# Can an EMT B become an ER tech?



## CardiacJunkie23 (Nov 20, 2008)

l


I am an EMT Basic and I am getting tired of the late nights. Can an Emt b become an ER tech??


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## aandjmayne (Nov 20, 2008)

I am not sure about your area. But in Louisiana you can. If you go to the hospitals website and look up the qualifications/job description for an ER Tech it will tell you. In Baton Rouge, the minimum is CNA or EMT-B cert. required to work as an ER Tech. That's not to say that you wont have to work nights though. Remember just like in EMS, ERs are 24-hour facilities too. In Baton Rouge each ER shift is 12 hours.


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## medicdan (Nov 20, 2008)

http://www.emtlife.com/search.php?searchid=498848


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## JPINFV (Nov 20, 2008)

You could always try looking at hospital websites. There're generally a section called "careers" where the hospital lists their open positions. Generally a search for something like "emergency" will list all of the emergency department jobs, which could include openings for ER techs.


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## BossyCow (Nov 20, 2008)

Our ER requires either an EMT-B, CNA or current enrollment in nursing school.


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## emt83 (Nov 20, 2008)

*Why not?*

I have been out of EMT school since May 2008, and I work at a hospital here in TX as a businness associate. I have failed my EMT Nat Cert 2 and have one more chance before a 24 hr remedial is needed. I have talk to the hospital and they said if I could get my Cert I can pull some Overtime as ER Tech. So just ask around and get to know your hospitals around you!! I am definitely back studying hard and will pass!!


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## BossyCow (Nov 20, 2008)

So what makes you think the hours will improve with ERT. The new ones work the late shifts here.


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## Code 3 (Nov 20, 2008)

BossyCow said:


> So what makes you think the hours will improve with ERT. The new ones work the late shifts here.



From my personal experience, hospitals tend to me more flexible when it comes to scheduling. You can hire on as PT, FT, or Per Diem/Casual whereas the EMS agencies down here require FT employment for at least 6 months and new shift bids every 3-4 months. Starting shifts at the hospitals for ER-Tech are based on needs and you'll see openings for both days and nights. Obviously, it all depends on the HS and area.


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## MMiz (Nov 20, 2008)

My EMT-Basic partner worked as an ER Tech in an urban hospital.  I know of many EMT-Basics who have been ER techs with phlebotomy training and ACLS.


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## KEVD18 (Nov 20, 2008)

emt-student said:


> http://www.emtlife.com/search.php?searchid=498848



shocking.....


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## alphatrauma (Nov 20, 2008)

CardiacJunkie23 said:


> l
> Can an Emt b become an ER tech??



.......Yes


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## VentMedic (Nov 20, 2008)

Try this link:

http://www.emtlife.com/showthread.php?t=9824&highlight=tech

There are a few other threads also.


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## WuLabsWuTecH (Nov 21, 2008)

KEVD18 said:


> shocking.....




um.... vBulletin Message
Sorry - no matches. Please try some different terms.


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## JPINFV (Nov 21, 2008)

Google 

site:www.emtlife.com ER tech


http://www.google.com/search?hl=en&...25&q=site:www.emtlife.com+ER+tech&btnG=Search


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## Xueyon (Dec 21, 2008)

CardiacJunkie23 said:


> l
> 
> 
> I am an EMT Basic and I am getting tired of the late nights. Can an Emt b become an ER tech??



Well if ur tired of the late hours then Er tech is out of the ? In Cali, hospitals mostly just prefer you be a Basic of CNA with bls card. I have 3 buddies who are tech and make $21.50hr an do 4/12 and sometimes 5/12. But they had no social life. So think again before going to er.


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## WuLabsWuTecH (Dec 21, 2008)

Can you calrify what 4/12 means and 5/12 means?  Around here we use FTEs or hours per pay periods.


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## Xueyon (Dec 21, 2008)

WuLabsWuTecH said:


> Can you calrify what 4/12 means and 5/12 means?  Around here we use FTEs or hours per pay periods.



Oh sorry I'm new to this... So 4/12, 5/12 mean working 4, 12hr shifts a week or 5, 12hr shifts.


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## Levinoss (Dec 21, 2008)

I'v not worked in a hospital but I have worked 7/12's for 3 months at a time doing hard construction in the elements. 3 months of 7/12's in what I did was about as long as I could go without a few days of real rest. Took me about a week to get used to working 12's and they are not too bad as long as you have a day or two off for rest. I'm kinda looking forward to working 4-5/12's a week.

Don't let 12 hour shifts scare you untill you can judge for your self if you want to do them or not imo. Not saying anyone is trying to scare you or anything just giving a little insight into 12's.


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## EMERG2011 (Dec 21, 2008)

If you live in DC - GW (Level 1 Trauma Center, if you're interested!) is a definite yes. The only one thats a definite no is MedSTAR (Washington Hospital Center, also Level 1), they only accept paramedics.


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## Xueyon (Dec 21, 2008)

Levinoss said:


> I'v not worked in a hospital but I have worked 7/12's for 3 months at a time doing hard construction in the elements. 3 months of 7/12's in what I did was about as long as I could go without a few days of real rest. Took me about a week to get used to working 12's and they are not too bad as long as you have a day or two off for rest. I'm kinda looking forward to working 4-5/12's a week.
> 
> Don't let 12 hour shifts scare you untill you can judge for your self if you want to do them or not imo. Not saying anyone is trying to scare you or anything just giving a little insight into 12's.



WHOA!! 7/12's.... How bout family time? How did you do that? Haha I'd be going crazy. But for ER tech go for it. Better pay and benefits. But if you want to go into ER take a phlebotomy course. That'll get you in ER for sure. Some will train you while working as an ER tech.


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## FF894 (Dec 22, 2008)

EMERG2011 said:


> If you live in DC - GW (Level 1 Trauma Center, if you're interested!) is a definite yes. The only one thats a definite no is MedSTAR (Washington Hospital Center, also Level 1), they only accept paramedics.



Do you know if the medics can use their standing protocols or are limited to just "helper" work?


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## JPINFV (Dec 22, 2008)

FF894 said:


> Do you know if the medics can use their standing protocols or are limited to just "helper" work?




The protocols and standing orders inside the hospital bear no relation to the protocols and standing orders outside of the hospital.


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## FF894 (Dec 22, 2008)

JPINFV said:


> The protocols and standing orders inside the hospital bear no relation to the protocols and standing orders outside of the hospital.



Some hosptials do carry over the pre-hospital standing orders, maybe with procedure changes.  Thats one of the advantages to having an EMTP in the hospital setting though - if needed, a medic can act immediatly, caring out life saving interventions that otherwise may have needed to wait for a MD, PA, etc depending on which unit you are in and specific protocols etc.


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## JPINFV (Dec 22, 2008)

^
Still, at that point you are not relying on the EMS medical director for orders, but the hosital's physicians/insurance to determine what you can/can't do.

