# Useless



## Ethanol4all (Jul 16, 2007)

Hey Guys,

I finally finished my EMT-Basic class, got through the NREMT_B np, and grabbed my license asap..... and I couldn't help but feel .... "that's it?"  

...honestly, and I mean absolutely no disrespect to any seasoned EMT-B's here,  I felt as if Basics are allowed to do nothing but serve as extra hands, possibly to set up an IV or Oxygen, and to work as human triage buffers to make sure a small medical problem or a bogus call doesn't wake up the lazy ALS team that's sleeping back at base. Lol.....well now that I've offended every EMS member.... 

It just seemed to me that EMT-B's in real life actually don't get to do jack-squat in urban/suburban areas, and I found that ridiculously frustrating. Granted that if i was the patient, I'd want paramedics and no one else working on me....but it just seems to me that EMT-B's are useless in actually healing a patient. At best, we possess minimal knowledge in keeping the patient alive until better help can get to them.

Don't get me wrong, there's no doubt that Basics are the foundation of EMS... and maybe i'm just being ambitious at the age of 18, but I couldn't help but feel that at the end of the day, we're inferior and ridiculously subordinate and even useless compared to nurses, PA's, paramedics, and the almighty M.D.'s.....


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## Flight-LP (Jul 16, 2007)

You are correct in the aspect that basics' are minimally trained to provide a level of sustainment until arrival of or transfer of patient care to a higher level. Your frustration is admirable, I wish more basics could see the bigger picture like your eyes do, instead of thinking their s@#t doesn't stink because they can do _______(insert cool ALS intervention here).................

Wanna get rid of that frustration and limited feeling? Don't stop where you are at, go on to become a Paramedic. Your 18 and impressionable, this is the perfect time for you. Get your medic, take some college A-P, English, and Microbiology courses. FURTHER YOURSELF! Don't limit yourself to a lifetime of mediocity........

+5 points for your analysis and realization!


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## Tincanfireman (Jul 16, 2007)

Basic certification is just that, basic. You have to start somewhere in the learning process to achieve higher goals, and you've just completed the first step. I've worked with a lot of strong -B's who are firefighters and non-ALS rescue squad members. Some folks don't get the opportunity to go higher in their EMS certfication level without leaving an established job that they love. Would I like to take Medic courses? You bet! However, we do not run ALS services at my full-time job at the airport, and it's pointless to expend the time and effort to gain -P certification so I can work a single 12 or 24 hour shift every week as a part time job. I'm flattered that many of my part-time coworkers have urged me to continue on, but it's just not a commitment I'm willing to make for some professional and some personal reasons. I agree with FlightLP that your enthusiasm and motivation are commendable, but take some time to gain experience at your current level before heading straight into Medic classes. You can be an invaluable asset to your medic partner as a "strong" -B or -I, while helping yourself at the same time by picking their brains at every opportunity. What works for me may not work for everyone, but it's my personal .02 on this subject. Best of luck in your future studies.


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## oldschoolmedic (Jul 16, 2007)

Twenty years ago it was put to me like this, "You're either the paramedic, or the paramedic helper. Now, do you want to go to paramedic school or not?" I went and haven't looked back. Just keep going to school.

And by the way, even paramedics who think they know everything, don't.


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## eggshen (Jul 16, 2007)

A grand majority of the stuff we do is BLS most of the time so relax and go to college.

Egg


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## Onceamedic (Jul 16, 2007)

Basic was the hoop I had to jump thru to get to paramedic school.  It seems ridiculous to me as one of the first things the paramedic instructor said to our class was that basic stuff was useless to us and to forget it. Paramedic school was always my goal.  I "basically" agree with you.


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## BossyCow (Jul 16, 2007)

I believe any level of certification is only going to be as useful as the individual holding it.  If you see your basic as a 'hoop you had to jump through' or a pre-requisite for some other certification, you are going to behave differently while doing that job.  

If you take pride in what you do, it's not useless.  Even if you are only allowed to drive the ALS team to the ED, they wouldn't get very far if they had to push the gurney on foot now would they?  So, is driving 'useless'?  

