Certification/training beyond first aid/cpr?

July 10, 2005 10:55 PM

What's the highest level of medical training (focused on EMT stuff) I can get without looking at it as a career?

Red Cross offers CPR (have that), first aid (taking that) and AED (I plan on it), but nothing beyond that. The next step seems to be taking EMT classes, preparing for a job. I'd like to be more prepared (and preferrably certified for it) than the Red Cross training, which I feel is amazingly minimal, but I'm not seeing the oppertunities of how.

posted by devilsbrigade to health & fitness (14 comments total)

If you're this much into it, you may want to consider voluteering for your local volunteer fire department. You'll get to put that knowledge to the test PLUS you'll learn plenty more.

Just an idea... Many volunteer firefighters spend more time dealing with paramedic type stuff than putting out fires.
posted by shepd at 10:58 PM on July 10, 2005

CPR is divided into BLS (basic life support), ACLS (advanced cardiac life support), and PALS (pediatric life support.)

On thinking about it, it occurs to me that if you did the ACLS and pediatric interventions without a medical license, you'd be breaking all kinds of laws (although possibly protected by the Samaritan shield), so maybe just scratch that idea.
posted by ikkyu2 at 11:08 PM on July 10, 2005

Between First Aid and EMT come Advanced First Aid and First Responder certifications - if your local Red Cross doesn't offer them, some local hospital or ambulance service may. Or, groups like the National Outdoor Leadership School offer Wilderness Advanced First Aid and Wilderness First Responder courses.
posted by nicwolff at 11:44 PM on July 10, 2005

Depending on where you live, EMT courses might be available through your local community college, ambulance company, fire department or hospital. You can definitely get an EMT certification without looking at EMS as a career. Most classes here (Pittsburgh, PA) meet a few nights a week for one semester and are fairly cheap.
posted by nebulawindphone at 11:59 PM on July 10, 2005

There are several levels of EMT, ranging from Basic to Paramedic. Basic EMTs have the most limited repertoire and can't push drugs or intubate. Intermediates can do a bit more (start IVs and intubation primarily) and Paramedics have the most advanced skills and responsibility. I was an EMT over 10 years ago on a volunteer ambulance squad so keep in mind some of the below may be out of date.

Basic EMT training is not a huge hurdle -- when I did it it was 110 hours of training plus 10 hours clinical work and a state certification exam. The difficulty was at a par with a general-level high school course. Almost everybody on the squad except for the newest members had Basic EMT certification. Almost all of us were college students or had careers outside the EMS/medical sphere.

A very few more members had Intermediate certification. The fewest volunteers had Paramedic certification (maybe 2 or 3 out of a squad of about 60), and most of the time we relied on a paid Paramedic service for Advanced Life Support.

Becoming a Paramedic is a huge time commitment (> 1000 hours of study), which is why there were so few in our squad. While purely-volunteer Paramedics are not unheard of, most of the volunteer Paramedics I knew did part-time paid Paramedic work while holding down other careers.

To answer what I think is your other question, I really didn't feel prepared after my EMT certification. The way to build confidence as an EMT is to pull a lot of shifts and make a lot of runs, hopefully with supervision. Many (most? all?) volunteer squads run 3 crew members to a rig (Driver + Crew Chief + Assistant), so even if you have your certification, you don't have to do crew chief duties until you (and they) think you're ready.

Some of the certification stuff is state-specific, so call the chief of your local volunteer fire department or ambulance squad for better information. After you spend some time volunteering you will have a much better idea of whether you feel cut out for it and how far you might like to take your studies.
posted by Opposite George at 12:05 AM on July 11, 2005

To clarify the comment on volunteer Paramedics, the ones who had other careers usually did a mix of volunteering and paid shifts in addition to their "real-world" jobs.
posted by Opposite George at 12:12 AM on July 11, 2005

Wilderness First Responder courses are a great bet; more rigorous than first aid but less so than EMT training, they teach one how to respond to emergencies in remote areas using only stuff you'd pack with you anyway if you were going backpacking.