I'm also not 100% clear on the second part. Short of stationing a paramedic in every unit, an emergency situation is still going to have to wait for a paramedic to respond. Since I doubt that a hospital is going to want to spring for a paramedic on every floor, the wait might as well be for a code (generally comprised of RT, critical care nurse/s, and physician) or rapid response team (RT, CC nurses with a direct line to a physician) to respond since these providers are already on site and can be used for more routine care.


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## FF894 (Dec 22, 2008)

The hospitals I know of the chief of the department is the "medical director" for standing orders although if you are carrying out MD orders its whoever asked for them - 2mg of MS in room 14 is whoever saw that pt, signed the chart.  

As far as a code- it really depends on the hospital because I have heard of all different scenarios.  Most of the time the medic is on the code team to respond to any codes in the hospital.  As far as he unit they are working in (I know of ED more than anything else) the EMTP can push the ACLS drugs and intubate patient, etc without waiting for anyone to tell him he needs to.  Yes, some hospitals allow the nurses to push drugs in an arrest without waiting for orders.  Medcis also are responsible for admin and interpretation of ECGs and and appropriate protocol.  On the other hand many hospitals who have medics use them as any other tech although they can maybe start lines.  

Not sure if any of that made sense...


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## VentMedic (Dec 22, 2008)

The "skills" of a Paramedic are very limiting in the hospital setting. Other practitioners may have many years of critical care experience to quickly identify specific situations. We often will stabilize NOT according to the simplified EMS protocols which are meant for a blanket treatment but with a set of treatments, as well as a whole pharmacy of medications, to be more specific to the patient. The critical care medicine physicians write the protocols and train the experienced providers. Hospitals are now encouraged to develop programs to be compliant with JCAHO recommendations and those from the Institute for Healthcare Improvement which has established the plans for inhospital Rapid Response Teams. 

In other words, you may be able to intubate or start an IV, but then what? Your intubation and IV skills may also have to be fine tuned to prevent infections. These "skills" are just one small part of the equation. It might fly in some rural middle of nowhere hospital but with all eyes on quality and education to prevent screwups that lose Medicare reimbursement, it could be very risky for the hospitals. Many states also do not allow the recognition of the EMT-P inside the walls of the hospital. That is the way *EMS* wrote the statutes.

NO RN or RRT on a code or Rapid Response Team in most hospitals needs permission to initiate and carry through care in an emergency situation.


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## JPINFV (Dec 22, 2008)

FF894 said:


> Yes, some hospitals allow the nurses to push drugs in an arrest without waiting for orders.  Medcis also are responsible for admin and interpretation of ECGs and and appropriate protocol.  On the other hand many hospitals who have medics use them as any other tech although they can maybe start lines.




You know, I could make the same statement about paramedics. Maybe we should staff ambulances with a rapid response team since they rely on standing orders with a wider selection of interventions while the local EMS has their paramedics call a hospital for virtually all orders and rely on a 12 lead ECG machine's interpretation for when to call a STEMI alert.


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## FF894 (Dec 22, 2008)

So what I am hearing is that EMTPs are taught specific skills and cant possible be expected to expand those skills with the proper education and guidance?  By that concept, how can RNs start IVs?  They never learn that in their initial education - it is on the job training and is usually one of the most used skills in ED settings.  You are saying that paramedics are just monkeys that can intubate but then have no idea how to manage the patient after that?


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## FF894 (Dec 22, 2008)

JPINFV said:


> You know, I could make the same statement about paramedics. Maybe we should staff ambulances with a rapid response team since they rely on standing orders with a wider selection of interventions while the local EMS has their paramedics call a hospital for virtually all orders and rely on a 12 lead ECG machine's interpretation for when to call a STEMI alert.



What system are you working in that you have to call the hospital to ask for orders based on your ECG interpretation?  I agree MA is a little behind and could never be called "agressive" with their protocols, but you are making it sound like you can't do anything.


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## JPINFV (Dec 22, 2008)

FF894 said:


> What system are you working in that you have to call the hospital to ask for orders based on your ECG interpretation?  I agree MA is a little behind and could never be called "agressive" with their protocols, but you are making it sound like you can't do anything.



I used to work in Southern California. 



> CHEST PAIN/CARDIAC ISCHEMIA
> • Cardiovascular Receiving Center (CVRC) triage: If field 12-lead machine interpretation identifies “Acute MI” [ST-segment elevation MI (STEMI)] – report this to the base hospital for possible triage to a CVRC.



http://ochealthinfo.com/docs/medical/ems/treatment_guidelines/c15.pdf

On a side note, I noticed that Orange County finally got around to writing BLS protocols (there weren't any when I worked there). Thanks for telling me that I need to put a patient on oxygen and take some vital signs.


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## FF894 (Dec 22, 2008)

Interesting, and I thought MA was behind.  Cal does get 10mg more MS than MA though...  

SoCal to Boston eh?  HOws the weather treating you?


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## JPINFV (Dec 22, 2008)

Let's just say it took me 30 minutes longer than I though to get to work on Saturday (I budgeted an hour) with most of that spent just getting out of my driveway.


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## VentMedic (Dec 22, 2008)

FF894 said:


> So what I am hearing is that EMTPs are taught specific skills and cant possible be expected to expand those skills with the proper education and guidance? By that concept, how can RNs start IVs? They never learn that in their initial education - it is on the job training and is usually one of the most used skills in ED settings. You are saying that paramedics are just monkeys that can intubate but then have no idea how to manage the patient after that?


 
How many pressors do you use in the field? How familiar are you with line and drug compatibility? Various vascular access devices? Do you know what labs to order? When was the last time you messed with an ICU ventilator...legally? Initiated a Sepsis protocol? VAP protocol? How many cardiac conditions are your familiar with enough to identify on an EKG besides STEMI? Knowledge of the many Pacemakers? Can you administer blood products? Thrombolytics? Dosed Heparin? Hung an insulin drip? Lasix or Bumex drip? 

How much time do you have in the ICU as a primary care giver being responsible for the care of a patient? 
Do you have at least an Associates degrees in EMS or some allied health profession? Many hospitals long ago did away with the LVN or Resp Tech who only had a mere 1 year of training. 

Who writes *your* inhospital protocols? Who is responsible for your QA? Training? Who do you directly report to for orders and who is your immediate supervisor. An ER tech normally works under the nursing department.

All of our student RNs get a chance to start IVs and a whole host of other invasive procedures. 

Our CCT RNs also intubate along with many other providers in the hospital. It is skill that can be learned rather easily especially if the Pulmonologists are mentoring. However, learning all the things that make up critical care knowledge requires a solid foundation of education and experience. Thus, RNs and RRTs are not so cocky to believe their 2 - 4 years of college prepared them for the ED or ICU. However, it gives them the foundation to now be trained for just about anything. Unfortunately, paramedics believe their 700 hours of training has prepared them for everything. 

