EMT/Paramedic Insignia

[DC]

Does anyone know the requirements for being able to wear the EMT/Paramedic badge. Or, more specifically, would a NREMT Registered First Responder be able to wear it. The title accompanying the cert is NREMT-FR, and FR is a recognized level of EMS provider... 39-1 doesn't really define who can wear it, neither does 160-1...

Semper Vi,

[isuhawkeye]

generally speaking there is not insignia for FR. 

Im sure people will site regs shortly

[MIKE]

First Responder don't count.

[JCW0312]

EMT's/paramedics are referrred to as "health technicians" in 160-1, but First Responders are not. And since the certification for a first responder is not considered a level of EMT licensure, I would have to assume that first responder is not qualified for the EMT/Paramedic badge.

[BlueLakes1]

EMT's/paramedics are referrred to as "health technicians" in 160-1, but First Responders are not. And since the certification for a first responder is not considered a level of EMT licensure, I would have to assume that first responder is not qualified for the EMT/Paramedic badge.

Depends on your state. Kentucky actually uses the term "EMT-First Responder".

That being said, I'm on board, you should be an EMT-Basic to wear the EMT badge.

[SARMedTech]

Does anyone know the requirements for being able to wear the EMT/Paramedic badge. Or, more specifically, would a NREMT Registered First Responder be able to wear it. The title accompanying the cert is NREMT-FR, and FR is a recognized level of EMS provider... 39-1 doesn't really define who can wear it, neither does 160-1...

Semper Vi,

Also, the NREMT does not offer certifications, it offers Registry. There is a difference. Registry in and of itself does not allow you to practice as any level EMT unless your state uses only the NREMT exam as its qualifier or allows either the state test or the NREMT exam.

[stillamarine]

Does anyone know the requirements for being able to wear the EMT/Paramedic badge. Or, more specifically, would a NREMT Registered First Responder be able to wear it. The title accompanying the cert is NREMT-FR, and FR is a recognized level of EMS provider... 39-1 doesn't really define who can wear it, neither does 160-1...

Semper Vi,

Also, the NREMT does not offer certifications, it offers Registry. There is a difference. Registry in and of itself does not allow you to practice as any level EMT unless your state uses only the NREMT exam as its qualifier or allows either the state test or the NREMT exam.

Such as FL, which doesn't recognize the National Registry. When I moved down here I had to challenge Florida's registry.

[DC]

Does anyone know the requirements for being able to wear the EMT/Paramedic badge. Or, more specifically, would a NREMT Registered First Responder be able to wear it. The title accompanying the cert is NREMT-FR, and FR is a recognized level of EMS provider... 39-1 doesn't really define who can wear it, neither does 160-1...

Semper Vi,

Also, the NREMT does not offer certifications, it offers Registry. There is a difference. Registry in and of itself does not allow you to practice as any level EMT unless your state uses only the NREMT exam as its qualifier or allows either the state test or the NREMT exam.

I understand that, poor choice of words on my part..

Thank you, everyone, for the clarification.

[Duke Dillio]

There used to be a note about this is CAPM 39-1 but I can't seem to find anything regarding the requirements for any of the EMT badges.  I also didn't know that they had 3 levels of them now.  Anyway, the only thing I could find was on knowledgebase:

"Upon satisfactory completion of a US DOT EMT/Paramedic Training Course or approved equivalent, the "Star of Life" patch meeting the requirements in CAPM 39-1 (embroidered in white cotton thread) may be worn on the CAP uniform. The patch may be awarded or purchased from a number of sources. See some examples and sources below."

First Responder is, I believe, classified as an Advanced First Aid course and I don't believe that it qualifies for wear of the EMT badge.

[Stonewall]

People will totally disagree with me and I appreciate their argument, but back in the day when I wrote up a proposal for a 3-tier EMT badge for CAP, my suggestion was that a National Registry First Responder, State Recognized (DOT), or Wilderness FR would get the Basic badge, EMT-B and I would get Senior, and EMT-P (Paramedic) would get the Master. 

I suggested this as a means to motivate folks to get more_than_basic_first_aid training.  And while EMT-B isn't crazy-insane to accomplish, it may be too much to ask of a high school student or busy-body senior member.  But a 40 hour FR course would be enough to learn those advanced skills and be rewarded with something to show your accomplishments.

YOMV

PS:  My proposal went to wing and maybe region, and I got an email back basically saying "this is stupid, there is already an EMT badge, no need for 3 of them..."

[Duke Dillio]

I haven't found anything in the regs however I did find three levels of the EMT badge on Vanguard.  It was my understanding that they were for EMT-B, EMT-I, and EMT-P.  I know that most states don't recognize the EMT-I but there are still a few that do.  I agree with you on the three levels though.  A paramedic should be able to wear something more than an EMT-B considering the extra amount of training and skills they need to perform.

[isuhawkeye]

Not to throw mud on this fire

1.  To clarify the national registry recognizes two different levels of Intermediate. 

2.  The WFR program's and wilderness first aid courses are a great resource, and (especially the wilderness first aid) they could be molded to fit within CAP's existing guidelines referencing care. 

[Stonewall]

I hate to say this because I know I'm right, but if the basic "EMT" badge were authorized for First Responders, I bet the number of FR's in CAP would more than triple....just to get a badge.

