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Intermediate Class

Shane Moore EMS-Shane at comcast.net
Mon Oct 17 22:54:05 BST 2005

	As a current EMT-Intermediate (AND EMT-I instructor), I feel your
pain.  The state of Oregon DHS-EMS section is just winding up a total
overhaul of the OR EMT-I; while an updated scope of practice seemed an
obvious choice, there were multiple issues uncovered regarding the gap
between the original design and implementation of the EMT-I.  
	The long and short of it?  Designed as a 'bridge' between BLS care
and an ALS intercept en route to the hospital or providing a higher level of
care than first responders and -Basics could in rural (or frontier) areas
where an abundance of ALS providers in the field was unlikely, the OR
EMT-Intermediate was supposed to allow providers access to a wider range of
procedures and training w/o having to commit to the time-consuming (and
expensive) education surrounding the EMT-Paramedic program while still
providing the best patient care available.  Contrary to some providers'
fears at the time, the program did not create 'junior' Paramedics or
encourage agencies to fill ALS slots w/ EMT-I personnel to save costs.  
	The committee found that, while a more updated 'tool box' of
procedures and training was needed, another real issue was that current
EMT-Intermediates tended to be gun-shy when presented w/ patients requiring
more than BLS care.  This was not necessarily an issue of poor training;
lower call volumes reduce the chance the rescuer has to maintain 'real
world' skills.  We all know riiight where the AC vein on the mannequin arm
is located, don't we? 
	I was fortunate enough to sit on this committee for a time and
although multiple additional issues were looked at, that one has really
stuck out in my mind; how to better prepare an EMT-I to have the competence,
confidence and ability to correctly manage patient care to the full extent
of the scope of practice and then encourage them to continue the process of
learning and keeping their skills up-to-date.  Initial education is only a
slice of the full pie, isn't it?  That in mind, here's my two cents:

1) Keeping YOUR skills (and knowledge) as an instructor up-to-date is
2) Be passionate about EMS and specifically about EMT-Intermediates.  It
will be contagious.
3) Encourage critical thinking skills
4) Most folks tend to drag their feet when it comes to continuing education;
incite excitement (or at least desire) to stay sharp on knowledge and
skills.  EMT-Intermediates seem to me to most need continuing education due
to the very nature of their certification level (designed for rural/frontier
communities).  Their initial EMT-Intermediate training is just that;
5) Finally, something I teach all of my students regardless of which class:
Most of EMS is NOT rocket science, really.  While 'book' smarts and skills
proficiency are important, those alone will not make you great providers.
It's about interacting w/ people.  All of us can probably think of a
colleague who is aces in his/her field but has zero 'bedside manner'.  

Don't know if that was any help, but I wish you the best...  

 Shane Moore, OR EMT-I
Portland, Oregon

"I never think of the future.  It comes soon enough."
    A. Einstein

-----Original Message-----
From: Roger Ekins [mailto:remt14 at msn.com] 
Sent: Sunday, October 16, 2005 7:29 PM
To: Trauma & Critical Care mailing list
Subject: Intermediate Class

Hello, I am Roger and I will be starting a EMT Intermediate class.  Every
time I begin a class and think of the responsabily that I feel to 
teach each student how to become a great EMT.  So I was thinking of each of
you and you vast expertise. I would like to pose a Question to each of you.
That question is?   If you were teaching this class what would be the most
important thing that you would want to teach each student?


Roger Ekins
REMT Medical Training

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