ICS Courses

[isuhawkeye]

since you brought up the ICS courses can anyone explain how a document entered our training pipeline with answer keys to 6 EMI (Emergency Management Institute) courses.  This answer key was distributed as a "training aid".  Upon examination the document was created during the dates of the hawk mountain program. 

Can anyone also explain how a GTM entered Hawk last summer, and exited at the end of the program as an IC with out the wing CC's knowledge. 

as i have stated before I am a big supporter of the ranger program (In spite of my experiences)

[CadetProgramGuy]

......cut......... 

Can anyone also explain how a GTM entered Hawk last summer, and exited at the end of the program as an IC with out the wing CC's knowledge. 

Yes, that is quite interesting.  Any explinations?  If it is that easy, I will be a Hawk this summer.

[JC004]

......cut......... 

Can anyone also explain how a GTM entered Hawk last summer, and exited at the end of the program as an IC with out the wing CC's knowledge. 

Yes, that is quite interesting.  Any explinations?  If it is that easy, I will be a Hawk this summer.

I did support staff as a cadet for a couple years and got a lot of my quals knocked off (at least as much as I could being 17/18 at the time).  But believe me, the school commander at the time maaade me earn them.  He wasn't the type to sign things off for no reason.  Can't how it is now, but I don't think that GTM to IC happens too often, especially since key staff there don't have quals that high.  Plus, there is little opportunity to get Scanner/Observer there for AOBD, so there must have been additional quals on this person in question.

[floridacyclist]

You don't need AOBD....just AOBD OR GBD.

I know my kids went from basically nothing (still recovering from the electronic transition) to most of their GTM 1, 2, and 3 stuff with just a few signoffs left. I finished off GTM1 and GTL at Falcon. Not sure how you would go from almost nothing to IC in a week legitimately; even if it was possible, I wouldn't trust the experience level of that person. I think you need some time to simmer at each place along the way.

[Stonewall]

In NATCAP we had a couple of "shake 'n bake" ICs, but it took them a year.

[JC004]

You don't need AOBD....just AOBD OR GBD.

I know my kids went from basically nothing (still recovering from the electronic transition) to most of their GTM 1, 2, and 3 stuff with just a few signoffs left. I finished off GTM1 and GTL at Falcon. Not sure how you would go from almost nothing to IC in a week legitimately; even if it was possible, I wouldn't trust the experience level of that person. I think you need some time to simmer at each place along the way.

yea...

GBD and Mission Scanner

or

AOBD and GT/UDF

(to make PSC)

[floridacyclist]

Where are you seeing that about needing scanner or GTM/UDF for PSC? I heard it at Sun n Fun, but can't find it in writing anywhere.

[sardak]

^^
CAPR 60-3
2-3 i. Planning Section Chief (PSC).
1) Trainee Prerequisites. Satisfy the following to begin training for PSC:
a) Qualified Air Operations Branch Director or Ground Branch Director (need not be current).

Personnel applying based on qualification as an Air Operations Branch Director requirement must have been qualified as a ground team or Urban DF team member at one time. Personnel applying based on qualification as a Ground Branch Director must also have been qualified as a mission scanner at one time.

Mike

[JC004]

^^
CAPR 60-3
2-3 i. Planning Section Chief (PSC).
1) Trainee Prerequisites. Satisfy the following to begin training for PSC:
a) Qualified Air Operations Branch Director or Ground Branch Director (need not be current).

Personnel applying based on qualification as an Air Operations Branch Director requirement must have been qualified as a ground team or Urban DF team member at one time. Personnel applying based on qualification as a Ground Branch Director must also have been qualified as a mission scanner at one time.

Mike

What he said.  You just gotta go down the line to the pre-reqs for IC and the pre-reqs before that...

[floridacyclist]

I see that in 60-3. Funny that it never made it into the SQTRs. It never was an issue for me since Scanner was the first specialty I finished.

[JC004]

I see that in 60-3. Funny that it never made it into the SQTRs.

