Anyone know if AEMT training exists in CA?

[Akulahawk]

Take this Corona pandemic for example, it takes 350 extra hours on top of EMT to become an AEMT in most states. Think about it on a level of time constraints and places needing a more fast track bridge to some limited ALS skilled personnel vs time a governing body doesn't have to train individuals for years in Paramedic school during a pandemic or terrorist attack.

Its just hands down a game changer to have AEMT education available, especially during times of mass crisis, when you need EMTs able to push IVs, Etc. asap.

Actually, the AEMT is more a cost-saver post for employers and/or communities that find having Paramedic services too expensive. Paramedic training can be done in about 6 months, though it is usually done over 1-2 years. AEMT training can be done much faster than that but the education the AEMT gets is quite limited compared to what a Paramedic gets. The best utilization of an AEMT, in my opinion, is to act as another set of "trained hands" for a Paramedic. When with a Paramedic, the AEMT usually has a wider scope than when they're not simply because it's the Paramedic deciding what needs to be done or not. In any very large scale incident, often the level of transport provider is less important than simply having transport. It's when local resources become too impacted to function that things start getting truly bad because they've been completely overwhelmed.

I'm sensing a pattern.

Perhaps a 2-3 year pattern...

 

[hometownmedic5]

Its just hands down a game changer to have AEMT education available

The only time Intermediate/Advanced was a game changer was when "they" figured out they could hire I's, pay them much less than basics, and still get to bill ALS, and paint it on the side of the truck. If it was the revolutionary EMS cert you make it out to be, you wouldn't have to look so hard to find a course to get the card.

That level of EMS cert has always been and will always be a half measure designed and supported for the express purpose of increasing billing rates. The minimal skill set increase over BLS doesn't justify the time and expense to get the training. As it stands now, Basics in even some of the most outdated EMS states has largely caught up to I/A level; and if the COVID protocol waivers stick, there won't be more than an inch of daylight between a B and an A in Massachusetts.

 

[NomadicMedic]

We use AEMTs as a force multiplier. We have moved the majority of our paramedics back to fly cars and we staff ambulances with basics/AEMTs.

The vast majority of calls dispatched as ALS can be effectively and safely managed by an AEMT.

Id rather have fewer, better trained paramedic that I can pay more, than a cadre of mediocre medics, just because we want (or need) to staff every truck to the paramedic level.

 

[MonkeyArrow]

The vast majority of calls dispatched as ALS can be effectively and safely managed by an AEMT.

Does your system allow AEMTs to interpret 12 leads?

 

[NomadicMedic]

Does your system allow AEMTs to interpret 12 leads?

No, very few places do. But if a medic arrives and gives it a look and it’s not an acute STEMI, hey can downgrade to an AEMT. Also, an A can transmit a 12 and transport, starting a line and giving NTG and ASA if there is no medic available.

As an example, a patient presented at urgent care with chest pain, hx of PE. 12 lead non diagnostic. Patient was stable and I downgraded to the AEMT. Totally appropriate.

If you “what if” every call, you have paramedics transporting lots of low acuity calls and wasting your resources.

I’d love to see basic EMT eliminated and AEMT the entry point for any 911 response.

 

[MonkeyArrow]

If you “what if” every call, you have paramedics transporting lots of low acuity calls and wasting your resources.

I wasn’t suggesting that. My main question was that you have paramedics dispatched to every chest pain call and they still assess the patient and then can make a determination to allow the A to transport? AEMTs aren’t getting dispatched to chest pain type calls alone?

 

[Jim37F]

In any case, I don't think too many people are dying from Corona because they spent a few minutes in a BLS ambulance vs an ALS one...

 

[NomadicMedic]

I wasn’t suggesting that. My main question was that you have paramedics dispatched to every chest pain call and they still assess the patient and then can make a determination to allow the A to transport? AEMTs aren’t getting dispatched to chest pain type calls alone?

Gotcha. I'm so used to fighting off the "what if" doomsayers, I'm a little reactionary.

We don't have AEMT, or as we call them here "intermediate", dispatch criteria. It's been an ongoing project for our regional medical director, but C19 put a crimp in that. The expectation is that strokes, diabetics, mild allergic reactions and the like will be an Intermediate level dispatch. Our As now carry Epi 1:10 for arrests, Zofran, Benadryl and Toradol along with the legacy AEMT meds. They can do quite a bit on thier own. Having them start working an arrest with an SGA and IO placed and an Epi on board before the medic arrives makes life so much easier.

We still send a Paramedic to every ALS call, but if it's one of our guys, we're downgrading most of the "ALS lite" calls to the As. If we arrive simultaneously, we usually let the A lead the call until they need help or until they've got it and don't need a medic. Of course, some As are more competent than others so we're reviewing every Paramedicv to AEMT downgrade chart.

This summer I plan to run 8 of our current EMTs through the A program. I think they'll do well.

 

[Akulahawk]

I’d love to see basic EMT eliminated and AEMT the entry point for any 911 response.

If you've got a non-tiered system, and your system won't support P/P 911, I absolutely agree with this. In a tiered system, you could do E/E, E/A, A/A, P/P or P-fly car and be able to handle most call types very effectively and efficiently. I would prefer E/A or (better) A/A staffing for the lower tier of 911. A's can handle most of the stuff we get around here. Then with fewer P's, we can train them to a very high level and utilize them on those calls where they'd be most useful/helpful.

 

[NomadicMedic]

Part of the rationale for moving medics off ambulances is because my service does a mix of 911 and ift. The ift is all BLS and it makes no sense to pay a paramedic to chauffeur a basic around on a bunch of hospice or SNF transfers.

The goal is to move to basics on a mostly transfer truck that will occasionally get a 911call. AEMTs and a basic on the primary 911 trucks that will get the occasional ift. Paramedics in fly cars covering a larger area and only riding on calls that need paramedic level care.

Making sure the medics don't get lazy and downgrade everything is where the QM is important.

 

[DesertMedic66]

Part of the rationale for moving medics off ambulances is because my service does a mix of 911 and ift. The ift is all BLS and it makes no sense to pay a paramedic to chauffeur a basic around on a bunch of hospice or SNF transfers.

The goal is to move to basics on a mostly transfer truck that will occasionally get a 911call. AEMTs and a basic on the primary 911 trucks that will get the occasional ift. Paramedics in fly cars covering a larger area and only riding on calls that need paramedic level care.

Making sure the medics don't get lazy and downgrade everything is where the QM is important.

I think this would be the only type of system that would make me give up my flight job as long as the pay and benefits were good.

 

[VentMonkey]

Part of the rationale for moving medics off ambulances is because my service does a mix of 911 and ift. The ift is all BLS and it makes no sense to pay a paramedic to chauffeur a basic around on a bunch of hospice or SNF transfers.

The goal is to move to basics on a mostly transfer truck that will occasionally get a 911call. AEMTs and a basic on the primary 911 trucks that will get the occasional ift. Paramedics in fly cars covering a larger area and only riding on calls that need paramedic level care.

Making sure the medics don't get lazy and downgrade everything is where the QM is important.

I think this would be the only type of system that would make me give up my flight job as long as the pay and benefits were good.

Same.

 

[NomadicMedic]

I’m not at the point where I’d recruit anyone I like and respect to this job... but give me a few years.

 

[VentMonkey]

I’m not at the point where I’d recruit anyone I like and respect to this job... but give me a few years.

No need. Just clone yourself and apply at different services throughout the nation. Win/ win.