Preparing for NREMT First Responder & Accelerated EMT-IV

[aebrown37620]

I am prepping to take the NREMT First Responder Exam and wonder if anyone out there has taken this yet? I have done extremely well on all of my class tests, the majorit 90%+, but have heard this test is a bear. Anyone got any tips?

Also, planning on enrolling in an accelerated EMT-IV program that will run January-March. Is this a wise decision? Anyone that give give me some pros & cons will be greatly appreciated.

Thanks!!!!

[Dustdevil]

Is this a wise decision?

Probably not. But we'd really need to know more about you and your plans to know for sure. What is your motivation and ultimate goal? Different goals necessitate different paths.

I don't know what an EMT-IV is. It must be specific to your area, so please tell us where you are. Is it the entry level of EMT for your state, or is a step above the entry level? If it is a step above EMT, and your goal is to become a paramedic, then I would strongly recommend against half-steps like IV certification or Intermediate class. They stunt your intellectual development in the long run. If you want to be a paramedic, go to paramedic school and do it right instead of half-stepping there in baby steps. That will always produce a better practitioner.

I can think of no good reason to do a first responder course prior to an EMT course. There are some weird places that require it, like Alberta. But Alberta, unlike anyplace in the U.S., builds their EMT curriculum off of the FR course like a foundation. In the U.S., EMT is just a repeat of FR with a little more info thrown in, so it's pointlessly redundant to do both.

Some "accelerated" programmes are good. Many are not. Whether or not it is good for you depends upon two things: the quality of the school (which you really have no way of knowing), and what kind of learner you are, which you should know. Assuming that two schools provide the exact same amount and quality of instruction, then the results are entirely up to you. If in your prior educational efforts, you have found that you absorb information like a sponge, and retain it like an elephant, and that you have a proven scientific aptitude, then you can excel in a fast-paced "accelerated" environment. If you do your best learning in a more relaxed environment that allows you time to study in between classes, if you need reinforcement in order to commit complex concepts to memory, or if scientific concepts are not something that naturally click with you, then an accelerated programme would be disastrous for you, even if you passed. Success is not about getting a patch. Success is about learning as much as you possibly can and becoming the best practitioner you can. If you pass the course, but could have learned more if given more time to study and practise, then that is failure.

Accelerated prgrammes are best taken by those who have already established a solid theoretical foundation for the course of study. Especially at the paramedic level, but also at the EMT level. The amount of learning you gain from an EMT or paramedic course after you have already completed a couple semesters of college Anatomy & Physiology is many, many, many times greater than taking the course with no preparatory foundation. The difference between an EMT who had that preparation and one who did not is enormous.

What exactly is the big hurry anyhow? Anything worth doing is worth doing right, and to the best of your ability, is it not? Human lives depend on your competency. Given that, are shortcuts really a good idea?

[crotchitymedic1986]

My advice is to look for a National Registry Quiz Book if they have one for responders (I know they have them for medics and EMTI). The problem with the NR tests are the way the questions are worded. If you have never taken college level tests, you may or may not have trouble with the questions. Many who fail know the material, but arent good test takers.

If you are going to be in this field as a career, you need to go all the way to Paramedic.

[Lone Star]

I would have to agree with Dust on some of his points, but not all.

The points I can agree with is that the 'accelerated' courses are usually disasterous in producing "cookbook practitioners"; take away 'the book' and they're completely lost both in theory and in actual application.

There are instructors that can teach a rock to pass the EMT courses, but simple regurgitation of facts or treatments doesn't make one a 'competent practitioner' if they cannot understand the logic, pathos, and the science behind each treatment rendered.

The best that most 'accelerated courses' provide is a 'in situation A, do this'; in situation B, do that' format. To become a good practitioner, you also need to know WHY these treatments are used, the effacacy of each treatment, and what the next logical step in patient care is going to be.

Remember, that if you aren't able to provide a logical sequence of events, you're only "guessing" at the patient care, and you'll end up in court defending yourself in no time!

As Dust said, "Human lives depend on your competency". Are you willing to take shortcuts, knowing that lives could actually be hanging in the balance?

[aebrown37620]

THANK YOU SO MUCH FOR ALL YOUR ADVICE & PLEASE KEEP IT COMING!! I am currently a volunteer at a local rescue squad and absolutely love what I do. However, the first responder level does not give me the total satisfaction that I am seeking due to my local protocols. As for the question that Dust posed about what an EMT-IV tech is...it is an advance level trained EMT with additional training with intravenous procedures. I am still tossing the idea of becoming a Paramedic around. I do know that I want more in depth ability to provide the best patient care possible. In the past years, I have taken many tough accelerated courses and did extremely well. The amount of hours that this class requires (even in accelerated mode) is still equal to the 10 month regular class, but is in a much shorter period of time...3 months to be exact. The exact same material, I am told, is taught.

My field skills are very good and everything this far has came very easy & natural for me. One of my partners at the squad is making sure that every practical skill I have had this far has been done to highest standards. So far, no problems. I have exceptional study, practical & retention habits.

