# Advanced EMT's



## cmetalbend (Jan 28, 2011)

Most here know the national standards changed Jan 1, 2011. According to a EMT-I instructor under the new standards the Advanced EMT wil be able to administer 22 drugs. According to a Mict/ director, he confirmed this and added he hated it. Due to the lack of training needed, and "It steals from the Paramedic scope." He also stated that the change came from lower funded areas that wanted ALS type service that couldn't afford Paramedics. I really don't know what to say other than this is going to create a bad vibe towards the EMT/Paramedic relationships. I can see how this could be good or bad, but what does everybody else think?:unsure:


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## TransportJockey (Jan 28, 2011)

The I/99 is the thing that should be hated and it's luckily going away. EMT-Is in most states are great support for medics. Here in TX I can and do function as a low level ALS provider. Rural areas ARE the reason that AEMT is not going away completely though, but it's not a good thing. And trust me, anywhere can afford to have paid 24/7 medics if they really want them bad enough

EMT-Is have been around for years and there's not really any bad relationships I've noticed. I'd actually rather have a new EMT-I as a partner when I'm a medic than a seasoned EMT-B


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## Epi-do (Jan 28, 2011)

cmetalbend said:


> Due to the lack of training needed...



This can be said about ALL EMS providers in the states.  I really wish we would fix the dismal education requirements for providers here before we start changing what different certification levels can or cannot do.  That is a whole 'nother discussion though.


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## Lady_EMT (Jan 28, 2011)

Huh, thats odd. As AEMTs in Connecticut, we don't push drugs. The only difference between us and B-techs (now simply EMTs) is that we can start IVs and CombiTube patients. We can also do EpiPens without med control.

It's unfortunate we can't administer meds. But CT is behind the times


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## cmetalbend (Jan 28, 2011)

Epi-do said:


> This can be said about ALL EMS providers in the states.  I really wish we would fix the dismal education requirements for providers here before we start changing what different certification levels can or cannot do.  That is a whole 'nother discussion though.



I agree here for sure. My EMT-B course only required 48hrs clinical. 24 in EMS and 24 in ER. Heck some of my classmates didn't see one call the entire time in EMS.


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## TransportJockey (Jan 28, 2011)

cmetalbend said:


> I agree here for sure. My EMT-B course only required 48hrs clinical. 24 in EMS and 24 in ER. Heck some of my classmates didn't see one call the entire time in EMS.



Keep in mind that NM EMT-Bs don't get any clinical time for training. At all. Yet NM EMT-Bs have one of the broadest scopes for basics in the country


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## rwik123 (Jan 28, 2011)

cmetalbend said:


> I agree here for sure. My EMT-B course only required 48hrs clinical. 24 in EMS and 24 in ER. Heck some of my classmates didn't see one call the entire time in EMS.



I didn't have any clinicals. 

Thankfully I had a non-ems related internship at a city trauma center for the summer... But yea, I think clinicals should be mandatory.


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## fast65 (Jan 28, 2011)

I don't know if I would really say that it's going to create a bad relationship between paramedics/EMT's, but I do think it's sacrificing patient care in a way. I mean, if they can push 22 drugs, then they should really learn WHY they're pushing those drugs and HOW those drugs are taking effect; without that education they're not going to be able to think critically and determine if they really should be giving that drug.


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## NREMTroe (Jan 28, 2011)

fast65 said:


> I don't know if I would really say that it's going to create a bad relationship between paramedics/EMT's, but I do think it's sacrificing patient care in a way. I mean, if they can push 22 drugs, then they should really learn WHY they're pushing those drugs and HOW those drugs are taking effect; without that education they're not going to be able to think critically and determine if they really should be giving that drug.



I agree, but as the new changes came out, are they just saying here this is what you can do? Is there no mandatory class to take to make sure they know what they are doing, how to do it, and why? If not, then yes I do have a problem with it. If they take on more training, then they could be a great asset to a medic, if not, patients may be screwed.


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## wyoskibum (Jan 28, 2011)

Lady_EMT said:


> Huh, thats odd. As AEMTs in Connecticut, we don't push drugs. The only difference between us and B-techs (now simply EMTs) is that we can start IVs and CombiTube patients. We can also do EpiPens without med control.
> 
> It's unfortunate we can't administer meds. But CT is behind the times



Agreed.  It's interesting that CT requires EMT's & EMT-A's to take refreshers but no such requirements for Paramedics.

