Renewing a Rusty EMT

This thread is prompted by the current thread dealing with practicing survival skills. One of the critical skills is certainly First Aid, something that most of us never get to use unless we are working in the medical field.

In my case, I am a "rusty EMT," trained way back in the 70s, and updated since then with various certs, but none in a while. I am not currently active in SAR, but the occasional situation still develops. I recently treated a fellow worker while everyone else stood around and gawked - at least the supervisor called 911 quickly while I gave basic care to the victim.

I clearly need to update my training and skills, which are likely to come in handy during everyday life as well as in the Next Big Disaster.

So, what are my options and what are the relative costs and time commitments? In order to make this thread more broadly useful, what are the options for the first aid neophyte and their relative costs and benefits?

I became a CERT volunteer through the local fire department. They do not know what to do with me in the current city budget crisis, but did sponsor me through free CPR, basic first aid, and portable defibrilator training. I was going to go to the next bigger city for more advanced training either free or on a cost-of-supplies-only basis, including wilderness first responder, but again budget woes have put that on hold.

I started the other thread, almost forgot , I took the St. John's Ambulance first aid course about two years ago.....I should take it again to refresh my knowledge and skills.

In most states in order to receive an EMT certification a person must be able to demonstrate need (i.e. have an affiliation with a rescue organization, ambulance service, guiding service, work requirement etc.) and also have a supervising physician. Usually anyone can take an EMT class but simply wanting to be an EMT is not sufficient to become certified at a state and national level.

With a basic EMT certification a person is typically trained to provide initial care to sick or injured people and assist them in obtaining higher level care in locations close to medical and rescue services. There are many adjunct and higher level training plans for EMT's. A useful and interesting program is the Wilderness EMT adjunct (WEMT) that trains EMT's to provide initial and longer term medical care in remote locations with limited resources. Some places offer a combined EMT/WEMT class.

Probably the most useful and easiest to obtain training for people involved in outdoor recreational activities is a Wilderness First Responder certification. The class teaches a range of first aid, rescue and improvisation skills for initial and long term first aid in remote locations.


Here are some links to reliable places for wilderness first aid training.
Most of these places also sell high quality preassembled first aid kits and supplies.

http://www.nols.edu/wmi/

http://www.remotemedical.com/

http://www.wildmed.com/

http://www.soloschools.com/

http://www.aeriemed.com/

http://www.wildernessmedicine.com/

This statement is incorrect. Every EMS program I've seen, both at community colleges and private "certificate only" places, allows people with no prior medical/rescue/etc affiliation at all to enroll for EMT-Basic.

When you say "...and also have a supervising physician", I think you are confusing medical control (which IS required to provide care beyond the first responder level) with the mere ability to go get the training. Don't confuse what it takes to get trained with what it takes to use your skills on the public in an official capacity.

However I concur with your statement that Wilderness First Responder is an excellent goal for those who want useful knowledge and skills but don't want to work in EMS.

To the original poster:
EMS certs & systems vary wildly by state and sometimes by county. You will need California-specific info.

Glock-A-Roo, NREMT-I, WEMT (via SOLO)

Glock-A-Roo,

The issue isn't being able to enroll in and complete an EMT class but to actually get certified. As I said, almost anyone can take EMT classes. Certification is a separate issue. In the 2 states where I have been certified as an EMT it was necessary to demonstrate need, although in Alaska it is considered to be automatic. The protocols, in AK, are supervised by the State department of health and they are the supervising physician. When I certified in Colorado it was to for work with a guiding organization that had a physician advisor and protocols. If you are going to do more than provide basic first aid to family and friends as an EMT it takes more than just completing an EMT class. There are serious liability issues and competency issues involved.

I was a rusty EMT. I had been out of the field and let my certification lapse for a good 15 years. However, a recent move put me in an area served by a volunteer ambulance corps, and volunteer I did. My squad sent me to EMT school free of charge, and provided me with additional training and gear.

I would highly recommend contacting your local volunteer ambulance or fire company to ask about training. While becoming an EMT is not learning rocket science, it does involve knowledge and skills that deteriorate if not used. Volunteering is a great way to use the skills, and make your community a better, safer place all at the same time.

Trust me on this, the first time you confront a major medical emergency or trauma, it is easier if it's not your family member. If you get some experience working "the street," wherever that may be, you'll be much more prepared to help those around you when they need it!

Dude, that certainly is your experience. What I'm telling you is that saying "In most states in order to receive an EMT certification a person must be able to demonstrate needs" is wrong.

I got my NREMT-B and NREMT-I, plus my State cards in those areas, before I ever affiliated with any agency. In fact is was only AFTER I got those certs that I could work for EMS around here.

If you explore SOLO's WEMT material, you'll see that you achieve NREMT-B after SOLO's 30-day WEMT course, in which there is no affiliation with any agency.

Again, I think you're confusing "medical control" via a physician and sponsoring agency with "EMT certification", even at the national level.

I chuckled when I read this. You are absolutely correct. During my active EMT phase, I was also raising three children. Between the two situations, I learned why first aid is a necessary life skill....

Sorry, no confusion on my part:

http://www.cdphe.state.co.us/em/Operations/medicaldirection.html

"All emergency medical technicians in Colorado are required by Board of Health and Colorado Board of Medical Examiners Rules to have a Medical Director if they are providing direct patient care as an EMT in any setting. EMTs in Colorado may function in prehospital and in-facility settings with appropriate medical supervision."

