Advanced Emergency Medical Technician ─ Fireline Qualified

Introduction

The AEMF provides emergency medical services (EMS) at the medical unit and/or other incident location as requested by the Incident Commander or representative.

NOTE:  Some states may use the terminology for this position:  “EMT-Intermediate”.

Duties

• Performs a combination of basic and limited advanced lifesaving procedures focused on the initial management of injured and sick persons. 
• This position has the knowledge associated with, and is expected to be competent in all the skills of the EMT. 
• AEMFs are not independent practitioners and therefore must be supervised by a physician medical director.  Although many of the procedures that an AEMF is allowed to perform do not require real-time oversight by the supervising medical director, more complex decision making (such as that concerning patient disposition) must be made with consultation from the medical director.
• While all AEMFs receive essentially the same training, the specific procedures that each individual AEMF is authorized to perform vary depending on the AEMFs scope of practice.  An AEMF’s scope of practice contains only those procedures for which he or she is educated, certified (by passing an exam), credentialed (medical director grants “permission” to practice), and licensed by a state to perform.  Therefore, the scope of practice of an AEMF will vary by individual.
• The AEMF will be required to work on the fireline or other remote areas of an incident.  The AEMF would be expected to participate in and/or lead the evacuation of a sick or injured person from this environment.  The AEMF would also be expected to perform these lifesaving skills with the equipment available to them on the fireline, which is significantly less than those AEMTs in the medical unit or typical urban EMS system. 
• The AEMF may be the only medical provider on scene for an extended period of time in less than ideal conditions.

Position Knowledge and Skills

The following is a list of the typical skills that an AEMF can perform:

• Airway and Breathing
  • Using upper airway adjuncts, bag-valve-mask, manually triggered ventilators and automatic transportation ventilators for airway management.
  • Tracheobronchial suctioning of an already intubated patient.
• Pharmacological Interventions
  • Providing lifesaving medications with an auto-injector.
  • Helping a patient take his or her own prescribed medications.
  • Giving specific over-the-counter medications (with appropriate medical oversight).
  • Administer sublingual nitroglycerine to a patient experiencing chest pain of suspected ischemic origin.
  • Administer subcutaneous or intramuscular epinephrine to a patient in anaphylaxis.
  • Administer glucagon to a hypoglycemic patient.
  • Administer intravenous D50 to a hypoglycemic patient.
  • Administer inhaled beta agonists to a patient experiencing difficulty breathing and wheezing.
  • Administer a narcotic antagonist to a patient suspected of narcotic overdose.
  • Administer nitrous oxide for pain relief.
  • Establishing intravenous (IV) or intraosseous (IO) access to deliver fluids or medications.
• Using an automated external defibrillator.
• Trauma Care
  • Stabilizing suspected spinal injuries and extremity fractures.
  • Controlling bleeding.
  • Evacuation of a sick or injured patient using purpose made and improvised litters.
  • Appropriate triage of sick or injured patients in order to assist with the formulation of an evacuation plan.
  • Application and inflation of the pneumatic anti-shock garment (PASG) for fracture stabilization.

Position Requirements

• At a minimum, possess a current Advanced Emergency Medical (AEMT) licensure care from their home (state) EMS authority
• Introduction to ICS (I-100)
• Firefighter Training (S-130)
• Introduction to Wildland Fire (S-190)
• NIMS:  An Introduction (IS-700)
• Annual Fireline Safety Refresher (RT-130)
• Human Factors in the Wildland Fire Service (L-180)
• An arduous physical fitness level has been established for this position

Other Training Supporting Development of Knowledge and Skills

• Intermediate Wildland Fire Behavior (S-290)
• Basic Air Operations (S-270)
• Helicopter Crewmember (S-271)
• Wilderness Emergency Medical Technician