I did a size-up on the SQTRs vs. 60-3 a while back.  Pretty interesting...but I guess that a reg is the rule, right?  You could change the tasks, but I imagine you can't change the prereqs and all without changing the reg itself...

[floridacyclist]

Considering how much checking they put into other prereqs (cadets can't get GES until Curry is checked etc), I'm surprised that they let this one by, especially since it's not so obvious as to just make sense without any forethought.

[JC004]

Considering how much checking they put into other prereqs (cadets can't get GES until Curry is checked etc), I'm surprised that they let this one by, especially since it's not so obvious as to just make sense without any forethought.

I think you'll also notice that on some of the SQTRs, the "or" option isn't clear.  It makes it look like you need to have BOTH of something.  Not to mention spelling errors, incorrect task numbers, and/or variations from the SQTRs in PDF on the NHQ site.   

[floridacyclist]

I still get a kick out of having to "insect the team members"

Do we hose them down with bug spray or something?

[JC004]

I still get a kick out of having to "insect the team members"

Do we hose them down with bug spray or something?

Febreze if it's been long enough...kinda like encampment...

[sarmed1]

One major reason for the restriction is the plethora of different requirements for each state and, in some cases, within each state. Plus the whole Physician Advisor issue.

As Tony said, not something to hard to solve.

Firstly one could argue that when on an AF assigned mission status, state law does not apply as we are an AF instrumentality, hence need not meet state requirements as far as lincensure or scope of practeice.  When I was in the nasty guard, we had a similar predicament, medics could not operate using the Army standard unless they were on Federal status, unless they held an equivilent state certification.

Secondly, that "scope of care" that FEMA is looking at is pretty minimal.  I think EMT or Wilderness FR is more for the knowledge level rather than a specific skill set.  In that aspect it is level of competency that CAP could easily achieve.

Thirdly in the never ending debate by medical personnel:

6. Medical care policy.
a. Medical care within CAP is limited to emergency care, only (i.e., first aid and stabilization) within the training and qualifications of the person rendering such care, until such time that private professional or authorized military care can be obtained.

Honeslty what in the EMT-B or First Responder level are you going to do thats outside of that statement.  I doubt you are going to hump around enough oxygen cylinders to adminsiter that drug.  Oral glucose, I can buy it over the counter.  I dont see the time frame from exposre to find to make activated charcoal a likely administration.  AED, though a nice idea a) not in the wilderness setting and b) not likely readily (though would be nice) available to the average GT.  Everything else is pretty much accepted bystander care...bandaging, splinting.

The biggest stumbling block would be the liability issues, and as always I will argue that CAP is at a bigger liability risk for NOT assuring EMT-B as the prescribed standard of care, and via the NIMS document in the land of WSAR an expected standard of care.
Any EMT or above that values their certification would be a fool to not hold thier own personal liability/malpractice insurance anyway, and that would keep you out of trouble in the case of volunteering your skills with CAP.

mk

[arajca]

The biggest stumbling block would be the liability issues, and as always I will argue that CAP is at a bigger liability risk for NOT assuring EMT-B as the prescribed standard of care, and via the NIMS document in the land of WSAR an expected standard of care.

Only for Type I and II teams. Type III and IV require local EMS support. Realistically, CAP would only be fielding Type III or IV teams.

Any EMT or above that values their certification would be a fool to not hold thier own personal liability/malpractice insurance anyway, and that would keep you out of trouble in the case of volunteering your skills with CAP.

mk

That may save your money, home, etc from legal system losses, but it does not address the issue of losing certification/licensure for practicing without proper medical direction. There are cases where an EMT performed their duty appropriately, had a good outcome, but lost their cert because they were outside the area covered by their phys. adv. and were technically operating with medical control.

[JC004]

Only for Type I and II teams. Type III and IV require local EMS support. Realistically, CAP would only be fielding Type III or IV teams.

Absolutely agree.  Given the requirements, we will be Types III/IV.  But even to accomplish that, we have to seriously look at how our ES team system is organized.