It is a lot harder to start from scratch with a person who has no formal A&P, Pharmacology, Microbiology, Psychology, Pathophysiology etc and attempt to get them up to speed on the many different disease processes and protocols that apply to them.


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## Xueyon (Dec 22, 2008)

VentMedic said:


> How many pressors do you use in the field? How familiar are you with line and drug compatibility? Various vascular access devices? Do you know what labs to order? When was the last time you messed with an ICU ventilator...legally? Initiated a Sepsis protocol? VAP protocol? How many cardiac conditions are your familiar with enough to identify on an EKG besides STEMI? Knowledge of the many Pacemakers? Can you administer blood products? Thrombolytics? Dosed Heparin? Hung an insulin drip? Lasix or Bumex drip?
> 
> How much time do you have in the ICU as a primary care giver being responsible for the care of a patient?
> Do you have at least an Associates degrees in EMS or some allied health profession? Many hospitals long ago did away with the LVN or Resp Tech who only had a mere 1 year of training.
> ...



Regardless of a Medic or Emt b, ER techs are assitants to the RN's and physicians in the ED. They work under the RN at every hospital actually that I've notice look it up. And another thing RN's are trained in IVs and Phlebotomy so I don't know where the source says that they aren't when they really are.


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## JPINFV (Dec 22, 2008)

Xueyon said:


> Regardless of a Medic or Emt b, ER techs are assitants to the RN's and physicians in the ED. They work under the RN at every hospital actually that I've notice look it up. And another thing RN's are trained in IVs and Phlebotomy so I don't know where the source says that they aren't when they really are.



This thread has taken a little side route based off of the following post.



FF894 said:


> Some hosptials do carry over the pre-hospital standing orders, maybe with procedure changes.  Thats one of the advantages to having an EMTP in the hospital setting though - if needed, a medic can act immediatly, caring out life saving interventions that otherwise may have needed to wait for a MD, PA, etc depending on which unit you are in and specific protocols etc.


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## VentMedic (Dec 22, 2008)

Originally Posted by *FF894* 

 
_



Some hosptials do carry over the pre-hospital standing orders, maybe with procedure changes. Thats one of the advantages to having an EMTP in the hospital setting though - if needed, a medic *can act immediatly, caring out life saving interventions* that otherwise may have needed to wait for a MD, PA, etc depending on *which unit* you are in and specific protocols etc.

Click to expand...

_ 
_I forgot to comment on this. _

_You run to the ICU for an unstable patient. Do you know which of the drips you may need to discontinue or add to initiate your prehospital protocols? Usually an ICU patient may be on 2 different pressors, neither of which is used in prehospital. Have you titrated Diprivan? Continuous paralytic? Worked a patient that is now at 33 degrees on a hypothermia protocol? Do you know if all of your ACLS drugs will be compatible with what is hanging and what line to use? If something goes wrong, will your license protect an RN "working under your orders"? Or, will you just work the code by yourself? _

_Some EDs may be required to initiate ICU protocols while holding a patient in the ED if it is for an extended period of time. This is also where it is difficult to use a Paramedic as a Paramedic in the ED and rely on them as a primary care giver. The Paramedic is not qualified to administer many of the meds that are used in the ICU or manage an ICU ventilator. If they are counted in staffing the same as an RN, it may make them short-staffed when ICU patients need to be taken care and you as a Paramedic still rely on RNs to hang blood products or provide other care to your patients that you can not do by your state's scope of practice. _

_If a Paramedic does go on to get a degree in another Health profession such as RN or RRT, they will soon see how vastly different the professions are and yet very similiar. Critical Care medicine is the common thread. _


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## triemal04 (Dec 22, 2008)

VentMedic said:


> Can you administer blood products? Thrombolytics? Dosed Heparin? Hung an insulin drip? Lasix or Bumex drip?


It's interesting that you'd use an example like that.  Let's really look at that, shall we?  Now, while I have no doubt that there are many RN's out there that have the autonomy to start the above med's without consulting with a doc, for the vast majority, that will not be the case.  (just like there will be many paramedics who are able to do various procedures/administer various meds that the vast majority will not)  No, what they'll be doing is getting an order from a doc for an amount of the med to be given over a certain time.  Do a bit of math, set the IV pump, and you're done. Not that complicated.  Even starting it autonomously, still not that complicated, although more knowledge is definetly required.  Why did I bring this up?  Because I really don't like hypocrisy, and saying the above is no different that someone saying how much better paramedics are because we can intubate and most RN's can't.  

If you're going to point out why it might not be beneficial to have the average paramedic working in an ICU setting (just like the average RN for that matter) you should probably stick to valid arguements; there are plenty out there, which I'm sure you know.


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## JPINFV (Dec 22, 2008)

That is true, but most RNs are not going to be a member of a rapid response team either. What FF894  was proposing was essentially hiring paramedics on AS the rapid response team.


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## triemal04 (Dec 22, 2008)

JPINFV said:


> That is true, but most RNs are not going to be a member of a rapid response team either. What FF894  was proposing was essentially hiring paramedics on AS the rapid response team.


Sure, I got that.  My issue was, and is, the reasons that Ventmedic gave for WHY a paramedic should not be in that role.  While she did much better a couple posts later, that first bit is just a wee bit hypocritical on her part.


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## VentMedic (Dec 22, 2008)

triemal04 said:


> It's interesting that you'd use an example like that. Let's really look at that, shall we? Now, while I have no doubt that there are many RN's out there that have the autonomy to start the above med's without consulting with a doc, for the vast majority, that will not be the case. (just like there will be many paramedics who are able to do various procedures/administer various meds that the vast majority will not) No, what they'll be doing is getting an order from a doc for an amount of the med to be given over a certain time. *Do a bit of math, set the IV pump, and you're done. Not that complicated.* Even starting it autonomously, still not that complicated, although more knowledge is definetly required. Why did I bring this up? Because I really don't like hypocrisy, and saying the above is no different that someone saying how much better paramedics are because *we can intubate and most RN's can't. *
> 
> If you're going to point out why it might not be beneficial to have the average paramedic working in an ICU setting (just like the average RN for that matter) you should probably stick to valid arguements; there are plenty out there, which I'm sure you know.


 
Times are changing. Inhouse teams are providing a need that was lacking in your mother's or grandmother's day. 

I take it you have no progressive hospitals in your area. They need to get with the program because Medicare and many other agencies have spoken. Unlike EMS, hospitals do have various organizations pushing them to improve and provide better care. 

