AEMT Scope of Practice

MicahW

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I am thinking about becoming an AEMT in CT. I was wondering what the scope of practice of AEMTs is wherever you work (yes, I have read over the national model; however, in my area, EMTs are able to do far more than that model says we can and I assume that it is the same for AEMTs). Are they considered ALS personnel? Can they manually defibrillate and use a 12 lead? I tried to ask some of the guys where I work and even some of the supervisors and with the national models changing and all of the confusion as the result, I get different answers every time. Thanks for the help!
 

luke_31

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You could try doing a search for the area in CT that you want to work in for the protocols that they use. That would tell you what each level is allowed to do.
 

Tigger

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I have not heard of any place that allows an AEMT to manually defibrillate or interpret a 12 lead. However there are many states that still use EMT-Intermediates, which is no longer a National Registry recognized certification. Many states still certify and train intermediates though, and in some places an Intermediate as almost an identical scope to paramedics but they have to call for most treatments.

As for CT, I have no idea. In some states it's up the region to set protocols for its providers, in others it's a statewide set (like MA).

AEMTs in might part of Colorado don't have a significantly greater scope than our EMTs as EMT with IV endorsement (very common, nearly every paid EMT has it as do many volunteers) can start IVs, initiate and maintain fluid infusions, start IOs (in my area), give IV naloxone and dextrose, Zofran ODT and IV in some areas, and nebulized albuterol (with orders). AEMTs add SL nitro (not the patients), Benadryl, Atrovent, Epi-1:000 ampules, and Zofran IV. All AEMTs can start IOs and EJs as well. That's about it for differences, and they aren't particularly common.

I would however like to see EMT-IV go away and be replaced by AEMT so we could be operating in line with the rest of the country.
 

jryan06

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In the Hartford area, both Hartford hospital and St Francis will not give you med control. Neither will John Dempsey Hospital. ASM,Aetna and AMR will not recognize the AEMT. The big hospitals are swallowing up the smaller hospitals so if you are near any of the cities you may well be wasting your time
 

Akulahawk

EMT-P/ED RN
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Here in California, we do legally have an intermediate level that's between the Basic EMT and the Paramedic. They may still be known as "EMT-II" or they may be known now as EMT-Advanced, not sure since I haven't followed development on that end of things... but regardless, here they're considered "Limited ALS" as they can provide some ALS services but not all. IIRC, they can use the AED mode of a defibrillator but they're not allowed to interpret a 12-lead, though they could hook the machine up (EMT's can do that too). Most EMS systems in California only recognize EMT-B and Paramedic. An AEMT in those systems is recognized as an EMT-B.

Your best source for what an AEMT can do in Connecticut is to look at the CT laws/regulations for that level of service and the local EMS systems to see if they're locally recognized.
 

EpiEMS

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I am thinking about becoming an AEMT in CT. I was wondering what the scope of practice of AEMTs is wherever you work (yes, I have read over the national model; however, in my area, EMTs are able to do far more than that model says we can and I assume that it is the same for AEMTs). Are they considered ALS personnel? Can they manually defibrillate and use a 12 lead? I tried to ask some of the guys where I work and even some of the supervisors and with the national models changing and all of the confusion as the result, I get different answers every time. Thanks for the help!

CT EMT with an ALS volley/career hybrid service here.

Currently, in most of Connecticut, AEMTs/EMT-Is are limited to the EMT scope of practice (1) plus peripheral IV initiation and NS/LR administration. In a handful of areas, blind insertion airway devices (Combitube, specifically) are permitted (Region 5 comes to mind).

However, there is a move to full national AEMT scope, and we should have "true" AEMT scope soon-ish, it seems like - once medical directors and services move to include it.

(1) EMT scope could be as narrow as National Scope or as expansive as allowing CPAP, 12-lead acquisition, IN Naloxone, and glucometry (the latter two not being standard shows how behind the times Connecticut is).

Some resources:

- Protocols at EMSProtocols.com for Connecticut
- A helpful UConn Health Center School of Medicine 4th Yr. Selective Project
- Protocols at the CT EMS Councils website
 
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