# WFR vs EMT-B



## lmyers (Jun 10, 2008)

Ok, I am looking for some help from my fellow buzzards...

I am currently enrolled in an EMT-B course through Colorado Mountain College set to begin next week. I know I need additional medical training with all the outdoor activities I do, but the real reason for the course is that I want to get into kayak instruction/ski patrol.

Unfortunately back in a previous life I was convicted of a felony drug possesion, and I am currently in the process of having it expunged. However, the EMT-B course requires a background check be done in the first 2 weeks of class, and it's looking like I might not have the expungement done in time.

My question is, what advantages does having an EMT-B certification have for working in the outdoor industry, or should I just withdrawl and put my refund towards WFR? If so, any recommendations on who I should take it through?

Thanks


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## cpollema (Mar 9, 2009)

lmyers said:


> Ok, I am looking for some help from my fellow buzzards.
> My question is, what advantages does having an EMT-B certification have for working in the outdoor industry, or should I just withdrawl and put my refund towards WFR?
> Thanks


I would suggest the WFR. The EMT-B is a good course if you plan to get into the emergency services field. However, for the outdoors, many of the techniques need to be adjusted to account for the potential long delays until the patient reaches definitive care. In addition, the skills of an EMT tend to be use-it-or-lose-it techniques. If you aren't planning to function on a regular basis as an EMT, many of your skills will fall off quickly. The wilderness first responder seems more appropriate to your application.


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## JCKeck1 (Oct 28, 2003)

Ski patrols don't recognize WFR. If you're really trying to patrol, get the EMT. I'd imagine that CMC would let you take the course regardless of your background. Being certified by the state of CO is another matter, but not until the end of the course. The EMT course is an actual serious medical course, if you're just running around in the woods with your buddies, go WFR - you'll get more out of it. If you need it for a job, definitely EMT.
Joe


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## lmyers (Jun 10, 2008)

JCKeck1 said:


> Ski patrols don't recognize WFR. If you're really trying to patrol, get the EMT. I'd imagine that CMC would let you take the course regardless of your background. Being certified by the state of CO is another matter, but not until the end of the course. The EMT course is an actual serious medical course, if you're just running around in the woods with your buddies, go WFR - you'll get more out of it. If you need it for a job, definitely EMT.
> Joe


Cass, the head of ski patrol at Monarch said WFR is their minimum, but EMT training is looked at favorably.
CMC requires a background check be completed within 2 weeks of the course beginning - and I don't think my expungement will be completed by then, @ $900 with tuition and fees I am leaning toward getting my refund while I can and going WFR this year...

It seems like WFR would be more appropriate for ski patrol and kayak instructor, since you would have to deal with injuries in backcountry situations, as opposed to on an ambulance with all the appropriate equipment...


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## salsasean (Apr 20, 2005)

hey logan, i have had a wfr for 10 years now and quite satisfied with it. have guided rafts, snowmobiles and safety kayaked many places and it is exceptable and looked at favorable. i have heard that many resorts won't except wfr for ski patrol, monarch being the exception. don't know if that helps.


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## lmyers (Jun 10, 2008)

salsasean said:


> hey logan, i have had a wfr for 10 years now and quite satisfied with it. have guided rafts, snowmobiles and safety kayaked many places and it is exceptable and looked at favorable. i have heard that many resorts won't except wfr for ski patrol, monarch being the exception. don't know if that helps.


It does, thanks! Who did you take yours through? I'm looking at NOLS/WMI, and a few others online, but would like some suggestions


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## salsasean (Apr 20, 2005)

originally took mine through cmc, not very good, since then i took one with wmi and definitely recommend going through them. i almost took the emt class that you are talking about but could not make room ini my schedule and several emt friends suggested against it if not going to be working on ambulance. kind of like jckeck said, use or lose.


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## Porkchop (Sep 19, 2007)

you need to check w/ emt national registry about your history. I'm pretty sure cmc won't care, its the national registry test you take at the end that you'll be concerned with. once you pass the national registry than you apply w/ the state you want to work in. I passed the national registry but never did anything mine. Just wanted it for the resume.


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## Mike Hartley (May 1, 2006)

I'm an RN that worked in the outdoor industry for 20 years. Unless you are thinking of working pro ski patrol I can't think of a typical outdoor job that would require an EMT over a WFR. Employment aside, the WFR is much more appropriate for wilderbum types. The EMT course emphasizes using lots of equipment that you won't have (O2 and such). WMI does a great job and is highly recommended.