I'm part of a volly agency.  There are calls when I'm the only medical responder and there's calls where everyone shows up and I end up copying the pt's med list or, helping back up the ambulance or even just standing by the station filling out the all important Call Log.  We are part of a system.  It's not all hands on and its not all exciting, but it all has value.


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## firetender (Jul 16, 2007)

All right, so you feel like an understudy who'll never get to really play the part!

It hardly matters because sometime soon you WILL find yourself in the situation where you are the only one who can do anything, and you'll have to do it -- and MORE -- regardless of your training or how over your head it is. Meantime, rather than focusing on what you aren't allowed to do, I'd suggest really paying attention to EVERYTHING you can see and do, and you know what? Part of your job is to really make sure all the basics of the basics are taken care of, because your Diva partners WILL forget!


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## Onceamedic (Jul 16, 2007)

I didnt say I thought it was useless Bossy... the paramedic instructor said it...   I think there are a lot of really good basics out there... I just never had the opportunity to try my hand at it.  My town is paramedic service only.  I applied for a basic job when it was available in a neighboring county but didnt get it.  I didnt sweat it tho cause paramedic was always my goal.  Eventually, I hope to get a degree in paramedic science because I am really interested.


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## BossyCow (Jul 17, 2007)

Kaisu said:


> I didnt say I thought it was useless Bossy... QUOTE]
> 
> No, you didn't... but the title of the thread did use that term. I was responding to the thread in general, not you in particular.


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## Ethanol4all (Jul 17, 2007)

Yeah, I know what you guys mean.....I'm definitely going to continue my education, and i'm already in college (I'm a second-year at UCLA right now, Neuroscience Major geared towards Pre-Med)

...just sorta wish I could take it a little farther in EMS than basic....but CA doesn't have intermediates and paramedic school is too much time and effort (it's more of a career).....   
ah well....
....guess I just gotta give it time, find some sort of meager satisfaction in what I DO manage to do for the patient, and hope it all works out for the best....

Sorry BossyCow....I didn't mean to insult anyone....more than "useless," i meant to say subordinate/inferior to other healthcare providers..... 

Thanks a lot though guys..


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## BossyCow (Jul 18, 2007)

I didn't take the 'useless'  comment as an insult to me.  I saw it as representative of an attitude taken by some others.  I understand in some of the more urban areas that Basics are not given the responsiblity for real patient care and are treated like a set of auxiliary hands for the higher medical authority to direct.  This has to be frustrating.  But attitude is everything.  

There are going to be times as a paramedic or even as a doc ( you mentioned being pre-med) when your hands are going to be tied by your job description, company policy, insurance reimbursement criteria... and more ad nauseum.  Every job has the 'shut up and just do as you are told' component.  

I have a friend who is a very successful studio musician.  He was talking to a young musician who was telling him in a very superior tone how he would never give up his dream and get stuck playing 'backup' to someone else's music.  My friend looked at this young man and said.... "I've been part of making some really spectacular music.  There is no shame in that!"  

From time to time we all have to play backup to someone else's music.  The sooner we accept that, the happier we are.


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## Tincanfireman (Jul 18, 2007)

BossyCow said:


> From time to time we all have to play backup to someone else's music. The sooner we accept that, the happier we are.


 
My nomination for Best.Post.Ever.


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## sarahharter (Jul 18, 2007)

okay i have been an emt-b for about four years and some months know and i have done alot of stuff that has determined whether a  pt lived or not. where i live we runa bls and als truck and you don't always get als, so you have to be able to do what ever you can to get your pt alive to the hosp. i think you need emt-b and medics just the same. some of are medics just hopp right in my truck and wait for me to do everything before they have to do there stuff and yes sometimes we are just extra hands however sometimes those extra hands are very important. yeah i wish i could do more but for my state i had to drop my nremt-i so that i could be an emt in the state. i will eventually go through medic class.  the medics around me are really good and have told the emts that we are a good thing to have and then there are the ones who say emt-b are trash and shouldn't be allowed on a truck. everyone has their own opinion on the matter and this is mine:

emt-b is as important as a medic when you work together everything goes great. the medic may be able to do more if needed but an emt-b can also save a persons life with just bls skills.