As a cadet in Florida, I did the 40 hour FR course put on by the St. Johns County VFD.  On my CAP fatigues, then BDUs, I wore the big blue/white "MEDICAL RESPONSE TECHNCIAN" / "FIRST RESPONDER" with blue star of life patch on the pocket.  While big and gawdy, it did match the CAP color theme of blue/white.  I later went on to become EMT and was pleasently surprised in 1993 when they came out with the EMT badge.

[Duke Dillio]

^I totally agree with you in that FR's would pop out of the wood work just to get the badge.  Wouldn't this take away from people like you and me who have gone through the EMT-Basic course?  We'd get a little star on top of our badge but I'm not sure how a GBD/EMT-P would look with two master blaster badges on their uniform.  Just a thought though.

[Stonewall]

^Well, as much as I truly disagree with throwing a carrot out there so people advance, it wouldn't be too much give for quite a bit of take.  We could take account of the different levels of medical training folks have across the nation in CAP and boast about it in the Annual Report to Congress.

In CAP, with 55,000 members, 8 thousand are First Responders; 4 thousand are EMTs, and 1 thousand are Paramedics.... or something more realistic. 

[Duke Dillio]

^Just a thought but why not mandate FR for say GTM-2 or GTM-1.  In CAWG, they want the GTL's to have "advanced first aid training."  I wouldn't mind seeing FR as a requirement for these levels.  If you really think about it, most of the first aid training that is provided is not all that difficult to comprehend.  I'm sure that we could find FR instructors who would teach higher levels of First Aid to our members..... for a fee of course   

[Stonewall]

Remember though, CAP is not an EMS organization, nor do we advertise [officially] as such.  So any training above basic or advanced first aid is just incentive training and skills as far as CAP is concerned.  In my mind, although not an EMS org, it only makes us look better and gives the disaster response community more resources when disasters or emergencies happen and CAP is there to assist.

[Duke Dillio]

^My response is that while CAP is not an EMS organization, we sometimes find ourselves in such a position that we need to apply certain skills in order to save a life.  The more skillful we are, the better our chances of helping someone in need.  Don't get me wrong, I am not advocating that we should all become paramedics or provide care that is not needed (i.e. the emergency trach with a ball point pen.)  In my mind, a FR is not an EMS provider.

We should be able to sustain a patient until the pros get there and take over.  I would personally prefer to have a ground team with 3 FR's and an EMT on it than 4 people who have the required first aid only find a crash site with survivors.  More often than not, our skills are not required.  We do put ourselves into HUGE liability if we are going beyond our scope, which if I am not mistaken has occurred on occasion.  I have seen ground teams carrying all sorts of crud that they will never use (i.e. oxygen cylinders, BVM's, intubation kits, etc.)  I just don't see any reason why our people should not be certified in "advanced first aid," which is what I hear is the level of a FR.

From the political aspect, of course we would look good if all of our members are FR qualed.  I'm pretty sure there wouldn't be a whole lot of liability considered if another major disaster were to occur and we had CAP teams on site providing assistance to the EMS providers.  Any training that makes our organization stronger and more able to assist the community should be highly recommended, in this case FR.

One point that I would like to bring up though is that we currently don't have a real good way of documenting care that we provide.  I think that this presents us with a liability issue.  I like the idea of having a PCR of some sort included in the ground team paperwork bundle.  Yeah, we are killing more trees but I think that this would help us should we find ourselves in a legal issue.  If not a PCR, then some sort of written statement explaining the care that we provided and why.  I know that I have been called to court several times on patients that I cared for who were suing.  These court cases came down 6-12 months after the incident.  As a rule, I would always go back and look at the archived PCR to find out what happened and why I did what I did.  Remember though that the lawyers will also have your PCR and they will call you on it.

[MIKE]

I should just lock this one now.

[isuhawkeye]

^^^ might not be a bad idea. 

Weve hashed this out time, and time again

[capchiro]

I propose that we buy a bunch of used MASH tents and set up field hospitals for our use during missions.  I am proposing that we just do medical treatment on our own members, the ones that are too old, too out of shape, and too far gone to know their own limits...Oh and also for the cadets that trip over their berets or parachute harnesses and fall on their Bowie or KaBar knives.. 

[John Bryan]

WOW....this got off topic fast.

But what the heck.....question for the poster who said FR is not part of EMS. What is it part of??? In my state (Indiana) the state EMS commission has control of FR, certified ambulance driver (very few of these around any more) EMT-B, EMT-I, EMT-A, and EMT-P.

For the record I think they should not wear the EMT badge....but maybe we need something for them....maybe a gold EMT badge..the current one for EMT's is silver.

Also we should bring back the state patches on the BDUs. On a crash scene or disaster local police, fire , EMA, and EMS will know what those mean. Our little EMT badge means a lot to us but thats about it.

[Stonewall]

But what the heck.....question for the poster who said FR is not part of EMS. What is it part of???

I agree.  Back in the day, before all the firefighters were EMTs they were FRs, at least in my county and the neighboring one.  And mine is the 3rd largest in the country.  Yes, they were and probably still are a part of the EMS system.  Maybe not in tree-huggin' Cali, but they are here in Fun-in-the-sun-Florida. 

Also we should bring back the state patches on the BDUs. On a crash scene or disaster local police, fire , EMA, and EMS will know what those mean. Our little EMT badge means a lot to us but thats about it.