Every thing is a "skill" mentality with the Paramedic? Just plug in the numbers on the pump and who cares what the drug is? Guess what? Doctors make mistakes and that is why RNs are now required to have more education and UNDERSTAND all the meds they are giving. A doctor that is not right there may not see the full patient and may need to be reminded about other patient conditions that make giving that med unwise. The same can apply for RRTs who should NOT take ventilator orders via the phone for a Pressure setting. More often not, they have their own protocols from their medical director for vent management. 

Also, why do you think so many hospitals have established their own CCTs with RNs? The Paramedic scope, education and experience varies so widely that it is difficult for find any consistency between the services or even within the same service. What one ambulance service considers to be a Critical Care Transport Paramedic may be totally different than another service. 

RNs at least have some consistency for their foundation education for the hospital to work with. At this time that can not be said for the Paramedic. 

Again, comparing a "skill" such as intubation which by the time the CCT RNs start intubating they have probably seen it done well over a 100 times at the very least and have probably already done RSI for the majority of those as well as all the meds for maintenance. They will have their ICU experience and foundation education to better understand the "skill".


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## triemal04 (Dec 22, 2008)

Oh boy...so you still do need to work on your reading comprehension.  Again.  Perhaps you should go back and really, really read the last 2 posts that I made.

Edit:  because you still probably won't get it maybe I should elaborate:  the line about intubating...no :censored::censored::censored::censored:, it's a worthless arguement, it's just another way of comparing the skills someone can do without comparing their actual knowledge, which is ridiculous.  Just like saying that because someone can give 1 med that automatically makes them better than someone who can't; without the knowledge to back it up, it's pointless.
Double edit: and knowing the indications/contraindications/interactions that a drug has...SOP for the drug's that you give.  Face it, you made a lousy arguement to start with.  Get over it.


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## EMERG2011 (Dec 22, 2008)

FF894 said:


> Do you know if the medics can use their standing protocols or are limited to just "helper" work?



I dont know about MedSTAR, but at GW standing orders apply on the BLS level (i.e. - O2, airway management, spinal precautions, splinting/bandaging, etc).


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## VentMedic (Dec 22, 2008)

JPINFV said:


> That is true, but most RNs are not going to be a member of a rapid response team either. What FF894 was proposing was essentially hiring paramedics on AS the rapid response team.


 

If you read the guidelines for Rapid Response Teams nationwide, they are very well written for RNs and RRTs. Hospitals have been rapidly adopting the suggested guidelines and protocols to where the results are very positive. 

A Rapid Response Team is different than a Code team in that you must know your labs very well and all of the ICU protocols.

They also act as the Critical Care primary care givers intil the patient can be moved to a Unit. Unless a Paramedic is a full Primary Care giver in the ICU with the same scope as RNs, it would be doubtful they are used on a Rapid Response Team.

However, Flight Paramedics that are hospital based have been known to intubate with a code Team or in the ED of hospitals.


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## VentMedic (Dec 22, 2008)

triemal04 said:


> Oh boy...so you still do need to work on your reading comprehension. Again. Perhaps you should go back and really, really read the last 2 posts that I made.


 
You are not going to get me to agree that setting up a med is just copying the numbers to the pump. I've already seen way too many Paramedics get into difficulties by trying that on CCT with pumps that they aren't even familiar with. 



> If you're going to point out why it might not be beneficial to have the average paramedic working in an ICU setting (just like the average RN for that matter) you should probably stick to valid arguements; there are plenty out there, which I'm sure you know.


 
As I said before (talk about reading comprehension), we kicked out the LVN and Respiratory Tech from the ICUs, as well as the hospitals in some areas, because they only had a mere 1 year certificate. Now, you are suggesting that we put a Paramedic who may only have 700 hours of training and not college A&P, Pathophysiology, Microbiology, Pharmacology etc into the ICU? 

LVNs and Respirtory Techs functioned in a similiar capacity as RNs and RRTs for many years, but as medicine progressed, the need for a higher level of education to be understand critical care concepts became evident. 

I suppose you would also want the 3 month wonder medic mill graduate paid the same as an RN with his/her BSN and CCRN.



> Edit: because you still probably won't get it maybe I should elaborate: the line about intubating...no :censored::censored::censored::censored:, it's a worthless arguement, it's just another way of comparing the skills someone can do without comparing their actual knowledge, which is ridiculous. *Just like saying that because someone can give 1 med that automatically makes them better than someone who can't;* *without the knowledge to back it up, it's pointless.*
> Double edit: and knowing the indications/contraindications/interactions that a drug has...SOP for the drug's that you give. Face it, you made a lousy arguement to start with. Get over it.


 
No. I just wounded your fragile ego again. You still have to resort to using profanity in hopes that will make your point clearer. 

If you don't understand the difference between training and education, it would be an easy determination to know which you have the least of.

Do you give meds you don't know anything about? Do you just follow your recipe? How many Paramedics do just follow the recipe? 

If you do not understand what happens inside an ICU or a hospital, don't make assumptions.


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## triemal04 (Dec 22, 2008)

This is ridiculous.  Seriously, you do realize that I'm not, and have not made any kind of arguement for a paramedic working in an ICU type setting.  I'm not sure why that is so hard for you to see.  To be as blunt as possible, which is hopefully blunt enough for you, I don't see the reason for it, or the need.

Likewise, I'm not sure why it's so hard for you to see that in the quote from you in my first post, you made a piss poor arguement.  Like I said, get over it, you screwed up.  The rest of what you said?  You'll notice I didn't quote it.  Why?  Because for the most part I agree, and those were pretty accurate and jusified reasons.  Face it, everyone one makes mistakes, and that does include you, so please, get over yourself.

Now, I know that this is pointless, but let me see if I can (blunty) put this in a way that you'll get, and in the same format as your arguement that I quoted.  An EMT-I in Oregon can give nalbuphone.  A paramedic in Washington cannot.  By your logic it would seem that an Oregon EMT-I is better than a WA paramedic.  Which is just a bit silly.  Seriously, is this even a bit clear for you now?


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## ffemt8978 (Dec 22, 2008)

Ahem....


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## VentMedic (Dec 22, 2008)

triemal04 said:


> Now, I know that this is pointless, but let me see if I can (blunty) put this in a way that you'll get, and in the same format as your arguement that I quoted. An EMT-I in Oregon can give nalbuphone. A paramedic in Washington cannot. By your logic it would seem that an Oregon EMT-I is better than a WA paramedic. Which is just a bit silly. Seriously, is this even a bit clear for you now?


 
If you want to use that example, some EMT-Bs are doing ETI and some Paramedic services are considering not doing it at all. 

ONE med is one thing. A whole bucket full of ICU meds is totally different. 

We were talking about a Paramedic working in the hospital and also running from their ED tech position to work on ICU patients under their Paramedic with prehospital protocols as FF894 suggested. How many Paramedics do you know routinely work with all of the ICU meds and technology? How many have extensive understanding of disease processes and intimate knowledge of ICU protocols that are used on a daily basis?

