EMT National Training: why so different - EMT National Training

There are a lot of questions under EMT-B that are out of Colorado's scope of practice like anything to due with intubation and I was told that BURP is EMT-I? Is this due to the differnt states allowing different skills at the same level or what? Also there was a question that asked what 140/p means, answer palpated 140 BP. My book and instructors say palpated BP is 40 femoral, 60 corotid, 90 radial, and 120 pedal. Is the teaching material really that different across the country?
Thanks

So here is how this all works. The NREMT test covers the information that is outlined in the National Highway Traffic Safety Administration (NHTSA) guidelines for EMS. Each State is responsible for adopting it's own rules and regulations governing how EMS operates, and what levels are allowed to perform what skills in that state. Let's take for example Hawaii. The State of Hawaii only recognizes two levels of EMS; EMT-B and Paramedic. However, if you look closer into what they really involve, you will find that an EMT-B in Hawaii is actually trained to the EMT-Advanced level (ie Intermediate). So an EMT-B in Hawaii is trained in IV therapy, some EKG and some drug administration. These are things that an EMT-B in Idaho, for instance, can not do.
What we have done is put together a list of questions that follow the same document as the NREMT. We design our questions to cover content that you could see on the NREMT test, not any other State's test or training curriculum. So if you take your class in Colorado, chances are that your instructors will teach how Colorado EMS operates, which is good. But since Colorado requires you to take the NREMT exam to get your state certificate then you might be left struggling to pass the test if you never were taught ALL the things under the EMT-B guidelines published by the NHTSA.

Now let me answer your questions on palpated B/P. Your instructor and book are both correct in their list of palpable pulses indicating certain B/P. The question is actually addressing something a little different. I'm gathering from your question that you were never instructed on how to obtain a blood pressure by locating the radial pulse, then inflating the B/P cuff until the pulse is absent. Then watching the sphygmomonometer as you slowly deflate the cuff. The palpated B/P is the pressure at which you feel the radial pulse return. This is a great way to find a Systolic B/P on a patient when there is a lot of noise present and you can't hear the pulses in your stethoscope. It is documented on a chart as Pressure/P (so if you felt the pulse come back at 140, it is written 140/p).

I hope this helped clear up some confusion.


Scott
FF/Paramedic