EMT-B Seeking Wisdom from Medics

[EMSLaw]

The Great Garden State

and who is that reputation from? people who actually work in NJ, and continue to still do so? or have just heard stories?

I guess your right, we could have the rep of California (where an EMT-P cert will get you a job flipping burgers until a FD offers you a job, or so I read on here) or florida (the land of a medic on every ambulance, fire truck, tow truck, and DPW vehicle). maybe you want to look at Philly, the capital of Pa? or DC? all shining examples of EMS

New Jersey has its upsides and downsides. You're right, the tiered ALS/BLS response system means that medics spend most of their time seeing sick people, and can turf the not-so-sick to BLS for transport. And, despite the limitations on the number of programs out there, all the Paramedic programs in New Jersey are paired with a community college, and are generally at the Associates degree level. The training is on the order of 350 hospital hours and 600 field internship hours, plus two or three semesters of classroom work, so far more than the bare minimum.

On the other hand... There are only 1700 licensed paramedics in the state, give or take a few, working for the MICU programs, which means that when you really need a medic, they will be several towns away and caught in traffic. None of the medic programs are accredited, though maybe that will change. The paramedic protocols seem limited, and there is a lot of "mother may I." Pre-hospital pain control in my area is a pathetic, sick joke.

Then, of course, there are the complaints about how NJ's BLS system is, in most of the state, largely volunteer based. Frankly, as long as the rigs get out, and there's trained EMTs on them, I don't see the difference whether that person collects a paycheck or not, but I don't want to start a volly/paid debate, and I know there are times, and places, where the rigs don't get out, and they don't have trained people on them. I will say that MICU projects love volleys. Not because they have any sort of particular soft-spot, but because volunteer services don't bill, which means the MICU can collect the entire insurance payment, rather than kicking back the BLS transport rate to the transporting company.

It seems to me like New Jersey isn't a bad place to be a medic, all things considered. It's not the most progressive EMS system in the world, granted, but it has its strong points and not-so-strong points.

 

[medic417]

Well first off, the EMT-Basic should be seen as an advanced first aid certificate, because *gasp, that is what is!

You may be onto something here. Those cities with less ALS such as Boston, Tulsa and Seattle with very strong first-response and BLS level care do have better cardiac arrest survival rates than say oh, Miami or Dallas where every Firefighter is a Paramedic. What a shocker!

Yes basic is barely more than a boy scouts first aid class.

And as has been mentioned on this site before it is not truly accurate to compare saves as each service collects data on codes differently. Some include every call that CPR is performed. Others only include witnessed codes. Still others only base the claims on non traumatic witnessed codes with a shockable rhythm. Another difference is the way success is determined some it is just getting ROSC others surviving a week and yet others the patient has to leave the hospital basically intact. So you can see why one service would be almost 0% while another claims nearly 50%.

 

[EMTinNEPA]

I guess your right, we could have the rep of California (where an EMT-P cert will get you a job flipping burgers until a FD offers you a job, or so I read on here) or florida (the land of a medic on every ambulance, fire truck, tow truck, and DPW vehicle). maybe you want to look at Philly, the capital of Pa? or DC? all shining examples of EMS

Without changing the subject, look at which entity is providing EMS in each of those cities and ask yourself if it's more to do with lots of paramedics or lots of people pretending to be paramedics in order to get a fire job.

 

[triemal04]

Because they are smart enough to realize that an all ALS system is unnecessary, and most good systems use BLS as the backbone of a good EMS system, leaving ALS for the sick patients? Not only that, but they keep a relatively few paramedic units in the city (compared to BLS), to ensure their paramedics are highly trained and experienced because they only deal with sick patients. and not every BLS unit is staffed with 2 paramedics who are waiting for a paramedic spot, there are EMTs who are happy as EMTs (I know, amazing concept).

But then, why bother hiring paramedics (who are paid at a higher rate than EMT's, even when working as one) as EMT's? Why not just keep the BLS units staffed with EMT's and the ALS units staffed with paramedics? Seems like they have thier reasons, whatever they may be.

 

[DrParasite]

But then, why bother hiring paramedics (who are paid at a higher rate than EMT's, even when working as one) as EMT's? Why not just keep the BLS units staffed with EMT's and the ALS units staffed with paramedics? Seems like they have thier reasons, whatever they may be.

I am guessing for this exact reason:

NOTE: Paramedics are promoted from within the Department only. Many of our EMTs are certified Paramedics but work for us as EMTs, gaining valuable experience until the opportunity for promotion arises.

so everyone, if they want to be a medic with BEMS, has to start out as a BLS provider. Makes sense to me, they learn the operational rules about BEMS, and when a medic spot opens up, then they can transition to the clinical rules of being an ALS provider.