Advanced Emergency Medical Technician - Critical Care (AEMT-CC) is a former
Emergency Medical Services (EMS) certification
Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of a ...
that was unique to
New York
New York most commonly refers to:
* New York City, the most populous city in the United States, located in the state of New York
* New York (state), a state in the northeastern United States
New York may also refer to:
Film and television
* '' ...
. The curriculum for AEMT-CC's in New York was similar to that of the national standard EMT-I/99 (
EMT-Intermediate - I/99) but with a broader scope of practice. EMT-CCs are fully classified as
Advanced Life Support (ALS) providers within New York and are trained in advanced airway management, including intubation, IV fluid administration, cardiac monitoring, cardiac pacing, and both synchronized and unsynchronized cardioversion, and medication usage/administration in adult and pediatric patients.
In New York, AEMT-CC's are also called "Level III" providers as New York formerly recognizes four levels of Emergency Medical Technicians: EMT-Basic, Advanced EMT (AEMT), AEMT-Critical Care, and AEMT-Paramedic.
New York State will no longer approve original AEMT-CC classes beginning after January, 2018. AEMT-CC traditional refreshers will cease after August 2019. AEMT-CC may continue to refresh their certification via CME.
The NYS EMS Policy is accessible here: https://www.health.ny.gov/professionals/ems/policy/17-07.htm
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 and 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
Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of a ...
. However, program requirements to obtain AEMT-CC certification vary by the institution teaching the class. While some require a set number of patient contacts rather than a set number of hours, others require tracking of individual performed skills (i.e., x number of IV sticks, x number of medication administrations), along with the tracking of patient populations (i.e., x number of pediatric patients treated, x number of adult patients, x number of geriatric patients), and call types (i.e., x number of OB/GYN patients, x number of Behavioral/Psychiatric, etc.), significantly increasing the number of clinical and field hours needed to meet the requirements to be admitted to take the state exams at the end of the class.
However, an EMT-CC's education never truly ends as continued medical education is required to maintain certification. Most agencies have a CME (Continuing Medical Education) programs where required core subjects are taught on an ongoing, usually once-a-month, basis to keep providers current. Other ways of earning required CME credits for maintaining certification include state EMS conferences, such as Vital Signs, where classes are given over the duration of a weekend.
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
Clinical Setting
A significant amount of time is spent observing and assisting health care professionals in various clinical settings such as the
Emergency Department
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
,
Operating Room
Operation or Operations may refer to:
Arts, entertainment and media
* ''Operation'' (game), a battery-operated board game that challenges dexterity
* Operation (music), a term used in musical set theory
* ''Operations'' (magazine), Multi-Man ...
,
Coronary Care Unit
A coronary care unit (CCU) or cardiac intensive care unit (CICU) is a hospital ward specialized in the care of patients with heart attacks, unstable angina, cardiac dysrhythmia and (in practice) various other cardiac conditions that require contin ...
,
Pediatric Intensive Care Unit
A pediatric intensive care unit (also paediatric), usually abbreviated to PICU (), is an area within a hospital specializing in the care of critically ill infants, children, teenagers, and young adults aged 0-21. A PICU is typically directed by o ...
,
Neonatal Intensive Care Unit
A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. Neonatal refers to the first 28 days of life. Neonatal care, as kn ...
,
Burn Unit and
Medical Intensive Care Unit
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practice ...
. 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.
Field
EMT-CC students participate in many EMS calls in the field that require ALS skills under an EMT-CC or
Paramedic
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
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. "Ride time" in the field usually happens in phases where the student only observes in Phase I, applies skills as directed by his preceptor in Phase II, and functions independently with oversight and input from the preceptor in Phase III. Students are generally considered "ready to function as an entry-level AEMT-CC" upon passing state practical and written exams, although individual agencies may require them to also complete in-service training and supervised probationary time once they receive their AEMT-CC card.
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 Advanced Life Support protocols vary slightly 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), and Basic Trauma Life Support (BTLS). Some AEMT-CC programs include both ACLS and PALS certification as part of the course of instruction. Ultimately, EMT-CC's are capable of initiating venous access, administering medications, performing endotracheal
intubation, obtaining
ECG
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the hear ...
s, performing electrical cardiac therapy, performing chest decompression, performing
intraosseous
Intraosseous infusion (IO) is the process of injecting medications, fluids, or blood products directly into the marrow of a bone; this provides a non-collapsible entry point into the systemic venous system. The intraosseous infusion technique i ...
access and comply with all state defined
Basic Life Support (BLS) protocols.
Notably, the EMT-CC certification is not recognized in the
City of New York. EMT-CCs operate at the Basic Life Support level in that city's 911 system.
References
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External links
New York State Department of Health Bureau of EMS Homepage
Emergency medical responders
Emergency medical services in the United States
Medical credentials
Emergency services in New York (state)