Certification levels

Levels of Certification

The State of Vermont Dept. of Health recognizes 4 levels of Pre-hospital providers at the present time. They are: First Responder/Emergency Care Attendant (FRECA), Emergency Medical Technician- Basic (EMT-B), Emergency Medical Technician-Intermediate (EMT-I) and Emergency Medical Technician-Paramedic (EMT-P). At the present time DVR has personnel trained up to the EMT-I level. The number of providers at this time are as follows:

Trainees: 2

Driver: 2

First Responder: 4

EMT-Basic: 16

EMT-Intermediate: 10

The following is a brief description of each level of provider:

First Responder/ECA: The FRECA is an approximately 39 hour course that gives the individual an introduction to care of the sick/injured. The student is taught patient assessment skills, vitals signs, airway management and other basic skills that will be utilized. This is very basic information and is a good way for someone off the street to enter EMS. The test is a written multiple choice test, and 5 practical stations. Once the test has been passed, the student may complete 6 modules, each about 12-16 hours in length. Once these 6 modules are completed, the student has all the curriculum necessary to take the National Registry EMT-B test. This format allows a student to take the initial course, affiliate themselves with a squad and because the modules are ongoing, the student has the opportunity to learn, then put the skills to use by running calls, then learn more and repeat the process over and over.

EMT-B: The EMT-B class is approximately 110 hours in length, dependent upon the content covered, and also involves 10 hours or Emergency Room observation time. This class obviously goes beyond what is taught in the FRECA course. This class does not allow the student to learn and then put the skills to use like the FRECA, but instead the student completes the class and tests and is a certified EMT-B and can then put the skills to use. Of course a student can run in the interim period with a squad while in class, but the skills they are allowed to use may be decreased until successful completion of the National Registry test. The testing for this level involves a 150 question multiple choice test, and 5 practical stations. This level allows the student to utilized an AED (Automated External Defibrillator), administer Oxygen and administer oral glucose.

EMT-I: Once completion of the EMT-B, a student can proceed to the EMT-I class. This is a minimum of 102 hours in length and includes competency based Emergency Room observation time as well. This advanced course allows a student to learn more advanced patient assessment skills, advanced airway skills and overall some advanced knowledge in medical emergencies and the human body as a whole. This class allows the student the ability to perform advanced airway maneuvers by utilizing the Combitube, perform peripheral intravenous administration (IV's), and to utilize 7 medications for certain medical conditions. Those medications are Dextrose (Diabetic emergencies), Glucagon (Diabetic emergencies), Narcan (Narcotic overdoses), Epinephrine (Anaphylactic reactions), Aspirin (Cardiac conditions), Nitroglycerin (Chest pains) and Albuterol nebulizer (Asthma and other respiratory conditions). All these medications are given only under medical direction of the physician on duty at Southwestern Vermont Medical Center.

One of the biggest questions is what does it take to keep up your certification. The State of Vermont requires 24 hours of continuing education (CE) over 2 years for an FRECA/EMT-B to keep up their certification. To keep National registry certification requires more hours. The 24 hours includes several hours of required topics, and the rest being elective. Once the 2 year period is up, the student must test again, this time a 100 question test and 3 practical stations. For EMT-I's, an additional 10 hours of CE is needed specific to the EMT-I level. At the present time, there is no re-test for the EMT-I level. DVR's training schedule is arranged such that a member should not have to go outside of the squad for training to meet their 24 hours. Our schedule is designed so that all required topics are covered each calendar year, and the remainder of the year is filled in with electives. So during their 2 year certification period if a member is unable to attend Airway Management training during the first year of their certification, it will be covered in the next year and the member will not have to go elsewhere for education.

Certification levels