Hospitals are striving to reduce mistakes. You can refer to the guidelines and mandates set by Medicare, the Institute for Healthcare Improvement and JCAHO.


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## daedalus (Dec 22, 2008)

As it stands, paramedics are not able to manage complex ICU cases. These cases may involve IABP and pressors and may involve the use of medications like Integrilin and heparin to hold the patients cardiac perfusion until cath lab in cardiac instances. Can a paramedic understand goal oriented therapy in the ICU for a patient is severe septic shock? Sure, but they need a better foundation in basic clinical sciences such as the topics Vent discussed (microbio, bio, chemistry, O chem, A&P). Currently, if asked by medical doctors who used to be paramedics, they will tell you that paramedics are masters of a very very thin slice of medicine, prehospital care. Until we can expand that slice we should not be welcome managing complex cases (not that triemal was suggesting that anyways).


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## triemal04 (Dec 22, 2008)

I don't know what more I can say than this, I thought it would be clear enough.  





> Likewise, I'm not sure why it's so hard for you to see that in the quote from you in my first post, you made a piss poor arguement. Like I said, get over it, you screwed up. The rest of what you said? You'll notice I didn't quote it. Why? Because for the most part I agree, and those were pretty accurate and jusified reasons. Face it, everyone one makes mistakes, and that does include you, so please, get over yourself.


  The reaons why the arguement doesn't work have been listed but oh well.  This has become pointless.


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## FF894 (Dec 23, 2008)

Wow, this really took off since I've been away.  A lot to catch up to.  Simply put Vent-you have some valid points for what you are trying to say.  I don't think anyone will argue that an ICU RN needs years of training and experience to work in their position effectively.  As I breeze through this, I feel you are coming across with the impression that I implied that EMTP replace RN in these settings which is not the case at all.  It also comes across that you have only worked in one or two facilities where structure is similar which is not a bad thing if its true.  All I was trying to poll is how the DC area hospitals handle the protocols, which apparently differs there as well.  I have seen many different variations of the EMTP Tech role - both within the same hospital but working in different units, and obviously different facilities have their own way of doing it.  Despite what may be practiced where you work, other models do exist and it must work for them or they would not do it the way that they do it.  Again, let me stress that EMTPs do not replace the RN but augment, which I believe is a fairly common theme for all tech positions as we discuss it here.  As to briefly address some of the things you have said about managing pressors I will say that at this point in my career I do not have the training, knowledge, experience, or education to manage pressors and all of the other things you mentioned.  One of the reasons is due to the fact that I don't work in that environment.  The EMTPs that I do know who do, have worked very hard to learn and gain experience to do so.  Sure, they are rare and not widely seen because EMTP is traditionaly a pre-hospital position, but that does not mean that the right person cannot evolve into an appropriately placed and managed in-hospital position.


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## VentMedic (Dec 23, 2008)

FF894 said:


> It also comes across that you have only worked in one or two facilities where structure is similar which is not a bad thing if its true.


The one advantage of my job, especially after being there for many, many years, is that I have several days off to work at various hospitals in 2 different states. I also fly to at least 4 different states, several countries and the islands. Our helicopters also do scene response for some EMS agencies. So, I get to see many hospitals. I've also been a Paramedic for 30 years and have stayed actively involved with what is happening in the academic environments and legislative issues. 

Some of us also have dual licenses so that we can see the best of both worlds while knowing the limitations of each for specific licenses. 



> variations of the EMTP *Tech* role


At least this statement sums it up pretty well.


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## FF894 (Dec 23, 2008)

Hey, power to ya.  I just hope your performance keeps up with your ego.  As far as the tech jab goes, I don't know what that's supposed to mean exactly.  Being as experienced as you are, you must have learned by now that teamwork is the key to any profession, especially this ours.  We all play a role in working _together_ to make a difference in peoples lives'


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## VentMedic (Dec 23, 2008)

FF894 said:


> As far as the tech jab goes, I don't know what that's supposed to mean exactly.


 
Licensed healthcare professionals in the hospital have attempted to rise above the "tech" mentality to become well educated and not just rely on a "tech" training or limiting education.

While there is nothing wrong with being a "tech" as they are a valued member of the healthcare team, it is when your license has the educational backing to be given professional status that others will start to view you differently.  Your profession is only as strong as your weakest link.



> I just hope your performance keeps up with your ego.


 
It is also unfortunate that EMS providers interpret ego problems for those that do have higher education. We see this constantly with the Paragod comments. Often what you are seeing or hearing is confidence from having quality education and a decent understanding of medicine to know there is a whole lot more to learn. 



> We all play a role in working _together_ to make a difference in peoples lives'


That is why hospitals emphasize multidisciplinary care plans. In the majority of hospitals, the licensed healthcare professionals work off the same charting care plan to ensure a well rounded treatment plan. This again was instituted by recommendations from JCAHO and a few other organizations that have the patients' best interests as a concern.


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## FF894 (Dec 23, 2008)

Well, to go back to the beginning of this, I was not trying to argue any of what you said was wrong, I was simply trying to say that just because one area does things a certain way does not mean that the same practices are followed everywhere.  Thats one of the reasons why I like this forum, we get to hear about everyone's own experiences and different working environments.  I value everyone's opinion and like hearing the different views.  As we all know, we don't always agree on issues but thats what makes America great is'nt it?  We have the freedom to come to a forum such as this and vocie our opinions!

I do want to say I can't agree with your opinions of people with less education than you.  You talk about people as if they are nothing until they have achieved what you have.  Maybe that's not the case and I am sounding too harsh, but its just the way you come off which is why people will view you as egotistical.  I just think that yes, knowing peoples limitations within their position is very important.  However, just because someone is a "tech" does not mean they cannot learn from experience and grow within the position.  Believe me, I hear your argument and know people that you probably have in mind.  Sure, they exist.  But to say that you are only as strong as your weakest link, to me that does not apply to the scenario.  The team leader working a code can be a MD with 40 years experience with every cert in the world under his belt, but if he is not effective in the position for any number of reasons he becomes the weakest link.  An over-eager tech who does everything his postiion requires to 110% of his ability is not. 

Honestly in my experience if someone is as cocky as you are (dont take that the wrong way, you must be able to admit you are a little, which is ok  then they usually do have the snuff to back it up and are good people to team up with and learn from.   I am not downplaying education by any means, constantly improving certification levels and learning from any means possible including this website is certainly what anyone in the profession would expect from a worthy professional.  I just get the impression from you that unless people aspire to be a MD some day and work to get there they are not worthy of being called a professional.  I just have a different take on it I guess.  I feel we are all part of an intricate team and each person holds an vital role within that team.  Each person should stive to be the best they can at that role.  Just because someone doesn't have as many letters as I do after their name, does not make me better than them.  I might be able to perform more procedures and sure have more education, but without the other persons help I am nowhere.  We all work together towards the same goals, just play different roles to get there.


