EMT-Enhanced

[rescue1531]

Hey guys!

I took the EMT-Enhanced state test about a month ago and I was just wondering if anyone else has taken this test. I had a lot of people tell me that when they took it 2 years ago or even when it was Shock Trauma that is was easy. I felt that the E test I took was very hard and we had 5 out or 10 pass. I was just wondering if it was just me. I did pass but it was close! I liked the class though it was a lot of fun and the ones who did not pass I am surprised because I know they know the information.

EMT-EN

[ericenglund]

EMT-Enhanced is state of virginia only, correct? (I know its virginia because i am a VA resident but i dont know if any other random states have a similar level)

Congratulations on passing. EMT-E is a big step from B and I'm sure you'll find the new skills/scope of practice interesting. I'm sure the others will pass with a bit more studying. The pass/fail rate for all of the levels(B/I/P) is about the same. You get out of a program what you put into it.

[rescue1531]

Im not exactly sure if it is just Virginia I think that it is but I think North Carolina is looking into it. I think some other states have a similar level just not called the same. Yes, I did study alot. There is no National Registry to this level thats the only down fall that I have found.

[JakeEMTP]

als newbie, I can assure you NC is not looking at this level. There has been talk for the last few years of NC becoming a NR state. Personally, I can take it or leave it. I know it's good for EMS as a whole, but unless I decide to move, it doesn't affect me.

IMHO, there should be only 2 levels. Basic ( which would be the current EMT-I) and Paramedic. Or, we could do like ours friends to the north ( Go Senators! ) do and call everyone a paramedic, just different levels of it.

[cwilliams17]

I took the test when it became Enhanced from shock trauma. I thought it was a fairly challanging test mostly because you are a emt-b with a few als skills. If I remember right my test had a lot of bls skills on it and that threw me off because here I was studying all the als skills. I passed on the 1st try with a 92%. Congrats on passing, now you can work your way up to paramedic!

[ericenglund]

IMHO, there should be only 2 levels. Basic ( which would be the current EMT-I) and Paramedic. quote]

If EMT-B was given the scope of practice as an EMT-Enhanced rather than intermediate(I'm not all to knowledgable about it but EMT-Es can start IVs, intubate, and give a few meds like albuterol and subcutaneus epi, etc), I think it would be better than having EMT-I's and EMT-Ps because really there isnt that much of a difference (at least in Virginia)besides calling for orders on things that a paramedic has standing orders.

[Sup64]

PA here. Can someone explain what exactly is included in the enhanced status?? There is talk of a nantional standard (EMT Advanced) which will give the provider some mediciation, IV, Intubation and cardiac Monitor privleages. The goal for the advanced is 2008-2010. You all are referrring to the enhanced as shock trauma? is that similar to basic Trauma Life Support. THanks for any information you all can provide. Feel free to PM me to ensure I get the responce via email.

[livnbreathems]

Yes Sir,

The EMT-E's in Virginia are allowed to start IV's, Intubate, and administers some medications per protocol. Yes, the EMT-E is the old Shock Trauma and to me is more based on the medical side instead of trauma. There were more questions reguarding medical situations. I have heard that maybe they will come up with the EMT-A again but I am not sure how soon or what the difference is. It would be great if they could figure out a way to combine EMT-E and I because there are so many different levels. The meds I am allowed to administer per our protocols are: Oxygen, EPI(SC), Albuterol, Nitroglycerin tablets and paste, Benedryl, Narcan, Glucagon, D50 and aspirin. I know its not much but if anything we do have the capabilites to use advanced airway manuevers if needed and thats the most important right? If you don't have an airway you don't have a patient. I am fairly new at this level and I have much to learn if anyone has any advise I would appreciate it. Otherwise, if you have any more questions for me just let me know. I did take the college level Anatomy and Physiology so I would understand the human body and its functions a little better. I learned a lot in that class and advise anyone else who would like additional training to take that course.

CJ

[scope2776]

From my post on another thread:

This may seem a little harsh but - and i do have plenty of EMT-I friends - plain and simple, there should only be two levels of prehospital providers. EMT-Basic and Paramedic. I think it's best not only from an education and patient advocacy perspective, but from a public perception angle. I already have to correct enough people calling me an "Ambulance Driver", I don't want to have to deal with people mistaking me for an Intermediate or whatever. Hell, not only does the general public have a hard time understanding what we do and the medical interventions we provide, most of our colleagues in the medical services have no idea either. I think it's just ridiculous that there are such things as EMT-Epi and EMT-Defib. I think as members of professional agencies such as the NREMT or NAEMT - or whatever state EMS agencies we belong to - we need to advocate the removal of recognition for these "Intermediate" levels.

I've heard the argument that not recognizing Intermediate levels will hurt rural areas. This is simply not true. If you want an expanded scope as an EMT for your special circumstance, then have a conversation with your medical director. And if the state doesn't allow some expanded practices, then have a conversation with your congressman. That's how it's supposed to work. Maybe your medical director could actually train and sign off your EMTs on the special skills. Or hire a Paramedic!

As a Paramedic student just finishing up school I feel like I have such a basic and entry-level knowledge of advanced care and cardiology/pharmacology. It's hard to describe, but it's like i'm on the cusp of ALS, and I think any education level below Paramedic, such as Intermediate, that picks and chooses ALS skills - not focusing ALS education or mindset, just skills - is below that entry-level understanding. And this cheats patients.

Whereas there is increasing pressure for Paramedics to justify practices such as intubation (EMT-E are allowed to intubate!?!?!?!) or the administration of cardiac drugs. And whereas many other ALS providers are continually challenging the Paramedic's ability to provide certain interventions based on lack of education. Then there is little if any justification for Intermediates to provide the same advanced skills.

Furthermore, I think it would be a great idea to increase the EMT-Basic curriculum to absorb some of the Intermediate stuff and requiring Paramedics to have degrees. But hey, that's a whole other conversation.

Also some more good replies in this thread

[Rescue0ne]

Congratulations on completing the EMT-E. You ARE looking into the EMT-I, riiiiight?

As far as the argument for doing away with the intermediary EMS levels goes, in a perfect world, we'd all be Paramedics, with BS degrees. Obviously, it's not a perfect world. I can't speak for other localities, but in rural Virginia, the EMT-Enhanced is a valuable asset where your agency may not have a full complement of I's & P's to cover every shift. (While this brings up the other argument of taking volunteers out of the equation, it's one that will not happen anytime soon, so we won't go there right now.) The fact of the matter is, Virginia needs volunteers right now. Virginia Department of Health, Office of EMS must have thought that the EMT-E is a necessary level of care, otherwise they would not have instituted it.

I'm not going to second guess them at this point. After I get my MD license, and they appoint me as Director of OEMS...maybe.

In the meantime, we're all in this together. Volunteer & Career, Basic & Paramedic. Until the legislators & EMS representatives get it right, and the ball is rolling toward the Professional EMS goal...I'm going to concentrate on Patient Care.