Let’s look at getting an emergency medical technician – basic (EMT-B) certification as the basis for growing your wilderness and grid-down medicine skills. An EMT-B is capable of providing basic life support in the forms of CPR, first aid, and trauma care. In addition, you learn how to do basic patient assessments as well as the protocols for participating in a mass casualty incident and doing triage. You’ll also learn the FEMA Incident Command System that is the basis for any multi-agency response to anything, from a house fire to the Yellowstone Caldera erupting and eating one third of the country.
You’ll get to learn how to do some cool guy stuff like:
- Treating a sucking chest wound
- Using a tourniquet to stop an extremity hemorrhage
- Using hemostatic agents and packing wounds to stop extremity hemorrhages
- Splinting
- Using an automatic external defibrillator
And much, much more.
The reality is, moving on to wilderness and grid-down medicine will go much more smoothly if you get a basic understanding of human anatomy, physiology, pathophysiology and identifying and treating maladies in the grid-up world.
There are two main ways to get your EMT-B education that will allow you to take a certification test.
1. Community colleges: This is the cheaper route in general. It’s going to take about 200 hours of your life with a couple of night classes a week and one Saturday a month over a span of about four months. The benefit of meatspace is the hands on work of doing basic assessments and skills. You’ll do scenarios with groups – and those are fun. It’s a good mix of lectures and hands-on work. Here’s a list of accredited EMT courses from the Journal of Emergency Medical Services.
Benchmark costs, these come from the community college system in a metro area of about 500,000 people:
- $180.00 EMT Tuition plus fees
- $7.50 Liability Insurance (Required)
- $5.50 Accident Insurance (Recommended)
- $5.00 Tech Fee (Required)
- $12.00 CAPS Fee* (Required)
- $21.00 Lab Fee (Required)
- $185.00 textbook and workbook
- $60.00 uniform ( Required)
- $60.00 Physical Exam (Required)
- $509.00 Total
2. Online resources: There’s not a really easy answer on this one. There are online courses, and they can tend to cost two to three times as much as the community colleges, as these are private companies that need to make money, and do not have subsidies from state governments to back them. What you gain in convenience, you do lose in not having a group of people to regularly conduct skills, assessments, and scenarios with. In any online program, you will have to report to a location to do your hands-on practical exam if not your written test. Any online program that says you can do it without doing the practical exam should not be trusted.
Getting your patch
The National Registry of Emergency Medical Technicians is the national credentialing body for EMTs. They administer a written test on a computer and conduct a “psychomotor” test, which is the practical exam. States that honor the National Registry certifications tend to have reciprocity, so in the event of another Katrina-type disaster, it is easier to cross state lines and function in another locality. Your state may require that you get the state certification instead, and it’s still a written exam and practical exam.
Once you get your EMT-B certification, you can apply at volunteer fire services and EMS agencies to practice.
You’ll need to take 72 hours of continuing education over the three years that your certification is valid.
Something a little easier and cheaper
If getting your EMT-B is too much at this point, that’s totally understandable. Look into what the American Red Cross has in your area for basic first aid and CPR courses for the lay person. They are a start, and they run around $100 for an eight-hour class.
Also look into Community Emergency Response Team (CERT) training. Doc Grouch did an excellent Quick Post about it.
Most importantly, people that are doing these things have mindsets similar to yours. They are being prepared. These classes are excellent opportunities to meet like-minded people and expand your network.
Once you get these done, the Wilderness Medicine world will be easier to absorb. There are lots of courses available through the Wilderness Outdoor Leadership Society Wilderness Medicine Institute. Some of their stuff can get a little pricey, but it’s all about priorities.
Hogwarts School of Grid-Down Medicine and Wizardry 
People might also see if their town has a voluntary ambulance association. The ones in the area where I live need volunteers so badly that they pay for the course if you join the association and agree to go out on calls.
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Very good point. A lot of states with volunteer fire departments will pick up the tab for your certification as well.
Thanks for the reminder!
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EMTing is really kind of fun.
BUT
It is incredibly important to do everything in your power to get your hands dirty(bloody) as you do your training.
NOW is the time to find out you can’t click ON and do the job when it gets messy or noisy or…
I know nurses, docs, etc who can’t EMT. Something about the rain, the darkness, the mud the cold…
In a grid down you will find yourself doing a lot of improvising. It REALLY helps to understand what your options are and what you are trying to improvise, and most of that comes out of the EMT or Advanced First Aid book. Honest.
