EMT-B to EMT-P... A Bad Idea?

[VentMedic]

Vent - My one company provides drivers and trucks for the Children's hospital and one of the other large hospitals (with a big cardiac and burn program). I've subbed at both places at one time or another, and some of the staff just want us to be drivers and stay out of their way. Its a shame.

It is but if you knew the hours some of these teams have spent training and educating together, it is sometimes hard to bring in outsiders into the patient care aspect. Also, remember the bystander and EMS thread we had on this forum recently and the attitudes about "outsiders" trying to offer information, ask questions or help even for CPR?

They may also have been given attitude by those before you which spoiled the atmosphere. There have been Paramedics who challenge team members with the "I can intubate and start IVs. It's in my scope." However, few can ever say they have intubated or started IVs on a 23 week preemie and not more than 100 times in the past year.

Some states now specify the minimum requirements for EMS/Specialty teams as in the past some BLS and ALS trucks transported patients they were not qualified for. Florida is also making specific requirements of the medical director and having the facility deemed as the higher level of care that the baby/child is being transported to determine what team is needed. But yes, it does make it difficult for EMT(P)s to be part of these teams as their education does not prepare them or allow them to work in NICUs to gain the hours needed.

 

[daedalus]

And then you have the 'odd one out' situations that no-one's blanket statements will be able to cover.

Take me, for example. I'm an EMT-B student, who has, as I've stated, no misunderstandings about the fact that when I finish my training, I will be qualified to give Basic. Life. Support.. What's more, I even work as a volly (quelle horreur!).

So, some might say "you don't have enough knowledge to know whether what you're doing is the best thing for the patient under the circumstances" (the 'raise the bar' refrain, which I actually happen to agree with). What do you do then when I tell you that I went through medic(al) school? Actually, that's not quite accurate, I did biomedical science in Australia.

For those not in the know, medicine in Australia used to be exclusively an undergraduate degree (albeit a six, then five year one). Around 15 years ago, the biomedical science course was introduced, similar, but not identical, to a more U.S. system of "pre-med", with post-grad medicine as an option.

So I have no experience in the field at the moment, and I got no practical medicine experience (no rounds, etc) at school.

But while many are assured and confident in the belief that an EMT-B couldn't possibly know (as a great generalization) "just how much they don't know", a brief list of my studies: biomedical chem, cells tissues and organisms, medical biophysics, human neurobiology, molecular biology, A&P, biochemistry in human function, body systems, genetics, microbes in health and disease, bioinformatics, molecular medicine and biotech, biomedical basis of disease, nutrition, embryology, immunology, and pharmacology. Assumption, as they say ...

`Tis sad to see something that we can all agree on, I believe (after all, who would argue that less education is a good thing), be such a source of tumult.

That is an awesome education to have for yourself before going into EMS. However, in the United States, 120 hour course is all that is needed for certification as an EMT. That means anyone from a high school drop out to your level of education can get an EMT card. Your statements are as if a janitor in a major legal practice told one of the partners that he did pre legal education at UCLA. Doesn't matter, he is still the buildings janitor...

 

[Shishkabob]

But to say all janitors are high school drops outs would be wrong, wouldn't it?

 

[daedalus]

But to say all janitors are high school drops outs would be wrong, wouldn't it?

Yes, I do not believe that all janitors are high school drop outs. What I am saying is that it doesn't matter what kind of background education you have, if you are hired as a janitor, you are a janitor. Same with EMT, if you are certified as an EMT, you are an EMT. Not a super dooper EMT just because you have a degree in biomedical science.

 

[Akulahawk]

Yes, I do not believe that all janitors are high school drop outs. What I am saying is that it doesn't matter what kind of background education you have, if you are hired as a janitor, you are a janitor. Same with EMT, if you are certified as an EMT, you are an EMT. Not a super dooper EMT just because you have a degree in biomedical science.

