About EMT intermediate

[word2yamutha]

I was wondering why the state of Missouri doesn't recognize EMT-I's? Basically here In MO you go from basic straight to paramedic.

 

[Ridryder911]

I was wondering why the state of Missouri doesn't recognize EMT-I's? Basically here In MO you go from basic straight to paramedic.

Because they were smart. They foreseen what other states did not and do not have multi labels or half excuses, it's either all or nothing. So many get caught in the trap of ..."almost like or similar to" in comparison to Paramedic level.

I discussed this over 10 years ago with MO State EMS office and wished my state had went that route as well. Now, almost every other state is considering the same idea (especially if there more money).

R/r 911

 

[akflightmedic]

It is a good thing, Florida does not recognize Intermediates either.

It is basic or medic....period.

 

[Sapphyre]

neither does California (with very few exceptions).

 

[Lifeguards For Life]

agree with ak and rid. in florida, and i like there no being any middle ground, all or nothing.
I think someone on this forum had said that getting an EMT-I only shows you want the skills but not the knowledge of why you're doing these skills. I don't support the idea of multiple half way levels

 

[8jimi8]

in defense of intermediates.

i think it is good as a way to begin practicing very basic "paramedic skills"

not that you aren't getting any education for it. Can you honestly claim that intermediates learn nothing to back up these "skills?"

And as practice i mean... while you are continuing on to the paramedic level. It will take most intermediates at least a year after completing intermediate to get to the paramedic level.

So why not have a year of starting IVs, intubating people and beginning to interpret ECGs to make the transition into being a paramedic smoother?

Just so you don't have someone who's only been a basic stepping out into the paramedic role like a deer caught in headlights.

 

[Lifeguards For Life]

in defense of intermediates.

i think it is good as a way to begin practicing very basic "paramedic skills"

not that you aren't getting any education for it. Can you honestly claim that intermediates learn nothing to back up these "skills?"

And as practice i mean... while you are continuing on to the paramedic level. It will take most intermediates at least a year after completing intermediate to get to the paramedic level.

So why not have a year of starting IVs, intubating people and beginning to interpret ECGs to make the transition into being a paramedic smoother?

Just so you don't have someone who's only been a basic stepping out into the paramedic role like a deer caught in headlights.

why not jump straight into medic class? as my state does not recognize I's everyone in paramedic class has more or less jumped straight in. I went straight from emt to paramedic. Took the NREMTB about a week after paramedic school started. I like the views generally supported here about needing the knowledge, knowing when and why you perform a certain intervention, not just doing skills under supervision of a medic. To me it seems that if one understands why they are perfroming a skill, learning the physical skill would be the easy part

 

[Flight-LP]

Can you honestly claim that intermediates learn nothing to back up these "skills?"

So why not have a year of starting IVs, intubating people and beginning to interpret ECGs to make the transition into being a paramedic smoother?

Just so you don't have someone who's only been a basic stepping out into the paramedic role like a deer caught in headlights.

From the mouth of a Texas educator, yes I can ascertain that the intermediate level focuses mainly on the skills set and not the pathophysiology behind electrolyte disturbances and the carbonic acid buffering system. Electrocardiography is nowhere in the "I" curriculum.

So why not have people out there playing "intro paramedic"? For one, it isn't needed and honestly the time spent in an intermediate class can be spent in a paramedic class with no additional time spent and no worries about getting a partial half a$$ed education. Secondly, there is absolutely no need to dip the student's toes in the water. They can dive right on it! Thousands of students have gone straight into Paramedic school without an issue. Its done every year, it is my personal recommendation to all of my EMT-B graduates, and it allows for a reduced number of ignorant habits based on the personal opinion of the student vs. sound medical facts and reasoning.

You can soften the blow as much as feasible, but I have yet to see a new medic NOT have the "deer in the headlight look", myself included when I was first released to kill people on my own. I would be more frightened of one who doesn't have that look. Then it would tell me that either they don't care or are a cocky cowboy that needs to be heavily supervised............

 

[MrBrown]

Personally I am in favour of as few levels as possible; we're moving from five to three (Ambulance Technician, Paramedic and Intensive Care Paramedic).

The intermediary level (Paramedic) is the pretty much the defacto standard for career entry-to-practice, there are some paid AOs (Techs) but it's the exception rather than the rule here which is fine by me!

From what I have seen your Intermediate level (from the national scope of practice model) isin't all that great and if we can get as many people up to ALS level provided they are properly educated and deployed I don't see the need for an Intermediate level.

 

[bunkie]

I don't believe my area has I's either. I believe my instructor was saying around here they didn't. I could be wrong though. However all the agencies that teach P require a year of B before you can get in and you usually need to be sponsored by your agency as well. I asked why the year was necessary and quickly hit a very sore spot on that instructor. :glare:

 

[VentMedic]

I don't believe my area has I's either. I believe my instructor was saying around here they didn't. I could be wrong though. However all the agencies that teach P require a year of B before you can get in and you usually need to be sponsored by your agency as well. I asked why the year was necessary and quickly hit a very sore spot on that instructor. :glare:

If you are talking about Washington State, this is an example of what a state should NOT do.