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## BarryDingle (Mar 13, 2008)

EMT is a buttload of work,and you gotta recertify in 3yrs--flys by way to fast. Lots of hours in the classroom and Practicals,seemed like the whole semester was devoted to that class. Not just class time but spare time....so much reading and studying for those final tests. That National test is a doozy...

Worth it though. I came close to using my skillz once. 
Never hurts.


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## SummitAP (Jun 23, 2007)

I almost never recommend this, but you should be doing OEC. This gives you the best certification for a ski patrol resume without the background check of EMT. It's enough to get on with virtually any patrol, volly or pro, although less desirable than EMT by some pro patrols.

I'm shocked that Monarch would take WFR as their basic cert level. I think very highly of the WFR program, but it is not a professional certification suitable for ski patrols. There's enough lacking in EMT and OEC! WFR is great for advanced recreationalists, backcountry guides, SAR, etc.

OEC is more respected by patrol than WFR by far. Outside of ski patrol, OEC is regarded as a little more than than a WFR. The outdoor industry will be happy with WFR or OEC. They'd rather see those than an EMT. Of course, they'd probably like a WEMT, but extremely few operations place much weight on having a WEMT.

I think that CMC Timberline teaches OEC. You should definitely take OEC if you can. Take this recommendation seriously. I haven't recommended an OEC in lieu of a WFR or EMT to anyone in years.

(for the record I help instruct WFR, EMT, and WEMT classes for CMC)


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## IdahoJay (Mar 19, 2009)

I gotta go with SummitAP on this one. OEC is your best option if you want to patrol, but keep in mind many patrols require either a basic or advanced level of competancy due to their authority. Some of the larger resorts even have paramedic patrollers. That said some resorts are only OEC and therefore it makes no difference if you have your EMT or not. It that is the case you will have to challenge the OEC test and drop down. Think about where you want to patrol and then decide what level you should shoot for...

Good Luck!


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## ajpz (Mar 8, 2009)

I took WFR and EMT Basic at SOLO, NH = WEMT. I remember the WFR is more information, and more protocols, and the EMT-B being mostly about decision making (should I stay or should I drive them in now?) and proper packaging. I do not agree that it was a buttload of work, or that it was at all hard. I took them both in a month residency program. The downside of the EMT is that, once you are certified, you are locked in to protocols that might keep you from performing a different standard of care. e.g. - you can perform an emergency tracheostomy, and be legally defensible under good samaritan laws; but not if you are an EMT. not a likely situation.


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## SummitAP (Jun 23, 2007)

ajpz... there are so many things wrong with your post I don't know where to start.


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## bldrmorgan (Apr 23, 2007)

What you should also look at is the OEC (outdoor emergency care). It's sorta like a Wilderness EMT course. I was talking to some ski patrollers today and they were telling me to get that or the EMT. 

I am actually in the same decision process you are in right now. I'm signed up to take my EMT-B through Front Range CC this spring, but was wondering the same questions about if it would work for guiding and patrolling. I'm still going to get my EMT-B since I'm set to go in that, and will look to get some work in that field. But I'm going to keep working for my outdoor cert's and get into the field. 

Good luck to ya in whatever you decide though.


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## bam bam (Mar 22, 2009)

I took a WEMT class from WMI. It was a month long and was a lot of work. I took the class for a few reasons. 1) I want to make more money raft guiding and 2) possibly ski patrol. 3) I wanted to further my medical knowledge to posibly go back for a nurseing degree someday. I did not make more money from guideing but i did get a patrol job (take my NSP test in two weeks) and gained alot of medical knowledge.

When i started patroling as a cadet, i was able to wear the cross because i was an EMT. some other cadetes can not b/c they are not EMTS. Also i am taking a OEC bridge class b/c NSP (i think) only reconizes OEC (could be wrong here, but i am having to get my OEC for some reason.)

i am pretty sure that they do the back ground check for the national reg. They make an account for you early on for record keeping. My teachers checked stuff off through out the course using the National Reg website. 

hope this helps some.


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## SummitAP (Jun 23, 2007)

There is no background check for national registry. States like CO do background checks for the state registry. The reason his school (CMC) does a background check is that as part of your EMT class, you will do clinical rotations with ambulances and hospitals. Those entities require the background check. OEC and WFR have no clinical rotations.