[fyrfitrmedic]

The biggest stumbling block would be the liability issues, and as always I will argue that CAP is at a bigger liability risk for NOT assuring EMT-B as the prescribed standard of care, and via the NIMS document in the land of WSAR an expected standard of care.

Only for Type I and II teams. Type III and IV require local EMS support. Realistically, CAP would only be fielding Type III or IV teams.

Any EMT or above that values their certification would be a fool to not hold thier own personal liability/malpractice insurance anyway, and that would keep you out of trouble in the case of volunteering your skills with CAP.

mk

That may save your money, home, etc from legal system losses, but it does not address the issue of losing certification/licensure for practicing without proper medical direction. There are cases where an EMT performed their duty appropriately, had a good outcome, but lost their cert because they were outside the area covered by their phys. adv. and were technically operating with medical control.

Complex, but still not insoluble by a long shot.

[fyrfitrmedic]

Only for Type I and II teams. Type III and IV require local EMS support. Realistically, CAP would only be fielding Type III or IV teams.

Absolutely agree.  Given the requirements, we will be Types III/IV.  But even to accomplish that, we have to seriously look at how our ES team system is organized.

Agreed.

Any such examination must be done by a group diverse enough to transcend any parochialism or tribalism currently found within the organization.

[JC004]

Only for Type I and II teams. Type III and IV require local EMS support. Realistically, CAP would only be fielding Type III or IV teams.

Absolutely agree.  Given the requirements, we will be Types III/IV.  But even to accomplish that, we have to seriously look at how our ES team system is organized.

Agreed.

Any such examination must be done by a group diverse enough to transcend any parochialism or tribalism currently found within the organization.

[DNall]

I see that in 60-3. Funny that it never made it into the SQTRs. It never was an issue for me since Scanner was the first specialty I finished.

SQTR makes it look like noth are required:
Planning Section Chief - Prerequisites
AOBD - Air Operations Branch Director         
GBD - Ground Branch Director

[JC004]

I see that in 60-3. Funny that it never made it into the SQTRs. It never was an issue for me since Scanner was the first specialty I finished.

SQTR makes it look like noth are required:
Planning Section Chief - Prerequisites
AOBD - Air Operations Branch Director         
GBD - Ground Branch Director

Wonderful, aren't they?  You'd think they could get this together.  Hell, if they'd let me, I'd go in and fix all the mistakes myself.

[DNall]

Firstly one could argue that when on an AF assigned mission status, state law does not apply as we are an AF instrumentality, hence need not meet state requirements as far as lincensure or scope of practeice. 

First of all, those AFAMs are under state jurisdiction. Remember the states have responsibility for SaR, and the AF is the designated federal agency to provide air spupport to them when they have a need they can't fill on their own. CAP's SAR mission is to take the bulk of that, particularly the non-distress work, and keep it off the AF's plate.

In otherwords, you do have to comply with state requirements, because it is the state that decides if CAP gets called by AFRCC or not, and under what limits. Not that it matters, those requirements are supposed to be replaced by the standardized FEMA requirments, which we clearly have no choice but to get compliant with.

When I was in the nasty guard, we had a similar predicament, medics could not operate using the Army standard unless they were on Federal status, unless they held an equivilent state certification.

91W is an EMT-B

Secondly, that "scope of care" that FEMA is looking at is pretty minimal.  I think EMT or Wilderness FR is more for the knowledge level rather than a specific skill set.  In that aspect it is level of competency that CAP could easily achieve.

If you'll look at how the teams are shaped, you're talking about one EMT back at base with the command & control element of 48 people in the field. My understanding is they are there for triage & to provide support to field teams.

[BillB]

What law puts SAR under state jurisdiction??? In some states SAR is placed under County control. In others, no mention of what agency has jurisdiction. A missing aircraft search has, under the Inland SAR regulations always been a USAF controlled activity. Maybe in Texas there is a law that transfers control to the state, but that law doesn't appear in other state statutes.
In Florida a missing person search falls under the County Sheriffs jurisdiction, or in many local seaches under the City Police Department. But large area searches are conducted thru AFRCC. There have been few (a VERY few) search missions where the Sheriffs helicopters were asked to stand down due to USCG or CAP Search operations.