Again, I really appreciate all of the advice. One thing that I have learned quickly, there are some of the kindest and most helpful people in this line of work. Everyone has offered their support. Its almost like a VERY BIG family with common interests....helping those who need it!

[Dustdevil]

Well, I'm still confused. You still didn't tell us where you are. And I still don't know what your current educational level (both within EMS and in general) is. What are all these other accelerated courses you have taken in the past?

Anything between EMT and Paramedic is worse than a waste of time. It is counterproductive to your professional development. Dicking around with IV certs and getting "experience" before paramedic school just slows you down and ends up making paramedic school harder for you.

Don't take the course. Instead, go to college and take both semesters of Anatomy & Physiology. That will do a hundred times more to make you a competent provider than any IV course. And it will prepare you for further education, should you decide to get it. If you choose not to be a paramedic, you certainly haven't wasted any time like you would with the IV class.

And since the moderators are ignoring it, minus 5 for posting in the wrong forum. Attention to detail will make you a better provider.

[aebrown37620]

Sorry for omitting the info. I have a B.A. in Business. However, that was not my first choice of a major. I was originally in for a B.S. in biology, but instead of pushing on through, I let peer pressure take over my decision and opted for an easier major. I have kicked myself many times over the years for switching majors when I was more than halfway done. Again, that was a young & dumb mistake. Now 12 years later, I regret my decision. I have already had Anatomy, Physiology, Chemistry, Advanced Math, Biology. I took both of my biologies on an accelerated program as well as Calc A and Chemistry. They were not easy, but I pulled A's in all except for Calc A and ended up with a B.

Again, I am not trying to rush things, but I am a wife & a mother of 2 young boys. We own our own business, but I am doing this for me. I have always had a desire to work with emergency medicine, and knowing myself, I will probably go on to Paramedic school. However, in our area, they encourage you to go on and get your EMT-99 (which is the EMT-IV Tech), get hours under your belt, then choose whether or not to go on further. My question is, if I will get the same education under a accelerated EMT class vs. the regular 10 month program, and will come out with the exact same skills and understandings, why shouldn't I do it? This is offered through a college.

In the county I am working in, there are 2 paid levels- EMT-IV & Paramedic. No longer a basic EMT. As for where I am at, I am in TN.

Since I am in the wrong forum, where should I be? I thought this was the one for taking the test chats. That was one of my original questions if you will look back--Advice on the NREMT First Responder test.

[Dustdevil]

I have already had Anatomy, Physiology, Chemistry, Advanced Math, Biology. I took both of my biologies on an accelerated program as well as Calc A and Chemistry. They were not easy, but I pulled A's in all except for Calc A and ended up with a B.

Well then, it's time to move to the head of the class! An accelerated programme is likely to work well for you. However, this is assuming that you are able to give it the same amount of time, attention, studying, and consideration that you were able to give twelve years ago. Not necessarily a sure thing, now that you have family responsibilities to deal with. In an accelerated programme, you're going to find yourself coming home at the same time as your family. Good luck finding quality study time alone. Keep that in mind. But lesser people than you have successfully done it, so I am relatively confident that you can too.

...I am doing this for me. I have always had a desire to work with emergency medicine, and knowing myself, I will probably go on to Paramedic school.

Good attitude. Too many losers try to fool themselves and everyone else into believing that they are doing it "to help my community". That's utter bullshyte. Do it for yourself. Do it because medicine is the most interesting and intellectually stimulating thing you can ever think of doing. As long as you are doing it for yourself, you are more likely to strive for excellence. Those who maintain they are doing it for the community are liars, and they are more likely to practise mediocrity because they believe that anything they give the community is good enough. You can bullshyte the community, but you cannot bullshyte yourself.

However, in our area, they encourage you to go on and get your EMT-99 (which is the EMT-IV Tech), get hours under your belt, then choose whether or not to go on further.

It is a double edged sword. Obviously, exposure to the profession can very much help you to determine if this is really something that you want to do long term. However, I maintain that this is the ONLY value of pre-paramedic experience. Otherwise, the more EMT experience you have before paramedic school, the worse it is for you. Think of it this way: would you rather raise your own children from birth, or someone else's teenagers? From an intelligent professional educator's perspective, trying to teach experienced EMTs to be paramedics is like trying to raise someone else's teenager. Too many bad habits and lame misconceptions to break and dispel, significantly retarding the educational process. A clean slate is always the best way to go. If anyone is advising you that a few years of EMT experience is necessary, or even advisable before paramedic school, they are an idiot who knows nothing more than what they heard when they were an EMT.

Likewise, taking the IV or Intermediate routes to paramedic education is a very poor choice. Those courses are too narrowly focused on monkey skills to give you the big picture. Ideally, everything is learned in the context of the big picture. Otherwise, it is much harder to tie it all together in the end. There is an ideal synergy to medical education, and it is not a step-by-step approach. It is one, fluid, linear process from beginning to end, where each concept builds upon the last one. Too many schools take the piece-mail approach to medical education, resulting in a disjointed process that perpetuates the vision of paramedicine as nothing more than a collection of monkey skills learned just like first aid. It is not.