Don't even get me started on CT liquor laws! ;-D


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## fast65 (Jan 28, 2011)

NREMTroe said:


> I agree, but as the new changes came out, are they just saying here this is what you can do? Is there no mandatory class to take to make sure they know what they are doing, how to do it, and why? If not, then yes I do have a problem with it. If they take on more training, then they could be a great asset to a medic, if not, patients may be screwed.



I doubt that they'll just tell them "here ya go" and hand them a new skills sheet, I imagine that they'll have some sort of training to go along with it. The only thing is that they should be educating them on pharmacology and pathophysiology to go along with this new skills set.


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## reaper (Jan 28, 2011)

This has been dicussed before. Basics will remain basics. I-85's can take a transition class to advance to an AEMT or go back to a basic. I-99's can take class to transition up to medic or go down to AEMT.

I think it will be a while before most states even try to make this work.


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## cmetalbend (Jan 28, 2011)

And to make matters more confusing, just because your national standard level is such, doesn't mean your protocols will alow it anyway. Here EMT-I's can't start a line by themselves. A Paramedic must be onboard. Why can't they make it simple?  My guess is due to liability issues. Since the standards changed my first re-cert hours has to spent on an up-date course, 28hrs to my understanding.


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## Handsome Robb (Jan 28, 2011)

I love how I just finished I school and now I have to either take another class or go back to being a B... Gotta start lookin for that upgrade class.

Does anyone have a link to the new standards?


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## MrBrown (Jan 28, 2011)

That guy is talking out his rectum, an "Advanced" EMT can start a drip and give a couple meds like GTN, salbutamol, entonox and glucose.

The new standards promlugate EMT and AEMT to have skills and knowledge which require "limited training" and its really a half step ahead, two steps backward.

http://www.nhtsa.gov/people/injury/ems/EMSScope.pdf


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## medicRob (Jan 29, 2011)

fast65 said:


> I doubt that they'll just tell them "here ya go" and hand them a new skills sheet, I imagine that they'll have some sort of training to go along with it. The only thing is that they should be educating them on pharmacology and pathophysiology to go along with this new skills set.



I can speak for TN. The board moved to allow (After Gap Analysis was completed) to allow EMT-IV's in the state to take an 8 credit hour transition course to EMT-Advanced, those courses start at the end of this year. All EMT-IV who do not bridge to advanced within 4 years will revert to EMT. 


Now, I am awfully tired at the moment and not thinking straight... Could the OP link me to the section in the guidelines where it outlines that the AEMT is gonna have 22 drugs? All I see are 



> Pharmacological Interventions
> o Establish and maintain peripheral intravenous access
> o Establish and maintain intraosseous access in a pediatric patient
> o Administer (nonmedicated) intravenous fluid therapy
> ...



The only difference between this and our current EMT-IV's s Narcan and N20


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## lampnyter (Jan 29, 2011)

Lady_EMT said:


> Huh, thats odd. As AEMTs in Connecticut, we don't push drugs. The only difference between us and B-techs (now simply EMTs) is that we can start IVs and CombiTube patients. We can also do EpiPens without med control.
> 
> It's unfortunate we can't administer meds. But CT is behind the times



I hate being a basic in CT. Cant even give aspirin.


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## cmetalbend (Jan 29, 2011)

lampnyter said:


> I hate being a basic in CT. Cant even give aspirin.



Once again, I am amazed how things are different depending on location. B's here can use combitubes, not ET's tho. Charcoal, nitro, epi pens, glucose here, but thats after Director approval, except for the glucose.


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## 18G (Jan 29, 2011)

Pennsylvania already incorporated the new Advanced EMT provider level into their new EMS Act that went into effect not too long ago. The actual scope and training program is being developed and is projected to roll out I believe I read in 2012. 

Time will tell how the new provider level will work out. I have to admit I see it as another short cut and reinforce EMS is all about skills.


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## lampnyter (Jan 29, 2011)

cmetalbend said:


> Once again, I am amazed how things are different depending on location. B's here can use combitubes, not ET's tho. Charcoal, nitro, epi pens, glucose here, but thats after Director approval, except for the glucose.



We can give nitro if it belongs to the PT. But i guess it doesnt really matter cause all our trucks our Medic/Basic or Medic/AEMT


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