I will disagree with this statement, with all due respect, of course 

Although we can and are state and local assets, we're the Air Force Auxiliary.  You wouldn't find an AF Med Tech wearing the local or state EMS patch, and many military types do get their training locally.  In the Army, we did the NREMT course at Walter Reed, but ER time was at Baltimore Shock Trauma and Extrication was done at a local FD.  My buddy, an AF PJ, does all of h is Paramedic and specialized training outside of the military...no state or local EMS affiliation there.

Sorry, but I'd vote against having non-CAP EMS insignia (patches) on our BDUs.  I'm not affiliated with any EMS agencies, but I'm still an EMT and have been since '93.  I've stopped at tons of accidents, house fires, beach rescues, etc., and have never had to show any insignia or credentials.  I've simply said to the patient.  "my name is Kirt Bowden and I'll be your EMT today", or the few times, about three or four in all, that I've been in a CAP or Military uniform, I've simply advised the police or patient the same thing.  If they ask for credentials, I'd gladly show them my card. 

Actually, thinking now, back in 1990, as a cadet and state first responder (remember, I had the big white/blue FR patch on my BDUs), I stopped at a head-on where Life Flight had to come.  I was first medical person on scene.  Being a 17 year old in BDUs, even with the big EMS patch, the officer still said to me, and I remember this vividly, "don't be doing anything you aren't trained to do".  I responded with a "Roger that, sir". 

These days, however, I have a "POLICE" reflective vest in my car and throw that on if I get out to help.  Even did that last summer when I witnessed a motorcycle wreck and I was in my AF BDUs.  After this discussion though, I think I'll throw my "EMERGENCY SERVICES" reflective vest in my Exploder Explorer so I'm more neutral with the whole ID thing.  See, these discussions are good.

Here is what we all got at my last squadron, except in orange and the title was "EMERGENCY SERVICES".

[Duke Dillio]

Just a quick response to the question they asked of me.  In tree-huggin Cali, FR is a qualification but not a license to practice medicine.  To be more precise, the only EMS personnel that are "licensed" to do treatment are the Paramedics.  EMT's in Cali are extremely limited in the amount of care that they can provide.  The FR's are about the same way but worse.  It is basically like I said before, an "advanced first aid" course.  I guess each state treats them differently.  While some of the cops around here are FR qualed, they do not routinely provide medical treatment.  In Colorado, the standard for firefighters was EMT-Basic and I think that the same applies here in Cali, although I admit that I haven't really looked into it.  I don't want to sound like I am saying that FR's are useless because that's not what I believe.  I am simply saying that they are treated differently here in Cali.

[Flying Pig]

I am an EMT-B in Ca.  Firefighters in Ca dont need to be EMT's.  Compared to an EMT, a first responder is somewhat of a glorified First Aid course.  You cant get a job employed soley as a first responder.  You can as an EMT.  We really don't need a badge for every level of every skill set under the sun.  What happened to the days of just getting the training to get the training?

If you wanted the badge, you went to the local college and took the EMT course.  Now.....everyone else wants a badge.  Everyone wants a patch.   If your trained, then show up and help.  As a 10 year law enforcement officer Ive never asked to see a card, or paid much attention to a patch some Good Samaritan had on his shirt.  When you get into the EMS community, at least where Im at, people aren't covered in patches and badges.  CAP members start showing up with CPR/First Aid patches we are going to look silly.   Because you are working in a world where your big fancy patch is, often times, lower than the minimum required for the other people, Fire/EMS, to even start.  Lets not advertise that we possess the minimum qualifications and lets reserve the badges for the people who are on an equal playing field with the rest of the EMS community, ie. EMT/Paramedic badge, Nurse, etc.

[Stonewall]

I We really don't need a badge for every level of every skill set under the sun. 

I agree to an extent, but like in the military, CAP has a 3-tier system for badges.  I agree, FR is a 40 hour version of the 20 hour advanced first aid course, and we do already have 3 levels for the EMT badge.  I'm not lobbying for change or sending letters to NHQ, it's merely my humble opinion and if I were king when EMT badges came out, I'd consider adding FR to the mix.  Until that day comes, I'm content with the EMT badge system.

BTW, not that it matters, but I don't even wear my EMT badge.

[Flying Pig]

What are the requirement for the 3?  When I got my EMT badge, there was just the basic one.

[Stonewall]

EMT-P


EMT-I


EMT-B

[Flying Pig]

I propose this for the CPR badge......

[isuhawkeye]

the state of Iowa recognises the I-1985 curriculum as an intermediate, the I-199 curriculum as a Paramedic, the Paramedic curriculum is a Paramedic Specialist in the state of Iowa, and to be the king of the ambulance we also have a Critical Care Paramedic level. 

How would this be applied to our luttle system of glitter

recognising that none of them will be alloud to function as an EMS provider

[fyrfitrmedic]

 Forgive my potential obtuseness, but is the three-tier badge system in the regs?

[Eclipse]

Forgive my potential obtuseness, but is the three-tier badge system in the regs?

Yes.