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## VentMedic (Dec 23, 2008)

FF894 said:


> Well, to go back to the beginning of this, I was not trying to argue any of what you said was wrong, I was simply trying to say that just because one area does things a certain way does not mean that the same practices are followed everywhere. Thats one of the reasons why I like this forum, we get to hear about everyone's own experiences and different working environments. I value everyone's opinion and like hearing the different views. As we all know, we don't always agree on issues but thats what makes America great is'nt it? We have the freedom to come to a forum such as this and vocie our opinions!


 
I am merely trying to make you aware that there are NATIONAL laws, regulations, rules and whatever that a hospital must abide by. EMS does not always have that type of oversight to answer to. 



FF894 said:


> I do want to say I can't agree with your opinions of people with less education than you. You talk about people as if they are nothing until they have achieved what you have. Maybe that's not the case and I am sounding too harsh, but its just the way you come off which is why people will view you as egotistical. I just think that yes, knowing peoples limitations within their position is very important. However, just because someone is a *"tech" does not mean they cannot learn from experience and grow within the position.* Believe me, I hear your argument and know people that you probably have in mind. Sure, they exist. But to say that you are only as strong as your weakest link, to me that does not apply to the scenario. The team leader working a code can be a *MD with 40 years experience with every cert in the world* under his belt, but if he is not effective in the position for any number of reasons he becomes the weakest link. *An over-eager tech who does everything his postiion requires to 110% of his ability is not.*


 
And your job classification will still be a tech. We have phlebotomists that haven't missed a vein or artery in 20 years, but they are still a "tech". 

You still are hung up on "certs" as a measurement of worth. Gee whiz a doctor can have 12 years of college, a residency and a couple of fellowships, yet, you still look only at a "cert". 

Yes, there are physicians who are considered weak links by their peers. That is why hospitals have professional peer review boards. 



FF894 said:


> Honestly in my experience if someone is as cocky as you are (dont take that the wrong way, you must be able to admit you are a little, which is ok  then they usually do have the snuff to back it up and are good people to team up with and learn from. I am not downplaying education by any means, *constantly improving certification levels and learning from any means possible including this website is certainly what anyone in the profession would expect from a worthy professional.* I just get the impression from you that *unless people aspire to be a MD some day and work to get there they are not worthy of being called a professional. *I just have a different take on it I guess. I feel we are all part of an intricate team and each person holds an vital role within that team.* Each person should stive to be the best they can at that role. Just because someone doesn't have as many letters as I do after their name, does not make me better than them. I might be able to perform more procedures and sure have more education, but without the other persons* help I am nowhere. We all work together towards the same goals, just play different roles to get there.


 
Improving cert levels should be accomplished through improving solid education coupled with sound clinical experience. Unfortunately EMS has gotten "cert happy" and apply the label to every little weekend course to view as an accomplishment. 

There is a difference between being an asset as a team member and also being a licensed healthcare provider who is considered to have achieved professional status through education and licensure. 

I am not down playing the role of the ER Tech, CNA or Phlebotomist. They are very valuable team members. But, they also should know what is viewed as a professional in healthcare and why. If recognition was solely based on hard work, there are many CNAs and ER techs that I would put up for an honorary doctorate. 

I can use RNs as an example. When they were diploma educated, they were viewed very differently than they are now with their degree status.

In a professional setting for most healthcare professions today, there is a minimal entry level for education to be considered a professional in that profession. 

I can now use Respiratory Therapy as an example. The profession doesn't care how well you can intubate or put in arterial lines if you are still at a "tech" level and have not increased your education to become Registered (RRT). The profession has moved on and left you behind. If you do not have at the very minimum of an Associates degree, it doesn't matter how much you promise to work really, really hard and will get all the certs such as ACLS, PALS, NRP, etc...you do not meet the minimum requirements for the profession and some hospitals may not allow you to work in critical care or even as a tank jockey. 

If you think that sounds harsh, you should listen to the other professions within the hospital. PT has moved on to a doctorate and the other Therapists have no less than Bachelors. Masters is the preferred degree for entry. They may have "assistants" who have a mere Associates degree but these assistants may need to prove they are studying toward a higher level. This is why Respiratory Therapy is trying to rapidly advance to a Bachelors as entry level because RT with a mere Associates degree is also considered the weakest link of the therapies especially if your work for a specialized physical rehab unit. It also doesn't matter that I also have a Masters degree because that still does not change the fact that entry level is still only an Associates. If the whole RT department has at least a Bachelors or Masters, then maybe the RRTs will be viewed differently. Nursing is also feeling the shift to higher education when they notice their allied health and new grad RNs are entering the work force with no less than a Bachelors degree. 

Times are changing as medicine progresses. EMS should have realized this 25 years ago. They did recognize this in the 1970s but then took the same stance you have on certs and hard work to get them recognition in the world of health care and medicine.

I am an advocate for EMS providers to move up the professional healthcare ladder. I will not refrain from using harshness to get my points across for the need of a solid education especially when I just hear more excuses.


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## daedalus (Dec 23, 2008)

Off topic a bit, but Dr. Bledsoe's critical care transport text for paramedics was recently released this last fall if I remember correctly. For paramedics that have taken real A&P, this book will be an easier follow. An official course and government recognition nation wide of a critical care paramedic (as in Canada) would be pretty cool.

I do stand against more letters behind names, but if properly done, a we could actually take a paramedic and upgrade their license to CC-P or something along those lines after pre-req science courses and than a CC course based on Bledsoe's text. 

Than we can talk about letting go of the "tech" aspect of paramedicine and truly making ourselves the experts in all of transport medicine.


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## FF894 (Dec 23, 2008)

Pre-hospital EMS is still in its infancy - only been around (for real) for 30 years so I think it's fair to say its still evolving, albeit a little slow.

So again, I do not disagree with you that education is important.  I just respect the team members I work with, regardless of their status within the team or their personal education.  I don't talk down to a tech or think any less of him just because he may have less education than me.  Maybe they are in school working towards the next level?  Maybe they like being a tech and plan on staying in that position?  

Back to your original post- are you saying that the education and skills that paramedics have learned does not adequatly prepare them to operate as a paramedic with those same skills in the hospital setting?  Just the ED, not ICU.  Many skills from the pre-hospital setting transfers to valuble skills in the in-hospital setting.


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## VentMedic (Dec 23, 2008)

FF894 said:


> Pre-hospital EMS is still in its infancy - only been around (for real) for 30 years so I think it's fair to say its still evolving, albeit a little slow.


 
EMS is 40+ which makes it middle-aged. Many of the Allied health professions are less than 20 years old but have established their positions well. RT has only been licensed in Florida and CA for about 22 years. 