[SAR-EMT1]

While all 91W's attain the National Registry at the Basic Level, they have the option of retesting for The "D" / Basic-Extra tag...
Also Combat Lifesavers  can certify at  Nat. Reg. First Responder -Extra
- I keep saying "extras" because thats the common term I hear at the station or in the ER. The cards Ive seen actually Say "D" - but thats IL.

[DNall]

What law puts SAR under state jurisdiction??? In some states SAR is placed under County control. In others, no mention of what agency has jurisdiction. A missing aircraft search has, under the Inland SAR regulations always been a USAF controlled activity. Maybe in Texas there is a law that transfers control to the state, but that law doesn't appear in other state statutes.
In Florida a missing person search falls under the County Sheriffs jurisdiction, or in many local seaches under the City Police Department. But large area searches are conducted thru AFRCC. There have been few (a VERY few) search missions where the Sheriffs helicopters were asked to stand down due to USCG or CAP Search operations.

The national search & rescue plan, which is the US portion of an international treaty.

All inland SaR, including missing aircraft, is a state responsibility. States can then in use thier own laws to delegate that responsibility to counties if they wish. That tends to be the case for missing persons, but not far beyond that. Aircraft searches are generally under a state dept of aviation/transportation/state police/something like that. Ours is under the aviation division of DPS (state police).

AFRCC is not in charge!!! They are much like FEMA in that they are there to coordinate federal support to an outside effort. They are in charge of that federal support, and to the extent states may choose thru MOU to hand over that authority thru an assistance request, in some narrow situations.

My point being, it's not a federal HLS mission in which the state has no interest or authority. The state is legally the governing agency for all inland searches, and the AF is secondary. Our part is as one inexpensive tool in a full box of federal resources that AFRCC can call on to provide aid to states in fulfilling their obligations. So, we most certainly would have to meet any state mandated qualifications & such, or the state can and will freely cut us out of SaR missions. And there are limitations in some states (Colorado & Nevada I believe are examples) based on our qualificatiosn, and extra requirements in other states (Washington I believe for example).

While all 91W's attain the National Registry at the Basic Level,

That's what I said. So obviously they can practice under that license while on state active duty & acting as an instermentality of the state. The problem would be (and is w/ CAP) one of acting in a federal capacity while only holding a state license, which isn't a problem within your state, but is an issue going outside to stuff like Katrina. I believe the FEMA standards state national certification, at least at the type I level, but that's going from memory.

The bigger deal though is what I said about their capacity & duties. They are basically the missions medical officer for a GBD/CUL supporting 48 GTL/Ms, NOT a field medic. The standard of care we're talking about is still GTL/M w/ first aid & an EMT on the other end of a radio (be that local EMS or otherwise). Having an actual EMT on the team itself would be nice, but that's overkill.

[stillamarine]

Not for nothing,

But if I remember correctly (it's been a couple years since I've let my NREMT-P expire) but an EMT is required to work under a Medical Director. 

I like the idea of an EMT on a ground team, but you would have to figure out who is going to be that Director.

Now, I don't think MFRs or WFRs are required to have an oversight. True they can't provide all that an EMT can, but there is plenty they can do to accomplish the mission.

I think you would have to look at how often you are putting ground teams into rural areas where local EMS systems are not readily available. This includes hospitals. I lived in the Northwoods of WI once and in the winter time getting to the hospital by ambulance could take almost an hour. I know. I drove it A LOT. Up there we required all of our FFs to get MFR as soon as possible and we also payed anyone interested to get at least their EMT-B.

If your in an area where you have EMS readily available, then it may not be as important to you.

[DNall]

All full-time FFs in our state have EMT-B as a prerec, not that it matters to the conversation, but it's real useful.

