AEMT-CC

Advanced Emergency Medical Technician - Critical Care (EMT-CC) is an Emergency Medical Services (EMS) certification unique to New York. The curriculum is similar, but beyond that of the national standard EMT-I/99 (EMT-Intermediate - I/99). EMT-CCs are fully classified as Advanced Life Support (ALS) providers within New York and are trained in advanced airway management, IV fluid administration, cardiac monitoring/defibrillation and medication usage/administration in adult and pediatric patients.

Training

Like all ALS providers, the fundamental prerequisite is current EMT-Basic certification. Most instructors require at least one year of active experience at the EMT-Basic level. On average, students receive approximately 300-400 total hours of instruction. This instruction is broken up into 175-225 classroom/practical laboratory hours, 50-75 clinical hours and 75-100 field internship hours. At the end of the class, students must pass the state's practical skills and written exam to obtain certification. However, an EMT-CC's education never truly ends as many continuing medical education requirements are required to maintain certification.

In The Classroom

A wide variety of topics are covered in class with specific didactic laboratory time. These topics include:

* Foundations of the EMT-Critical Care Technician
* Overview of Human Systems/Roles and Responsibilities
* Emergency Pharmacology
* Venous Access and Medication Administration
* Airway Management And Ventilation
* Patient Assessment
** History Taking
** Techniques of Physical Exam
** Clinical Decision Making
** Communications and Documentation
* Trauma Emergencies
** Trauma Systems and Mechanism of Injury
** Hemorrhage and Shock
** Burns
** Head, Thoracic & Abdominal Trauma
** Trauma Practical Laboratory
* Medical Emergencies
** Respiratory Emergencies
** Cardiovascular Emergencies
** Diabetic Emergencies
** Allergic Reactions
** Poison/Overdose
** Neurological Emergencies
** Non Traumatic Abdominal Emergencies
** Environmental Emergencies
** Behavioral Emergencies
** Gynecological Emergencies
** Obstetrical Emergencies
** Neonatal Resuscitation
** Pediatrics
** Geriatrics

In The Clinical Setting

A significant amount of time is spent observing health care professionals in various clinical settings such as the Emergency Department, Operating Room, Coronary Care Unit, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, Burn Unit and Medical Intensive Care Unit. The clinical time is designed to expose the student to a large volume and variety of patients in an educational setting so didactic skills and clinical knowledge can be practiced and refined.

In The Field

EMT-CC students participate in many EMS calls in the field that require ALS skills under an EMT-CC or Paramedic preceptor. Field clinical time represents the phase of instruction where students learn how to apply cognitive knowledge, and the skills developed in the didactic laboratories and hospital clinical time, to the EMS field environment.

Scope of Practice

EMT-CCs, like all EMS providers, follow a set of protocols for patient care under the guidance of a medical director. These protocols are typically listed in an algorithm format and consist of either routine standing orders or orders that require direct, on-line communication with medical control via radio or telephone. As compared to a Paramedic, an EMT-CC has fewer routine standing orders and requires more contact with medical control.

While the ALS protocols vary slight between the different regions in New York as to which are standing orders versus those which require on-line medical control, all protocols follow current guidelines for Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Pre-hospital Trauma Life Support (PHTLS), Basic Trauma Life Support (BTLS) and Advanced Trauma Life Support (ATLS). Ultimately, EMT-CC's are capable of initiating venous access, administering medications, performing endotracheal intubation, interpreting ECGs, performing electrical cardiac therapy, performing chest decompression, performing intraosseous access and comply with all state defined Basic Life Support (BLS) protocols.

Sources

* [http://www.health.state.ny.us/nysdoh/ems/main.htm New York State Department of Health Bureau of EMS Homepage]
* [http://www.health.state.ny.us/nysdoh/ems/emtcco.htm New York State AEMT-CC Curriculum on the New York State Deptartment of Health Webpage]