Attention all EMTs

CT Pixie, BSN, RN · Jan 4, 2008

I know here in CT you can ride the ambulance as an EMT OR nurse (LPN or RN) but you can't have your scope of practice encompassing both. Meaning if you are riding as an EMT, you cannot do what you can as an RN and riding as an RN you can't do what you can as an EMT..make sense? I use to ride with an RN who was an EMT-B, I was in training as an EMT-I (intermediate, aka intravenous trained). I was able to start lines she wasn't..even though she had many many years as an ICU nurse, since she was an EMT-B her scope of practice didn't include iv's. Didnt' I feel stupid with a difficult stick and she was talking me through it :specs: she was an IV team nurse too!! Ahhh!

Are you asking if your skills as a critical care nurse will help you with EMT-B school? Most definatly! You are have A&P under your belt, BLS, emergent care skills..etc. Concentrate on the steps of care..what's first, 2nd, 3rd etc..but honestly your schooling and training as a critical care nurse already taught you 99% of if.

Testing is a National test just like the NCLEX (most States are National Regististy EMT aka NREMT so if you test in a NREMT State, you can work as an EMT in any other NREMT State). First you have to pass the "practical/skill" portion of the test, then you sit for your written part a few days later. skills part is just like clinicals in school. You perform the skill, explain verbally as you do so, and its a pass/fail thing. I think there were like 5 stations of skills to do. All senerio type ones. Called to the scene, find man who was pinned under car for X minutes, pulled out by friends...and your off..what do you do.

Honestly don't remember the written part, but it wasn't difficult at all.

Best of luck to you. I loved riding the ambulance.

mom2michael, MSN, RN, NP · Jan 4, 2008

EMT-B is basic life support and support role of the Paramedic. You will learn your ABC's and a handful of meds you can assist patients in taking (but you can't give meds as a EMT-B). You'll also learn basic skills of putting a patient in C-spine, on a backboard and some splinting techniques for the field. You'll learn to take manual blood pressures and you might possibly learn to insert a combitube or LMA in a clinically dead patient.

My test involved a practical test station where I had an assessment station and 2 skills (one was putting a splint on, the other was spider straps for backboard but they can be a varieity of things). Once we passed our practical, we took our written, it was 50 questions and very basic, ABC type stuff and in my opinion was a very easy test. Believe me, it was NOTHING like the NCLEX.

I took the class before nursing school and it was helpful for my 1st semester of NS.

The major challenge I forsee for you is NOT thinking like a critical care RN when you take the class. This class is a very basic class, 99% of my class had zero health care experience before they stepped foot in the door....so the class was extremly basic. I would struggle after being an ER nurse taking the class now.

The major skill for a paramedic that an RN can not do is intubation. I work in 3 hospitals that use paramedics in the ER and none of them are allowed to intubate in their role in the ER.

An EMT-B can not intubate a patient - they are only allowed to use a combitube in a clinically dead patient.

And CT-Pixie is correct - if you are working as an EMT-B, that is your skill level at the time and it doesn't matter that in the hospital you can start IV's until the cows come home, in the unit you are an EMT-B and you are not allowed to start IV's.

CT Pixie, BSN, RN · Jan 4, 2008

EMT-B's in CT have in their scope of practice the ability and authorization (per hospital protocol) to insert airways, we just can't intubate, but we can assist the EMT-P who's doing it. We can insert NG tubes, we can give Epi-Pen injections, we can assist the pt w/NTG if the patient has a script for it and has it w/them, we can give glucose to diabetics if needed. We can ONLY declare a pt DOA, IF they are decapitated, in rigor, or its obvious that life is not compatable with the injury...burned beyond recognition etc.

Like with LPN/RN scopes of practice..it can vary from State to State on whats allowed and not allowed.

Dunno? · Jan 4, 2008

A lot of people dont know that EMTs and paramedics are totally two different positions..A paramedic has more education than an EMT..An EMT can get trained in 4 months or less..But a paramedic needs about a year or more..That is in California..Like I know, when you call an ambulance or 911, make sure there is a paramedic in there and not just EMTs..My co worker mentioned this to me one time, when she called 911 and there was no life support for the patient because only EMTs where in the ambulance..