FF894 said:


> So again, I do not disagree with you that education is important. I just respect the team members I work with, regardless of their status within the team or their personal education. I don't talk down to a tech or think any less of him just because he may have less education than me. Maybe they are in school working towards the next level? Maybe they like being a tech and plan on staying in that position?


 
Read my posts. I said anything against "techs" or non-licensed providers. Don't make it sound like I am bashing them. 



FF894 said:


> Back to your original post- are you saying that the education and skills that paramedics have learned does not adequatly prepare them to operate as a paramedic with those same skills in the hospital setting? Just the ED, not ICU. Many skills from the pre-hospital setting transfers to valuble skills in the in-hospital setting.


 
If that state does not recognize the Paramedic license within the walls of the hospital, then they are in the non-licensed category as an ED Tech. 

As far as the Paramedic operating as a Paramedic inside the hospital? You didn't answer any of my earlier questions about who is your supervisor or medical director. It would also depend on the billing structure of your facility. Paramedics may not be able to be reimbursed for advanced skills performed. It could mean a huge loss of revenue for the hospital. It is also fraudulent to have a doctor take credit for a Paramedic intubating, except in a teaching situation. That has happened when a doctor was regularly allowing an ER-Tech, who was a Paramedic in the field, intubate. The Paramedic didn't know enough about billing practices to know what was happening. Not a nice scene for the hospital. 

You still continue to refer to skills. There is more than just skills involved in being a healthcare provider in a hospital. A PCT can start an IV and do a 12-lead. 

Even in a code situation, in many EDs we now have the ability to do STAT labs and deviate from the way a patient might be resuscitated traditionally in the field to run with one of our other protocols. The same for stabilization. We may also treat by ultrasound. There are many, many types of patients with many types of diseases and some patients will have to be treated individually rather than a blanket protocol. 

So you see there are alot of factors involved in making someone whose license is prehospital an employee of the hospital with the same privileges. 

Again, if you want to work in the hospital at a higher level, get a degree in something other than Paramedic. The Paramedic was trained and educated for prehospital. 

See the Paramedic to RN bridge thread. I think Rid summed that up pretty nicely.


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## FF894 (Dec 23, 2008)

I was thinking that EMS wasnt truely EMS for a while there, more scoop and screw. 
You keep saying "you" as if you are referring to me.  I no longer work as a tech, however when I did I was able to use the (afraid to use the term skills here) that I used pre-hospitaly.  I know of several EDs and one CCU (for sure-haven't really checked into it though, could be more) that allow paramedics to work as paramedics and all the (another word for skills) that go with that cert.  For the most part, in the ED, they do the same thing as the RNs.  When a difficult case comes in that requires pressors then the RN obviously has a larger role in patient care.  If a patient needs to be intubated its typically the paramedic due to experience although if a resident is around they may give them a shot first.  
I also know of hospitals that do not let a paramedic do anything above the basic level.  Thats why I asked my inital question.


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## Ridryder911 (Dec 23, 2008)

Actually, I performed more "skills" 31 years ago. Fortunately, we learned and establish that skills are just that. Performing skills are only good if you understand the full effect. There are few EMS clinical skills that cannot be mastered with repetitious practice. As I always will say, a chimp can perform most of those, it is the understanding and the why, we still have EMT's. 

Most hospital organizations only recognize prehospital training as that .. training. This is why they are not usually recognized as a health professional rather given a technician status; especially in critical care areas. The same as a LPN/LVN. When in all actuality the LPN program is usually longer in length than a Paramedic program. 

We still want to stick to the excuse that EMS is a "young profession" and that was a nice statement 30 years ago. As Vent described there are many other health careers that have been formed later than EMS and has moved up the professional ladder. The difference is they did not have excuse for themselves and keep taking the easy way out. 

The only way those that come from prehospital education will be accepted is through rigorous credentialing and accepted outstanding clinical experience from reputation. When we have "proven" ourselves by academia and clinical outcomes, then and only then a consideration might be considered. 

R/r 911


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## FF894 (Dec 23, 2008)

So, the EMTP program and state or national certifcation is currently the standard by which prehospital EMS operates, agree? 

What do you propose the new standard to be (specifically) and what courses/certs/licensure do you recommend an EMTP who works in the field seek?


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## daedalus (Dec 23, 2008)

FF894 said:


> So, the EMTP program and state or national certifcation is currently the standard by which prehospital EMS operates, agree?
> 
> What do you propose the new standard to be (specifically) and what courses/certs/licensure do you recommend an EMTP who works in the field seek?



A few of us believe that the "standard" for Paramedics should be a four year degree.

Yes, to answer the question, many fire departments would than have to re-evaluate their role in EMS.


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## FF894 (Dec 24, 2008)

I only know of a few BS in paramedicine and they are all on the west coast.  What other options do you propose a paramedic seek to be "professional"


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## VentMedic (Dec 24, 2008)

FF894 said:


> I was thinking that EMS wasnt truely EMS for a while there, more scoop and screw.


 
EMS got off to a great start. If you notice that many of us with 30+ years in EMS have Associates degrees in EMS from the 1970s. At that time nursing was making a push for professionalism by going with the degree and eliminating diploma programs. EMS was taking note and had every chance at that time to become a well established profession. However, by the late 1980s, the FDs and private ambulances pushed for their own home-grown medic mills for a quick fix instead of sticking to a sound educational plan. Many community colleges had already established degree programs but quickly had to estalish "academy style" rapid training certficiates to be competitive. 

So in reality, back in the 1970s, Paramedics in some parts of the country were better educated as well as having more skills. We just dropped the ball by not continuing to follow through with setting the standards higher as nursing and all of the other healthcare professions have done.

There is probably more "scoop and run" mentality today with those who argue for the BLS systems to remain or with the insistance of keeping everything divided into BLS and ALS. 

A little history lesson:

http://www.freedomhousedoc.com/5.html

http://www.emsresponder.com/article/article.jsp?id=4901&siteSection=1



> The first training program began in October *1967 *with 44 *"ambulance attendant*" trainees. The program included about *300 hours* of classroom and clinical work, followed by *nine months of physician-supervised*, on-the-job training. The trainees learned CPR, basic nursing, rescue techniques and defensive driving. They assisted in autopsies to study anatomy. They learned to deliver babies.
> 
> The vehicles were designed to Safar's specifications and outfitted with electrocardiogram monitors, intravenous drips, intubation kits, blood pressure cuffs and defibrillators.


 
Interesting photos of Miami's history in EMS. 

http://www.fl-ems.com/BEMS/historyhome.html

http://www.nemsmf.org/


*1967 *

_In 1967 ,*Dr. Nagel* in Miami , Florida (USA) , established the _
_first Paramedics Unit that provided ALS (Advanced Life Support) ,_
_and he is considered to be "The father of the__*PARAMEDICS"*_

http://www.nemsmf.org/

1967: That makes EMS almost 42 y/o.