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## MedikErik (Jul 19, 2007)

EMT-B's are limited, but are still extremely useful. Sometimes an OP airway, a BVM, and an AED/chest compressions are all it takes to save a life. Seattle has the highest save rate in the world, and they use BLS first response. 

It depends also on where you ride. If all you do is ride third on an ALS unit, then yes, you're a gopher. Carry the bags, make the cot, etc. But if you run on a BLS unit, you can get some good skills in. Either it's a BLS transfer, or you have a crashing patient all to yourself until ALS shows up. Keep your chin up! Don't be afraid to ask the paramedic "hey, can I run this one and you drive?". Most will be happy to get out of the box and into the drivers seat on what is, to them, a "BS call". That, and they get out of writing the report, contacting the hospital, etc. Try it!


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## Flight-LP (Jul 19, 2007)

MedikErik said:


> Seattle has the highest save rate in the world, and they use BLS first response.



Not to hijack a thread, but could you enlighten us as to where you received this information?


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## MedikErik (Jul 19, 2007)

I believe it was JEMS, though it could have been one of the other EMS mags lying around the station; I'll look it up and post.


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## MedikErik (Jul 19, 2007)

I found this; I'm pretty sure a related article had the exact statistics.

http://publicsafety.com/article/article.jsp?id=3451&siteSection=17


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## VentMedic (Jul 19, 2007)

*MedikErik* Was this the data?  It has been referenced in several journals. USAtoday loves to gather this info for their newspaper.

Also, if you really want to know what is happening around the world as for as different resuscitation topics, there is a journal call RESUSCITATION. You can read the abstracts. For the full article, you can usually pull it up at a medical library or teaching hospital. 
http://www.sciencedirect.com/science/journal/03009572

*Paramedics not always the saviors of cardiac-arrest patients *
http://www.usatoday.com/news/health/2005-03-01-ems-cover_x.htm

*Six Minutes to Live or Die*
http://www.usatoday.com/news/nation/ems-main.htm

*Survival by the numbers*
http://www.usatoday.com/news/health/2005-03-01-ems-numbers_x.htm

*How 50 Major Cities Stack Up*
http://www.usatoday.com/graphics/life/gra/ems/flash.htm

*Cardiac arrest survival as a function of ambulance deployment strategy in a large urban emergency medical services system * from RESUSCITATION journal

http://www.sciencedirect.com/scienc...serid=10&md5=ff8a8f5bf1046e1ae87ad5b86a41a9cc


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## MedikErik (Jul 19, 2007)

Well, while this arguement really belongs in its own thread, my initial point was that BLS does save lives, and isn't just a bag carrier/driver for the EMT-P. I dare say that in my personal opinion you do just as much good holding C-Spine on someone with a fractured neck from falling down the stairs as you would performing an RSI on a trauma arrest. Giving a 5 year old an epipen jr. (I know it's not BLS everywhere, but it is in my state) can work just as well as epi given through an IV in terms of warding off anaphylaxis. And to a pt. with an airway obstruction, sometimes a good old heimlich or suctioning followed by BVM/NRB  (depending on condition of the pt., how long they couldn't breathe, etc.) will work as well if not better than dropping an ET/NT. BLS is the foundation everything is built on, and over the course of your career the number of BLS calls you'll run with most likely exceed the number of ALS calls (exceptions made for those who do critical care transports, medivac, etc.).