[SARMedTech]

Just a quick response to the question they asked of me.  In tree-huggin Cali, FR is a qualification but not a license to practice medicine.  To be more precise, the only EMS personnel that are "licensed" to do treatment are the Paramedics.  EMT's in Cali are extremely limited in the amount of care that they can provide.  The FR's are about the same way but worse.  It is basically like I said before, an "advanced first aid" course.  I guess each state treats them differently.  While some of the cops around here are FR qualed, they do not routinely provide medical treatment.  In Colorado, the standard for firefighters was EMT-Basic and I think that the same applies here in Cali, although I admit that I haven't really looked into it.  I don't want to sound like I am saying that FR's are useless because that's not what I believe.  I am simply saying that they are treated differently here in Cali.

Not quite right, sargrunt. EMT-Bs are quite licensed to practice pre-hospital emergency medicine, just like paramedics as we both operate on the license of the state or regional medical director. At least, thats what the IL DOPH EMT license in my wallet says. Here in IL, while on duty, EMTs give about a half dozen meds, assess patients, treat shock and trauma, perform airway treatments (IE albuterol nebulizer) and even intubate patients with combitubes. Im also "licensed" to deliver babies in the field, stabilize fractures, eviscerations, lacerations and abdominal wounds. The meds I can give are aspirin for possible MI, nitro for chest pain, O2 (which is considered a drug so any CAP member carrying a cylinder since CAP has not medical direction is doing so illegally) glucose, glucagon, epinephrine and albuterol. EMT-Is can give about 3 times that many drugs including morphine and can also needle decompress a pneumothorax and perform and emergency surgical field airway (cricho-thyroid stab/tracheostomy).

[SARMedTech]

the state of Iowa recognises the I-1985 curriculum as an intermediate, the I-199 curriculum as a Paramedic, the Paramedic curriculum is a Paramedic Specialist in the state of Iowa, and to be the king of the ambulance we also have a Critical Care Paramedic level. 

How would this be applied to our luttle system of glitter

recognising that none of them will be alloud to function as an EMS provider

The NREMT does not recognize I-99 as paramedic level, and I have never heard that Iowa does. THE DOT/NHTSA recognizes persons trained and licensed under I-85 or I-99 as Intermediates and to my knowledge no state is allowed to supercede those requirements since DOT/NHTSA is the primary "governing" body for EMS in the United States.

[CadetProgramGuy]

[topic drift]

Are you allowed to wear both ground team and EMT badges on the same line?

IOW, I am a pilot, wearing my pilot wings, can I also wear EMT and GBD on the second line?  And no I haven't looked up the regs yet.....

[/topic drift]

[CadetProgramGuy]

Never mind, found answers in 39-1.  A Maximum of 4 badges per uniform, 2 on the left side.  Looks like a choice will have to be made.......

Pilot wings and either GTL or EMT (when I earn it)

[SARMedTech]

As I am sure folks remember, I used to be the biggest advocate for EMTs allowed to practice medicine with CAP in the field and the insignia is still on my uniform. Since joining a field medical team, I dont really feel that way anymore and its primarily just because there is no system in place within CAP to support EMTs of any level working in the field. Just like when CAP goes on a SAR and has commo folks, ground pounders, etc, when the Im on goes out we generally send a team of between 30 and 45 people and we do what capchiro suggested with his tongue in his cheek: we set up a field hospital. We did it during Katrina, during a huge ice storm that shut down a hospital in South Central IL, we "pre-deploy" as medical standby for events where huge numbers of people are present or where dignitaries will be attending.

The difference is this: we travel with semi-trucks full of medical equipment. Literally millions of dollars worth of gear. We have doctors, nurses, EMTs, Paramedics, dentists, respiratory therapists and yes even morgue personnel from one of the country's DMORT teams. Our process is: triage, treat and if necessary EVAC. Repeat.

The reason I am saying this is because it seems that the conversation started with a talk about MFRs (medical first responders) in the field. I say great because what they provide is moderate to advanced first aide and I think all members, if they are going to be in the field should have to have this 40-60 hours class. But when we start to talk about EMTs and Paramedics in the field, what are you going to do? The same things as your cadet MFR. As I say, I used to be the biggest, most gung-ho advocate of having EMT/medical personnel in the field, but I now (I have a thick skull) see that all they are going to be able to do is pull up a log, sit down and wait for helo or ground evac along with everyone else. Honestly, if there were some kind of catastrophe, say an airliner crashing, and I got there to see CAP members moving patients around, etc in a field, my face would probably peel off. Say you find a survivor still in the plane. He is strapped into his seat and hanging at a funny angle. What are you going to do? Cut him down?  Better not. Because unless you have away to maintain c-spine and are carrying a long board, you should not touch that person. If you recognize that you have a person in shock, what will you do..I say IF you recognize it. What we are talking about that CAP is going to need is a disaster medical team of some kind and technical (confined space, high angle, etc) rescue, at the minimum.

What this all gets to is really the patch on a working uniform or the silver and blue enamel one on a service uniform. Its nice recognition from CAP, but its basically a merit badge. If you have a critical care paramedic on your team, he still cant do anything. That being said, focus on first aide and advanced first aide. A past president of the AMA said that often the fate of a patient is dependent on the care given to them by the person who applies the first field dressing. So if you are a medically inclined soul, carry Israeli field pressure dressings, space blankets, maybe a few burn sheets, a SAM splint and some gloves and some various sizes of bandages and tape and if youre feeling high speed, a BP cuff. This is about all you can do in the field. Start doing more than that, and eventually you are going to have a problem. And if youre really inclined to practice austere field medicine, join your state's DMAT team where you can actually use what you learned.  One thing that would be helpful is if CAP EMTs, know START or MASS triage. That way when the medical help starts to roll in, you can say we have 44 major, 68 minor and 12 deceased.