OEC is only required for NSP volunteers or if a particular hill wants OEC no matter what else you have (eg Loveland). Otherwise OEC and EMT are generally equally accepted though some hills require EMT be acquired after one year (eg Vail Resorts) and some require EMT no matter what (eg Copper).


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## lmyers (Jun 10, 2008)

Thanks for all the comments and advice everyone, especially SummitAP...I will look into the OEC this evening.


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## lmyers (Jun 10, 2008)

Ok, the CMC OEC course starts Monday and is Monday, Wednesday, Friday - from 1-3pm. Which I can't do and still work...I am having trouble finding any up-to-date information about anyone else offering the course.
Any ideas for an OEC educator?


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## raftus (Jul 20, 2005)

Try calling the Ski Patrol's of various mountains. Since they are the main users of it they often also have certified instructors. I took my OEC with Vail Ski patrollers who also were raft guides at Timberline Tours. As said before most people outside of Ski Patrol have no idea what OEC is, some places I have guided don't recognize it as an equivalent to a WFR.


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## dograft83 (Jun 16, 2008)

I think that almost all the ski patrol trainings are just about done. I will have to check but I know there are a few oec classes you can take around denver.


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## ajpz (Mar 8, 2009)

SummitAP said:


> ajpz... there are so many things wrong with your post I don't know where to start.


Not seeing it. please help me out here. for the most part, it seems to me that I have posted my opinions; having taken both courses, I have a basis for those opinions. the bit about the tracheostomy is up for attention, and may vary by state laws; but I am under the impression, again from information from school, that as an emt, you are not covered under good samaritan laws if you work outside of your protocol, or cause harm to someone out of negligence. e.g.- if you screw up, you can be held responsible.


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## seth65 (Jun 19, 2009)

*Know what to expect!*

I just acquired a LMT license through the state of CO and for that certification there was NO tolerance for felony charges. If you check with your license issuing agency they can give you the specifics. The org that offers the class will not care. I took my WFR through SOLO back on the Atlantic coast. It was a great class and I have used my skills 3 times or more since. If you believe you will get your charge exponged you will have no problem as long as this has happened BEFORE you apply for the state/org licensing. Just keep all you paperwork including the original charge/s data.

Good Luck


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## SummitAP (Jun 23, 2007)

OK then I'll give you the short break down.



ajpz said:


> WFR is more information, and more protocols, and the EMT-B being mostly about decision making (should I stay or should I drive them in now?) and proper packaging.


If that's what you got out of your courses, then you didn't learn much. Whether that was the course format, the instructors, or the student, can't say.

WFR is a first aid with an emphasis on improvised care and extrication, care longer than 2 hours, and has an emphasis on decision making regarding whether a patient's injuries require immediate evacuation, delayed evacuation, or rest followed by continuing on an expedition. It is aimed at a guides, volunteer SAR, and recreationists. It should now be an 80-100 hour course based on the new MFR standards. (80 hours old FR standard)

EMT is a higher level of training focused on a more thorough diagnostic process and a better understanding of body systems, pathophysiology, and underlying causes than a first responder curriculum. This is coupled with decision making focused on determining the immediacy of the care needs of the patient, determining the destination necessary, and the level of care needed. It is focused on an ambulance environment and aimed at those wishing to enter the EMS profession (fire fighters, ski patrollers, ambulance crew). It should now be a 160-200 hour course based on the new standards and an additional 24+ hours of clinical rotations (120 hours and 24+ hours on the old standard).



> The downside of the EMT is that, once you are certified, you are locked in to protocols that might keep you from performing a different standard of care. e.g. - you can perform an emergency tracheostomy, and be legally defensible under good samaritan laws; but not if you are an EMT. not a likely situation.


Again, either your instructors grossly misinformed you or you weren't paying attention. 

Your EMT gives you absolutely NO power to perform special procedures when you are not operating under medical direction, though in some states, it binds you to a duty to act as a good Samaritan if certified by that state. Good Samaritan laws vary by state, but there is a lot of commonality between them. 

Cricothyrotomy is not in any EMT's scope in this county. Being an EMT does not allow or disallow you to do it as a good samaratin. Having an EMT or not, you will probably charged with practicing medicine without a license. 

Good Samaritan laws allow you to, in good faith, practice basic first responder level medical care up to the level you were trained in and to a standard of your peers without fear of lawsuit due to unavoidable accident. It doesn't allow you to perform surgery, give medications, or be negligent.


