diff in paramedic and intermediate

[medic 4-2]

what are the differances in being a paramedic and an intermediate?
what are the scope of practice for both?
are there anythings that a medic can do that an intermediate cannot do?
- thanks alot

 

[rescuecpt]

In NY we have 2 levels of intermediate: intermediate and critical care. I's can do barely anything. CC's can do almost as much as the medics with one exception (needle crych's -sp?) except that medics have more under standing orders than CC's do. Some protocols, however, we have the same. But the big difference is the amount of time spent in school and clinicals, and the fact that medics know WHY they do stuff (as they were trained to know why) while CC's know what to do when, but weren't taught the why's in as much depth (or any depth) as the medics. Although good CC's will learn the why's through CME's and extracurricular learning.


(how'd I do Seb? any better?)

 

[usafmedic45]

Originally posted by medic 4-2@Jul 5 2005, 08:32 AM
what are the differances in being a paramedic and an intermediate?
what are the scope of practice for both?
are there anythings that a medic can do that an intermediate cannot do?
- thanks alot

It varies wildly across the states and even from service to service within some states, but at least where I worked at EMT-I's could administer most ACLS drugs and a few others (epinephrine, atropine, lidocaine, naloxone, D50, thiamine, glucagon, nitrous oxide (when we carried it), albuterol, ipratroprium bromide, nitroglycerin, aspirin, etc), intubate, needle decompress, IV, IO, manually defibrillate and a few other assorted procedures. This however is the exception to the rule- most EMT-I services are far more limited in scope and require far more online medical control authorization for what they can do than we did.

We didn't have medics available so we were the top of the food chain as far as EMS providers go, so I can't get into specifics as to what medics could do locally since we don't have them, but the general rule is "everything else"

By the way, most medics are just as clueless about the reasoning for what they do as most EMT-I's. It's just a matter that medics have a wider expanse of topics to know about. But then again, a lot of medics are still not too swift on the mechanisms underlying what they do (but neither are most RN's, a lot of RT's, and a frightening number of MD's).

 

[medic 4-2]

yeah i am from virgina and i just got my emt-b and i am looking to further my education. are you are to go from emt-b to paramedic? i am looking into trying to get a paid career. do you have any suggestions i am a ff/emt right now. i prefer the ambulance better. i dont mind riding the fire truck. i just like riding the ambulance. do you have any sugestions on what certs i should have to get on a paid medic unit

 

[usafmedic45]

If you can, go straight for your paramedic certification. I'd recommend obtaining ACLS and PALS instructor certs if you can, as these look very nice on a resume.

 

[medic 4-2]

thanks i was definatly looking into pals. acls sounds like a good class. how about ce hrs i know medics in va have to have 72hrs in 2 yrs. is it tuff to get all of the ce credits. what about evoc i was thinking about level 1 and 2

 

[TTLWHKR]

Going off the original subject, you can pretty much ask "What's the difference" with all branches of EMS, since there is no true national standard.

There are so many DIFFERENT variations of EMT and First Responder, the list is literally too long to remember. At one point I recall there being at least 20 different certifications among the FR & EMT.

 

[TTLWHKR]

Since I have nothing better to do at the moment, I made a list.
EMT-ADVANCED
EMT-AMBULANCE
EMT-BASIC
EMT-CRITICAL CARE TECH
EMT-CARDIAC TECH
EMT-DEFIBRILLATION
EMT-ENHANCED
EMT-INTERMEDIATE
EMT-I85
EMT-I99
EMT-MAST
EMT-PARAMEDIC
EMT-SHOCK TRAUMA TECH
WILDERNESS EMT
ECA (EMERGENCY CARE ATTENDANT)
CAA (CERTIFIED AMBULANCE ATTENDANT)
FR (FIRST RESPONDER)
MFR (MEDICAL FIRST RESPONDER)
PHRN (PREHOSPITAL REGISTERED NURSE)
ETT Emergency Trauma Technician
EMT I
EMT II
EMT III
MICP Mobile Intensive Care Paramedic
LP - Licensed Paramedic
NREMT-P - Nationally Registered Paramedic
NREMT-B
NREMT-I
CCEMT-P - Critical Care Paramedic

I compiled the list from several commercial sites that I didn't write down.

 

[Jon]

CCEMT-P is Critical Care Emergency Medical Transport - Provider

Supposedly anyone can pay the money and take the class


Also - EMT-MST - local TI offers it - EMT-B + Phelbotomy and some other BS stuff to create an ED tech.

 

[911 DJ]

Originally posted by MedicStudentJon@Jul 5 2005, 05:23 PM
Also - EMT-MST - local TI offers it - EMT-B + Phelbotomy and some other BS stuff to create an ED tech.

Wouldn't it maqke more sense to hire a EMT-I or EMT-P in the ED? I work as a Emergency Care Tech. (ERT, EMT-I/85) in a ED, and believe it or not, without taking a phlebotomy class.... (drumroll).......... we all collect blood without killing patients! I guess it all depends on medical direction.

 

[TTLWHKR]

But Why?

When you can be a Certified EMT-ABCDEFGHIJKLMNOPQRSTUVWXYZ?

