# NMEMT I 85 and I 99



## syd (Apr 15, 2009)

Can anyone explain the difference between the two I levels on the NREMT?  I haven't gotten too much sleep in the past week (EMT-B clinicals, class, VFD calls, family, etc...) but, I can't seem to get through the legalese... oh yeah and if this is a repost, can someone point me in the right direction???


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## 2630 (Apr 16, 2009)

99 has some meds and a few more procedures and is a bit longer in hours. in ohio you take the class to the 99 level but you are tested on the 85 stuff... just something to keep in mind.


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## medicdan (Apr 16, 2009)

Consider either performing a search on this site. "I85" and/or "I99" should do the trick in giving you the results you want. Your answer may be better answered by going to ems.gov, specifically 
http://ems.gov/portal/site/ems/menu...toid=468910d898318110VgnVCM1000002fd17898RCRD
where there are comparison documents- comparing the curricula.

Good Luck!

Dan


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## Ridryder911 (Apr 16, 2009)

The 99 is on the way out, so I would not recommend even taking or obtaining this level. I was informed that they will no longer be testing or will disbanding it very shortly. 

The 99 was a modified version of including more of the Paramedic curriculum and was a neat way of administrators to have pseudo Paramedics for less money. 

The 85 is the traditional Intermediate level. It is still currently being used but over all less and less each year. 

Both levels will soon require a transitional course to maintain those levels. The 99 will require one's to finish the Paramedic course or be reclassified as an Advanced EMT and the Intermediate to complete a transitional course to be called a Advanced EMT; if they do not complete the transitional course they will re-classified to the EMT level. 

There will be more information as this becomes more developed within the next year or so. 

R/r 911


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## 2630 (Apr 16, 2009)

Ridryder911 said:


> The 99 is on the way out, so I would not recommend even taking or obtaining this level. I was informed that they will no longer be testing or will disbanding it very shortly.
> 
> The 99 was a modified version of including more of the Paramedic curriculum and was a neat way of administrators to have pseudo Paramedics for less money.
> 
> ...





can you elaborate any more on the transition? just started the medic path recently and have been wondering about the rumors of emt-i going away. i figured you would either go back to basic or maybe take a bridge course to medic?


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## Ridryder911 (Apr 16, 2009)

2630 said:


> can you elaborate any more on the transition? just started the medic path recently and have been wondering about the rumors of emt-i going away. i figured you would either go back to basic or maybe take a bridge course to medic?



The transition has not yet been made formally. It is perceived that it will be with the new refresher courses. Yes, officially the EMT/I has gone away as the three new national levels are now in effect. However; it will take time to change. Even my new re-certification NREMT card no longer says EMT-Paramedic; just simply Paramedic as the new levels state. 

Each state will have to adopt the new curriculum before the transitional course will be administered in within your own state. 

R/r 911


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## bstone (Apr 21, 2009)

Intermediate is becoming "Advanced". I like the name better, anyhow.

My state, New Hampshire, is beginning to figure out what to do with us. More news at 5.


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## VFFforpeople (May 2, 2009)

CA almost has them out, I believe there are 37 active EMT-Is in all CA (correct if wrong). You can't even become and EMT-I unless you pay$$$$..lol it is cheaper here to just become a Medic. To me EMT-I is like becoming an LVN..just a few more courses and you get that sexy R!! same applies, a few more classes you will get that sexy P.


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## JPINFV (May 2, 2009)

VFFforpeople said:


> CA almost has them out, I believe there are 37 active EMT-Is in all CA (correct if wrong). You can't even become and EMT-I unless you pay$$$$..



Even still, for a county to use the EMT-Intermediate (EMT-Two)  level in California the county has to apply to California EMSA with justification on why they cannot provide full paramedic coverage. If a county can provide advanced life support for the entire county, then they cannot provide limited advanced life support (LALS).


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## daedalus (May 2, 2009)

JPINFV said:


> Even still, for a county to use the EMT-Intermediate (EMT-Two)  level in California the county has to apply to California EMSA with justification on why they cannot provide full paramedic coverage. If a county can provide advanced life support for the entire county, then they cannot provide limited advanced life support (LALS).



One thing that California has gotten right.


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## VGFDEMT34 (May 3, 2009)

EMT-I's are great. They are there to provide _almost_ the same ALS care as medics. Unfortunately, many people can't afford to sink 1-2 years into medic education - that's where EMT-I's come in.

I'm all for them.