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## ajpz (Mar 8, 2009)

SummitAP said:


> If that's what you got out of your courses, then you didn't learn much. Whether that was the course format, the instructors, or the student, can't say.


I agree, I didn't learn much (compared to what I think I know now). I do not agree that the learning amount is a matter of fault of format, instructors, or student. These may be your opinions, but they are not fact. 



SummitAP said:


> Again, either your instructors grossly misinformed you or you weren't paying attention.


According to a search from 5 minutes ago, here is what I have found: 

The National Registry for EMT-B derives their testing from the US Dept. of Transportation EMT-B Standard Curriculum; it is 110 hours:

http://www.nhtsa.dot.gov/people/injury/ems/pub/emtbnsc.pdf

For the National Registry statement on felony charges, see here: 
NREMT - Felony Conviction Policy

SOLO, the east coast gold standard for WEMT, has a WFR at 80 hours, and the WEMT at 170+ hours; a WEMT= WFR+EMTB. WMI, a popular course in the rockies has a WFR at 80 hours, and WEMT at 180 hours. their websights are here: http://www.soloschools.com/courses.html
and here: http://www.nols.edu/wmi/

In either WEMT course, the WFR portion is 80 hours. If you subtract that from the WEMT, you are left with ~100 hours. so there is a bit of overlap in information. 

I found the extended care of the WFR more challenging/exciting than much of the EMT-B protocols such as intubating, oxygen management, and AED usage. I enjoyed it all, and did learn quite a bit about the basics of emergency care.

As for good samaritan laws, I am not an attorney. I do not know how summitap interpreted my post to mean that an EMTB has surgery within their protocol, if indeed that is what is being said. the colorado law is here:
Colorado Good Samaritan Law

In NH, where I took my course, they told us that if you are Joe 'no-training whatsoever' samaritan, and you are first on the scene and decide to poke a hole in someone's throat to help them breathe (maybe you saw it in a movie), and they survive because of it, you are LESS liable of negligence under good samaritan law than Joe 'off-duty' EMTB who does the same thing; this is because he has training, and was acting outside of his standard of care [and knows better].

If I remember correctly, this topic was instigated by a student posing unlikely scenarios to the instructors. Again, this is highly unlikely, and it is what I was lead to believe. not a fact, or an opinion, just a statement. any attorneys care to comment?


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## bradslob (Apr 20, 2006)

Jumping into this thread a bit late, some good info here, also some stuff where my opinion differs. 

I'm a 20 year EMT, 12 year ski patroller, firefighter, and a WFR instructor for WMA. 

In my humble opinion the medicine taught in a reputable WFR class meets or exceeds that taught in an EMT. The EMT curriculum suffers because its created by a huge committee, doesn't empower the student to use judgement or diagnose problems, and teaches mostly to the NREMT test. The reason an EMT class is a 110 hours is a bunch of beaurocrats decided that was a good number. WFR at 80 hours? Thats what it takes to take somebody from no medicine to a knowledge level to make good calls on an emergency scene. 

If I find myself on a scene in the front country or backcountry I would rather have a newly minted WFR assisting me than an new EMT. 

Jobs wise an EMT is a huge asset for patrol jobs, also in some clinics, or if you want to be medical guy for a wilderness program like those for youth at risk. 

Most outdoor jobs are thrilled with a WFR and in my experience its acceptance far exceeds that of OEC. The exception would be ski patrols mostly those that are vollunteer or at the smaller mountains. Many mountains have tiered patrols and WFR is the minimum for the lowest level. Vail would be an example. WFR has become the standard in the US for outdoors jobs and is gaining internationally as well. 

An EMT can challenge the OEC test and thus get the cert pretty easily, that option is currently not open to WFR's. 

If you decide on a WFR just make sure its a good company and maybe even look into the experience of the instructors. There are a lot of folks out there teaching these classes with little or no patient care experience. Most folks here have endorsed WMI, and they are top notch. Also check out Wilderness Medical Associates, we have a pretty extensive schedule in Durango, Crested Butte, and BV and I think our classes are some of the best as well. 

Also there's no evidence that in actual lawsuits that advancing your training results in an increase in liability. Also if you talk to 100 big city medics you might find 1 or 2 cases of a save with a cricothorotomy (sp?). Its such a low possibility occurence with high possibility of problems that its not even worth mentioning. Now reducing a shoulder dislocation would be a good example. WFR's are taught to do that, lots do in a variety of situations, there's also lots of stories out there in Good Samaritan situations of EMTS doing it and even no training folks, no-one's been sued yet. I'd be interested in hearing the story if somebody knows of one.

