# Advanced EMT



## joeshmoe (May 7, 2012)

So whats the deal with EMT intermediate/Advanced EMT/EMT specialist training and licensing these days? In Michigan I see no schools offering training for anything other than EMT-Basic or Paramedic, nothing in between. 

I plan on going to Paramedic school when the time, living situation, and financial situation permits, but in the meantime Im wondering if the National registry and the states have pretty much given up on EMT Intermediate. No one seems to know when or if this training will be offered to new students, which has been the case here for the last 3 years.


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## EpiEMS (May 7, 2012)

Certainly seems like they're trying to give up on it, in some states (CT, for example). The AEMT/EMT-I level is really very useful when used to its full potential, I think – whereas in systems like mine, the protocols are so restrictive that all AEMTs can do that I as a Basic can't is start an IV. That's it. Regardless of training or ability.


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## RowdyB (May 8, 2012)

Georgia uses only EMT-I/AEMT and Paramedics on their 911 trucks. There is almost no EMT-B except on some transports, very rural areas, and possibly FD although most departments I've seen want EMT-I or higher.


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## joeshmoe (May 8, 2012)

Ive heard that about Georgia, but apparently they are the only ones still training people to be EMT Specialists these days. 

The ALS companys around here all have Basics working with Paramedics, or on some calls 2 paramedics working together. There are some EMT specialists, but these are people that got their specialist license years ago, and they do the exact same thing the Basics do on actual calls, which pretty much means drive the truck and do what the medics tell them. 

Im not sure how they keep their specialist license, since they dont do any intubations and rarely if ever start IVs. I asked one of them where he went to school to get his Intermediate, and he said he dropped out of Paramedic school before it finished and was allowed to test out, which is probably how the others got it too. I have yet to meet someone who actually went to school to be a specialist/Intermediate, like I said I dont even know of any schools in Michigan that even offer such a class.


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## EpiEMS (May 9, 2012)

RowdyB said:


> Georgia uses only EMT-I/AEMT and Paramedics on their 911 trucks. There is almost no EMT-B except on some transports, very rural areas, and possibly FD although most departments I've seen want EMT-I or higher.



I was looking through Georgia's protocols, and it seems like your EMT-Is and AEMTs can't do much more than the EMTs: they can do an IV, IO, give clear fluids, and drop a BiAD (e.g. Combitube or King). Why no Basics when AEMTs can't do much more?


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## RowdyB (May 9, 2012)

...D50, glucagon, nitro SL route or paste, Narcan, CPAP/BiPAP.

I don't know why Georgia requires these levels but I don't think I've ever gone more than a week without using some if not most or all of the above.


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## EpiEMS (May 9, 2012)

RowdyB said:


> ...D50, glucagon, nitro SL route or paste, Narcan, CPAP/BiPAP.
> 
> I don't know why Georgia requires these levels but I don't think I've ever gone more than a week without using some if not most or all of the above.



Ok, so a couple of meds. Not really anything that couldn't be given by EMTs, other than D50, I suppose. Narcan can be IN, Nitro SL, CPAP is easy to use, and Glucagon can be IM.


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## RowdyB (May 9, 2012)

Those things aren't in the scope of practice for EMT/EMT-B in the State of Georgia/National Model. Why do you need EMT/EMT-B when you're just going to allow them to do the same things as an EMT-I/AEMT?


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## EpiEMS (May 9, 2012)

RowdyB said:


> Those things aren't in the scope of practice for EMT/EMT-B in the State of Georgia/National Model. Why do you need EMT/EMT-B when you're just going to allow them to do the same things as an EMT-I/AEMT?



Consider my last silly comment withdrawn, you're totally right about this.


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## ARose (May 10, 2012)

I'm currently in a hybrid AEMT program in GA and have heard through the grapevine (no confirmation on this) that there may be restrictions to Basic skills. So, this thread was rather enlightening, and helpful.


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## mycrofft (May 10, 2012)

The Feds are trying to get states to prune back the proliferation of EMT subtypes. It all started (cue mysterioso music) with EMT-A(mbulance) and EMT-P(aramedic). The states, notably Calif., started inventing their own subtypes, allowing employers to pay EMT-A wages to people doing SOME EMT-P skills as well as the regular ones.

My thought is we need to discard all the ways to sneak advanced skills into basic EMT, make employers hire/pay providers with the full set of skills and training.


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## smokeater (May 21, 2012)

Not sure about other states protocols, but I am in an AEMT program. I actually test for registry tomorrow. Anyway, as an AEMT in Alabama there is quite a bit more that I can do and a basic cannot. Off the top of my head...use of supraglotic non-visual airways, IV, IO (pretty sure not in EMT-I's scope), roughly 18 meds (i.e....zofran, nitrous, glucagon IM, nitro and albuterol (not just assist with the patients personal meds), xopenex, nerve agent kits incl. cyanide,thiamine, narcan, epi, diphenhydramine, d50-10-5, lactated ringers(not in Bama actually), and other basic fluids to name a few. Really the only drugs I cant give and a parmedic can are cariac and pain, which consists of alot. Two more intrventions a paramedic can preform and an AEMT cannot are ET tubes and cardiac pasing. Also, in Alabama, they are phasing out the EMT-I level. All who possess this level of training must transition to paramedic or AEMT. Not sure if you can just take a short class or just retest if you just go to AEMT. Also, in Alabama, it is my understanding that AEMT and EMTB are required prerequisits in the process of obtaining your paramedics licensing. Hope this is helpful.