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## VentMedic (Jul 19, 2007)

MedikErik, you have opened a door for an interesting topic.  The articles and research usually reflect the opinion of the person(s) doing the study. They have the control of what is studied, not studied, and what data to publish. Of course it has to have some guidelines to remain credible.  Everyday there are new research articles submitted for evaluation and publication. Some are product or politically motivated. If you want a point made, you can search through a 100 articles and find 5 that will agree with you. The other 95 may not agree with you, but those you are not interested in.  Yes, this is done when someone wants a new tax passed to support a new ALS system or acquire a flight program. There are also studies to support BLS systems for the area. 
http://pdm.medicine.wisc.edu/20-4 PDFs/Isenberg.pdf

*medic5740* has posted a new thread for Rural EMS which I hope will get some good replies.  Sometimes even in the rural regions, it's not always about the ALS or BLS but the skills appropriate to the region.  Farm machinery, coal mines and water require something very different.   For this reason, some industrial and agricultural companies will send some of their own employees to EMT classes. Many times BLS support and swift extracation can save a life. ALS is good, but may not be the closest. A paramedic working solely at an industrial or agricultural site may not be able to keep up their ALS skills.   

Yes, I know all of my posts have been pro-education in the medical fields, but sometimes, there are some situations where different experiences, expertises and other areas of education are required.

The EMT-B is still a very important part of many systems especially if they have other skills and knowledge to compliment their EMT-B.


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## Emtgirl21 (Jul 20, 2007)

Ya know, I bet the kid that I laid with inside a demolished car two nights ago for 30 minutes while FD cut her out wouldnt say that my EMT-B license is useless. And I know all my paramedic co-workers who dont have to get up at 3am to go do a psych transfer after they have ran 10-15 calls already that day wouldnt say me and my bls truck is useless. Matter of fact when we go out of town on a long distance trip went we get back we always here....we didnt realize how much you guys do. So needless to say....i'm a little offended.  

Paramedics do alot more "skills" than a Basic....but us Basics have our place.


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## VentMedic (Jul 20, 2007)

BossyCow said:


> There are going to be times as a paramedic or *even as a doc *( you mentioned being pre-med) when your hands are going to be tied by your job description, company policy, insurance reimbursement criteria... and more ad nauseum.  Every job has the 'shut up and just do as you are told' component.



That comment is very true for doctors.  Almost every hospital will have a list of different skills and privileges granted to each doctor.  Some doctors can not intubate, put in central lines or manage ventilators along with a whole list of other things.   It is also understood that a consult for a specialty physician must be obtained for certain patients.  So yes, some hospitals make some doctors feel "inferior" and a little useless at times.


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## BossyCow (Jul 20, 2007)

Emtgirl21 said:


> ....i'm a little offended.



I wouldn't waste time being offended.  No one can make us feel inferior without our compliance.  I have met 'useless' EMT-B's.  I've also met 'useless' Paramedics, docs, nurses, plumbers, bank tellers, and hoards of others who bring a sense of drudgery and minimalism to the performance of their jobs.  It's all in the attitude.... heh heh, and I've often been accused of having more than my share of _that_!


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## madone (Jul 21, 2007)

I agree with Tincanfireman on this subject.  We all pick our own choices on how far we go, but being a basic has its place no matter what.  I would love to continue on to medic school, but it is not practical for me.  My chosen profession "allows" me to serve as a member of our Emergency Response Team as an "extra" for my job.  It is funny how everyone else dosent think much of your skills or training until the sh*t hits the fan.  Then all of those expect to see you there doing something to "make it all better"
Good luck no matter how far you go and remember no matter what things would be a whole lot different without you there.


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## MMiz (Jul 22, 2007)

When I was looking into EMT school, and even after I graduated at the age of 18, I didn't understand what the big deal was.  I too couldn't imagine why someone wouldn't just go through to get their paramedic license.  *I am one of those people that never went beyond EMT-Basic training.  Somewhere between my idealism, ego, and reality, I soon found out that Paramedic school wasn't in my reality*.

My grandfather was saved by "just" a mall security guard trained in CPR/AED.

I think you'll find that many EMTs also have other jobs.  In fact I haven't worked with a single partner that is *just* an EMT.  Some are raising kids, some worked corporate jobs, and *some work as an EMT because that's what made them happy*.

In the perfect system, EMTs act as first responders and provide care prior to ALS arrival.  Then they stick around and support the ALS folks by doing the BLS stuff (Patient assessment, bagging, pumping, grabbing, etc).