The same applies to you... and me. You are an EMT. You may utilize the scope of practice of a Paramedic while you're in training to be one, but you're still "just" an EMT. That does NOT mean that while working as an EMT you can't utilize what you've learned in assessing patients. In fact, it would behoove you to do so... as long as you don't exceed your authorized EMT scope of practice while doing so.

From previous training, I gained knowledge and skill that go way beyond anything that any US Paramedic can do in the field. That would most likely also go beyond what most RN's can do. I'm "just" a Paramedic... That doesn't mean that I can't bring my clinical knowledge into play on certain patients... it enhances my decision-making abilities for those patients.

It just means that I can not exceed my authorized scope of practice...

Med Students are in the same boat. They may be licensed in another field of healthcare, and the knowledge they gain while in school is incredible... but until they get their Medical License...

 

[Achromatic]

Yes, I do not believe that all janitors are high school drop outs. What I am saying is that it doesn't matter what kind of background education you have, if you are hired as a janitor, you are a janitor. Same with EMT, if you are certified as an EMT, you are an EMT. Not a super dooper EMT just because you have a degree in biomedical science.

No, and that is a valid point to make.

As I said in my original comment, "I realize that my qualification is one that allows me to provide basic life support", not "I'm an EMT-B but since I've done this and that you should allow me to do -P tasks", definitely not. More that "you can't say it's impossible for you to know how ignorant you are" ('you' in the generic sense, not you specifically).

And whilst I'm aware that my experience is far from the norm, I think akulahawk's comment bears repeating, that people who care enough about this topic to discuss it here are far from the norm in at least that regard.

 

[Shishkabob]

Not all Muslims are terrorist. Not all Doctors are smart. Not all NRA members want to shoot anything that moves. Not all Vegans hate meat eaters.



To classify all people as the same thing, simply because they share a title, is weird.

 

[daedalus]

Not all Muslims are terrorist. Not all Doctors are smart. Not all NRA members want to shoot anything that moves. Not all Vegans hate meat eaters.



To classify all people as the same thing, simply because they share a title, is weird.

Your posting behavior is bizarre to me. This is not an insult, but a request for clarification. I say one thing and you find an irrelevant aspect of it, twist up, and than question it. I am hard pressed to see how your last two posts have contributed to this thread.

I did not call Janitors high school drop outs, nor did I make any sort of sweeping generalizations other than to say an EMT is an EMT.

 

[Shishkabob]

Yea, I'm pretty random in my rants.


My one and only point I've been trying to make in all my post in this thread is this:


Don't make sweeping generalizations about a title. Not everyone in a group is the same. Even though with some generalizations, more often than not they hold true, but it's still an insult to the people that it is not true.

Yes, there are idiotic EMTs, but to say all EMTs are uneducated is laughable, if for no other reason than you and I are both EMTs and we're in medic school.


The exception disproves the rule.

 

[daedalus]

Yea, I'm pretty random in my rants.


My one and only point I've been trying to make in all my post in this thread is this:


Don't make sweeping generalizations about a title. Not everyone in a group is the same. Even though with some generalizations, more often than not they hold true, but it's still an insult to the people that it is not true.

Yes, there are idiotic EMTs, but to say all EMTs are uneducated is laughable, if for no other reason than you and I are both EMTs and we're in medic school.


The exception disproves the rule.

True! However, would you agree to this:
The harder it is to become an EMT, the less idiots we will have?

For example, if EMT meant taking college a&P, microbio, bio, chem, med terminology, and english, do you think that a lot of the idiots might fall through before making it to EMT?

But, idiots always make it through, even to medical school. I give you that. Just a lot less idiots are doctors than EMTs.

 

[Shishkabob]

I've always been for more education (says the medic student who hasn't taken A&P). I'm all for making the EMT-B level harder to obtain because of the education required.


Never going to argue on more education. Just going to argue on people labeling me as not knowing anything simply because my patch is blue and not red.

 

[daedalus]

I've always been for more education (says the medic student who hasn't taken A&P). I'm all for making the EMT-B level harder to obtain because of the education required.


Never going to argue on more education. Just going to argue on people labeling me as not knowing anything simply because my patch is blue and not red.

reeeeelaxxx. I know you are pro-education.

