Intermediates attending 911 call

[RALS504]

I am just opening up the discussion. I just came from a rural service where we had full time rigs that were staffed by one EMT-P and one EMT-I. We had volunteer rigs in the surrounding areas that were ILS or BLS depending on the responding staff. On the full time rigs the Intermediates attended every 911 call within their scope/ confidence level. This usually meant that the I's attended about 80% of the 911 calls. I receive patient in the ER from an urban EMS system and they only allow medics to attend 911 calls.

 

[DT4EMS]

That really depends on the service. I have worked for services that mandated the medic tech all calls. Then I have worked for services that allow the EMT to tech calls within their scope.

On certain calls that came in as a 911 may turn out to be BLS. In that case, I would ask my partner if he/she felt comfortable ( after assessment) then allow them to make the decision to tech or not.

I never pushed the BS calls off on them. If they didn't want to tech for any reason I gladly took the call.

 

[MMiz]

I work for a private service that provides 911 EMS services to a city. All of our ALS units are Senior Medic/Medic. As a BLS unit they would stage us in the city at night to respond to 911 calls with the ALS unit.

Now BLS no longer do ALS calls, as the company wanted to improve their image and response times. Whereas in the past we'd show up on scene, help, and have always ALS transport the patient, now we're simply the hospital transfer people.

Unfortunately while many programs offer a EMT-I/Specialist class, no county in the area recognizes it. EMT-Is are recognized as Basics. As such, chances are they wont be working any 911 calls unless a FF-Medic is in the back helping out.

I'd be interested to see what others say.

 

[rescuecpt]

I have recently been told that my EMT-CC in NY is similar to the EMT-I 99, but I haven't checked it out.

We (CC's) have the same protocols for everything except medics have a few more standing orders, perform 12 leads, and needle crychs. CC's can perform 12 leads but it's not taught in class - but if we take a 12 lead class we can do it. Even when there is a medic on scene (our paid medic works as a first responder) I end up transporting. The last time I was on a call with a medic was Thanksgiving because we had a cardiac arrest and it was myself, the paid medic, and my fiance (as a medic ride-along), usually I have a full crew - and the shift I'm riding now doesn't have a paid medic (we have them 19hrs/day x 7 days).

 

[emtd29]

Here in Nassau County, NY, EMT-I is not even a recognized level of training.
I's can only operate as EMT Basics here. Trying to remember if Suffolk ( and NYC for that matter) is the same way.I think so, but..... Maybe my neighbor to the east (rescuecpt) can refresh my memory??

 

[Wingnut]

Here in Nassau County, NY, EMT-I is not even a recognized level of training.
I's can only operate as EMT Basics here.

Ditto here.

 

[TTLWHKR]

It's better than nothing at all..

 

[rescuecpt]

Here in Nassau County, NY, EMT-I is not even a recognized level of training.
I's can only operate as EMT Basics here. Trying to remember if Suffolk ( and NYC for that matter) is the same way.I think so, but..... Maybe my neighbor to the east (rescuecpt) can refresh my memory??

I believe Suffolk County has only 2 active I's... they're not teaching it in Suffolk anymore - it's Basic, CC, or Medic.

 

[JJR512]

My county is nearly entirely suburban. My fire station only has EMT-Bs and one BLS ambulance. So 911 medical calls frequently get a BLS-only response. My fire stations covers a relatively small area (compared to some of the other stations in the county), and all of the stations with first-due areas that border my own station have ALS units with EMT-Ps. If the EMD determines the nature of the 911 call in my station's first-due area requires an ALS response, they will dispatch us and whatever is the closest available ALS unit. We'll get there first and start things, then the ALS unit will show up a few minutes later and take over.

 

[emtd29]

I believe Suffolk County has only 2 active I's... they're not teaching it in Suffolk anymore - it's Basic, CC, or Medic.

That's what I figured. EMT-I seems to be a dying breed.