I can't tell you how relieved many of our patients were to see us arrive within a minute or two, and how relieved I was knowing ALS was only a few minutes behind.  Often we'd start the assessment, start vitals, and start treatment (O2, EPI, Backboard, etc) and have all of that started when ALS arrived.  _It worked perfectly!_

There were times when our BLS units would get an AED shock or two in before ALS arrival, and times when BLS would be bagging the patient when ALS arrived.  _Our ALS was required to be on scene within 5 minutes, _but still, a BLS unit would arrive on scene and get the party started.

I'm just an EMT... and a middle school teacher... and student council chair... and coach... and student... and web designer... and...(you get the point)


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## Ethanol4all (Jul 22, 2007)

....right....and I completely understand how an EMT-B is extremely important for the EMS industry, and how he/she definitely plays his/her own vital role in saving/caring for the patient...  

but my issue is with how useless and practically inept we become, in terms of our ability to treat the patient and our medical knowledge, when ALS gets on scene and takes over....(then we're just hands)...

I mean, in front of ALS, EMT-B's are hopeless....   my point being....wouldn't it be better if every call was responded to by Paramedics? Granted that this would be radically inconvenient and expensive, but wouldn't it be better for the patient.....and please don't take offense to this....if the EMT-B profession was sort of eliminated..?  I mean, it seems to me EMT-B's are only in action where Paramedics cant be expected to run every call...and they sort of function like triage buffers with a few skills thrown in to keep the patient alive...


So in that sense.....isn't the EMT-B position obsolete? (except to save the Paramedic's time?)


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## Emtgirl21 (Jul 22, 2007)

ah no. Even when I have a paramedic partener....there are still times when I do all of the pt care and he just drives.


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## Emtgirl21 (Jul 22, 2007)

I really think that you just really need to go work or ride with a service that uses EMT's and follow an EMT around for a while. I had a really long post about all the things an EMT does but my computer decided to erase it. 

I have days when I work with a medic partener and there are times I do all the pt care. Last shift. I did all the patient care until bout 5pm. We had a prehospital birth. He treated mom. I treated baby. I mean there really is alot that EMT's do. 

I lost the rest of my post. I really did have a good point....but oh well.


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## daemonicusxx (Jul 22, 2007)

I'm a Paramedic, but i ride with a basic. i ride with the same guy everyday, and ill be the first to say, i dont know what i would do without him. 

He is filling out applications for fire dept's in the area, and i told him the other day, he better not put me down as a reference because i will lie through my teeth when they call. ill tell those guys what a lazy, wierd guy he is... just so that they wont hire him, and i can keep him. 

Personally i like riding with a basic way way better than riding on a double medic truck. dont ask me why, cause theres plenty of reasons, i just like it better. 

Basics ARE a second pair of hands, a second pair right when we need them. i wont take credit for a save, because i know i couldnt have done it without the help.


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## Guardian (Jul 22, 2007)

Ethanol4all said:


> ....right....and I completely understand how an EMT-B is extremely important for the EMS industry, and how he/she definitely plays his/her own vital role in saving/caring for the patient...
> 
> but my issue is with how useless and practically inept we become, in terms of our ability to treat the patient and our medical knowledge, when ALS gets on scene and takes over....(then we're just hands)...
> 
> I mean, in front of ALS, EMT-B's are hopeless....   my point being....wouldn't it be better if every call was responded to by Paramedics? Granted that this would be radically inconvenient and expensive, but wouldn't it be better for the patient.....and please don't take offense to this....if the EMT-B profession was sort of eliminated.



No, it would be better if we had internal medicine specialists (MDs who are the real experts of medicine, aka, the doctor's doctor) riding on every ambulance.  But that isn't going to happen and similarly, your idea isn't going to work either.  Plus, if we required every ems responder to be a paramedic, invariably the quality of paramedics would go way down.  I do know where you're coming from and I think we should constantly be challenging ourselves to provide better care and not go backwards (like we are now), but making everyone a paramedic isn't realistic.