Another option I haven’t seen a lot of (and it may no longer be an option I’ve been out of the training loop for a bit) is the 100(+/-) hour DOT First Responder Course. ARC used to offer one of these called either Emergency Responder or Responding to Emergencies, I’m not sure current name. I’ve taught both and they can be dang good hands on experience if the teaching cadre is good.
bmp
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I have unfortunately seen many towns/small cities with volunteer services cut back/have no funding for emt training,this includes my town now and town I used to live in which both in past had the monies.Is a shame and am thinking of ways to maybe get a county level program going as the pay off seems worth it,perhaps volunteer trainers and get folks to in town donate for training supplies ect.I hope to have monies to personally go for it and will to best of ability share knowledge and even though not picked up by town tuition wise would volunteer when /if needed plus feel better about being in the backlands ect. alone or with a group with more knowledge.
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OK, so I feel a little soiled recommending this, BUT, it’s there and we might as well wade into the cesspool of FRN debtbucks that are flowing freely out of DC.
Check out the grants section at FEMA under CERT. You might be able to score some money to get your locality trained up for disaster recovery. May not be as medically detailed, but it’s a networking opportunity and teambuilding exercise if nothing else.
https://www.fema.gov/preparedness-non-disaster-grants
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Mike,nothing wrong with any means that would help,in theory,we paid for the printing presses that allow this.Thanks for the link,will do a bit of research.In the end the goal is the ability to help others in tough times,and the more knowledge/training the better,doesn’t mean because you train with them you have to be part of that specific team.
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I’m in the process of getting my EMT-B cert after which I plan to take a TCCC based course. I did CLS in the Army but it’s been 6 years since I last used any of the skill sets covered in that course. At present, I’m trying to decide if I want to go on and study for an EMT-I cert or just go to work till my fitness level is where I feel it needs to be and sign a REP-63 contract with the National Guard. I’m not considering EMT-P level certification because a good bit of the hands on skills are covered at the Intermediate level and the Paramedic level skills that go beyond the Intermediate level depends on drugs and equipment that you won’t have a reliable route of access to in a grid down situation.
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Good on you Dustin. Unsolicited advice, if you don’t mind. Ride the EMT-B for a while and see how you like it. Do everything you can to get as much patient contact as possible and really learn the ropes. Once you do that for about 6-12 months, then make the call to go to EMT-I school or what have you. If you are in the Guard by then, you can also leverage them to help you climb the clinical ladder.
You’ll love TCCC. Blows CLS out of the water.
Good luck!
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Advice gladly accepted. I’ve been leaning more and more towards working and improving my fitness as there aren’t any EMT-I programs I can find in my area and more importantly, I’m a noob, I need more immersion than I currently have. In regards to the Guard, that line of thought was present when I was considering my options. Ultimately, I would like to become a PA and I was considering the Guard/Active Duty to help knock out the required medical experience as well as help finish college. But frankly, with the way things are going at home and abroad, I’m not certain anything beyond the EMT-B will be feasible. Again, thank you for tbe advice!
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You got it. BlueMudPatriot is spot on, too. Except for having para-god syndrome, I could have been his partner. I went directly to P-school right after Basic and I would not do that again if given the choice. I was all book knowledge and all thumbs. I was terrified of everything, and for the first few months did a great job of freezing up and standing there bug-eyed while my annoyed preceptor ran the call. Took a while to get the confidence, and after a few successful ALS calls, it started to flow. Now I am an arrogant para-god and look at myself in the mirror all day while I wear sunglasses.
In all seriousness, like BMP said, a good medic partner is going to delegate lots of stuff to you. You want to be on the bleeding edge of scope of practice after a while. Once you get a good rhythm, you and your partner will be able to walk into a room and know through body language what needs to get done.
There’s a saying in the business:
“Paramedics save patients, and EMTs save paramedics.”
Good luck buddy!
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Dustin, Mike has this right. 6-12 months as a B before you start up the merit badge and clinical ladder. WORST BAR NONE partner I ever ran with was a 0 to -P guy 3 months out of P school. Still had much basic to learn, and gave EVERYONE a world class ‘tude as a Para-God. Didn’t last long and couldn’t understand why.
As a -B you will do a lot of driving, but you will also be a major part of the treatment team if your -Ps are good guys. If THEY are doing THEIR jobs they will be teaching you what they need from you and you will be able to bring your BLS skills which you have developed to the table as a set of reminders to them.
Good luck.
bmp
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I hear you BMP, I appreciate your input!
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Instead of just a first aid course, consider getting Wilderness First Aid certified. Takes a weekend and covers a lot more gound than just the regular FA. Besides, when you need this stuff, you’re often beyond the ‘golden hour’ and you need alternatives to just dressing the wound and waiting for EMS to arrive. Checkout http://soloschools.com/ for information.
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We also recommend this. The more training, the better. First aid is a good start, wilderness first aid (or first responder) is much more comprehensive.
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