On a type I/II incdent, there would be a medical officer with the IC staff that oversees your organic EMT, who in turn oversees your field operators. I'm not really an expert, but there's an EMS response plan just like thre is a SaR one, that's where I'd direct my question. The kind of supervision you're talking about, like authorization for drugs & such, should rarely ever be an issue, but where it is there are AF emergency physicians avail 24hrs on-call to AFRCC. It's ashame we don't practice it, but they will put such a person on the phone that will supervise care.

[isuhawkeye]

just a point for this thread

The national registry is simply a testing entity.  this entity is very widely recognised, but not all states accept national registry status. 

Secondly the national registry certification does not allow you to practice medicine.  All states require a state issued licenser or certification in order to function.

These are mutual aid procedures in most states which allow out of state health care providers to function during times of emergency

[sarmed1]

In regards to 91W (or bravo at the time) EMT-B does not allow a Military Medic to start IV's or administer any medications even thou 91W are at the EMT-I level of skills they are not certified there, under the NG rule they could only perform those skills if the held an equivilent state certification (EMT-I, CRT, EMT-Advanced or Paramedic depending on where you live)

Yes Medical direction is still a requirement at the EMT-B level, other wise you are operating as a first responder (kind of super first aid). Dont do EMT-B skills, ie assisted medications, oral glucose, activated charcoal etc etc, without having some kind if in writting physican oversight (based on how your state does taht sort of thing).
The AFRCC fligh surgeon is a nice idea, I have never tried to call as a CAP person, we tried once from a C-130 on an aeromedical evac training mission and it took forever to get patched thru.  If this is an area you feel strongly about I would pursue it with either the wing medical officer or your home volunteer/paid medical director.  When I lived in Texas our service medical diretor told us that if we were ever out and about and needed to be covered for something not at work, call him.

[Nick]

EMT-B does not allow a Military Medic to start IV's or administer any medications even thou 91W are at the EMT-I level of skills they are not certified there, under the NG rule they could only perform those skills if the held an equivilent state certification (EMT-I, CRT, EMT-Advanced or Paramedic depending on where you live)

[snip]

When I lived in Texas our service medical diretor told us that if we were ever out and about and needed to be covered for something not at work, call him.

Hey Mark, long time ...

That limitation on administering IVs doesn't apply to saline, right?  I mean, I see CLS' running around with bags of it all the time... and they're not even EMT's.

As for that medical director... that's some pretty [darn] good support right there.   I think an AFRCC on-call medical director (or even a joint service RCC medical director; perhaps at that level it could be a 24/7 standby medical director) would be ideal.  Of course, then that enters into a whole new wide world of "what are the limitations of a CAP EMT?"  I can't see them toting drugs or anything else requiring medical direction.

[DNall]

I can't speak for other states, but the way I understand it here is TX or fed test is good enough to get you a state license. So all our guard folks are state licensed if they like it or not. They are further acting on governor's orders, and that trumps licensure requiremnts as the governor has power over that. I believe that's also the case when deployed to another state at that governor's orders. We're also reciporicle with other states to a degree, though I don't know details on that for EMT.

I'm with Nick in thinking very little medical direction is actually required. The med kit carried should be fairly limited to minimal stabalization. I can see cases where it would be very helpful to have a doctor on call, but more as a practical consultant than a formal medical director. In a real ICS situation there would be a medical director in that chain that you'd have your organic EMTs reporting to for those matters. I don't really see any of this as all that complicated.

[PA Guy]

You have hit on part of the problem. Licensure/certification can vary widely from state to state. For instance, in CA EMS certification is a county function. An EMT must be certified in each county they work. The EMS standardized procedures can also vary from county to county.

Medical direction is required and all legend meds, supplies and equipment must be approved by the medical director. If you are going to do ALS you must be prepared to do it completely, there is no such thing as partial ALS. The cost of medication, supplies, equipment and training/sustainment to provide ALS would be prohibitive for CAP. Therefore the best CAP could  supply would probably be BLS. There would also have to be some sort of  credentialing process for all providers and a quality assurance program.

