at levels in-between EMT-A and EMT-P. In the early 80s, the NREMT Board of Directors adopted a new national certification; EMT-Intermediate, based on several state's recommendations. In 1985 the Department of Transportation developed the first national standard curriculum for this new level of EMT/intermediate. The 1985 course provided advanced knowledge and mainly three "advanced interventions" (at that time); IVs, MAST trouser application and use of the esophageal obturator airway. Simply stated, EMT-I care centered on trauma patients. Soon after 1985 some states started adding "enhancements" (skills) to the intermediate and others adopted a more expansive level called "cardiac care" which included some ACLS drugs. In 1994 a blue ribbon panel of EMS stakeholders gathered and endorsed the EMS Education and Practice Blueprint. That blueprint was to resolve the fragmented levels of intermediates used across the nation. In 1999 the Department of Transportation, based upon the blueprint, developed a national standard curriculum for the EMT-intermediate. Immediately it ran into political opposition and the National Association of State EMS Directors (now the National Association of State EMS Officials) asked the NREMT board to continue to offer intermediate certifications at both the former (I-85) and the new (I-99) designated levels.