 

[medic03]

Originally posted by TTLWHKR@Jul 5 2005, 12:25 PM
Since I have nothing better to do at the moment, I made a list.......

You forgot FP-C = flight paramedic-certified
(the only reason I knew this is cuz I have my cert )

 

[Jon]

Originally posted by 911 DJ+Jul 5 2005, 09:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (911 DJ @ Jul 5 2005, 09:31 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Jul 5 2005, 05:23 PM
Also - EMT-MST - local TI offers it - EMT-B + Phelbotomy and some other BS stuff to create an ED tech.

Wouldn't it maqke more sense to hire a EMT-I or EMT-P in the ED? I work as a Emergency Care Tech. (ERT, EMT-I/85) in a ED, and believe it or not, without taking a phlebotomy class.... (drumroll).......... we all collect blood without killing patients! I guess it all depends on medical direction. [/b][/quote]
I never said it wouldn't.... that school is notorious for passing anyone who will pay the outragous fees and can pass the state exam after LOTS of coaching... they love to charge 20 grand to make you a medic from NOTHING, with NO street time experienc except school...

Jon

 

[shorthairedpunk]

Originally posted by 911 DJ+Jul 5 2005, 08:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (911 DJ @ Jul 5 2005, 08:31 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Jul 5 2005, 05:23 PM
Also - EMT-MST - local TI offers it - EMT-B + Phelbotomy and some other BS stuff to create an ED tech.

Wouldn't it maqke more sense to hire a EMT-I or EMT-P in the ED? I work as a Emergency Care Tech. (ERT, EMT-I/85) in a ED, and believe it or not, without taking a phlebotomy class.... (drumroll).......... we all collect blood without killing patients! I guess it all depends on medical direction. [/b][/quote]
Blood draw is a monkey skill for the most part. The ER receptionists took an in ER informal training and can do them, and they arent even medically trained. Its not hard, since it doesnt stay in and if its a complicated case, then lab gets called, which is a rarity. when you get to use a small needle, with no catheter to advance, its easy, even with tiny lil veins. Arterial draws on the other hand, only get done by lab.

 

[Ridryder911]

Most states have developed their own criteria above the national standard curriculums recommendation.

Unfortuantely, I feel like many of the employers are using the EMT/I as a excuse to get ALS coverage, without paying for it, more scarrier is EMT/I are allowing this to occur. I have read how " we almost do everything.. or .. samething except"

A couple of things come in mind...
1) You are being used. If you are treating the patient as a Paramedic, & not recieving compensation.. is that fair ? I am sure they are billing at ALS rate, & thus recieving compensation as such.

2) Really you are not a Paramedic.. short & simple.. the same a LPN is not a RN. Sorry, until you have completed the full program & credentials, you are not sorta-or almost. Either you are or you are not.....

Be safe,
Ridryder 911

 

[Summit]

Originally posted by ridryder
Unfortuantely, I feel like many of the employers are using the EMT/I as a excuse to get ALS coverage, without paying for it, more scarrier is EMT/I are allowing this to occur.

Our system has begun doing this due to a shortage of P's (inability to retain P's and attract new P employees). They have even started to assign some I's "Medic" callsigns and place them in ALS fly cars, and assigning them as ALS coverage for districts.

I am sure they are billing at ALS rate, & thus recieving compensation as such.

Yep

 

[rescuecpt]

Originally posted by Ridryder911@Jul 13 2005, 10:57 AM
A couple of things come in mind...
1) You are being used. If you are treating the patient as a Paramedic, & not recieving compensation.. is that fair ? I am sure they are billing at ALS rate, & thus recieving compensation as such.

WHAT?!? I'm supposed to receive compensation????? WOW, I wonder what 5 years of back pay will add up to........ :lol:

Oh wait, you were talking paid services, lol, nevermind.


Seriously though, around here, as far as I know at paid services intermediates can only perform BLS, not ALS. I know a couple I's (or CC's as you may) who work in private and are not allowed to perform ALS and are paid as basics because that is what they do.

 

[KEVD18]

round here, if my information is correct(thin ice here) i's can start line, but cant push anything but ns, intubate, depib plus all the bls stuff of course

we're trying to get rid of the i's in the boston metro area. pointless rating that causes more harm than good. not too long ago, there was a pair of newly minted i's on a truck. they responded to a c/p call. the nearest er was maybe 10 away. they sat on scene for THIRTY trying to establish a line, unsucessfully at that. they ruind every vein he had and took forty minutes to get him to the er, ALL TO PUSH SALINE!

 

[ffemt8978]

I don't see the benefit of I's in a metro area, but in a rural area I think they can be a good thing. Given our long transport times around here, we can prep the patient for our ALS intercept and save the P's precious minutes that would be wasted by establishing a line. Of course, we don't start our lines on scene but do them during the transport. After all, BLS before ALS.

 

[usafmedic45]

I don't care what level of training you are- you're still a moron if you sit on scene trying to get an IV on a patient like that. There are very few (maybe 1 in 10) that I will sit around after I get them in the back of the rig. We might not be time sensitive in terms of what the case is, but there is still no point in delaying transport, even if it is just going to be a nicely non-emergent transport.