EMT Intermediate and Paramedic Comparison
In 1999 the new National Standard Competency based curriculum was
implemented by the National Registry of EMT’s, it replaces the old EMT-I/85 and
allows the new and improved EMT-I/99 to an expanded scope of practice many
states have adapted this new transition. You must be a Basic EMT to upgrade to
any ALS level such as the EMT-I/99 or the EMT-Paramedic. The hours listed in
this document are a range, there are minimum National Standard Hours. Most
programs give a range and state in their documents that we exceed the minimum
training Hours listed in the National Paramedic Module for Training Schools. If a
class requires remedial teaching in a certain area i.e. Cardiac or Medications the
class hours will be extended and that subject matter will be repeated as a whole.
Emergency Medical Technician-Intermediate/99- required attending a stateapproved, course in addition to the EMT-B training program with 300 total hours
including 100-150 hours of classroom/practical hours, 100 clinical hours, 100
field internship. This year will be the last year for the EMT-I/85 and the Cardiac
Technician; most states are transitioning to the EMT-I/99 certification as
minimum ALS provider. Surely it is up to each state to retain their Cardiac or
EMT -Enhanced programs.
EMT-I/99’s are capable of providing lifesaving care to patients in the pre-hospital
field with increased knowledge and skills such as; advanced airway
management, cardiac rhythm interpretation and treatment among other skills. An
EMT-I/99 is required to be licensed through the National Registry of EMT’s. EMTI/99 Practice their skills learned under a licensed physician by following the
physician's established protocols or Standard Operating Procedures. EMT-I/99
not only work with Fire and EMS Departments they work at special events,
hospitals, private ambulance companies, hospital and retirement communities
based EMS Services. EMT-I/99’s are encouraged to further their knowledge and
skill base by upgrading to full Paramedic status. It should be noted that every two
years most EMS providers including the EMT-I/99 must accumulate CME and
Refresher Hours to maintain their certification these classes are meant to refresh
the student knowledge and skills of the EMT-I/99 curriculum. Alert the student of
any new EMS or American Heart Association changes also reviewed are any
new equipment that has been placed on the EMS market further recertification
questions should be addressed to the National Registry of EMT’s website that
has the most up-to-date information on EMS for all levels www.nremt.org.
EMT-I’s are authorized to perform any of the basic life support skills. In addition,
they may perform the following intermediate life support skills under the
supervision of a medical control physician:
Esophageal orbiturator airway application
Esophageal gastric tube airway application
Nasotracheal intubation
Endotracheal intubation
Combi-tube airway
Pharyngeal tracheal lumen airway
Intravenous therapy (peripheral, external jugular or intra osseous)
Sterile suctioning (endotracheal)
Chem strip analysis
EMT-I’s must also be members of an licensed Hospital Based, Private
Ambulance or Fire and EMS service that is licensed to provide Medical care or
advanced life support. Each EMT-I candidate must meet the following course
entrance requirements:
Must be a current certified EMT-B with 1 year experience or documented
100 calls with you being the team leader. You must maintain this status
throughout the entire EMT-I course. You are not a Certified ALS provider
until you have passed a state or national certification test.
Students are encouraged to affiliate themselves with an EMS agency
throughout and after their ALS training (EMT-I/99) to maintain their
knowledge and skill level. Practice makes perfect.
Class and program orientation, substance and felony free statement
testament. Current and up to date immunizations. Class essay and a
meeting with the program Director or their designee.
In order to successfully complete the Westlink ALS EMT-I/99 course, students
must do the following (it should be noted that students must pass the Westlink
Program before being recommended by us and the Medical Director to sit for any
ALS examination with the National Registry of EMT’s):
a. Attend the required number of classes to ensure that all attendance
requirements are met.
b. Complete all in-course examinations with an average grade of 75
percent or higher for both ALS and BLS skill and knowledge.
c. Pass all written unit examination.
d. Complete and account for all in Field and Hospital Clinical Hours and
Compentcies.
e. Must have current BLS,ACLS,PALS or PEEP and ITLS card by the end
of the course. (Courses provided and paid for by Westlink)
f. Pass a Final oral exam with Medical and Program Director.
g. Satisfactorily pass and complete a comprehensive ALS and BLS
Knowledge and skill proficiency examination with a 75% or higher and a
Pass on the skills levels evaluation.
