With the launching of the First AEMS Advanced EMT Course in the Philippines in partnership with Pilipinas911 for Manila City and Philippine Red Cross - Zamboanga City Chapter, there are questions raise by individuals and enrollees as to what is the difference between Advanced EMT and EMT-I.
Emergency Medical Technician-Intermediate (EMT-I) is a mid-level provider of pre-hospital emergency medical services in the United States; a transition of this level of training to Advanced Emergency Medical Technician (AEMT), which has greater training.
The Advanced EMT or AEMT is the new mid-level EMS provider that has been introduced in the US at the national level according to the new national EMS scope of practice model. The AEMT will replace the EMT-I/85 and EMT-I/99. The EMT-I/99 will have a total of three re-certification cycles to meet the requirements to transition to the Paramedic level, while the EMT-I/85 will have two re-certification cycles to transition to the AEMT.
EMT-1/85 and EMT-1 99?
EMT-I/85 is a level of EMT-I training formulated by the National Registry of Emergency Medical Technicians (NREMT) in 1985. This training level includes more invasive procedures than are covered at the EMT-Basic level, including IV therapy, the use of advanced airway devices, and provides for advanced assessment skills. The EMT-I/85 typically administers the same medications as an EMT-B (oxygen, oral glucose, activated charcoal, epinephrine auto-injectors (Epi-Pens), nitroglycerin, and metered-dose inhalers such as albuterol). However, in some states they are also allowed to administer Narcan, D50, glucagon, thiamine, and atropine. Like all other EMT levels, their scope of practice is governed by the State and/or their Medical Director.
The EMT-I/99 level is the closest level of certification to Paramedic, and allows many techniques not available to the EMT-I/85 or EMT-Basic. These techniques include needle decompression of tension pneumothorax, endotracheal intubation, nasogastric tube placement, use of cardiac event monitors/ECGs, and medication administration to control certain cardiac Arrhythmias.
As stated in The US' National EMS Scope of Practice Model from page 22 to page 28:
Emergency Medical Technician
The primary focus of the Emergency Medical Technician is to provide basic emergency medical care and transportation for critical and emergent patients who access the emergency medical system. This individual possesses the basic knowledge and skills necessary to provide patient care and transportation. Emergency Medical Technicians function as part of a comprehensive EMS response, under medical oversight. Emergency Medical Technicians perform interventions with the basic equipment typically found on an ambulance. The Emergency Medical Technician is a link from the scene to the emergency health care system.
Emergency Medical Technician
Description of the Profession
The Emergency Medical Technician’s scope of practice includes basic skills focused
on the acute management and transportation of critical and emergent patients. This may
occur at an emergency scene until transportation resources arrive, from an emergency
scene to a health care facility, between health care facilities, or in other health care
settings.
In many communities Emergency Medical Technicians provide a large portion of the o
ut-of-hospital care. In some jurisdictions, especially rural areas, Emergency Medical
Technicians provide the highest level of out-of-hospital care. Emergency Medical
Technicians work alongside other EMS and health care professionals as an integral part
of the emergency care team.
Emergency Medical Technicians’ scope of practice includes basic, non-invasive
interventions to reduce the morbidity and mortality associated with acute out-of-hospital
medical and traumatic emergencies. Emergency care is based on assessment findings.
Additionally, Emergency Medical Technicians provide care to minimize secondary injury a
nd provide comfort to the patient and family while transporting the patient to an
emergency care facility.
An Emergency Medical Technician’s knowledge, skills, and abilities are acquired
through formal education and training. The Emergency Medical Technician has the
knowledge of, and is expected to be competent in, all of the skills of the EMR. A major
difference between the Emergency Medical Responder and the Emergency Medical
Technician is the knowledge and skills necessary to provide medical transportation
of emergency patients.
The Emergency Medical Technician level is the minimum licensure level for personnel
transporting patients in ambulances. The scope of practice is limited to basic skills that
are effective and can be performed safely in an out-of-hospital setting with medical
oversight and limited training.
The Emergency Medical Technician transports all emergency patients to an appropriate
medical facility. The Emergency Medical Technician is not prepared to make decisions
independently regarding the appropriate disposition of patients. The Emergency Medical
Technician serves as part of an EMS response system, assuring a progressive increase
in the level of assessment and care. The Emergency Medical Technician may make
destination decisions in collaboration with medical oversight. The principal disposition
of the patient encounter will result in the direct delivery of the patient to an acute care
facility.
In addition to emergency response, Emergency Medical Technicians often perform
medical transport services of patients requiring care within their scope of practice.
