Certified First Responder being phased out?

[Millertime0521]

Hello guys,

I've been away from the forums for a while.

I've been in the fire service for about 5 years.
I started at the age of 16 in 2000. Now I'm with
a combo dept as a volunteer. I just took my CFR-D
course. I've been hearing word that the CFR program
is being phased out for the EMT-B. Is this done on
a state to state level or is it being done nation
wide?.

I'd appreciate anyone's input.

Thank you much,

Jeremy
Firefighter
Asst Director
Emerald Hose Co.4
City of Cortland Fire Dept
Cortland,NY

[HeavyRescueTech]

that rumor has been going around off and on for years. until you hear anything official about it, I wouldn't be too concerned.

[MikeWard]

Proposed changes to ALL EMS certification levels are coming.

Go to this thread:
http://cms.firehouse.com/forums2/sho...threadid=61049

[stm4710]

A rumor that was buzzing around was that Mass. was going to get rid of EMT-I. So it would just be FR, EMT-B,EMT-P.


Can anyone confirm nor deny this?


I hope they dont get rid of FR. It has a role.

[stcommodore]

What exactly do EMT-I's do? In PA we only have FR, EMT-B, and paramedics...I'm thinking about going to drexel to get my paramedic when I finish the BS I'm already working on. But I wonder if it would make more sence in PA to let EMT-B's expand there scope of pratice a little more.

[stm4710]

What exactly do EMT-I's do?

I wonder if thats what the Mass. OEMS said?

[TCFire]

The demise of the CFR program in NYS has been rumbling around for a few years now. As far as I know it continues to be funded by Department of Health. If you really want the straight scoop I would contact your local EMS coordinator/EMS council and ask them. The NYS DOH Bureau of EMS in Syracuse covers Cortland County, there are names and numbers where you can contact them. Since EMS is administered through DOH, I think they, or your local EMS coordinator, would be your best bet.

Overall, I believe NYS is gradually moving towards National Registry standards for EMS and OFPC is doing the same with FF training (now offering FFI, FFII, etc instead of the old Basic, Intermediate, Advanced).

[LeuitEFDems]

In Mass EMT-I's can start peripheral IV's run normal saline fluids, do lab draws and intubate with either ET tube or combi-tube/LMA. Mass has not adopted the National Registery standard for EMT-I's and probably never will. I am an EMT-I now, currently starting on the clinical phase of paramedic class. I am on a vol/paid service that provides only ILS level of care with no real paramedic intercept feasibility due to the proximity to the hospital for us and the distance of the closest ALS units. We have tried to no avail to have the state let us do a pilot program for "advanced EMT-I" in Ma...AKA National Registery. As for dropping the CFR, I doubt it will happen. I don't know if it's a federal thing or just a state thing, but here in MA, every public safety official...police officer, firefighter-both paid and volunteer, have to have a MINIMUM of CFR.

[PATF1engineer]

Originally posted by stcommodore
What exactly do EMT-I's do?

Make it easy for ambulance services to get rid of some of their medics.

The concept is to allow an EMT-I to maintain an IV, give nitro for chest pain, breathing treatments, assist with patient meds, use auto ventilating equipment, etc.

In theory, it sounds like a good idea, I have never been one to turn down trained help. However, in practice I am afraid it will tempt many EMS agencies to cut back on medics and hire EMT-Is for transports. This could end up, in my opinion, leaving these agencies short staffed for ALS providers for emergencies.

I hope this isn't what happens, because I think the Scope of Practice model is a good idea, one that is way over due.

[Daniel4880]

Virginia uses the National Registry standards for EMT-I's, who can give a wide variety of IV medications, interpret EKGs etc., and they are considered ALS. The class is ~275 hours, in addition to EMT-B. If the proposed scope of practice is made into law, it will seriously hurt EMS care around here. I think the best thing would be for the scope of practice people to simply adopt the national standards for now.



Daniel

[Diane E]

Overall, I believe NYS is gradually moving towards National Registry standards for EMS and OFPC is doing the same with FF training (now offering FFI, FFII, etc instead of the old Basic, Intermediate, Advanced).

The Firefighter I and II offered in Suffolk County are not National (much to the surprise of many I've talked to). The NFPA and codes information is not taught and not on the test. The big difference between the "Basic" firefighter course and the "Firefighter I" course is probably the addition of the hands-on requirements.

Having taken FF I in CT and getting Nationally Certified, I am probably one of a handful of volunteers in Suffolk that hold the National Certification. I find it sad since people go through all the work and if they move, they have to start over. From what I understand, many states honor the National Certification.

[loxfire16]

Well I don't believe it would be an smart move in any state and espically as far a national standard goes to remove the First Responder Certification. This is a good program, which volunteer EMS providers can readily afford and have time to enroll. Even if the training isn't very extentive (varies state to state)it gives someone at least a basic knowledge.

P.S. Already did away with the EMT-I in Alabama (CFR, EMT-B, EMT-P)

[Stuart]

Check out http://www.emsscopeofpractice.org

It proposes a nationwide standard for:

First Responder
EMT
Paramedic
Advanced Paramedic

[stcommodore]

i would think that this advanced paramedic is just a step below a PA/nurse/flight nurse...and is redundunt in itself. Just give EMT-B's more scope of pratice (IV's, ET intubation) and phase EMT-I's out.

[Dalmatian90]

Why do we always think we need national standards for everything?

Sometimes it leaves you with boxes that aren't full...sometimes with boxes that are crammed too full.

Is something like a CFR level (MRT is the term in Connecticut) good in areas with good EMS that builds upon it? Probably. Is it adequate if you have to be with a patient for 20 minutes? I don't know.

As for moving all EMTs to having IV skills...I know in my area the medical director has long been opposed to having EMT-Intermediates feeling that you would need so many volunteer EMT-Is to maintain the state required availability of one for every call if that's your agencies level of certification, that there wouldn't be enough needle sticks per EMT to maintain profeciency. Expand that to every single EMT. Yet in other areas, with different regulations and demographics, using volunteer/call EMT-Is can provide better service until they have the call volume to justify hiring Paramedics.

Now, if you want to eliminate the intermediate position, but offer "a la carte" expanded scopes of practices...so areas that need it could add better airway management and IVs, I don't think that's a bad compromise. I don't think every EMT-B needs to start IVs. Some, however, probably should be able to!

[VinnieB]

The CFR program in NYS is going to be around for awhile longer....as long as the FDNY requiers it for it members...it will still exists.

[Millertime0521]

I just got my results yesterday, I passed. So Im very pleased.
The CFR I felt was very good. It gives you good knowledge of trauma management, airway management and what not. The dept I am a volunteer for is a combo career/volunteer. The career staff run all of the EMS calls. However, when there is a MVA or a full arrest is when volunteer staff are activated along with the career staff. And of course all box alarms and structure fire's get a full response. I hope to be able to get out into the feild and put some of this training to use.

Thank's for all the replies.

Merry christmas folks

Jeremy
Firefighter/CFR-D
Assist Director
Emerald Hose Co.4
Cortland Fire Dept