Advanced emergency medical technician

AEMTs are usually employed in ambulance services, working in conjunction with EMTs and paramedics; however they are also commonly found in fire departments and law enforcement agencies as non-transporting first responders.

Along with classroom time, the AEMT student is required to complete several hours of clinical experience in an advanced life support ambulance or other ALS environment such as an emergency department.

During these clinical hours, the AEMT student must successfully demonstrate full practical knowledge of skills learned.

Upon completion of all classroom and practical skills hours, AEMT students must successfully pass a standardized psychomotor and cognitive assessment before they can be certified.

In the early 80s, the NREMT Board of Directors adopted a new national certification; EMT-Intermediate, based on several state's recommendations.

Soon after 1985 some states started adding "enhancements" (skills) to the intermediate and others adopted a more expansive level called "cardiac care" which included some ACLS drugs.

The EMT-I/85 typically administered the same medications as an EMT-B (oxygen, oral glucose, activated charcoal, epinephrine auto-injectors (EpiPens), nitroglycerin, and metered-dose inhalers such as albuterol).

The new scope consists of all EMT level skills, basic airway management and the insertion of supraglottic airways, suctioning of an already intubated patient, usage of a CPAP device, initiation of peripheral intravenous therapy, pediatric and adult intraosseous placement and several pharmacological interventions beyond the EMT level.

[3] These pharmacological interventions include administering Other states may use different names for the above and often have a scope of practice beyond the minimal national standards.

A sponsoring physician can broaden the scope of an EMT-III beyond state-defined protocols by providing additional training and quality control measures.

[5] This means that additional drugs and procedures (including wound suturing) can be accomplished by an appropriately trained EMT-III.

In addition to the National Scope of Practice, AEMTs in Arkansas can start Intraosseous infusions in adults and provide CPAP to patients with pulmonary edema.

AEMTs and paramedics in Arkansas are allowed to provide advanced interventions when off-duty, if in their normal coverage area.

[8] Iowa EMT-basics can administer EpiPen per protocol, insert a combitube, and set up and maintain (but not start) an IV that is non-medicated as well as all other basic skills.

In more recent years, New York has expanded its AEMT-CC level to include the administration of certain narcotics and some additional skills.

However, no advanced EMT certifications are recognized in New York City except at volunteer agencies such as Hatzalah EMS and Central Park Ambulance.

EMT-C or higher licensure may be required by Rhode Island fire departments, who provide emergency medical services in the majority of the state.

EMT-IVs can also administer the Mark 1 auto injector kit for organophosphate poisoning and suspected nerve gas exposure.

The State of Tennessee Board of EMS is currently evaluating allowing EMT-IVs to administer naloxone, nitrous oxide as well as intraosseous infusions (IOs).

[15] Texas has a five-tier system, consisting of emergency care attendant, EMT-basic, advanced EMT, EMT-paramedic, and paramedic.

The Washington EMT-B can set up and maintain an IV that is non-medicated, but EMT-I certification is required to start the IV.WA Office of Emergency Medical and Trauma System (May 2009) Some county protocols (such as Jefferson) accept an EMT/ILS tech which, in addition to all EMT-I and EMT-B skills, can administer D50W, naloxone, albuterol, and can now draw up epinephrine in addition to using an EpiPen.

This level of training is often used in rural areas where hospitals may be sparse and advanced life support intercepts or aeromedical transports can take a great deal of time.