EMT-B Certification

What would you like to see done with the EMT-B cert?

  • Do away with it all together and make EMT-A the minimum?

    Votes: 22 37.9%
  • Leave it in but require more CE hours and clinical hours?

    Votes: 19 32.8%
  • Leave it alone. It works just fine as is.

    Votes: 17 29.3%

  • Total voters
    58

Shishkabob

Forum Chief
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Brown:

Then in all fairness, most doctors never cure anything either, by your definition.




so EMT-Bs are useful!

^_^

I don't see a single thing on that list that the average EMT can 'cure' /fix anywhere near the level that a Paramedic can, if at all.
 
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tiffany9902

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I had did more then enough ride along and hospital hours but some other schools i talk to said they did very little hours and they nothing the whole time... i had a few crazy ride along and had to do chest compressions on a man in the hospital i wish i had more time on my ride alongs and hospital hours... but i think it should stay the same just so people can get a taste of what they are getting them selfs into and if they dont like it they dont have to more forward in this career...

just my opinion...
 

hippocratical

Forum Lieutenant
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EMT-Bs in my part of the world (EMRs) can;

> How about reversing respiratory arrest?

CPR & PPV isn't a bad idea... but nothing fancy that's for sure.

> How about stopping an asthma / COPD attack?

Assist with Salbutamol or Ipratropium admin.

> How about reviving a diabetic?

Unconscious? Pt. buggered. Oral Glucose if lucid and Hypo (EMRs can take a glucose reading)
Hyper? Pt. buggered.

All other conditions mentioned? Pt. buggered.

That said, defending the utter minimal usefulness of an EMT-B (EMRs) wasn't really my point. I was just saying that EMS providers primary role is to not cure, but stop a pt. from deteriorating until they can get the variety of services available at their local care facility.

Arguing about how much more a paramedic can do is beside the point.
 

MrBrown

Forum Deputy Chief
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Brown:

Then in all fairness, most doctors never cure anything either, by your definition.

You are learning .... western medicine has not been corrupted by the pharmaceutical industry and other poisonous interests to "cure" people but rather, to maintain profit generating diseases

/soapbox
 

Shishkabob

Forum Chief
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Actually I was going more for the fact that I have a different definition of "cure" than you do...


But you know, the conspiracy theory one works too.
 

usalsfyre

You have my stapler
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There's a good bit or medicine that not focused on "cure" but rather "relieving pain and suffering". This is where there's a HUGE difference between a paramedic and a basic.

What's unfortunate is many paramedics choose not to treat pain and suffering when they're entirely capable of it.
 

bstone

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Just for the record, it's "A-EMT" not "EMT-A".
 

DrParasite

The fire extinguisher is not just for show
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Many providers are also quite afraid to call for ALS. The medics come with a city BLS basic truck as well (to drive the medic truck to the ER), so there are a lot of eyes theoretically judging you. It makes no difference to me if four city guys think I am crappy provider for calling ALS on a perceived BLS call, but it does to some people.
wait what? so Boston EMS has enough free units to send 2 on an ALS intercept when the patient is already in an ambulance?

I mean, I can see pulling over to the side of the road, both medics jump in, do an assessment and basic interventions, and once completed, one jumps out and drives the BEMS truck behind the BLS one. or even both medics jumping in while the original treating EMT hopping out to drive the BEMS truck.

but tying up 3 trucks for an ALS call, esp when two are from a busy system like Boston EMS, is well, wooow
 

jjesusfreak01

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Don't get the misguided idea that an ER doc really does anything more than what paramedics do. In most cases, an ER doc doesn't "fix" anything. The usefulness of the ER is in the resources and other professionals available to the patient.

An ER doc can give a psychotic patient Haldol (just like a paramedic would), but he can also refer to behavior health professionals.

An ER doc could splint a fracture (although its more likely a CNA would do it) but if a break needs setting he has the benefit of radiology to assist.

An ER doc can diagnose a STEMI (just like a paramedic), but he's going to pass the buck to an interventional cardiologist to fix the problem.