First Responder
EMT-Basic
IV Technician
Airway Technician
IV/Airway Technician
IV Intermediate Life Support Technician (ILS)
EMT-Paramedic

 

[tcripp]

in defense of intermediates.

i think it is good as a way to begin practicing very basic "paramedic skills"

not that you aren't getting any education for it. Can you honestly claim that intermediates learn nothing to back up these "skills?"

And as practice i mean... while you are continuing on to the paramedic level. It will take most intermediates at least a year after completing intermediate to get to the paramedic level.

So why not have a year of starting IVs, intubating people and beginning to interpret ECGs to make the transition into being a paramedic smoother?

Just so you don't have someone who's only been a basic stepping out into the paramedic role like a deer caught in headlights.

As an NREMT-I in school to earn my paramedic patch...I really have enjoyed the ability to work at a slightly higer level than first reponder to continue to reinforce what I have learned. I wouldn't have done it differently.

Now, what gets my goat are those who only have a basic patch but then are granted permission by their medical director to do things such as starting IVs and didn't get the additional 2 semesters of education to back it up. Here's where the multi-levels really muddy up the system.

 

[Shishkabob]

You really think you need 2 semesters of school to learn how to start an IV?

 

[Lifeguards For Life]

You really think you need 2 semesters of school to learn how to start an IV?

i may be wrong, but when i was donating blood, the attendant had told me i believe, that it is a 16 hour course they take to work at the blood bank. and they can start iv's for instance when you donate using the Alyx. As a physical skill it is not hard to learn how to start an iv, there may be some pt. that area harder sticks than others, but it is not a hard skill to learn

 

[MrBrown]

i may be wrong, but when i was donating blood, the attendant had told me i believe, that it is a 16 hour course they take to work at the blood bank. and they can start iv's for instance when you donate using the Alyx. As a physical skill it is not hard to learn how to start an iv, there may be some pt. that area harder sticks than others, but it is not a hard skill to learn

You should also be learning about fluid compartmentilisation, osmolarity, tonicity, diffusion, facilitiated diffusion, Pouselles law and fluids in shock as well.

That may take more than 16 hours ... I still don't get some of it

 

[Lifeguards For Life]

You should also be learning about fluid compartmentilisation, osmolarity, tonicity, diffusion, facilitiated diffusion, Pouselles law and fluids in shock as well.

That may take more than 16 hours ... I still don't get some of it

agreed. as everyone else was saying learning how to make the stick is not hard. i think she said 16 hours not sure, but was very suprised the lack of training and education at the blood donation center. from the way she explained it one could gather that they learned the skill (starting an IV) with little to no education on what is happening inside the body

 

[Ridryder911]

You really think you need 2 semesters of school to learn how to start an IV?

No, actually longer. I bet I can ask you questions regarding IV's and their complications that most 2 year Paramedics cannot answer.

Let me ask you all honestly, can you immediate point out to me were & which one is the basilic vein?...

R/r 911

 

[EMSLaw]

No, actually longer. I bet I can ask you questions regarding IV's and their complications that most 2 year Paramedics cannot answer.

Let me ask you all honestly, can you immediate point out to me were & which one is the basilic vein?...

R/r 911

It's the big one on the inside of the arm, as opposed to the cephalic vein, which is on the outside of the arm. But that's more A&P stuff, rather than any EMS training I've received.

This reminds me of how my mother, who was an experienced BSN, was always worried about hitting a nerve when giving IM injections, whereas her less-theoretically educated associate or diploma-school colleagues never seemed to worry about it. Perhaps because they didn't know enough to realize there was something they /should/ worry about hitting?

I agree that getting a 'stick' isn't a hard skill to learn. But if you want to move beyond being a technician to being a technologist, who knows not only how to do the skill, but why, then that requires more time and study.

 

[audreyj]

We have intermediates here in the rural areas, which is pretty much every thing outside Chicago and the surrounding metropolitan area. EMT-Is are very rare where I'm at, it's all or nothing, Chicago Fire Dept. *might* take an intermediate, not totally sure on that (they were the only ones taking the EMT-I exam at testing). I personally don't understand why one would get an EMT-I over going straight for paramedic, just seems like an unnecessary step.

I went straight from basic to paramedic school and the only thing I would recommend is that if you struggle with A&P, then take a course, it will help in medic school.

 

[tcripp]

Wow, you guys are brutal around here, aren't you?

For those who had my back...thanks.

For the others...no, it doesn't take two semesters to learn how to take the catheter and stick it in the vein. As a matter of fact, we probably covered that in about two classes including practice sticks on each other.

But, it's not just about the invasive procedure. It's knowing how to choose the correct size catheter for the job. It's knowing when and when not to start a line. It's knowing how much or how little fluid to infuse...and which fluid type you should be using. It's knowing how to ensure that you've not caused further damage by infiltrating the vein or by shearing the catheter.

But, to clarify...the two semesters is the length of time required to become an intermediate and all that implies....not the length of time it took to learn this one skill.

Side note...even phlebotomists spend a single semester in training here in Texas.