of training, but how valuable is that in a hospital with RNs, RTs, PAs and MDs around? 

CNAs are taught what vital signs are normal and abnormal, and some  obvious reasons they may be abnormal. One more thing as well, taking accurate vital signs was considered a really big deal in CNA school, oddly more so than in EMT school, and one of the practical skill stations CNAs in my state are tested on is vital signs. 

You have to count resps and pulse on a patient with an RN doing the same for one minute, and must be within one for resps and 2 for pulse or you fail. You also have to check BP and demonstrate doing it by palpation, before doing it by ascultation with an RN listening with one of those dual steths. If you arent within 2 for both systolic and diastolic, you fail.

Now how many new EMTs do you think would have failed that station? Im guessing a LOT.


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## ExpatMedic0 (Sep 29, 2012)

Most ED's I have seen will hire EMT's as ED Tech's.
As for "which is higher" It is as someone else stated, "comparing apples to oranges"
I would apply for the job if I was you.


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## mycrofft (Sep 29, 2012)

Is peach higher than a watermelon?


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## Remeber343 (Sep 29, 2012)

mycrofft said:


> Is peach higher than a watermelon?



Obviously the correct answer is pineapple. I believe pineapple is at the top of the hierarchy.


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## JakeEMTP (Sep 30, 2012)

hogwiley said:


> One more thing. CNAs arent really taught to do these structured head to toe patient assessments the way EMTs are, and that is probably the one area EMTs have a "higher" level of training, but how valuable is that in a hospital with RNs, RTs, PAs and MDs around?



CNAs are taught other types of assessing for the long term and preventive. RNs, PAs, RTs and MDs aren't always able to perform a thorough assessment on every patient every shift or even every day.  MDs depend on the RNs to tell them daily assessment changes and RNs sometimes depend on CNAs to tell them of changes in appearance, skin condition and eating habits.  An skin condition or breakdown is a major ding for the hospital which now does not get reimbursed.

CNAs also have a Federal requirement for training in order for the facility to be reimbursed by CMS.  They must have no less than 75 hours and all initial and continued training is tracked in the inspections from state and Federal agencies.  It is still an entry level job but as not glamorous (TV standards) as EMT so it is difficult to fill positions even with only 75 - 200 hours of training. They don't get to eat at restaurants on their breaks or sleep even when doing a 16 or 20 hour shift.  Their patient load is very heavy and anything happens to a patient such as a fall or even skin breakdown, they may take the blame. 

But, the CNA does have many more employment choices than an EMT. They also have a better opportunity to get on the job training offered by the hospitals.  Many hospitals also like the ER Tech to be CNAs so they can be utilized in other areas of the hospital. Also, at the EMT level, the splinting and moving learned for the field does not apply very much to a hospital setting. CNAs are sometimes better at ambulating patients safely and have more knowledge with experience of the available bariatric lift devices than EMTs. CNAs are also experienced at moving patients with many lines and tubes. CNAs do usually have more experience with taking BPs on a greater number of patients with different anomalies and lines or tubes present.   

I have alwasy thought it was weird for someone with only EMT training to be transporting patients from one facility to another on the routine calls. The CNA is better trained for moving and caring for these patients. CNAs also know the culture of the hospital better and alot more about the various isolation practices.  A new type of Medical Technician should be created for the IFT transfers.


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## JPINFV (Sep 30, 2012)

hogwiley said:


> One more thing. CNAs arent really taught to do these structured head to toe patient assessments the way EMTs are, and that is probably the one area EMTs have a "higher" level of training, but how valuable is that in a hospital with RNs, RTs, PAs and MDs around?
> 
> CNAs are taught what vital signs are normal and abnormal, and some  obvious reasons they may be abnormal. One more thing as well, taking accurate vital signs was considered a really big deal in CNA school, oddly more so than in EMT school, and one of the practical skill stations CNAs in my state are tested on is vital signs.




...yet can't clinically correlate a pulse ox or troubleshoot one, thus initiating a rapid response call.


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## Tigger (Sep 30, 2012)

JakeEMTP said:


> But, the CNA does have many more employment choices than an EMT. They also have a better opportunity to get on the job training offered by the hospitals.  Many hospitals also like the ER Tech to be CNAs so they can be utilized in other areas of the hospital. Also, at the EMT level, the splinting and moving learned for the field does not apply very much to a hospital setting. CNAs are sometimes better at ambulating patients safely and have more knowledge with experience of the available bariatric lift devices than EMTs. CNAs are also experienced at moving patients with many lines and tubes. CNAs do usually have more experience with taking BPs on a greater number of patients with different anomalies and lines or tubes present.