Psychomotor Skills
The following are the minimum psychomotor skills of the EMT:
• Airway and Breathing
o Insertion of airway adjuncts intended to go into the oropharynx or nasopharynx
o Use of positive pressure ventilation devices such as manually triggered ventilators
and automatic transport ventilators
• Pharmacological Interventions
o Assist patients in taking their own prescribed medications
o Administration of the following over-the-counter medications with appropriate
medical oversight:
Oral glucose for suspected hypoglycemia
Aspirin for chest pain of suspected ischemic origin
• Trauma Care
o Application and inflation of the pneumatic anti-shock garment (PASG) for
fracture stabilization
Advanced Emergency Medical Technician
Description of the Profession
The Advanced Emergency Medical Technician’s scope of practice includes basic and
limited advanced skills focused on the acute management and transportation of critical
and emergent patients. This may occur at an emergency scene until transportation
resources arrive, from an emergency scene to a health care facility, between health care
facilities, or in other health care settings.
For many communities, Advanced Emergency Medical Technicians provide an option to
provide high benefit, lower risk advanced skills for systems that cannot support or justify
Paramedic level care. This is frequently the case in rural and volunteer systems. In s
ome jurisdictions, Advanced Emergency Medical Technicians are the highest level of
out-of-hospital care. In communities which utilize emergency medical dispatch systems,
Advanced Emergency Medical Technicians may function as part of a tiered response
system. In all cases, Advanced Emergency Medical Technicians work alongside other
EMS and health care professionals as an integral part of the emergency care team.
The Advanced Emergency Medical Technician’s scope of practice includes basic, limited
advanced and pharmacological interventions to reduce the morbidity and mortality
associated with acute out-of-hospital medical and traumatic emergencies. Emergency
care is based on assessment findings. Additionally, Advanced Emergency Medical
Technicians provide care to minimize secondary injury and provide comfort to the patient
and family while transporting the patient to an emergency care facility.
The Advanced Emergency Medical Technician’s knowledge, skills, and abilities are
acquired through formal education and training. The Advanced Emergency Medical
Technician has the knowledge associated with, and is expected to be competent in, all of
the skills of the EMR and EMT. The major difference between the Advanced Emergency
Medical Technician and the Emergency Medical Technician is the ability to perform
limited advanced skills and provide pharmacological interventions to emergency patients.
The Advanced Emergency Medical Technician is the minimum licensure level for
patients requiring limited advanced care at the scene or during transportation.
The scope
of practice model is limited to lower risk, high benefit advanced skills that are effective
and can be performed safely in an out-of-hospital setting with medical oversight and
limited training.
The Advanced Emergency Medical Technician transports all emergency patients to
an appropriate medical facility. The Advanced Emergency Medical Technician is not
prepared to independently make decisions regarding the disposition of patients. The
Advanced Emergency Medical Technician serves as part of an EMS response system
assuring a progressive increase in the level of assessment and care. The Advanced
Emergency Medical Technician may make destination decisions in collaboration with
medical oversight. The principal disposition of the patient encounter will result in the d
irect delivery of the patient to an acute care facility.
In addition to emergency response, Advanced Emergency Medical Technicians often
perform medical transport services of patients requiring care within their scope of
practice.
Psychomotor Skills
The following are the minimum psychomotor skills of the AEMT:
• Airway and Breathing
o Insertion of airways that are NOT intended to be placed into the trachea
o Tracheobronchial suctioning of an already intubated patient
• Assessment
• Pharmacological Interventions
o Establish and maintain peripheral intravenous access
o Establish and maintain intraosseous access in a pediatric patient
o Administer (nonmedicated) intravenous fluid therapy
o Administer sublingual nitroglycerine to a patient experiencing chest pain of
suspected ischemic origin
o Administer subcutaneous or intramuscular epinephrine to a patient in anaphylaxis
o Administer glucagon to a hypoglycemic patient
o Administer intravenous D50 to a hypoglycemic patient
o Administer inhaled beta agonists to a patient experiencing difficulty breathing and
wheezing
o Administer a narcotic antagonist to a patient suspected of narcotic overdose
o Administer nitrous oxide for pain relief
In 2011, NREMT released the newsletter as below... this is for information purposes only.
The AEMS Advanced EMT Course was designed to provide a brief transition course to the AEMS Paramedic Course. The AEMT course consists of 3 months of classroom and academic instruction followed by 3 months clinical / mentored practical phase whereby the students are then exposed to hospital skills and mentored road response with the necessary hands on {ambulance and response vehicle} with Doctors and Paramedics of AEMS. This is in line with AEMS vision to produce highly competent EMS professionals who are at par with their foreign counterpart in the international EMS community, therefore, making Filipino EMT's globally competitive.
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