Now if I can just get HMRS to stop calling its graduates medics...

PS- alot of this comes from the documentary I recently saw on PJs. These men and women train for months in austere field medicine and function at the level of paramedic. There is a reason for that

[JCW0312]

Now if I can just get HMRS to stop calling its graduates medics...

Amen.

[isuhawkeye]

The NREMT does not recognize I-99 as paramedic level, and I have never heard that Iowa does. THE DOT/NHTSA recognizes persons trained and licensed under I-85 or I-99 as Intermediates and to my knowledge no state is allowed to supercede those requirements since DOT/NHTSA is the primary "governing" body for EMS in the United States.

Sorry dude,

A "Paramedic" in Iowa takes the National Registry's I-99 test.  A "Paramedic Specialist" takes the National Registry Paramedic exam.  Thats just the way it is.

[JCW0312]

The NREMT does not recognize I-99 as paramedic level, and I have never heard that Iowa does. THE DOT/NHTSA recognizes persons trained and licensed under I-85 or I-99 as Intermediates and to my knowledge no state is allowed to supercede those requirements since DOT/NHTSA is the primary "governing" body for EMS in the United States.

Sorry dude,

A "Paramedic" in Iowa takes the National Registry's I-99 test.  A "Paramedic Specialist" takes the National Registry Paramedic exam.  Thats just the way it is.

That's crazy! It's like calling a Nurse Practitioner a Doctor and calling a Doctor a Doctor Specialist!

[JCW0312]

^ So is a First Responder called an EMT and an EMT called an EMT Specialist? 

[isuhawkeye]

I don't make this stuff up

This problem is exactly why the proposed national scope of practice document is in the works.  If it goes through we will have 4 levels of EMS provider as a standard across the entire country.

holding breath

Iowa scope of practice model
http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf

Proposed National scope of practice model
http://www.nasemsd.org/documents/FINALEMSSept2006_PMS314.pdf

[JCW0312]

I don't make this stuff up

I didn't figure you did. You'd have to be smoking something good to come up with that. 

[isuhawkeye]

^^ True, but the National scope of practice concept is very exciting. 

sorry to be so far off topic. 

Back to the badge/patch issue

[Duke Dillio]

Not quite right, sargrunt. EMT-Bs are quite licensed to practice pre-hospital emergency medicine, just like paramedics as we both operate on the license of the state or regional medical director. At least, thats what the IL DOPH EMT license in my wallet says. Here in IL, while on duty, EMTs give about a half dozen meds, assess patients, treat shock and trauma, perform airway treatments (IE albuterol nebulizer) and even intubate patients with combitubes. Im also "licensed" to deliver babies in the field, stabilize fractures, eviscerations, lacerations and abdominal wounds. The meds I can give are aspirin for possible MI, nitro for chest pain, O2 (which is considered a drug so any CAP member carrying a cylinder since CAP has not medical direction is doing so illegally) glucose, glucagon, epinephrine and albuterol. EMT-Is can give about 3 times that many drugs including morphine and can also needle decompress a pneumothorax and perform and emergency surgical field airway (cricho-thyroid stab/tracheostomy).

I was simply saying that in California, the idea here is a little different than what I have seen in the past.  I worked as an EMT in Colorado and things were a whole lot different than they are here.  We had the half dozen meds (charcoal, O2, Nitro assistance, MDI assistance, glucose, and epi assistance).  They were talking about letting us use combi tubes but that sort of fell to the wayside.  The issue I had there was that I worked in a hospital which had a habit of coming up with things that we weren't authorized to do because we only had a "field license."  I worked as a tech in an emergency room and I was basically a glorified phlebotomist.  CA does not recognize the I level for EMT's that I know of, of course this may be different in different areas but in Stockton, there is B and P and that's it.  EMT's in CA are extremely limited in their scope.  I assume that this is due to the amount of lawsuits that are filed each year by the huge number of lawyers that we have in this pretty little state.  I generally go with the old, "When in doubt, ask someone else," meaning I get on the phone with a doctor for anything higher than general first aid.

[afgeo4]

I have a new member in my unit and being the PDO, I have to figure out this question...

She was a paramedic whose cert lapsed. She is currently a NYS Certified EMT.

Which EMT/Paramedic badge, according to regs, can she wear?

I see NO guidance on this at all. Which regulation talks about authorization of specialty badges? Technically, if there is nothing that dictates who is allowed to wear this badge, then no one is.

[Eclipse]

The authorization for the badges was done in an interim change letter in 2005.

One of my CC's has a copy and I will get it posted as soon as he sends it to me.

Suzy Parker mentions them in her Nov 2005 presentation "Looking sharp today in a CAP uniform"   http://level2.cap.gov/documents/Uniform_ppt.ppt", slide #20, but beyond the Basic, Intermediate, Paramedic, mentioned in the slide and the ICL, there is no regulatory definition of what is required, specifically, for each badge.

Basically you need to align your states EMT ratings to he badge and get as close as you can  (assuming they don't have just Basic, Inter, Para).

