New Standards/Levels

[P_Instructor]

Ok, just got back from heated discussion/meeting concerning the new national standards and EMS level criteria. Now, what is your true opinion concerning the new levels. For, Ok, whatever, what?, or just WTF. Give me your honest opinion, even if you are one of the potential transitional providers (85I, 99I). I would greatly appreciate your response with possible debate. Thanks.

[Fox800]

Honestly...EMT-I/AEMT needs to go away. It's a stop-gap measure for communities and agencies that can't/won't pay for their EMT's to go to paramedic school. It's a filler...a way to tell people that they have "ALS" or to bill for an ALS transport to monitor a saline lock.

I can say this having been a former EMT-Intermediate (85).

[Dustdevil]

One licence level for all EMS personnel. Period. Just like physicians and nurses. No basics. No intermediates. Just degreed paramedics. Anything less is a strictly BLS first responder, not licensed, regulated, or employed by EMS authorities.

Edited October 15, 2009 by Dustdevil

[JPINFV]

Education requirements didn't go far enough. The biggest mistake made was not divesting non-emergency medical transport from emergency medical services. These two fields are separate with different patient populations and different needs. Neither is more important or better than the other just as RNs, RTs, and other allied health can't be compared in terms of importance or better. Once you remove non-emergent medical transports from EMS you remove one of the big reasons for keeping the EMT-B level around.

[scubanurse]

Honestly...EMT-I/AEMT needs to go away. It's a stop-gap measure for communities and agencies that can't/won't pay for their EMT's to go to paramedic school. It's a filler...a way to tell people that they have "ALS" or to bill for an ALS transport to monitor a saline lock.

I can say this having been a former EMT-Intermediate (85).

I disagree. EMT-I's in some states, such as Maryland, have just about the same protocol as an EMT-P. I understand the I-85 protocol is vastly different than the I-99 but to say that the EMT-I level is essentially a "filler" is somewhat of an insult.

While I agree that EMT-I may be considered a stop-gap and that ALS should be a 2-year degree, it isn't fair to just say they are a filler and a way to bill for monitoring a lock. EMT-I/99's in most places can do a hellova lot more than monitor a lock.

I think EMT-I/85 should be removed, and I/99 be the new basic level and the scope of practice to include IV's, 3-lead ECG, advanced airway, and code drugs (plus a few more but that's more to debate). EMT-B should be done with, they are valuable members so don't get me on "bashing basics", but they should be I/99's. EMT-P scope should remain the same but be required to be a 2 year or 4 year degree and have the ability to do more diagnosing in the field...

Just my $0.02 worth...

[RavEMTGun]

It's an improvement, but not much of one. I think Canada and New Zealand are the models we should be following. However, If they are going to do it the way they are going to do it, I think they should have given AEMTs needle thoracostomy.

Education requirements didn't go far enough. The biggest mistake made was not divesting non-emergency medical transport from emergency medical services. These two fields are separate with different patient populations and different needs. Neither is more important or better than the other just as RNs, RTs, and other allied health can't be compared in terms of importance or better. Once you remove non-emergent medical transports from EMS you remove one of the big reasons for keeping the EMT-B level around.

Agreed!

[chbare]

Problem being, the I99 level of education is rather minimal when you look at all the drugs and skills at their disposal. They can do allot; however, does this actually mean the education they receive prepares them for this scope of practice? This goes back to my chemistry thread. If you do not have a real understanding of the fundamental sciences and how things work, should you be performing interventions that actually effect these fundamental concepts? Rather significantly in some cases.

The point is moot as somebody pay grades above me thinks the I99 is roughly equal to a paramedic and should transition into the medic role with some classroom bridge training. I actually covered these national SOP changes several months ago in a thread with links to official sites and publications. Pretty scary stuff actually.

Take care,

chbare.

[RavEMTGun]

I disagree. EMT-I's in some states, such as Maryland, have just about the same protocol as an EMT-P. I understand the I-85 protocol is vastly different than the I-99 but to say that the EMT-I level is essentially a "filler" is somewhat of an insult.

While I agree that EMT-I may be considered a stop-gap and that ALS should be a 2-year degree, it isn't fair to just say they are a filler and a way to bill for monitoring a lock. EMT-I/99's in most places can do a hellova lot more than monitor a lock.

I think EMT-I/85 should be removed, and I/99 be the new basic level and the scope of practice to include IV's, 3-lead ECG, advanced airway, and code drugs (plus a few more but that's more to debate). EMT-B should be done with, they are valuable members so don't get me on "bashing basics", but they should be I/99's. EMT-P scope should remain the same but be required to be a 2 year or 4 year degree and have the ability to do more diagnosing in the field...

Just my $0.02 worth...

That is really really silly. I99 can do almost everything a medic can do but they have to call in... because they only go to school for 25% of the time of a medic!!!!!!! I99 was a regression in terms of educational thoroughness. That is why it is gone now.

Most calls don't need those skills. I'd rather see an EMT-B class that was 300 hours long instead of making the basic level of EMS a 300 hour EMT-I99. Better yet, let's make I99 skills the basic entry, but make it a 2 year associates degree. Then paramedic can be another year or two for a BS degree and have expanded scope. (Like CAN and NZ)

Edited October 15, 2009 by RavEMTGun

[scubanurse]

I disagree. My EMT-I course equated to over 1000 hours in both the classroom and clinical experience. In Maryland, I's only have to consult for at most 3 drugs that P's don't, and they only have one or two skills that they need to consult for or can not do. So that was a pretty big generalization you made there.

My EMT-B was 240 hours versus the 1000+ hours of EMT-I, so personally I would really rather the EMT-I on scene than the EMT-B.

[RavEMTGun]

I disagree. My EMT-I course equated to over 1000 hours in both the classroom and clinical experience. In Maryland, I's only have to consult for at most 3 drugs that P's don't, and they only have one or two skills that they need to consult for or can not do. So that was a pretty big generalization you made there.

My EMT-B was 240 hours versus the 1000+ hours of EMT-I, so personally I would really rather the EMT-I on scene than the EMT-B.

No. I did not make a big generalization. I am talking about classroom hours ONLY. Please educate yourself:

Most EMT-B classes are 100-120 hours in the classroom. EMT I/99 is usually 200-400 hours in the classroom. EMT-P is 700-1200 classroom hours (the DOT requirement is actually only 500 not counting the A&P prerequirements (usually about 200 hours)).

If you had over 1000 hours in your EMT-I, it would be a statistical outlier, a true rarity. Even if that 1000 hours included field time, it would be a rarity. I find it hard to believe because 1000 classroom hours is equivalent to two years of college classes.

Edited October 15, 2009 by RavEMTGun