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## Medic Tim (May 21, 2012)

Depending on the state/ region basics can do a good portion of those skills.

How long is the AEMT program? Class and clinical hours? I have heard of aemt but was not exactly sure what it consisted of. Hopefully it is more education based than skills based.


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## ARose (May 21, 2012)

Medic Tim said:


> Depending on the state/ region basics can do a good portion of those skills.
> 
> How long is the AEMT program? Class and clinical hours? I have heard of aemt but was not exactly sure what it consisted of. Hopefully it is more education based than skills based.



I am in a hybrid bridge program, which should be 8 wks. I'm also in GA.


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## Medic Tim (May 21, 2012)

ARose said:


> I am in a hybrid bridge program, which should be 8 wks. I'm also in GA.



Is it a busy 8 weeks (ex. m-f 9-5) or part time (Ex 2-3 days/nights a week)

Is this program supposed to be above the I-85 or I-99?

I have said it before and I will say it again. EMT should be a 1 year ft program with the scope of about an EMT-I or AEMT or whatever they call themselves now..... and a 2 year degree for Paramedics as a Minimum. The focus of EMS needs to shift from skills based to knowledge based.

Where I work the Minimum level to work on trucks is an 11 to 12 month program. (9 didactic, 2-3 practical) . some places the minimum is 2 years for BLS and 3-4 for ALS.


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## smokeater (May 21, 2012)

Medic Tim said:


> Depending on the state/ region basics can do a good portion of those skills.
> 
> How long is the AEMT program? Class and clinical hours? I have heard of aemt but was not exactly sure what it consisted of. Hopefully it is more education based than skills based.


If you have basic, A&P, and Med terminology it can be done in one semester. Thats what I did. It was actually pretty tough. Not so much the material, although challenging at times, but this was the second semester it was available and the course has not exactly been hammered into a science. As for clinica hours, I had to complete 60 hrs. on a rescue truck and 120 in the ER with a minimum of 30 successful IV's between th two. The state has already developed protocol and services are hiring, but monitary incentive for the additional capabilities is up in the air. And as for the fire service, I can operate within my scope if im assigned to a rescue truck or helping on sceen, but while riding a pumper I do not have the equipment to provide a higher level of care. The same for anyone riding a pumper who is hgher level than a basic, in most cities. Hope this answered your questions.


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## ARose (May 21, 2012)

Medic Tim said:


> Is it a busy 8 weeks (ex. m-f 9-5) or part time (Ex 2-3 days/nights a week)
> 
> Is this program supposed to be above the I-85 or I-99?
> 
> ...



It's a one day a week class (Sat, 9-5) with the rest of the lectures online. 

Take that as you may, and feel free to PM me any questions regarding this paticular hybrid class. 

I have been told from the owner of the school an AEMT is a "mesh" of 85/99, and a few skills short of a Medic, and several drugs shy of one (cardiac, pain). 

I think SmokeEater just completed it, and is currently waiting to test,  they may have more insight, as I am only toe into the class.


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## Medic Tim (May 21, 2012)

smokeater said:


> If you have basic, A&P, and Med terminology it can be done in one semester. Thats what I did. It was actually pretty tough. Not so much the material, although challenging at times, but this was the second semester it was available and the course has not exactly been hammered into a science. As for clinica hours, I had to complete 60 hrs. on a rescue truck and 120 in the ER with a minimum of 30 successful IV's between th two. The state has already developed protocol and services are hiring, but monitary incentive for the additional capabilities is up in the air. And as for the fire service, I can operate within my scope if im assigned to a rescue truck or helping on sceen, but while riding a pumper I do not have the equipment to provide a higher level of care. The same for anyone riding a pumper who is hgher level than a basic, in most cities. Hope this answered your questions.





ARose said:


> It's a one day a week class (Sat, 9-5) with the rest of the lectures online.
> 
> Take that as you may, and feel free to PM me any questions regarding this paticular hybrid class.
> 
> ...



thanks


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## smokeater (May 21, 2012)

Medic Tim said:


> Is it a busy 8 weeks (ex. m-f 9-5) or part time (Ex 2-3 days/nights a week)
> 
> Is this program supposed to be above the I-85 or I-99?
> 
> ...


That rational is similar to that of the program which I am attending. The university offers parmedic cert free standing and you must progress through AEMT and practice as an AEMT while finishing the paramedic cert. However, the university has developed an EMS B.S. program thats been tied into the cert. Completion of the program takes 4 years as usual if you have no college, but you can tailor schedule your classes for cert. as you like, as long as you complete them in order of requirement, to obtain your said cert in about your 5th or 6th semester, and it can be obtained free standing in 4 if you have basic, A&P, and med terminology. The goal of the staff is to educate people on the importance of prehospital care, exactly what level of care EMT's are providing at each level, and the interventions available at each level. Ultimately hoping to lend more legitimacy to the program, making it more of a profession that requires formal education and move away from the stigma of a trade school certification. Like you said...knowledge base focused not simply a set of skills.


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