The EMT-I course is taught from the Department of Transportation's
current Intermediate curriculum/99. We utilize the Brady EMS Intermediate
Paramedic Text and Workbook along with the Instructional manual and
power points that correlates with the text. The initial course consists of
300 hours of training pass the EMT-Basic level. 100 hours are devoted to
skills Didactic material is presented as follows:
Orientation 4 hours
Ambulance run report form
Laws of consent, abandonment, negligence
Do not resuscitate orders (DNR)
Roles and responsibilities
Medical terminology
Reporting and communications
Patient Assessment 12 hours
Human Anatomy and physiology
Signs and symptoms, vital signs
Advance Patient assessment skills
Medical/Trauma Emergencies with the Adult, child, infant and Elderly
Didactic and skills practice
Advanced Airway Management 12 hours
Basic and Advanced airway management EOA, EGTA, PTL, Combi-tube,
Endotracheal tube, Nasotracheal tube, LMA
sterile suctioning
Practice skills and check off
Shock/Trauma 16 hours
Trauma to the chest (blunt and penetrating)
Trauma to the abdomen (blunt and penetrating)
Head injuries
Spinal column/cord injuries
Hemorrhage control/soft tissue injuries
Musculoskeletal system/fractures and dislocations
Path physiology of shock
Shock treatment
Fluids
Intravenous therapy
Interosseous therapy
Pneumatic anti-shock garment
Practice skills and check off
CPR and obstructed airway
Hyperthermic conditions
Hypothermic conditions
Seizures
Burns
Drowning/diving emergencies
OB/GYN emergencies
Diabetic emergencies
Cerebrovascular accident
Anaphylaxis
Dialysis emergencies
Cardio-respiratory
Environmental
Behavioral
OB/GYN/Pediatrics/Neonatal
AED/Defrillator
Patient assisted medications
Auto-injectors
Basic skills review
IV,SC and IM injections along with IV drips
The EMT Paramedic Comparison
The new EMT-P National Standard Curriculum (NSC) was put in place in 1999.
The EMS educators met at the National EMS Educators Conference and were
presented with the EMS Agenda for the future blueprint. It was taken through
rigorous reviews by all levels of EMS Providers to include outside review and
critiques by Medical Personnel. States were asked to run pilot programs based
on the new NSC. This program has been tried and tested over the years by EMS
School in the US since 1999. Today the kinks and logistics have been ironed out
with the NSC at both the EMT-I/99 and the Paramedic level. It should be noted
that in or around 2013 the EMT-Intermediate title will be called EMT-Advanced.
The course in which you are about to under take is a Rigorous and
comprehensive competency based EMT-Paramedic Training Program at
Westlink we plan to utilize the community resources both medically and private to
full fill the NSC Objectives based on the 1999 Paramedic blueprint. The EMTParamedic level is the highest certification prehospital provider can obtain. Their
fore it is imperative that the Paramedic be prepared both mentally, clinically and
has the knowledge base to carryout the EMT Paramedic duties and
responsibilities under Medical Direction both direct and indirect. EMTParamedic must be able to independently discharge their duties and
responsibilities to function as a Paramedic.
The course we plan on running is two ALS types program an EMT-I/99 and an
EMT-Paramedic Program following the NSC 1999 DOT Objectives and skills. We
plan on using the Full EMT-Paramedic Student textbook which is also available
in Volumes and the Student workbook. Brady has done an excellent job assisting
EMS School teach the new 1999 NSC. It has for EMS schools prepared Power
Points/Instructional Aids and an array of EMT-Paramedic instructional materials
and CD’s. There are two ways a Paramedic Candidate can apply for admission:

Already certified at the EMt-I/99 level or equivalent; or

Initial EMT- Basic wishing to enter the ALS field and take the full
Paramedic Program
At both levels students must maintain a 75% and have a High school diploma
and meet all the program entrance requirements for either the EMT-I/99 or EMTParamedic.
Emergency Medical Technician - Paramedic – are required to attend a stateapproved training course which includes a minimum of 1,200- 1,500 total hours
of training and includes 740 hours of didactic, 420 hours of clinical observation,
and 240 hours of pre-hospital, advanced life support observation. Hours
completed during the EMT-I/99 will be applied to the EMT-Paramedic course
hours. This can be accomplished because each EMT-I/99 that holds a
Certification card has meet the minimum state approved and National Registry
Requirements no matter what state you took the EMT-99 Initial Training. EMTI/99 students will be taken through a thorough evaluation to assure Westlink that
you have met the Minimum EMT-I/99 NSC. You will be given an ALS test with 25
rhythm strips, Pass a mega code with the Medical director or designee and
complete oral interviews.
Paramedics strive to maintain high quality, reasonable cost health care by
delivering patients directly to appropriate facilities. As an advocate for patients,
paramedics seek to be proactive in affecting long term health care by working in
conjunction with other provider agencies, networks, and organizations. The
emerging roles and responsibilities of the Paramedic include public education,
health promotion, and participation in injury and illness prevention programs. As
the scope of service continues to expand, the Paramedic will function as a
facilitator of access to care, as well as an initial treatment provider.
EMT Paramedics are capable of providing advanced lifesaving care to patients
in the pre-hospital field with increased knowledge and skills such as; advanced
and surgical airway management, in depth cardiac rhythm interpretation and
management, Advanced IV placement to include I/O, External jugular and
peripheral, Basic and Advanced Patient Assessment for all ages both Medical
and Trauma treatment Defibrillation /Cardio version and Pacing, IV Drug
calculation Medications, IV push and IV Drip SC,IM injections are just some of
the skills students will learn.