The hospitals around here use techs exclusively for making ortho-plast splints and braces. When I asked an MD adviser why that was he stated that EMTs had a better grasp at splinting than his RNs did, hence he had the techs do it.


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## DesertMedic66 (Sep 30, 2012)

hogwiley said:


> One more thing. CNAs arent really taught to do these structured head to toe patient assessments the way EMTs are, and that is probably the one area EMTs have a "higher" level of training, but how valuable is that in a hospital with RNs, RTs, PAs and MDs around?
> 
> CNAs are taught what vital signs are normal and abnormal, and some  obvious reasons they may be abnormal. One more thing as well, taking accurate vital signs was considered a really big deal in CNA school, oddly more so than in EMT school, and one of the practical skill stations CNAs in my state are tested on is vital signs.
> 
> ...



We test out our EMTs exactly like that. Whe have high fidelity mannequins that we test the students out. Enter in blood pressure, pulse, resp, pupils, lung sounds, and skin signs into the computer and the mannequins replicate everything without human error. Resps have to be 100% accurate. Pulse they can be 4 BPM off. B/P they can be 4 off on systolic and diastolic.


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## hogwiley (Sep 30, 2012)

To get back to the original question, it wouldnt hurt to apply, but I doubt any EMT OR CNA without experience, and/or other certifications and training would be hired. If it says CNA is the minimum qualification, they probably mean exactly that. They want an experienced hospital CNA who also has some phlebotomy or ECG training/experience. Also having their EMT license would probably be a bonus.

Different ED heads probably prefer either CNA or EMT based on their background and who they think works better as a team with RNs. A lot of ER supervisors probably spent much, if not most of their career working ICU and med/surg as well as ER, so might be more comfortable having CNAs be techs, especially since many CNAs/PCTs are also Nursing students.


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## MexDefender (Sep 30, 2012)

In our hospital the EMTs who work in ED or any other part of the hospital also have the CNA qualification, you _need_ the CNA qualification and that alone will give you the opportunity to work in ED or another section of hospital. EMTs who do not have their CNA cannot work in ED according to our hospital guidelines that are in line with state (from what I'm told). 

It's not about higher or lower, its about the specialty of a CNA, they learn practical skills that are used in pt care even though I find some of them utterly ridiculous like 18 steps to change a bedpan (no joke) or how to properly wash your hands wear PPE etc etc... 

a better question would be asking could an EMT effectively do a CNA job or CNA do ambo? there are critical fails that both sides would have no prior knowledge unless you work closely with hospital staff like an ambulance service that is attached to a hospital.


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## bigbaldguy (Sep 30, 2012)

mycrofft said:


> Is peach higher than a watermelon?



Yes, peaches grow on trees and melons on the ground.


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## bigbaldguy (Sep 30, 2012)

Remeber343 said:


> Obviously the correct answer is pineapple. I believe pineapple is at the top of the hierarchy.



Pineapples are mid level fruit at best. Basically glorified mangos. Now dragon fruit, that's the top dog. You give lip to a dragon fruit and you'll be lucky to score a spot in a can of generic fruit cocktail.


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## Jambi (Sep 30, 2012)

I must be durian fruit then...


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## JPINFV (Sep 30, 2012)

Are grapefruits the alternative med gurus of the fruit world?


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## bigbaldguy (Sep 30, 2012)

JPINFV said:


> Are grapefruits the alternative med gurus of the fruit world?



Nah they're more like the O.D.s kind a sour and round  but not bad once you get used to em


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## bigbaldguy (Sep 30, 2012)

Jambi said:


> I must be durian fruit then...



Google says this about the durian fruit " It smells bad. It's hard to eat. It's unpleasant to the touch. Does this fruit have any redeeming qualities?" lol


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## JPINFV (Sep 30, 2012)

bigbaldguy said:


> Nah they're more like the O.D.s kind a sour and round  but not bad once you get used to em




So... OR nurses and techs?


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## JakeEMTP (Sep 30, 2012)

JPINFV said:


> ...yet can't clinically correlate a pulse ox or troubleshoot one, thus initiating a rapid response call.



In the hospital, anyone can initiate a Rapid Response including a family member.
CNAs in many places are taught to call if no Licensed staff member is in sight.


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## JakeEMTP (Sep 30, 2012)

Tigger said:


> The hospitals around here use techs exclusively for making ortho-plast splints and braces. When I asked an MD adviser why that was he stated that EMTs had a better grasp at splinting than his RNs did, hence he had the techs do it.



One doctor's opinion. 

An EMT can work ortho if they can be cross trained as an ortho tech. If the facility is not large enough to support this, they must be a CNA also. Usually it is the CNAs who are chosen to be cross trained since they are already working the ortho unit and are already assisting the Doctors.


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