The show stopper is tort liability. If you are providing a BLS service as an organization the Good Sam laws won't protect you. So, who is going to provide the protection? CAP doesn't have the money. Most states won't, since many won't cover their NG medics when in IDT status. That leaves the feds and they show no inclination. So until this is resolved all the discussions of levels of service, medical control etc. is not going to go anywhere.

[sarmed1]

Saline still falls under IV's... 
DNall, your NG folks are only licensed in Tx if they submit for reciprocity.  The  state governmental entities are not exepmt from state law/requirements unless specifically exempted by that law.

Medical direction is still required, be it on line (direct contact) or off line (ie  protocol)

Sure there is such a thing as partial ALS, states that have intermediate levels, they are limited ALS providers and by law are only allowed certain skills/medications.  Equally a medical director could limit what even paramedics are capable of doing, again it depends on how your state laws regarding EMS and provisions of prehospital care are written.

[PA Guy]

Sure there is such a thing as partial ALS, states that have intermediate levels, they are limited ALS providers and by law are only allowed certain skills/medications.  Equally a medical director could limit what even paramedics are capable of doing, again it depends on how your state laws regarding EMS and provisions of prehospital care are written.

You're right. My bad. When I wrote that I was thinking of ACLS. The point I was trying to make was that if you are going to do ACLS you must have all of the training, medications, supplies and equipment to do ACLS. You can't have bits and pieces.

Approved ALS procedures can and do vary from jurisdiction to jurisdiction.

[sarmed1]

either way ACLS intervention, as it applies specifically to cardiac arrest is a waste of time in a wilderness environment.  The time to definitive care is longer then you would likely be able to maintain meds needed to resucutate somebody.  After 15 years of EMS very few prehospital arrests survive even to the ER, and thats with good bystander CPR, early defibrillation and ACLS medications, in the wilderness environemnt, not likely.  Non-arrest ALS interventions are much more useful and likely to be needed in the wilderness environment:  treatment of diabetics, allergic reactions, heat injury/dehydration, pain management for trauma, seizures, asthma attacks and early cardiac management..ie asa, nitro.

mk

[SAR-EMT1]

just a point for this thread

The national registry is simply a testing entity.  this entity is very widely recognised, but not all states accept national registry status. 

Secondly the national registry certification does not allow you to practice medicine.  All states require a state issued licenser or certification in order to function.

These are mutual aid procedures in most states which allow out of state health care providers to function during times of emergency

Not so...
In IL, for example the National Registry IS the test, certification/ licensing body.
The reason behind this is because we had a problem with the Chicago FD stealing the answer keys to the old state tests and passing them out to new hires.  So, we no longer have a state test and just go through the NR

... I hate Chicago.. and all it stands for...
Needs to be a seperate state. lol
i kidd I kidd....

[isuhawkeye]

Iowa is the same way.  the test is administered under the direction fo the national registry, but that card doesnt meen anything with out your state cirt.  I still hold my Illinois card. 

[stillamarine]

FL is the opposite, NR is not recognized. Sort of. You can challenge the FL test but you still have to be FL certified.

[SARMedTech]

just a point for this thread

The national registry is simply a testing entity.  this entity is very widely recognised, but not all states accept national registry status. 

Secondly the national registry certification does not allow you to practice medicine.  All states require a state issued licenser or certification in order to function.

These are mutual aid procedures in most states which allow out of state health care providers to function during times of emergency

Not so...
In IL, for example the National Registry IS the test, certification/ licensing body.
The reason behind this is because we had a problem with the Chicago FD stealing the answer keys to the old state tests and passing them out to new hires.  So, we no longer have a state test and just go through the NR

... I hate Chicago.. and all it stands for...
Needs to be a seperate state. lol
i kidd I kidd....

UPDATE: the state of IL reinstated its EMT-B state test in January of 2007 and I believe it has also put the other level (I and P) examinations back since then. At this time, EMT-B license candidates may take either the NREMT exam or both.  SUMMARY: IL does have a state test again.

[isuhawkeye]

shall we take bets to see how long until it is compromised again?