In short, an EMT is like a CNA and a paramedic is like a licensed nurse..

getoverit, BSN, RN, EMT-P · Jan 4, 2008

Christie,

good luck with your EMT class. What made you decide to take it? Are you volunteering with a rescue squad? Most everyone's post is dead-on, it's a very simple class compared with what you do in critical care.

It's basic ABCs, what do you need to do before getting into the ER.

Testing is very different from the NCLEX, you will have a practical station where you probably have to perform a trauma survey, spinal immobilization, O2 administration, etc.

As far as separating the two roles, nurses can do many more things than a paramedic. Yes, as a paramedic I can intubate someone prehospitally, but as a paramedic I"m not allowed to even assist someone taking their own insulin even though I cover with sliding scale and use insulin gtt protocol everyday. There are plenty of other examples and it depends on state/local protocols; the higher your comfort level between you and your medical director, the more leniency you'll be allowed.

One of the big things you might find difficult is the section of the class on radio frequencies. Answering the radio in the ER is totally different than understanding effects of terrain/vegetation on bandwidth and selecting a channel based on that. Differing types of vehicles. I remember my EMT instructor would tell me "you're in that modified Type II today." and my response was "just tell me what number's on the side".

Hope this helps. let me know how it goes.

FlyingScot, RN · Jan 4, 2008

An EMT-B can not intubate a patient - they are only allowed to use a combitube in a clinically dead patient.

This is not true in all states. In the state of Ohio an EMT-B CAN intubate if the person is pulseless and not breathing. We are no longer being taught to use a Combitube.

As to the original question. Your nursing training and ICU experience will help you tremendously in the didactic portion of the class. You will probably find the practical portion challenging unless you have some sort of pre-hospital experience. This is the part where you learn how to apply c-collars,CID's, spineboards, KEDs, Sager and Hare traction splints and those darn cravat slings. Fortunately for me I have had 28 years as a National Ski Patroller so this stuff was a walk in the park as was the class work. The test is no longer a paper test. The NREMT test is computer based just like the NCLEX and you can get as few as 75 questions or as many as 250. Me personally, I thought the test was stupid because the questions were poorly written and covered things that I felt out of the scope and training of the EMT-B. I finished in ten minutes and the proctor thought something was wrong. The good thing was I tested on Wednesday morning and got my certificate in the mail on Thursday. I think it's a class definitely worth taking for the skills portion as we do not have this taught to us in nursing school and it does come in handy.

Christie RN2006 · Jan 4, 2008

I decided on taking EMT classes because I pretty much grew up around the fire department. My dad is a fire fighter/paramedic. I was just little when he took EMT-B and things have changed a lot since then, so thats why I'm asking all of you these questions. I understand the basic differences in the roles of EMT-B through paramedic already and I plan on taking the RN to paramedic bridge course some day down the road. I work in a Surgical/trauma ICU so luckily I have basic training on c-collars, back boards, etc. Thanks to our trauma classes! I am in the process of joining a fire department right now... all of the basic things are done, I'm just waiting on the final ok. I am not allowed to ride with a department until I have officially started my classes, which is a bummer because they had a really good run today :)

What types of things did the written test have on it?

sharona97, BSN, RN · Jan 4, 2008

I have a question about intubation. Being an ICU nurse I'm assuming you also have ACLS training. If you have this training and it is current, why not be able to intubate in the field or ambulance? Interesting? Thanks.

Christie RN2006 · Jan 4, 2008

I have a question about intubation. Being an ICU nurse I'm assuming you also have ACLS training. If you have this training and it is current, why not be able to intubate in the field or ambulance? Interesting? Thanks.

I am ACLS certified, but I'm not even allowed to intubate in the hospital.

TypeA · Jan 4, 2008

Have you considered bridging to EMT-P (this is an option for RNs)? It would probably be a lot more challenging and enjoyable for you. Some states allow it, some do not. In those that don't, you can challenge the EMT-B exam to essentially test out.

Good luck with whatever you decide to do.

FlyingScot, RN · Jan 4, 2008

I have a question about intubation. Being an ICU nurse I'm assuming you also have ACLS training. If you have this training and it is current, why not be able to intubate in the field or ambulance?.

The AHA is pretty clear that all of their classes (ACLS, PALS,BLS) are educational tools only and do not "license" the cardholder to perform procedures such as intubation. State and facility policies supercede AHA training.