[SAR-EMT1]

I have a new member in my unit and being the PDO, I have to figure out this question...

She was a paramedic whose cert lapsed. She is currently a NYS Certified EMT.

Which EMT/Paramedic badge, according to regs, can she wear?

I see NO guidance on this at all. Which regulation talks about authorization of specialty badges? Technically, if there is nothing that dictates who is allowed to wear this badge, then no one is.

Simple answer: Expired certs dont count for anything.
If she is CURRENTLY certified at the BASIC level, then she gets the BASIC badge.  If she is CURRENTLY a PARAMEDIC then she gets MASTER, anything in between gets you the SENIOR badge.

[sarmed1]

Now if I can just get HMRS to stop calling its graduates medics...

there is always hope.....

I wrote a draft document to the  Ranger Supplement on Health Services and eliminated the title medic, and upgraded it to medical specialist (ie as in just like in the USAR world, the medical pro that is assigned to support a team is a medical specialist regardless of their level of base certification)

we'll see where it goes form there....

mk

[Eclipse]

Simple answer: Expired certs dont count for anything.
If she is CURRENTLY certified at the BASIC level, then she gets the BASIC badge.  If she is CURRENTLY a PARAMEDIC then she gets MASTER, anything in between gets you the SENIOR badge.

Ditto - still waiting the copy of the ICL, but it doesn't have that guidance anyway. He tells me he discussed this with a staffer at NHQ charged with making these decisions, and the B-I-P designation is a national definiation and you get the badge based on your certification.

And yes, the certification needs to be current at the time of application for the badge.  This is extrapolation from my personally having professional promotion requests bounced because the cert was expired.

[afgeo4]

Ok... I know you guys are applying logic as to what these badges are authorized for, but... what are they actually authorized for and where does it state that?

The regs don't even say one has to be an EMT to wear this badge, so then technically everyone can wear it. As it stands in black and white currently, members may wear the EMT/Paramedic badge. That's all, right? No specific qualifications required to wear the badge in the regs?

How many of you think that's absolutely ridiculous? That someone took the time to create these badges, under guidance, and someone took the time to write the badges' existence, under guidance, and yet no one took the time to say who may wear them.

[CadetProgramGuy]

Well.....CAPM 39-1, 5-1 says.....

5-1. Wear of Awards and Decorations. Awards and decorations prescribed by CAPR 39-3, Award of CAP Medals, Ribbons, and Certificates, will be worn only by CAP members for whom they have been authorized and only on those uniforms outlined below.

CAP knowledgebase says.......

1. Any cloth patch displaying the blue six-sided cross referred to as the "Star of Life" awarded by a certifying/licensing agency upon satisfactory completion of a US DOT EMT/Paramedic Training Course or approved equivalent. Patch will be removed when no longer current or when certifications are withdrawn.

CAPM39-3 Says nothing.....

[Eclipse]

^ Further to this, wear of the badge requires commander's approval, so the onus on checking is there.

Still waiting on the ICL, but I'm told EMT-B, I & P are national standards and the badge you wear is based on what your current certification is at the time of the award.

[SARMedTech]

Ok... I know you guys are applying logic as to what these badges are authorized for, but... what are they actually authorized for and where does it state that?

The regs don't even say one has to be an EMT to wear this badge, so then technically everyone can wear it. As it stands in black and white currently, members may wear the EMT/Paramedic badge. That's all, right? No specific qualifications required to wear the badge in the regs?

How many of you think that's absolutely ridiculous? That someone took the time to create these badges, under guidance, and someone took the time to write the badges' existence, under guidance, and yet no one took the time to say who may wear them.

The really ridiculous part would be that in many states (IL and NM among them) it is illegal to "wear or otherwise publicly display" the star of life emblem if you are not licensed as an EMS provider as the SOL is the international symbol for EMS services, providers, etc. I guess the folks that would wear it without licensure would also wear military, CAP ribbons, insignia, etc that they are not entitled to. I take the wear of that insignia very seriously and have reported a couple of non-CAP members to the IL DOPH for wearing it when not authorized to do so. I dont go around wearing the FMRB that Im not entitled to wear (though i will be in about 18 months).

[chiles]

The really ridiculous part would be that in many states (IL and NM among them) it is illegal to "wear or otherwise publicly display" the star of life emblem if you are not licensed as an EMS provider as the SOL is the international symbol for EMS services, providers, etc. I guess the folks that would wear it without licensure would also wear military, CAP ribbons, insignia, etc that they are not entitled to. I take the wear of that insignia very seriously and have reported a couple of non-CAP members to the IL DOPH for wearing it when not authorized to do so. I dont go around wearing the FMRB that Im not entitled to wear (though i will be in about 18 months).

Totally agree here. I was an EMT-B in MD and I wore the badge. My license expired and I'm not a fully licensed nurse, so I wear the RN Caduceus. If something goes down at an activity and someone shows up sporting an EMT badge, I assume you're a licensed EMT. I think I'm going to stop assuming.

[afgeo4]

Well.....CAPM 39-1, 5-1 says.....

5-1. Wear of Awards and Decorations. Awards and decorations prescribed by CAPR 39-3, Award of CAP Medals, Ribbons, and Certificates, will be worn only by CAP members for whom they have been authorized and only on those uniforms outlined below.

CAP knowledgebase says.......