-Brad


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## lmyers (Jun 10, 2008)

Thanks for that info Brad.

I have withdrawn from the EMT course, and currently planning on taking the WFR through WMA Wilderness First Responder Course - Colorado Outside 04/11/2009- Wilderness Medical Associates
According to the National Ski Patrol's website there is an OEC course being offered at Eldora next week...I have been having trouble getting in touch with anyone who knows anything about it though.
I am not opposed to getting my EMT certification, especially since it seems to be a necessity for patrol. However, I can wait and take it next year.
In doing this, I should have enough money to take a swiftwater rescue course and get ACA certified this spring, in addition to the WFR.


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## bradslob (Apr 20, 2006)

That course will be taught by Darren Stokes, he's a great instructor and is currently working EMS in Chaffee county. He's also got a good backcountry resume, and he used to manage four corners rafting. Its a good course for boaters. 

-Brad


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## jtnc (Aug 9, 2004)

I'll jump in with a few tidbits...

As you likely found, OEC class schedules can be found at NSP: 
NSP Member Home
(it really links to the calendar despite it's name)

That said, they typically run late Aug/early Sept to early December. The Eldora class you mention is an EMT bridge class to familiarize EMT's w/OEC protocols. Unless you've already got an EMT (which you don't), you would not be able to take it. On the plus side, they are typically evening classes in order to facilitate most work schedules.

As others have stated, EMT is not a necessity for all patrols, it just depends where you want to go. If you want to do ski-patrol as a volly, and get a skill set that's a bit better suited for backcountry stuff, I'd err towards OEC. That said, OEC still generally assumes that you have a first aid room within say an hour of you and a toboggan within a radio call's distance. It does discuss what to do for longer distances, to some extent.

Having not taken WFR or WEMT (which is tempting) or EMTB I may stick my foot in my mouth, but I suspect that WFR/WEMT will actually go into more detail about how to handle a true backcountry emergency and improvise with what you have at hand than either EMT-B or OEC. This is one of the more annoying things (to me) about OEC (having taken it and taught it) for a backcountry patrol (which I'm on). OEC is good, but it really only devotes one small chapter (appendix A) to backcountry considerations. 

To me it really depends on what you want out of the material. If you are planning on going on river trips, backpacking in remote areas, etc and working with what you have, I suspect going for WFR will do much better for you than OEC, or if you want more knowledge WEMT. But if you really want to do ski patrol, than OEC or WEMT/EMT-B would be great choices.

Good luck with whatever you choose.
John


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## JCKeck1 (Oct 28, 2003)

ajpz said:


> I found the extended care of the WFR more challenging/exciting than much of the EMT-B protocols such as intubating, oxygen management, and AED usage. I enjoyed it all, and did learn quite a bit about the basics of emergency care.


Seriously? Intubating as an EMT-B? Random dudes performing cricothyrotomy saves? Did you learn anything in all of these classes? I'm not usually into calling people out on the Buzz that I don't know, but lots of your medical information is so mis-guided that I think you need to stop posting on this topic.

Joe


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## ajpz (Mar 8, 2009)

JCKeck1 said:


> Seriously? Intubating as an EMT-B? Random dudes performing cricothyrotomy saves? Did you learn anything in all of these classes? I'm not usually into calling people out on the Buzz that I don't know, but lots of your medical information is so mis-guided that I think you need to stop posting on this topic.
> 
> Joe


The throat cut save topic was and still is completely hypothetical, it never was my opinion, just a topic of discussion. as someone already pointed out, reducing a shoulder dislocation might have been [is] a better example. 

As far as what I have learned in those courses, and what I find interesting and/or challenging, these are my opinions and are not up for debate. to me, intubating was a fun little exercise on a dummy. I learned that it isn't all that easy and you need to be careful to not break out teeth. To me, oxygen management seemed like a simple task of putting on a mask, and setting flow valves; not a big deal - to me. maybe these things are a big deal and mean the world to someone else, but not me. 

Yes I learned many things in those courses, some skills have stayed with me, others probably need to be revisited. I think topics in the WFR, like the extended care, and the reduction techniques, and the packaging and moving of a back country incident, and the management of a back country scenario were more practical and more interesting than in the emt portion of the program I took. 

I hope this clears up your questions.


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