An ER doc can diagnose thousands of problems using their advanced knowledge of physiology, but in the end their goal is to get the patient walking out the door. Everything past that gets handed off to other specialist medical professionals. As EMS providers, we act as an extension of the hand of the physician, FIXING emergent medical problems or sustaining the patient until they can be turned over to professionals with the greater resources needed to fix their problems.
 

Tigger

Dodges Pucks
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wait what? so Boston EMS has enough free units to send 2 on an ALS intercept when the patient is already in an ambulance?

I mean, I can see pulling over to the side of the road, both medics jump in, do an assessment and basic interventions, and once completed, one jumps out and drives the BEMS truck behind the BLS one. or even both medics jumping in while the original treating EMT hopping out to drive the BEMS truck.

but tying up 3 trucks for an ALS call, esp when two are from a busy system like Boston EMS, is well, wooow

Private ambulance employees are not permitted to drive the city's trucks. If they only need one medic in back of the private truck then all is well but if two are needed the BLS is coming. There quite a few more BLS city trucks around...


Sent from my out of area communications device.
 

Tigger

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There's a good bit or medicine that not focused on "cure" but rather "relieving pain and suffering". This is where there's a HUGE difference between a paramedic and a basic.
.

Could not agree more. This is why I think American EMS needs to move away from using BLS units in 911 situations. Most of my patients do not have any "immediate life threats" but they do need medical care and the sooner the better.


Sent from my out of area communications device.
 
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crazycajun

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Don't get the misguided idea that an ER doc really does anything more than what paramedics do. In most cases, an ER doc doesn't "fix" anything. The usefulness of the ER is in the resources and other professionals available to the patient.

An ER doc can give a psychotic patient Haldol (just like a paramedic would), but he can also refer to behavior health professionals.

An ER doc could splint a fracture (although its more likely a CNA would do it) but if a break needs setting he has the benefit of radiology to assist.

An ER doc can diagnose a STEMI (just like a paramedic), but he's going to pass the buck to an interventional cardiologist to fix the problem.

An ER doc can diagnose thousands of problems using their advanced knowledge of physiology, but in the end their goal is to get the patient walking out the door. Everything past that gets handed off to other specialist medical professionals. As EMS providers, we act as an extension of the hand of the physician, FIXING emergent medical problems or sustaining the patient until they can be turned over to professionals with the greater resources needed to fix their problems.

Actually I have yet to meet and ER Doc diagnose a STEMI. When we took PT's to the ER every ER Doc I met would have someone come down and interpret the strip for the Cath lab and then make the decision that we had already given them. TAKE THE PT TO THE CATH LAB! Now we just go straight to the lab no questions asked.
 

Frozennoodle

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Who cares who can do what? Paramedics use the knowledge and tools at their disposal to treat and care for their patients. Are they health care providers or are they skill monkeys? I'm far more impressed by a medic who can articulate a patient's complaint and his history and give useful insight into that patient's current condition than I am by someone who can nail an IV every time.

My goal is to do what's in the best interest of my patient's and give them the best care I know how to give with the tools I have. This conversation has devolved into a debate as to what the role of EMS is and even the most staunchly pro-education posters on here are getting pulled into the skill-set debate.

Give us another 2 years beyond Paramedic school and you'll be amazed what kind of care we'll start to see from our EMS providers. I love my Basic partners but I don't think we need people with so little education on 911 trucks alone. We need well educated ALS providers.
 

Anthony7994

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Instead of waiting for NREMT to make us learn more. Why don't we do it ourselves? I do that every day. If you are an EMT-b you should have a general understanding of what a Paramedic needs, wants and is thinking. that just makes a better team..

I've talked to Paramedics who've said their EMT's have saved their asses. on Multiple occasions.....

If you became an EMT, You got your certs and you do your CEU's just to retain that cert. You belong in an IFT truck...

If you became an EMT, You continually bush yourself to learn more, understand the signs and symptoms of certain illnesses...If you can communicate to Paramedics, nurses and doctors in a way that helps them get a leg up..You belong in a real EMS gig..

