Attention all EMTs

[Christie RN2006]

I know that some of you on here are EMTs and I was just curious who so I could pick your brains :) I have been an RN in an intensive care unit for a year and half now and I am about to begin my EMT-B classes on January 8th.

My questions are: are you ever able to combine your RN and EMT skills? I know that EMTs (more specifically paramedics) are able to do things that nurses can't etc. Do you ever have trouble with the two different roles? Do you think my skills as a nurse in critical care will help me in my classes? What types of things do you recommend me paying close attention to in my classes? and last, but not least... what is the process of testing and getting your license as and EMT like? Is the test anything like the NCLEX?

Any helpful hints of advice would be greatly appreciated! Thank you!!

[GilaRRT]

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...

Basic EMT's intubating...I am not even going to touch that one. Please tell me that Ohio EMT's have access to some type of rescue airway device. (King, LMA, Easy Tube, PTLA, Cobra)?

[taxifolia]

HI

just one additional comment, in OR, an RN, if also current in ACLS, PHTLS, and PALS I think (going from memory on this, have not needed to look it up lately), can serve on an ambulance at a parmedic, you might just want to check if your state has any similar provision. although I was an EMT then Paramedic, then RN, I believe there would be value to taking an EMT course, and there is still truth to the saying that "basics" (EMTs) save paramedics, because of the knowledge from those courses.

[getoverit, BSN, RN, EMT-P]

Like Scott said, ACLS is a course completion card and does not license individuals to perform certain skills beyond the scope of nursing practice acts. For EMT-Bs passing ET tubes on a confirmed pulseless and apneic patient, why not? Of course they have a backup airway device but it's not like they're performing rapid sequence induction on a live patient. You can train a monkey to intubate, but you can't teach him all the different situations where it's indicated.

The types of questions on the EMT exam are basic medical/trauma management and triage. Everything from simple long bone fractures to anaphylaxis, basic extrication from vehicles, radio frequencies, cardiac/respiratory emergencies, OB/delivery, environmental (e.g. heatstroke, snakebites, etc.), burn management, CVA, etc. Nothing geared outside of prehospital stabilization and treatment en route to the ER. Your experience as a nurse will make it much easier to learn anything you're not already familiar with.

There is a saying about people who challenge a paramedic exam, "papermedic". they have a certification but don't have the same experience. Working with RNs who have gone through a 40 hr. course and then take a paramedic exam is fine, but they are at a disadvantage when we're at a 4 car pileup on the interstate and they don't understand the evolution involved in getting the patient's out. Some community colleges have night paramedic courses or similar options. Check around and see what's out there.

Congrats on joining the fire dept. I missed a big structure fire this morning at 6am while getting ready for work. the ICU manager wouldn't excuse that absence! haha

[paccookie]

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..

That is absolutely untrue. There are different levels of EMTs, but a paramedic is also an EMT, they are just EMT-P, rather than EMT-B or EMT-I (B=Basic, I=Intermediate). The different levels encompass different skills sets, but each can function on their own. Basics can function independently, as can Intermediates. They do not require a paramedic present at all times. Comparing an EMT with a CNA is not accurate at all. Do a little research before you post.

[Dunno?]

That is absolutely untrue. There are different levels of EMTs, but a paramedic is also an EMT, they are just EMT-P, rather than EMT-B or EMT-I (B=Basic, I=Intermediate). The different levels encompass different skills sets, but each can function on their own. Basics can function independently, as can Intermediates. They do not require a paramedic present at all times. Comparing an EMT with a CNA is not accurate at all. Do a little research before you post.

An EMT in California can be trained in 4 weeks..While community collleges in California train paramedics for about 9 months or more..

You tell this to a layman and you are going to have 2 EMTs who were trained for 4 weeks in an ambulance in an emergency, and see what you are going to end up with...As you said, EMT equals paramedics..That is what you are saying..I am not talking about levels..In an emergency, you have to react in what is going on...Call 911, and dont ask for a paramedic in the ambulance is lethal..

[Dunno?]

That is absolutely untrue. There are different levels of EMTs, but a paramedic is also an EMT, they are just EMT-P, rather than EMT-B or EMT-I (B=Basic, I=Intermediate). The different levels encompass different skills sets, but each can function on their own. Basics can function independently, as can Intermediates. They do not require a paramedic present at all times. Comparing an EMT with a CNA is not accurate at all. Do a little research before you post.

Why dont you do some research....Lives are at stake here and that is the most important issue to me....You are saying that you would let 2 people in an ambulance handle an emergency who was trained for only 4 weeks and they can do it without a paramedic....Read this:

http://firstaid.about.com/od/emergencymedicalservices/qt/06_EMTBvsP.htm

In the article it states:

"Within the industry, it is very common to refer to a basic EMT as simply EMT, and to refer to EMT-Paramedics as paramedics."

[EricJRN, MSN, RN]

To make scope of practice issues even more confusing, some states have a statewide scope of practice for each level of EMS provider, while other states leave these issues to the discretion of each agency's medical director.

Here in Texas, the EMS education programs generally cover specific skills at each level of training (IV therapy, intubation, and some IV push meds in the EMT-Intermediate class, for example).

However, when the EMT-I student gets out into the real world as an EMT-I, his medical director may allow him to give certain IV meds (like D50, thiamine and naloxone) or he may not be allowed to give anything IV at all.

Likewise, EMT-B's can give nitro at some services, while it requires and EMT-I or EMT-P at other services - and sometimes it depends on whether the nitro is for HTN or chest pain. Talk about confusing!

Bottom line: There are often no hard and fast rules when it comes to scopes of practice, especially when we all come from different places and hold combinations of healthcare licenses/certifications.

[Christie RN2006]

HI

just one additional comment, in OR, an RN, if also current in ACLS, PHTLS, and PALS I think (going from memory on this, have not needed to look it up lately), can serve on an ambulance at a parmedic, you might just want to check if your state has any similar provision. although I was an EMT then Paramedic, then RN, I believe there would be value to taking an EMT course, and there is still truth to the saying that "basics" (EMTs) save paramedics, because of the knowledge from those courses.

Here in order to become an EMT-B, you have to sit for the class. I can get out of the majority of my clinicals by working at the hospital. After I get my EMT-B I can take a RN to paramedic bridge course. The bridge course allows you to pretest in areas and if you pass, you don't have to take that part of the course, but if you fail, you have to take that class and retest. There are certain parts of the bridge course that are required no matter what degree you have. Here you have to be an EMT or in school to ride on the ambulance...RNs are not allowed.

[sharona97, BSN, RN]

Thanks to all that contributed to my question. In MN ACLS is not a license as one poster stated but a certification.

I do however now understand the reasoning on the intubation question.

Thanks.

[mcknis]

Congrats on joining the fire dept. I missed a big structure fire this morning at 6am while getting ready for work. the ICU manager wouldn't excuse that absence! haha

Yeah, congrats on getting on the fire department. I love being a volly, but for now I am only a FF, but do plan on going to be getting my EMT-B and then EMT-P when I am out of nursing school.

RNEMT-P: When you are out on runs, are you allowed to still do vitals and other basic things when with the FD? I have wanted to assist the medics and EMTs during big situations but was always worried that i might cross some state laws, etc. PS...just a student for now, but always want to help in whatever way I can.

[Christie RN2006]

Yeah, congrats on getting on the fire department. I love being a volly, but for now I am only a FF, but do plan on going to be getting my EMT-B and then EMT-P when I am out of nursing school.

Where are you at in Ohio?

[mcknis]

Around the Upper-Sandusky area...out in the country.