[SARMedTech]

shall we take bets to see how long until it is compromised again?

Given the current state of EMS in general here in the Land of Lincoln, that is a bet I would not take.

For example, we currently have no State level director of education and questions and decisions concerning EMS education are most often left to regional EMS directors, many of whom got their jobs through political means and have NO EMS TRAINING OR EXPERIENCE WHATSOEVER. The coordinator in my region cannot even correctly determine how continuing medical education credits are to be recorded in order to maintain one's license. When I questioned my regional co-ordinator as to who her immediate supervisor was, I was told "You just try to f****ing find out" and had the phone slammed down in my ear. That was over a year ago and I still cannot get anyone to confirm that any of my submitted CEU's have been approved and applied to my license currency.

[SAR-EMT1]

shall we take bets to see how long until it is compromised again?

The I test already was compromised in 2007. The redesign was released at hte beginning of '08 and pulled a month later due to the fact that the test had an 85% failure rate. ... The P isnt even that hard.

[SARMedTech]

shall we take bets to see how long until it is compromised again?

The I test already was compromised in 2007. The redesign was released at hte beginning of '08 and pulled a month later due to the fact that the test had an 85% failure rate. ... The P isnt even that hard.

One of the reasons for initial failure rates on the newly re-implemented state exams is that since 2004, students have been taught the needed information to pass the NR exam. Now that the state exams are back, we don't have to rely on the NR, but we also need to re-vamp the IL curriculum so that it more closely reflects IL EMS protocol.  I mean after all, how many coal mine questions are there on the NR. I know it wasnt covered in my class. 

[isuhawkeye]

First of all Illinois EMS does not have standardized protocols  you have regional medical directors who implement their own.  Second of all Illinois has several Coal mines. 

[SARMedTech]

First of all Illinois EMS does not have standardized protocols  you have regional medical directors who implement their own.  Second of all Illinois has several Coal mines. 

You're arguing semantics as far as my wording about protocols goes, though IL is considering adopting the NHTSA's standardized protocols for EMT, AEMT and Paramedic. Also, if you read my post more carefully, you will see that I am saying that it would be good to have an IL based curriculum instead of the NR since the NR does not reflect the EMT-Coal Mine designation nor the education or training it requires. And, as a resident of IL, I am well aware that we have coal mines, just as much as I am aware of how our protocol system works,  but thanks for the dose of condescension. 

[isuhawkeye]

I apoligise for not reading your post more thuroughly.  I grew up outside of chicago..  I held an EMT basic liscense ther for several years.  I currently live and work in a national registry state which does maintain several aditional cert/endoresment levels outside of the registry system.  I have always been bafeled at IL's intention to go it alone, and have their own test.  which seems to get either compromised or sewed every time it rolls out.  I would love to continue to discuess EMS with you, but we should probably do it over pm.  I'm sorry of I derailed this thread.

[SARMedTech]

While all 91W's attain the National Registry at the Basic Level, they have the option of retesting for The "D" / Basic-Extra tag...
Also Combat Lifesavers  can certify at  Nat. Reg. First Responder -Extra
- I keep saying "extras" because thats the common term I hear at the station or in the ER. The cards Ive seen actually Say "D" - but thats IL.

I know we have EMT-B/D here in IL. When I got my card, I knew a lot of EMTs who classified themselves as B/D's meaning that they were qualified to use the AED. We have one whole service in my area that has EMT-B/Ds. But does the D stand for defib as in AED or manual defib certification?

[isuhawkeye]

emt D has traditionally stood for AED.  that is a legacy certification in iowa and does not meet minimum staffing requirments.  this cert was lagasied becaause Basics learn how to use an aed, and aeds have become public access in nature.

[SARMedTech]

emt D has traditionally stood for AED.  that is a legacy certification in iowa and does not meet minimum staffing requirments.  this cert was lagasied becaause Basics learn how to use an aed, and aeds have become public access in nature.

Though, as you might imagine, we still have EMS regions in IL that do not allow EMT-Bs to use AEDs in the field.