1. Any cloth patch displaying the blue six-sided cross referred to as the "Star of Life" awarded by a certifying/licensing agency upon satisfactory completion of a US DOT EMT/Paramedic Training Course or approved equivalent. Patch will be removed when no longer current or when certifications are withdrawn.

CAPM39-3 Says nothing.....

1. Correct... 39-1 says they should be worn by those authorized... WHO is authorized? WHERE is the authorization? Don't guess. This is a black/white issue.

2. Knowledgebase... although a great guidance tool, is not a regulation and does not authorize anyone for anything.

3. Cloth patches aren't special badges.


Anyone here a CAP health professional and would like to pass this on to our health officers up at NHQ?

[chiles]

I'm a health professional and it's all part of the discussion and attempt to get a development program for us medical types. IIRC, this is one of the issues we were discussing awhile back on the health services mailer. If Col Greenstone is on here, he'd be able to help. If this issue got kicked up to me as the wing NO (we don't have a Wing Medical Officer), I'd say that only those certified could wear it. I'm not sure if this is something within my sphere of influence, but I will find out.

[Eclipse]

So it tuns out not to be an ICL, but an action by the NEC, below is the relevant passage.  The rest of the information came from one of my unit CC's who discussed the below in detail with a staffer at NHQ who is in charge of plans and programs implementation. (see attached for the full minutes)

As told to him/me, the grade of the badge matches the valid certification level of the member against the national definition of EMT-Basic, -Intermediate, -Paramedic.

CAPM 39-1 was last revised just before this meeting (MAR 2005), and beyond the Powerpoints referenced in previous messages, there appears to be no further clarification on the issue, with the assumption being that the next rev of 39-1 will clarify.

3. Modification to EMT/Paramedic Badge.
COL ROBINSON/RMR MOVED and COL GLASGOW/NCR seconded the committee
recommendation that the National Board approve the 3-level EMT/Paramedic
badges and eliminate the wear of an EMT patch on the left BDU pocket.
March 2005 National Board
1 6
MOTION CARRIED WITH NO DISSENTING VOTES.
FOLLOW-ON ACTION: Implementation of policy, notification to the field, and change to
regulation. There was agreement that the phase-in date would be set by National
Headquarters.
NOTE: There was clarification that members would wear these badges according to
their individual state licensure levels as an EMT.

[SARMedTech]

So it tuns out not to be an ICL, but an action by the NEC, below is the relevant passage.  The rest of the information came from one of my unit CC's who discussed the below in detail with a staffer at NHQ who is in charge of plans and programs implementation. (see attached for the full minutes)

As told to him/me, the grade of the badge matches the valid certification level of the member against the national definition of EMT-Basic, -Intermediate, -Paramedic.

CAPM 39-1 was last revised just before this meeting (MAR 2005), and beyond the Powerpoints referenced in previous messages, there appears to be no further clarification on the issue, with the assumption being that the next rev of 39-1 will clarify.

3. Modification to EMT/Paramedic Badge.
COL ROBINSON/RMR MOVED and COL GLASGOW/NCR seconded the committee
recommendation that the National Board approve the 3-level EMT/Paramedic
badges and eliminate the wear of an EMT patch on the left BDU pocket.
March 2005 National Board
1 6
MOTION CARRIED WITH NO DISSENTING VOTES.
FOLLOW-ON ACTION: Implementation of policy, notification to the field, and change to
regulation. There was agreement that the phase-in date would be set by National
Headquarters.
NOTE: There was clarification that members would wear these badges according to
their individual state licensure levels as an EMT.

I guess Im in violation because I still have the cloth insignia on my BDUs. I recently asked my squadron command if I should remove it and was told no. We also have members wearing their NREMT patch on their BDUs which I do not do and am fairly certain is not allowed, but I learned long ago not to get into spitting matches over uniform wear. Its not my area of concern.

[flyerthom]

Now if I can just get HMRS to stop calling its graduates medics...

there is always hope.....

I wrote a draft document to the  Ranger Supplement on Health Services and eliminated the title medic, and upgraded it to medical specialist (ie as in just like in the USAR world, the medical pro that is assigned to support a team is a medical specialist regardless of their level of base certification)

we'll see where it goes form there....

mk

To throw a further curve ball, several states have bridge course for RNs to work in the field with an EMT-P scope of practice.
They are doing EMS - can they use the badge? <somewhat retorical, keep reading>

To further confuse things - in PA my certification as prehospital RN is under the Bureau of EMS. In NV my EMS RN license is under the state board of nursing. In CA the MICN certiification is further different. My original training in PA is NREMT-P test eligible.
At this point i just use the Nurse insignia and do not wear the EMT badge. But I am working in EMS so I wonder if I could wear the EMS badge. If I was nationaly registered there would be less of a question. At this point it's best not to wear it.

[SARMedTech]

Now if I can just get HMRS to stop calling its graduates medics...

there is always hope.....

I wrote a draft document to the  Ranger Supplement on Health Services and eliminated the title medic, and upgraded it to medical specialist (ie as in just like in the USAR world, the medical pro that is assigned to support a team is a medical specialist regardless of their level of base certification)

we'll see where it goes form there....

mk

To throw a further curve ball, several states have bridge course for RNs to work in the field with an EMT-P scope of practice.
They are doing EMS - can they use the badge? <somewhat retorical, keep reading>

To further confuse things - in PA my certification as prehospital RN is under the Bureau of EMS. In NV my EMS RN license is under the state board of nursing. In CA the MICN certiification is further different. My original training in PA is NREMT-P test eligible.
At this point i just use the Nurse insignia and do not wear the EMT badge. But I am working in EMS so I wonder if I could wear the EMS badge. If I was nationaly registered there would be less of a question. At this point it's best not to wear it.