From SOLO website:

"Upon successful completion of both exams, participants receive a two-year SOLO WEMT certification, a two-year AHA CPR certification, and a National Registry of Emergency Medical Technician (NREMT) certification. It is the responsibility of each student to find out how certification and licensure work in their state."

"...THE RESPONSIBILITY OF EACH STUDENT TO FIND OUT HOW CERTIFICATION AND LICENSURE WORK IN THEIR STATE..."

The reason I brought up this issue in the first place is that although it is relatively easy to get EMT training, providing medical care as an EMT is not a trivial thing. As an EMT you are considered a medical professional, albeit a very low level one, and are legally held to a standard of care. Each state sets standards and has requirements and If you use EMT skills without proper authorization you are risking serious liability issues.

NJS,

You're probably both right and wrong, depending on the state, but I also think you're missing the point of the question, which was, "how do I get training" not "how to I work as an EMT."

I know of a few states that require you to affiliate with medical control and maintain that affiliation to get your Paramedic card, so it's possible that the same situation exists for BLS techs as well in some states.

However, that's not the point. Being an EMT does not allow me to outfit my minivan with lights and sirens and call myself an ambulance. It does allow me, with the appropriate medical control, to work on someone elses ambulance, but the ambulance would not exist without the medical control, so I don't really worry about it all that much.

Being an EMT also gives me the skills to help out when I'm not working under medical control. When I tended to a woman having a seizure at 35,000 feet on a transcontinental flight I was a passenger on, I was not acting with medical control - I was a good Samaritan who answered a call for help, and I was protected from liability by good samaritan laws.. Similarly, if I stop at a car accident while driving with my family (which I have also done) I am protected by good Samaritan laws, as long as I follow my training and protocols.

So back to the original question. I have already suggested volunteering with your local fire department or ambulance company. Other places to look are community colleges for courses you want to pay for, and the always popular WEMT certification. CERT and the Red Cross are good for basic first aid, which is certainly useful, but not as involved, and will not give you the same comfort and experience as working an ambulance will give you.

Sorry for the long post!

If you're expired, you'll need to do the entire 110 hr course. Check your local junior college. Typically a semester, but I did an accelerated 6-week, weekends only program.

NJS, I'm another one that has experiences at odds with that you've said. No class I've heard of says no to money. And even certification in California (at least) is suprisingly easy. I even recerted with CEU's from New Jersey one year; a seperate time (several years later) they waived the CEU portion, figuring that full time medical school was sufficient.

From the Maryland Institue for Emergecny Medical Services System (MIEMSS):


In Maryland, one must be affiliated with a recognized EMS program, which may fall under Fire, EMS and some Law Enforcement agencies. None of the training programs (to the best of my knowledge) will allow anyone to enroll unless you have affiliation with one of these entities. Even the programs associated with the high schools and colleges require that one to be associated with an approved EMS program (i.e. Fire and/or Rescue and/or LE agency).

Pete

Like so much in EMS, the rules vary widely by state and locality. I was responding to what I felt was an overgeneralized statement by njs.

As I said earlier, I had my NREMT-B and later NREMT-I before applying to the agency I eventually worked at. I certainly did not need agency affiliation to just take the training, let alone get the NREMT certs. That's how the system is in my state. And I know WEMTs who hold registry and do not work for EMS.

Now when it comes to renewing your certification, things get stickier if you are trained at an advanced life support (ALS) level, which is EMT-Intermediate and up. When renewing as an actively employed EMT you must show agency affiliation. If you are not employed as an EMT but want to retain your cert, you must show that you worked for an ALS-capable EMS agency for at least 6 months sometime in your life. This is how many instructors maintain their registry cert, they rely on their earlier field experience.

Bottom line to the original poster: seek out a Wilderness First Responder (WFR) course from one of the providers njs linked to, and you will be very well served.

This has gotten well away from the original question. Lets clarify the certification issues and put that issue to an end.

MOST states do not require an agency affiliation for certification at the Basic (EMT-B) level, SOME US states do require that you either have agency affiliation prior to certification, by the end of the first certification period, or some time period in between. These rules change frequently, check your state for the current rules where you live.

There is only one national certification organization for EMS, National Registry of Emergency Medical Technicians (NREMT). NREMT Does not require agency affiliation for any initial certification.

Every state has rules regarding medical direction for utilization of advanced skills as an EMS provider. These rules vary from state to state, and again each person should know the rules for their state and certification rule.

So... Southern Cal, where the OP is from, is where I worked for 10 yrs as an EMT.

When I got my EMT, back in 96, no EMS affiliation was required (in LA County). However, the state is ack-bassward. Every county does their own EMS cert's, or you can go through the state Fire Marshall course. so, concievably some counties would want you with an EMS agency, others wouldn't. But to my knowledge, none did. All counties offer reciprocity with one another, for a fee. Wildernss FA is tough to find, depending where you live (I think UCLA EMS offers it still).

Nat'l Registry doesn't exist in CA. However, some counties use NREMT as the basis for their tests, such as Orange County, so you may be served by learning that curriculum. LA Co. was a simple "home made" test.

I'd say call up the EMS agency for whatever county you live in, get the scoop on what they require, and where they have courses. Shouldn't be too pricey. If you don't like your options, go to the next closest county and repeat. You've got, what, 5 counties to choose from (LA, Orange, SD, San Bernardino and Riverside). Santa Barbara/Kern County too if you wanted (I heard good things about their tests)