My question is, if I will get the same education under a accelerated EMT class vs. the regular 10 month program, and will come out with the exact same skills and understandings, why shouldn't I do it? This is offered through a college.

First, forget skills. I can teach any ten year old every "skill" in paramedicine in one day. In fact, they are a lot easier than those you learn in EMT school. So then, why does it take ten to 24 months to learn it all if you can learn all the skills in one day? Because the practice of medicine is not about monkey skills. It is both an art and a science, with the technical aspect rating a very distant third place in importance. It takes a very, very long time to acquire the education to attain competence in paramedic practice. Doing the skills is the easy part. Understanding the rationale behind the skills, and the pathophysiology behind the conditions you will need to diagnose and treat with those skills is the hard part. Typically, the accelerated schools do a very poor job of that education. They are accelerated not because it's a good idea. They are accelerated because the fire departments don't want to pay people for two years of school. Consequently, they have these medic mills condense the programme into the bare essentials of monkey practice. And what is produced is usually someone who doesn't know WTF they are doing. They walk the walk, slamming tubes and IVs with the best of us. But they cannot carry on an intelligent conversation about medicine. And worst of all, they are inadequate at making proper diagnoses or formulating care plans intelligently. They are the practitioners who, instead of actually practising medicine, are really just practising advanced first aid. They're colouring by the numbers. Doing exactly what the cookbook tells them to do, with not the slightest clue as to why, or why what they are doing is wrong. The urban centres is where most of these schools are found, because that is where the fire departments usually force people to become medics who really had no desire to be one in the first place. It's hard to find accelerated schools in areas without large fire departments. That should tell you something.

So, can you become as good as anyone else with an accelerated education? That's entirely up to you. I think you have the potential. However, the honest truth is that better education will make you better than you would be with an accelerated education. Because no, they usually do not teach the same thing as the 2 year schools, just faster. They usually cut quite a few corners. And paramedicine is not first aid. There is not a finite list of everything you need to know. There is only a list of absolute minimum competencies necessary for entry. I don't take you for someone who is only interested in meeting minimum competencies for a patch. And to be more will take a tremendous effort on your part to educate yourself beyond what the school offers, which will take as much time as it would for you to take a 2 year programme in the first place.

The ONLY people I recommend any accelerated programme to are those with either a significant previous healthcare education (RNs, RRTs, PTs, etc...), or those with a significant scientific education like yourself. And as long ago as yours was, that may be iffy. Most nursing or paramedic degree programmes would make you take A&P over again with those being so long ago. But, if you choose that route, I expect you will be at the top of your class. It's just that being valedictorian of special ed is no great honour. On the other hand, not all one and two year schools are excellent either. In fact, quite a few of them suck too. It really all comes down to two things: The quality of the school (which again, we have no way of knowing without researching it), and the quality of the student. The better each is, the better your chances of excelling.

By the way, I figured you were in Tennessee, as they are the only ones I knew for sure had that silly EMT-IV course. Not a fan. It was a novel idea about thirty years ago, when we thought IVs actually saved lives. Sad to see that TN is still in the dark ages. But, as I understand it, EMT-IV is the entry level of EMT certification in TN. Is this true? Or is there actually an EMT level by itself without the IV?

Since I am in the wrong forum, where should I be? I thought this was the one for taking the test chats. That was one of my original questions if you will look back--Advice on the NREMT First Responder test.

My apologies. I must have seriously misread the original post. You are correct. My apologies also to the mods.

Best of luck!

[aebrown37620]

Love your eloquence! You are definitely a firecracker & out spoken...LOVE THAT QUALITY IN A PERSON!! I want to sincerely thank you for your advice. I have definitely gained some useful knowledge and insight.

As for the level of EMT that the EMT-IV Tech is, I know that it is above an EMT-B (or EMT-85....jeez, too many different titles!!). The area that I work is EXTREMELY rural and the vast majority of the fire depts. & rescue squads are strictly volunteer. To become paid personnel with EMS or EMA, you must either be an EMT or Paramedic. However, there are a few fire depts. that have paid firemen, but they are the larger cities.

Where are you a Paramedic? How long have you been doing this? Again, thx for the advice. I will keep you posted with my progress.

As for study time & my family, they have been very understanding and supportive of my decisions so far. Both of my kids are young, but currently in school. Since the classes will be during the week at night, I will have ample opportunity to study my tail off during the day while they all are away. I want to succeed in this field and always give everything I do 110%, and this will be no exception. One major difference between me now & 12 years ago, is if anything, my concentration and study habits have improved. Not sure if it is the maturity or the fact that I am doing this for myself, but school is much easier now than then. Rest assured, I am the type that always has to know why something is done so as for just learning the skill will not be my style. The who, what, when & why will have to be explained to me and I will have to understand before I will be satisfied.

[Dustdevil]

Where are you a Paramedic? How long have you been doing this? Again, thx for the advice. I will keep you posted with my progress.

I just retired due to injuries after thirty-five years as a medic, practising mostly in Texas, but also the military.

I hope you do stay with us here, because I am really interested in how things work out for you. You're the kind of person I love to see enter the field, so your success is success for the entire profession. And you will find no better resource for information and encouragement than this forum.

Good luck!