1. This discussion about EMS/Medical/CAP is more productive in terms of hashing things out than most.

2. I commonly see flight nurses wearing blue or green or black flight suits with the SOL on the back. As far as I am concerned, a nurse flying with a medevac crew, especially since alot of recent developments in flight med put the nurse in charge, give that nurse the "right" to wear the SOL. She is working as part of a crew, and possibly as the crew lead, and therefore gets to wear our "badge."

3. I think its a good idea that the SOL be more protected in terms of who can wear it, just like the red cross/red crescent is.

That being said, our IMERT logo is an outline of the state of Illinois with an SOL on it and the whole team wears it, including non-medical personnel. In my opinion, in that setting they should be wearing it because they are a part of a huge medical team and they are integral to everything we do. Logistics, commo, transport, supply, and on and on...without them we would be a travelling first aid stand.

Anyway, theres my .02 and YMMV significantly.

Ironically, the reason we wear the SOL is because the AMA decided it didnt like field medical crews wearing the Caduceus.

[SAR-EMT1]

The CAP SOL items aside....


Wiki terms the Star of Life as being the symbol for those rendering Prehospital Care at ANY OFFICIAL level

from that I took - CFR all the way up through Flight Nurses or those
funny PAs that ride on some european ambulances.
(And do surgery at 90 miles an hour)

[SARMedTech]

First off, whenever using wikipedia as a cited source, be careful to consider the source. I mean no disrespect to my fellow distinguished gentleman from IL, but anyone with a key board can write a wikipedia entry and if they call it a "stub" they dont even need to bother with a citation.

However, the first article offered by wiki on the SOL states many facts about its useage which can be documented and, in fact are:

1. The star of life as it currently exists was developed in 1977 when the Red Cross got upset because the orange cross currently in use by EMS was, (they felt) being misunderstood as having something to do with their organization, and...

2. In 1977, the now commonplace blue SOL was developed with each of the six points representing a different aspect of emergency prehospital care. They are as follows:

Symbolism

The six branches of the star are symbols of the six main tasks executed by rescuers all through the emergency chain:

   1. Detection – The first rescuers on the scene, usually untrained civilians or those involved in the incident, observe the scene, understand the problem, identify the dangers to themselves and the others, and take appropriate measures to ensure their safety on the scene (environmental, electricity, chemicals, radiations, etc.).
   2. Reporting – The call for professional help is made and dispatch is connected with the victims, providing emergency medical dispatch.
   3. Response – The first rescuers provide first aid and immediate care to the extent of their capabilities.
   4. On scene care – The EMS personnel arrive and provide immediate care to the extent of their capabilities on-scene.
   5. Care in Transit – The EMS personnel proceed to transfer the patient to a hospital via an ambulance or helicopter for specialized care. They provide medical care during the transportation.
   6. Transfer to Definitive care – Appropriate specialized care is provided at the hospital.

In 1997 when the DOT's patent on the blue SOL expired, it was "given" to the NREMT to denote pre-hospital emergency medical care providers. As I said previously, this would include (though it was not that original intention that it should, the NREMT only representing Emergency Medical Technicians and not nurses or PAs) flight nurses, flight RT's etc...that is, anyone involved in PREHOSPITAL care.

If you read carefully concerning the 6th point of the SOL you will see that it denotes transfer to definitive care, which not only describes the "signing over" of a patient to equally or higher licensed medical care providers, but also, the end of EMS, EMS being as it is defined as "emergency pre-hospital care."

It should be further noted that another reason that the blue SOL exists is that, as I said, the AMA and various nursing associations came rather unglued because EMS personnel were using the caduceus. If you look at old pictures of our predecessors in the "ice cream uniform and hearse" days, you will see that many of the ambulance personnel are wearing a caduceus on their collar, and, in fact, the caduceus was used by the military for decades to indicate a vast array of medical personnel with the "cut out" version being used for officers and the brass caduceus embossed on a circle being used for enlisted personnel.

I think the big thing here is "pre-hospital" care, which would include"

medical first responders, all levels of emergency medical technicians, air-evac pilots (many of who have adopted a version of the SOL with wings), flight nurses and various other medically trained and licensed personnel who care for a patient before he/she reaches the hospital. By definition, once a patient reaches the the door of the ER, EMS has ended and therefor the use of the SOL should end as well.

What does this mean for CAP members? If you are an MFR or EMT of any level, duly licensed and certified by your state and/or the National Registry, then this insignia belongs to you. It is not, however, appropriate for wear by CAP nurse officers, medical officers (ie physicians), dentists, veterinarians or any other allied-health personnel. While there is no official governing body for Emergency Medical Technicians in the US (Oh would that it were so) we have to be sort of self-policing, as it were. So basically, if you are a CAP member with medical training and certification or license other than EMT, leave the SOL to those for whom it was created and use the logo of your own profession. Certainly there are enough variants of the caduceus to cover most of the others.