 

[JJR512]

That's what I figured. EMT-I seems to be a dying breed.

I believe they're going to get more popular in my county. It's my understanding that the county is pushing all stations to be capable of an ALS response. I believe they want everyone who rides the ambulance on a regular basis to be EMT-I or -P. I believe the only people who are going to be allowed to remain at the EMT-B level are the firefighters who really just want to stay the hell off the ambulance (all firefighters in the county are now required to be at least EMT-B).

 

[ffemt8978]

Starting in May, my department is putting on an EMT-IV class that will have every EMT in our department (except 2) at the IV level or higher.

I think that the EMT-I serves a vital role in rural areas that can't afford to support ALS units but their patients need more than the EMT-B level. Unfortunately, I see the metro areas that don't need the EMT-I pushing to phase them out completely so that everyone can get "ALS" care.

 

[TRAUMARN]

In Tampa, Fire Rescue responds to all 911 calls, this truck is ALS and they decide if the pateint is to be transported either ALS or BLS. However, when I worked EMS in GA, we (I'm an EMT-I) rode with a medic and all trucks were ALS. Some counties in GA, although did not have to run ALS at all and were BLS counties only.

 

[Raf]

Here in Worcester all ambulances are Paramedic/Paramedic.
B's and I's have no jobs, unless they work for EasCare...who only work as a transport service (hospital to hospital, etc)

 

[RALS504]

Here in Worcester all ambulances are Paramedic/Paramedic.
B's and I's have no jobs, unless they work for EasCare...who only work as a transport service (hospital to hospital, etc)

Well that sucks. How do they expect to get paramedics that are street ready out of p-school with no prior field experience.

 

[Ridryder911]

Well that sucks. How do they expect to get paramedics that are street ready out of p-school with no prior field experience.

Just like many other services.. recruit other medics and yes... many services now prefer to hire new Paramedics without experience. New medics come in without prior bad habits or old EMS baggage. The get some experience in clinicals, then they should go through an intense preceptorship program.

Many EMS administrators are now looking at the advantages, instead of the disadvantages. Being, they are new .. you can mold them like you want to, they do not question your management techniques, eager to have a job, & cheaper, and yes within 3-6 months they will have enough field expereience to be out on their own, with some supervision.

The old "work for a few years as a basic" is becoming extinct, how many basic EMT jobs do you see at a emergency service ? Sure, you can get a job at non-emergency service and get experience of transfers.. but the same rate, that person can get emergency experience.

Do I like it ..NO!.. But it is reality and we now have to improve and adapt to the new changes in EMS.

Be safe,
R/r 911

 

[coloradoemt]

We could argue the importance, or lack of, Basics and Intermediates have in EMS all day long and never fully come to any agreement. I think the only comment I have is this, no matter what your training level is, if you are working in a system you better be ready to run a 911 call/ pt care. I work in a 911 system with a medic partner. We have been on plenty of calls where we are first onscene, while he is assessing the more critical pt or pt's, I am doing a scene size-up for incoming units, and calling for additional resources. Once that is done I move to the next critical pt and do my job. Folks in EMS who look down on others with less training instead of looking at them as an asset should reconcider, if for no other reason than simply excellant pt care.

 

[TTLWHKR]

That's what I figured. EMT-I seems to be a dying breed.

Well, there is really no justifiable reason to have 52 different EMS certifications...

Just to name a few... EMT-A, EMT-B, EMT-CC, EMT-D, EMT-E, EMT-I, EMT-Mast, EMT-P, EMT-STT, EMT-Wilderness...

I'd be good with just Basic, Paramedic and PHRN.

 

[disassociative]

...

Here in Sparta, TN; They won't send a rig out without a -P on it. Since we have a small ambulance service, most of the time; it is 2 Paramedics per rig.

 

[RALS504]

Well that is fine if your closest paramedic is not 20-90 miles away. I would rather roll a BLS or ILS rig to set up the medic or start rolling toward an ALS intercept with the patient aboard.