Those of you who have attended EMT-I/99 or Paramedic training prior to the new
NSC we no longer require Hours. The new NSC is Competency Skill based so
we are mostly concerned about how many IV or Assessments you have
performed verses you did 12 hours in the Emergency Room or specialty unit. Yes
you did 12 hours but did you perform any skills that would increase your skill and
knowledge base for EMS Education thus meeting the Programs goals and
objectives.
Paramedics are responsible and accountable to medical direction, the public, and
their peers. Paramedics recognize the importance of research and actively
participate in design, development, evaluation and publication of research.
Paramedics seek to take part in life-long professional development, peer
evaluation, and assume an active role in professional and community
organizations.
At the successful completion of this training program and required testing, the
entry level EMT-Paramedic will be able to:
Evaluate the patient’s condition, either medical or trauma, and provide
assessment-based treatment which includes patient packing and handling
designed to minimize patient discomfort and prevent further injury.
The updated core curriculum includes (but not limited to) topics on advanced
airway management, oxygen therapy, advanced pharmacology, interpreting heart
rhythms, medical and trauma patient assessment, environmental emergencies,
management of injured or ill infants and children, appropriate drug therapy for
various medical conditions, and advanced care of the trauma patient. In addition,
the curriculum includes fundamentals of rescue techniques, hazardous materials
scenes, and current EMS systems.
It should be noted that every two years most EMS providers including the EMTI/99 must accumulate 48 hours of CME and Refresher Hours to maintain their
certification. These classes are meant to refresh the student knowledge and
skills of the Paramedic curriculum. It’s also meant to alert the student of any new
EMS or American Heart Association changes, review any new equipment that
has been placed on the EMS market further recertification questions should be
addressed to the National Registry of EMT’s website that has the most up-todate information on EMS for all levels. WWW.NREMT.ORG.
Candidate ends the required number of classes to meet attendance
requirements. All students must discuss any absence with the course instructor
and must make arrangements to make up the class before the absence can be
excused. Any student who misses more than twenty-four hours of the course will
not be allowed to make it up or complete the course. All students must sign a
statement of understanding regarding attendance.
DIVISION 1: PREHOSPITAL ENVIRONMENTAL
Section 1. Roles and Responsibilities 2 hour
Section 2. EMS Systems 2 hour
Section 3. Medical/Legal Consideration 2 hour
Section 4. EMS Communication 3 hours
Section 5. Rescue 8 hours
Section 6. Major Incident Response 6 hours
Section 7. Stress Management 4 hours
DIVISION 2: PREPARATION
Section 1. Medical Terminology 8 hour
Section 2. General Patient Assessment 20 hours
Section 3. Airway Management and Ventilation 20 hours
Section 4. Path physiology of Shock 16 hours
Section 5. General Pharmacology 16 hours
DIVISION 3: TRAUMA
Section 1. Trauma 18 hours
Section 2. Burns 2 hours
DIVISION 4: MEDICAL
Section 1. Respiratory Section 18 hours
Section 2. Cardiovascular Section 100 hours
Section 3. Endocrine Emergencies 10 hours
Section 4. Nervous System 4 hours
Section 5. Acute Abdomen 4 hours
Section 6. Anaphylaxis 2 hour
Section 7. Toxicology, Alcoholism and Drug Abuse 10 hours
Section 8. Infectious Diseases 8 hours
Section 9. Environmental Injuries 10 hours
Section 10. Geriatrics/Gerontology 8 hours
Section 11. Pediatrics 20 hours
DIVISION 5: OB/GYN/NEONATAL
Section 1. OB/GYN/Neonatal 10 hours
DIVISION 6: BEHAVIORAL
Section 1. Behavioral Emergencies 10 hours
Each EMT-P student should be rotated through the following departments of the
hospital:
CLINICAL ROTATIONS
Labor and Delivery/Nursery
Pediatrics /PICU
Psychiatric
Operating Room /PACU
Intensive Care/Coronary Care
Emergency Department/ Telemetry
Each EMT-P student should spend a minimum of 400 hours in clinical rotation. In
addition to the clinical rotation, a minimum of 150 hours field internship (actual
time spent on an ambulance as a student) is required.
Total Paramedic Course Requirements:
Didactic 1200 -1,500 hours
Skill Practice 500-600
Clinical 400-600 hours
Field Internship 150 hours
The variations of the hours are dependent upon student ability to comprehend
and retain their knowledge and skill base. Some classes/Programs students don’t
comprehend and will need remedial sessions/Hours.
Please Read the remediation Policy established by Westlink and approved by the
Medical Director as a student you will have to sign a statement stating that you
have received a copy and are aware of this policy.