If anything, making EMT harder equals more money in my pocket, and less people with cards in their wallets to compete for jobs with.

 

[JPINFV]

Don't make sweeping generalizations about a title. Not everyone in a group is the same. Even though with some generalizations, more often than not they hold true, but it's still an insult to the people that it is not true.

Yes, there are idiotic EMTs, but to say all EMTs are uneducated is laughable, if for no other reason than you and I are both EMTs and we're in medic school.


The exception disproves the rule.

...but you take outliers as outliers, especially (in terms of education level) outliers to the right. You don't make policy, protocols, procedures, and scopes of practice based on the minority of basics who take college level courses. You don't make policy based on what courses a provider has the opportunity to take. You make those based on what the provider is required to take (either in order to pass a local certification exam or to be eligible to take state/nation certification exams) while considering your average to somewhat below average providers (defensive protocols).

As my saying goes, it's EMT-B, not EMT-JPINFV.

 

[EMS_Junkie]

Im an EMT-B with only a few months experience but Ive been on my ambulance service as a drive for a year and a half and I just started my Paramedic Specialist training last month.

 

[audreyj]

I do agree that there needs to be more pre-reqs to a paramedic program. I have college level A&P and microbiology and chemistry in high school. I can't imagine taking the paramedic program without the A&P, there is just SO much to learn and so little time afforded by a lot of programs. When I tested for the program that I'm currently in the coordinator said that those who are fresh out of the EMT-B course will probably have a better shot at getting in because they haven't gotten into any bad habits and they haven't forgotten the information. There are a lot of students in my class who are fresh outta EMT-B. I am one of those students.

Before becoming an EMT I was a CNA so I'm not totally green in the health care world but taking the biology's I have it definitely helps.

 

[EMSLaw]

For example, if EMT meant taking college a&P, microbio, bio, chem, med terminology, and english, do you think that a lot of the idiots might fall through before making it to EMT?.

Which, incidentally, are just about the requirements for most health care professional schools. BSN post-bac programs require that, plus maybe stats or calculus. Add organic chem and math, and you have the requirements for medical school.

PA programs are weird, I think they have lots and lots of pre-reqs, but don't quote me on that.

But yes, you'd exclude some idiots. You'd also get new, improved, college edjumicated eejits.

 

[JPINFV]

Err. I can't think of a single US medical school (MD or DO) that requires A/P or medical terminology. Few require microbiology (a lot more recommend it) or English (although there's a verbal section on the MCAT).

 

[Cory]

I think there should just a be another level. You can't raise the EMT B course to a harder curriculum because so many ff's (and other professions) have to take it now, and it wouldn't make sense for them to take such an exstensive class.

 

[TransportJockey]

I think there should just a be another level. You can't raise the EMT B course to a harder curriculum because so many ff's (and other professions) have to take it now, and it wouldn't make sense for them to take such an exstensive class.

Why should we cater to firefighters? Keep EMT-B just to make them able to justify getting so much money? For EMS to grow and actually become a prfession and a career that is respected by other divisons of medicine (of which we are closer to rather than public safety) we need to expand our education levels and raise the bar to get into EMS

 

[Cory]

Why should we cater to firefighters? Keep EMT-B just to make them able to justify getting so much money? For EMS to grow and actually become a prfession and a career that is respected by other divisons of medicine (of which we are closer to rather than public safety) we need to expand our education levels and raise the bar to get into EMS

I completely agree. Just the other day I was talking to college student who was getting ready to take an RN course in a few months (knew him from high school), and he beasically tried to tell me that EMS just wrap you up and drive you to the real heroes. then he went on to say that EMS looses way too many people to even be credible. Of course, none of this is true, but it does refelct a fresh view on EMS.

But the EMT-B course has been overrun by all sorts of small-time non EMS professions.

What is the deal with EMT - I? Do you even have to take a class for that? Maybe something can be done there, harder curriculum, required to work in EMS maybe? Just ideas...