Its not whether we need more hours..Its whether we choose to be cracker box (cert) EMT's or real EMT's....It doesn't take long for an employer to figure out you know or don't know your stuff..

eliminating EMT-b is a bad idea...I don't want unconscious incompetent Paramedics in the field working IFT or 911..You can have all the hours of training in the world..But if you get in the field and freak...That is bad...

If you are in the field as an EMT-b for a year or two...You are conditioned for alot more....If you do what I said (understand the abilities of a Paramedic and what they need to do) You'll be a better paramedic because of it...

I'm not interested in playing the game of defacing the guy under me....We are (should be) all professionals here..We should know our jobs and understand how the guy under or above me can assist in the EMS process....Reread the chapter (introduction to the EMS system) "Roles of the EMS system...

I don't want to work with an EMT or Paramedic who thinks they know all..and wants everybody to know that...They are usually the ones to screw up first...I want to work with somebody who KNOWS the job and does it...


This is exactly what I wanted to say. All through EMT school I would pride myself on learning and understanding MORE than the bare minimum. Not only because I enjoy it, but because it helps me and the paramedics we assist in my area. Through my ambulance and ER time (which for me was about 90 hours) I would continually watch the medics, ask them about everything I could and how I could further assist them. Some health providers (not just basics) get their certs and figure it's the end of studying and education, which couldn't be further from the truth. I find new things to study all the time in order to stay on top of things. Because, if I can do good at my job as a basic, it will help the paramedics and everyone else in the long run. Especially around here, where we are first on scene before the medics quite often. Do I think I'm a medic, or that I'm above anyone else? Absolutely not. I couldn't even begin to say such a ridiculous thing. But, do I feel I'm a competent new basic and that I try to stay on top of my game? Absolutely.
 

Cohn

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A very good medic and RN told me once:


"You know it’s the basics that save lives."
 

JPINFV

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A very good medic and RN told me once:


"You know it’s the basics that save lives."

Yes, the basics do save lives. But does not health, preperation, assessment, long term treatment, and the skill of the surgeon not also save lives? One cannot save lives on CPR and defibrillation alone.
 

Anthony7994

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Actually, scratch what I first said. I did some thinking about this tonight at dinner, and I realized that when I thought I was studying to be more competent as a basic, I was actually trying to FURTHER my education, since the scope of a basic class is so limited to the point where I feel like I'm providing an inadequate level of care. The idea of making EMT-B into first responder and the lowest level of EMT being Advanced makes complete sense. I just want to take an I or P class already, but since I'm going into the military, I don't have time. So, I will spend my time studying more and getting to understand more in the field, since the National B course really doesn't do much for you... :sad:
 

EMTSTUDENT25

Forum Lieutenant
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Im going to agree 100% with Linuss on this one...The mindset in basic school was that WE (as basics) we going to be pushing the meds, doing this, doing that, and in all reality there should have been more emphasis on assisting ALS...

Most of what was brought up at any given time was the idea of an ALS INTERCEPT(not sure how much that really ever happens). Im sure there are many BLS rigs in place in the US, but ALL of the clinicals I took part in were ran EMT-IV/Medic or Dual Medic rigs. Meaning that the emt's responsibilty was grabbing cot, monitor, and first in bag. I have no problem with that however not the picture we were painted in school.

To prove this point more, the shifts where the emt had been paired up with the same medic for long periods of time ran much more smoothly. They knew how to assist ALS...
 

MrBrown

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To prove this point more, the shifts where the emt had been paired up with the same medic for long periods of time ran much more smoothly. They knew how to assist ALS...

The UK has done exactly this. Each ambulance will have a State Registered Paramedic and a six week trained Emergency Support Worker (ECSW) who is basically the Paramedic's bag fetcher and driver with zero clinical autonomy. This is at the expense of the model of Ambulance Technician/Paramedic which has worked well for more than 20 years where the Technicians had actual clinical skills e.g. LMAs and a range of intramuscular drugs.

A Paramedic needs another Paramedic or a good Ambulance Officer to work with them and bounce ideas off, not an "assistant" to fetch bags or drive.
 
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