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My understanding is that there was a drug that can be given IV that is "somewhat" Beta specfic, and dosen't have the Alpha effects of Epi.
Jon
diff in paramedic and intermediate
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Jon
Medic38572
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It is also used to slow contractions in pregnant woman but has to be used cautiously. 
trauma1534
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Ok... well here in Virginia, in our region ofcourse, Intermediates can do everything that a Paramedic can do with the exception of RSI, and even then they can assist. Everything is on standing orders for every level here.
akflightmedic
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Strictly out of curiosity mind you, but why is there even an intermediate level if they are the same?
trauma1534
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They are cheaper paid, and can do basicly the same as a Paramedic. It's an economical thing in this state. Believe it or not, they make only a thousand dollars less than a Paramedic in a certain county I know of here in Virginia. They can needle cric, some can even surg. cric if the OMD signs off on them. They have standing orders for everything in the protocol. They are even refered to as "medics". At the agency where I work, if the truck leaves the building with an I onboard, they sign on as "Medic 31" or whatever the truck number is. If it is a paramedic onboard, it is signed on as "Paramedic 31", if it is Enhanced, it is "trauma 31", and Basic is "Rescue 31".
I don't know anyother way to explain it, maybe someone else can pick up and continue this for me.
jeepmedic
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We used to give Terbutiline 0.3cc SQ then 0.7cc mixed with 3cc of Saline Neb. for asthma attacks
Bad idea in my experience. Most medic school washouts are EMTs with no street experience. Remember, BLS before ALS, so a good medic must first be a GREAT EMT!
As for the difference in I vs P, in MN there is a world of difference, varying on were you work. The arguement that the diff is small, consisting of a list of drugs and procedures, is missing the larger point. In a cookbook world of paramedicine,
it's OK to look at it like that. But if we are to advance the profession, we must be thinkers. Were I work, there are no protocols, just guidelines and lists of meds and procedures. A medic should be able to work towards the problem at hand, and the totality of the pt. condition. This requires a strong knowlegde base, heavy in A&P, and well versed in critical thinking. How many EMT-I's can explain to me the different treatment modalities of rt vs Lt AMI or heart failure? how many can articulate the pathophysiology affecting treatment of a STEMI in a CHF pt? The ramifications of end stage renal failure
in a pt whom missed dialysis? I cant tell you the times when my EMT-I partners questioned my judgement becuase they did not understand the back story. One even wrote me up for not starting a STEMI alert, and not flying a pt to the cities' heart hospital becuase of mild chest pn, with global st elevation in a otherwise healthy 33 yo male. I had to explain to all that it was strongly suspicious for pericardititis, not stemi
. By no means am I stating that EMT-I's are not smart, but they lack the intense education that I would like to see in our medics. Good Luck!
Ridryder911
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I compare the difference similar to LPN versus RN's. Yes, both can perform some of the same procedures, however LPN are more task or technical nurses not understanding why or educated in detail of patient care. The same as Intermediates. They have accomplished a portion of the paramedic program and as of yet should not be considered as one, since completion has not occurred. The same as a P.A. attempting to compare themselves as a Physician, same classes for the most part without the completion and detailed needed to be at the highest level.
One has to remove the "emotional" part and realize what ever level or EMT____ (fill in acronym). One, is still being compared to gold standard of the Paramedic.
Unfortunately, administration usually sees this as a "cheap paramedic, commonly called placebo medic" and hopefully the dice does not roll for the patient requiring Paramedic procedures.
If the management only pays a differential of only a thousand dollars, shame on them for not either paying a larger differential or paying to get the real deal. Again, displays of poor management techniques which runs amuck in EMS.
Personally, I believe EMT Intermediate level should be encompassed into the basic program. Thus allowing two levels. We have way too many multiple levels in this industry.
R/r 911
One has to remove the "emotional" part and realize what ever level or EMT____ (fill in acronym). One, is still being compared to gold standard of the Paramedic.
Unfortunately, administration usually sees this as a "cheap paramedic, commonly called placebo medic" and hopefully the dice does not roll for the patient requiring Paramedic procedures.
If the management only pays a differential of only a thousand dollars, shame on them for not either paying a larger differential or paying to get the real deal. Again, displays of poor management techniques which runs amuck in EMS.
Personally, I believe EMT Intermediate level should be encompassed into the basic program. Thus allowing two levels. We have way too many multiple levels in this industry.
R/r 911
Medic2891
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It is so easy to get these hours. In NJ we are required to do more than 440 hours in about a year. We have a year of class time and depending on where you are getting that depends on whether or not you can start your clinical time in the second half. If not then you have 2 years to get your time in or you have to start over from the beginning.
firemedic1563
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First of all, glad I found this site.
I wanted to add my thoughts. In my state I's are titled Cardiac Rescue Technician- Intermediate, only as a matter of ease of changing laws to the national Intermediate standard. They are generally compensated between and EMT-B and a Paramedic. By state protocols, they can perform about every procedure as a Paramedic (minus NTT, NG, and surgical crich). They can administer all but Haldol, but have to consult for about twice what Paramedics do. They are not widely used to replace Paramedics for cheaper though. Some of the rural departments use volunteer I's as their standard ALS.
Larger departments utilize I's as a quicker access to ALS, but have Paramedics on the calls as well. My own department has I's with a Paramedic at all times, although Paramedics may be on their own with a Basic. This allows the Intermediate to have a Paramedic to administer med's we would otherwise have to consult for. We are actually in the process in my department of phasin out all the I's and training all new hires to the Paramedic level straight from Basic.
Similarly, private companies (which I do PT) still need the paramedics. I's in my state cannot transport vent patients or Heparin or Morphine drips interfacility. So the private companies need paramedics for critical care. They mostly utilize I's for basic monitor, IV, Nitro patch, etc patients.
I think Intermediate is a good idea in theory, but departments should not replace the training and education of Paramedics, rather support the care with higher than Basic training. I am currently completing my Paramedic licensure (done the training). Luckily I work for a department that believes Paramedic should be the standard of care for all patients, even though the downside is we have to run all the BLS too.
I wanted to add my thoughts. In my state I's are titled Cardiac Rescue Technician- Intermediate, only as a matter of ease of changing laws to the national Intermediate standard. They are generally compensated between and EMT-B and a Paramedic. By state protocols, they can perform about every procedure as a Paramedic (minus NTT, NG, and surgical crich). They can administer all but Haldol, but have to consult for about twice what Paramedics do. They are not widely used to replace Paramedics for cheaper though. Some of the rural departments use volunteer I's as their standard ALS.
Larger departments utilize I's as a quicker access to ALS, but have Paramedics on the calls as well. My own department has I's with a Paramedic at all times, although Paramedics may be on their own with a Basic. This allows the Intermediate to have a Paramedic to administer med's we would otherwise have to consult for. We are actually in the process in my department of phasin out all the I's and training all new hires to the Paramedic level straight from Basic.
Similarly, private companies (which I do PT) still need the paramedics. I's in my state cannot transport vent patients or Heparin or Morphine drips interfacility. So the private companies need paramedics for critical care. They mostly utilize I's for basic monitor, IV, Nitro patch, etc patients.
I think Intermediate is a good idea in theory, but departments should not replace the training and education of Paramedics, rather support the care with higher than Basic training. I am currently completing my Paramedic licensure (done the training). Luckily I work for a department that believes Paramedic should be the standard of care for all patients, even though the downside is we have to run all the BLS too.