More info on courses here (scroll down to "Where can I take a wfr or wemt course?").
posted by joshuaconner at 12:39 AM on July 11, 2005

Back when I had my EMT-B license for New Hampshire, it was:
Basic First Aid -> Advanced First Aid -> First Responder -> EMT-Basic -> EMT-Intermediate -> Paramedic -> Flight Nurse/Flight Paramedic.

But yes, these license at the state-level and there are differences by state, so check with your local licensing body.

I was licensed by SOLO Wilderness Medicine which has a great course that included outdoor medicine and emergency rescue and ropes classes in addition to all the EMT training. I highly recommend them.
posted by gen at 12:40 AM on July 11, 2005

Something to keep in mind that different states have different protocols and permissions, and the classes will train you up to that standard if it exceeds national standards. (At least, my class did.) When I trained in Rhode Island last year as an EMT-B, we were trained to push more meds than the national standard, things like epinephrine, albuterol, glucagon, while the national standrd only allows oral glucose, oxygen and activated charcoal to be pushed. We were also trained in more techniques in general, although I don't remember how they differed off-hand. However, in Arizona, EMT-Bs can only push friggin aspirin (for cardiac patients.) So while there is a baseline national standard that all states follow (except for one maybe, but I could be wrong,) states can vary wildly in the scope of your training. Also, you don't have to take the certification test, unless you want to practice, but if you're getting this just for your own personal edification, it's another test and a bunch of money you don't have to worry about.

But while I have yet become certified, (though I plan on it,) and only used my training once (when I was a First Responder,) I think that taking at least a basic level course is incredibly useful. You learn a great deal in a relativly short amount of time, and if you're ever thrust into an emergency, you can probably save someone's life when most people would have no chance of doing so.
posted by Snyder at 4:18 AM on July 11, 2005

I used to live in a small town with a volunteer rescue squad. They happily trained me (and several others) for certification. It's basically advanced first aid, CPR, emergency childbirth, light extrication, and defensive driving.

Advanced First Aid is the answer to the basic first aid question, "if I'm not supposed to move the victim, who does?" light extrication is training on getting people out of vehicles--as a result, I can break into pretty much any vehicle in a pretty dang short amount of time, with or without spraying glass everywhere.

The calls for volunteer rescue squad were very gratifying. I was disappointed to move to an area that contracted ambulance service out.
posted by plinth at 6:07 AM on July 11, 2005

One thing to keep in mind is that the more you know, the higher standards they can hold you to should you screw up. The good samaritan laws protect people based on their level of knowledge. So Joe Shmoe, who knows nothing about medicine, wouldn't be held accountable the same way Johnny Gage and Roy DiSoto the paramedics would. If you're not doing this as a career you won't have liability insurance to protect you.

This isn't a factor for everyone, I think most of us would rather help someone than worry about getting sued, but it's something to think about.
posted by bondcliff at 6:43 AM on July 11, 2005

Find your local Red Cross' website - mine offers disaster response classes as well. And I'm talking 9 separate (and free!) classes on that topic alone. It focuses more on mass injuries and shelter operations than individual injuries, though.
posted by IndigoRain at 7:06 AM on July 11, 2005

Ambulance Girl: How I Saved Myself By Becoming an EMT is a pretty good human angle on becoming/being a volunteer EMT.

You might want to look into if your area has a CERT (Community Emergency Response Team) set up. I found a little information on how a person could volunteer for and get training in emergency response (though, it isn't medical training specific -- it includes fire).
posted by LeiaS at 7:06 AM on July 11, 2005

I'm a former EMT/ wildnerness first responder instructor. I did it part-time while I was in college. I haven't seen any mention of this, so I thought I would chime in. I don't know about your background, but ensure that you are emotionally prepared before you embark on this journey. Some of what you witness will be gratifying and make you feel good about helping people, but some scenes can be very traumatic and stressful. There is a lot of substance abuse in the world of EMS.

I don't mean to come off entirely negative. Saving someone's life is an amazing feeling. As is knowing that you helped someone in their time of need. But not everyone can be helped, and sometimes that is very difficult to swallow.
posted by kamikazegopher at 3:39 PM on July 11, 2005