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## firetender (Jul 22, 2007)

As much as we all hate to face it, economics is a driving factor, too. EMTB's are cheaper to hire and there's a relatively high turnover rate so no problems of all those step-raises. It's convenient for services to keep that system going because training paramedics is costly. The ones who really, really want to be paramedics will put up with a lot of crap to get there since the EMTB, by definition (okay, I exagerrate!) is expendable.


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## Ethanol4all (Jul 22, 2007)

mm.....good points....thanks guys......


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## IrishMedic (Jul 23, 2007)

well ill put my point this way.....the best docs, paramedics and nurses etc are the ones who always remember the basics of their job....i mean i was offered paramedic school, straight after i qualified my EMT_B course, and i refused becaused i wanted exleast one years experience on the road, making sure i knew the basics, getting to listen to as many lung sounds/ heart sounds as possible, dealing with as many medical/trauma Pt's as i could, learning how to see and deal the "BS" calls etc....theres always gonna be something new everyday that i can learn for the rest of my career but thats the easy part, tough part is remembering that basic training i had, where i learned and perfected all my core skills...use the time to know what normal is and what isn't...in ireland 90% of the ambulance service is BLS and we are the guys saving lives....I've worked with ALS a few times in a just over a year and we have a very limited air ambulance service, basically the coastguards or Military provide it...but normally its only for major incidents we use them....one of the bases i work with serves a community thats 90 minutes exleast to the nearest treatment facility and thats in the best of weather...so right now all basic skills are being used....just gotta use them wisely and keep with it....you'll find your skills come in handy.....ive been on calls were some senior more qualified people are wondering how to treat or extricate a pt...and its the Basics that come up with the best solution....


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## DrParasite (Mar 8, 2019)

raising an old thread from back in the day.....


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## Phillyrube (Mar 26, 2019)

A good EMT is hard to beat.  Alleviates the need for ALS in a lot of cases.  Why?  When an EMT gets in trouble, he calls.......a paramedic.   I've been called to help with odd splinting or patient movement problems, cause the EMTs were stumped.  Velcro doesn't work all the time.......


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## E tank (Mar 26, 2019)

If personal validation (not the same as professional gratification) were a primary motivation for entering any level of care of the sick and injured, one would be in for a very short ride.


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## wtferick (Mar 27, 2019)

I 


Ethanol4all said:


> Yeah, I know what you guys mean.....I'm definitely going to continue my education, and i'm already in college (I'm a second-year at UCLA right now, Neuroscience Major geared towards Pre-Med)
> 
> ...just sorta wish I could take it a little farther in EMS than basic....but CA doesn't have intermediates and paramedic school is too much time and effort (it's more of a career).....
> ah well....
> ...


I would suggest even skipping Paramedic School and get into PA school. We have a ton of ex Paramedics at the Hospital that I work at who either became nurses and or PAs. 

Don't forget to look into ER Tech jobs. You get to learn overall care of a patient and start to make connections. You'll even get to pull cardiac arrest out of cars every once in a while 😬Lol


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## johnrsemt (Mar 28, 2019)

A fairly large county in Nevada has Basic's and  A-EMT's but no ACLS drugs;  they use Auto Pulses, and AED's.  They had 7 patients walk out of the hospital after cardiac arrest saves.  and it is a 2 hour drive to the closest hospitals for them.  either towards Vegas or over the border in CA.  Half of their ambulances are BLS only, I think they have 4 A-EMT's in the county.  
So BLS is good for something.


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## Stebe1020 (Apr 2, 2019)

I've been a emt-b for 10 years and have worked in ER's, 911 services, transport service, pediatric critical care transport and have found that your job will vary in all these settings. I have also had my IV cert for 8 of these years and at all of my jobs it has been accepted and I have been able to start IV's. When you first become a basic and start working yes you will be viewed as a newbie that doesn't know much but if you want to change this either become the best basic you can or go to medic or nurse school. Best wishes keep learning and don't get discouraged!!


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## Summit (Apr 3, 2019)

DrParasite said:


> raising an old thread from back in the day.....


WHY? Why bump this 12 year dead thread?


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