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## daedalus (May 3, 2009)

VGFDEMT34 said:


> EMT-I's are great. They are there to provide _almost_ the same ALS care as medics. Unfortunately, many people can't afford to sink 1-2 years into medic education - that's where EMT-I's come in.
> 
> I'm all for them.



So your for the skills without the pathophysiology?


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## VGFDEMT34 (May 4, 2009)

daedalus said:


> So your for the skills without the pathophysiology?



I'm for recognizing that somewhere, someone smarter than I am has shown that this system works. It is way more beneficial than detrimental. So, to answer your question, yes. 

We've both been through medic class, and I think you can agree that some of the material is useless in your day-to-day scenarios.


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## reaper (May 4, 2009)

Prime education at it's best!

It was not someone smarter then you or I that came up with the "I". It was brought about by the push from systems that wanted half ***-ed ALS services, so they could meet the standards, without having to hire Medics. There is a reason why it is being eliminated! Some states are now controlling what their "I's" can do. My state Does not allow much and our service only allows them to start an IV. They can not intubate or push any kind of medication. They are of no help, above a EMT-B.


Quote:
*We've both been through medic class, and I think you can agree that some of the material is useless in your day-to-day scenarios.*

I hope you are kidding? The material in medic classes barely meet the medical needs and you think it is useless?


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## VGFDEMT34 (May 4, 2009)

No reaper, not kidding. Look at the studies that have been done. How much help is an EMT-P compared to an EMT-I. How many people die every year as a result of mistakes by EMT-I's? Probably way less than the people they save.

Does ALS care make that big of a difference? Studies say not!

Doing this brings advanced care to people in need. Far better than doing nothing.

How much intelligence does it take for someone to initiate a peripheral IV? Not much.

How about administer D-50 for a diabetic with altered mental status? Glucagon? Phenergan, when they get sick?

Come on, EMS is NOT rocket science. Even as medics, we carry very basic drugs when you look at the big picture. Training someone to use them safely can easily be done in 400 hours or less.

That's why we have on-line medical direction. If you don't remember a dose, ask!

I should qualify what I said, medics in my area only have 16 medications. Our scope of practice is behind other states. If you work in a state that is different, then my statements do not apply to you.


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## VFFforpeople (May 4, 2009)

JPINFV said:


> Even still, for a county to use the EMT-Intermediate (EMT-Two)  level in California the county has to apply to California EMSA with justification on why they cannot provide full paramedic coverage. If a county can provide advanced life support for the entire county, then they cannot provide limited advanced life support (LALS).



Yes, there is that, I was just answering his to question that the EMT-I is pretty much gone, and no point in getting it. You will spend more time and money getting EMT-I, then you would if you just went to medic school.


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## reaper (May 4, 2009)

VGFDEMT34 said:


> No reaper, not kidding. Look at the studies that have been done. How much help is an EMT-P compared to an EMT-I. How many people die every year as a result of mistakes by EMT-I's? Probably way less than the people they save.
> 
> Does ALS care make that big of a difference? Studies say not!
> 
> ...



This is why we have a push to get rid of "cookbook' medicine. If you state is not pushing for better prepared Paramedics and ALS, then that may be something you want to start pushing for a change. The OPALS study was conducted in Canada and does not reflect a broad area of EMS. Most Emergency Dr's that I have spoke with, won't even quote the study, they see it as flawed.


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## VGFDEMT34 (May 4, 2009)

Reaper, I concede this argument. You're absolutely right in your contention that I have no business complaining about a system I haven't made any effort to change.

In any case, this has given me an idea. An idea that will help advance EMS care in our state.

^_^

EDIT: Once again, I will qualify my post by stating that my responses earlier were based on my state's scope of practice. When I said that the stuff wasn't useful, I was speaking regard to my state. For example, the paramedic class trained us for a wide variety of procedures and interventions that our state doesn't allow us to practice.


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## daedalus (May 6, 2009)

I am actually finished the pathophys chapter in my program not to long ago, so I cannot comment on its day to day uses. However I plan on using it as much as possible, and supplementing it with a few other textbooks.  I cannot imagine how education in fluid and acid/base balance, electrolytes, and the autonomic nervous system will not be used by the enterprising paramedic. 

As some have stated before on this forum, every time you start an IV, give a medication, etc, you are altering homeostasis. You should know about that so you can tip the balance towards favoring your patient's condition instead of harming them more. In fact, I argue that EMTs using advanced procedures without the background knowledge is breaking the fundamental principle of do no harm.


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