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## BossyCow (Dec 25, 2008)

daedalus said:


> A few of us believe that the "standard" for Paramedics should be a four year degree.
> 
> Yes, to answer the question, many fire departments would than have to re-evaluate their role in EMS.



Not necessarily. Many fire departments are now requiring 4 year degrees.


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## VentMedic (Dec 25, 2008)

BossyCow said:


> Not necessarily. Many fire departments are now requiring 4 year degrees.


 
Requiring a 4-year degree in Paramedicine? 

Often the 4 year degree is suggested to make rank. But, that can also be in any degree including the online questionable sources which got quite a few FFs in trouble who had been promoted based on these degrees. The Paramedic license may also be required but rarely do the FDs require anything other than a cert. 

Making the Paramedic a Bachelors degree might be a little unrealistic at this time. However, the Associates degree should be within reach. Oregon was successful in making it a requirement for licensure. That would definitely change things in states like Florida where the FDs require every FF to be a Paramedic at hire (or to even pick up the application) or within 1 year of hire. Too many FDs are accustomed to having a medic mill around the corner to meet these rapid requirements.


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## silver (Dec 25, 2008)

BossyCow said:


> Not necessarily. Many fire departments are now requiring 4 year degrees.



in what specific subject? or do they just need any BA/BS

There is like one college in 100 miles around that has a BS in EMS management/paramedicine

by requiring it, it seems like they are trying to give that specific college some extra business

I agree an associates seems more reasonable.


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## Xueyon (Dec 25, 2008)

Hmm I never seen any FD requiring you have a degree at all. As long as you have ur EMT cert. And ur required fire tech courses ur good to go. And for degrees in EMS I don't think it'll ever make a defference. As or Bs degrees will still only be degrees not meaning ur a better medic then others.


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## daedalus (Dec 25, 2008)

I should expand upon my post. Four year degrees for critical care paramedics.

A.S. in paramedicine for licensure. 

Merry Christmas


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## JPINFV (Dec 25, 2008)

Xueyon said:


> As or Bs degrees will still only be degrees not meaning ur a better medic then others.



Assuming it was possible, would you consider going to a physician who didn't have a medical degree (but had a medical license)? How about a lawyer without a law degree but who had passed the bar exam?


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## Xueyon (Dec 25, 2008)

JPINFV said:


> Assuming it was possible, would you consider going to a physician who didn't have a medical degree (but had a medical license)? How about a lawyer without a law degree but who had passed the bar exam?



1st off are any of us here talking bout doctors or lawyers??? 2nd is it possible to become a lawyer or doctor without a degree??? NO! how bout Paramedics? Yes!!!! And for who I would go to' well if he is lisence to save my life I don't think it would matter now would it. Or would you wait while ur dyin and ask hey do you have a degree to save my life? No I doubt you'd ask. This post has got way off topic... So yeah.


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## FF894 (Dec 25, 2008)

FF894 said:


> So, the EMTP program and state or national certifcation is currently the standard by which prehospital EMS operates, agree?
> 
> What do you propose the new standard to be (specifically) and what courses/certs/licensure do you recommend an EMTP who works in the field seek?



Okay, I appologize for getting the age of EMS wrong.  I was way off.  I still don't know that this was answered though.  What do you propose an EMTP have for an education right now, in this era of EMS, to be a "professional?"

MERRY CHRISTMAS!!


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## JPINFV (Dec 25, 2008)

Xueyon said:


> 1st off are any of us here talking bout doctors or lawyers??? 2nd is it possible to become a lawyer or doctor without a degree??? NO! how bout Paramedics? Yes!!!! And for who I would go to' well if he is lisence to save my life I don't think it would matter now would it. Or would you wait while ur dyin and ask hey do you have a degree to save my life? No I doubt you'd ask. This post has got way off topic... So yeah.



So basically you believe that education doesn't matter then.


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## daedalus (Dec 25, 2008)

Xueyon said:


> 1st off are any of us here talking bout doctors or lawyers??? 2nd is it possible to become a lawyer or doctor without a degree??? NO! how bout Paramedics? Yes!!!! And for who I would go to' well if he is lisence to save my life I don't think it would matter now would it. Or would you wait while ur dyin and ask hey do you have a degree to save my life? No I doubt you'd ask. This post has got way off topic... So yeah.



First, you have quite a bit of spelling errors. Maybe you think education should not matter because you seem to be lacking one.
Second, paramedics rarely save lives.
Third, I for one am trying to improve the professional standing of paramedics, and I find it insulting to all the the time I have spent studying for you to create a post like this for members of the public to read online.

And yes, a degree does matter. Do you want the paramedic starting fluid therapy on you to understand the chemistry of the colloid he is administering into your blood stream, the the physiology of fluid shifting between spaces in the body? Or are you like the many who think water is water and just infuse it in there so the blood pressure goes up?

I for one would rather have the paramedic working on me that had college level chemistry classes under their belt. Thats just me, though.


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## Xueyon (Dec 25, 2008)

JPINFV said:


> So basically you believe that education doesn't matter then.



I think you need to reread my post... Did I say education doesn't matter? No! I didn't, were talking about degrees. Its Not that I don't  think education matters cuz it does. But when it comes to Paramedics I think if someone gets lisences then it's just and good as someone with an AS or BS getting it. The only difference would be that the one with the degree has more science knowledge. It wouldn't mean there a better medic cuz of a degree. So I don't know where you got the idea of me saying education doesn't matter cuz it does.


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## daedalus (Dec 25, 2008)

Wow.

So science knowledge does not matter in the practice of Paramedicine?
What should I expect though, this guy is probably in EMT school.


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## FF894 (Dec 25, 2008)

Xueyon said:


> The only difference would be that the one with the degree has more science knowledge. It wouldn't mean there a better medic cuz of a degree. So I don't know where you got the idea of me saying education doesn't matter cuz it does.



Put the Eggnog down, step away from the computer and no-one gets hurt.


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## Xueyon (Dec 25, 2008)

daedalus said:


> First, you have quite a bit of spelling errors. Maybe you think education should not matter because you seem to be lacking one.
> Second, paramedics rarely save lives.
> Third, I for one am trying to improve the professional standing of paramedics, and I find it insulting to all the the time I have spent studying for you to create a post like this for members of the public to read online.
> 
> ...



My grammer has lots or errors umm ok. I'm making quick posts on my iphone  I'm not trying to win a writting contest here. And for education wise I have my AS and would finish school this year. I just decided to get my EMT cert. I'm not trying to insult anyone. If so i dont mean to. But for improving the EMS service by furthering education to get there degrees I think lots of medics we have now would have trouble in that part.


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## Xueyon (Dec 25, 2008)

daedalus said:


> Wow.
> 
> So science knowledge does not matter in the practice of Paramedicine?
> What should I expect though, this guy is probably in EMT school.



Yes actually I'm in a Emt course rite now and will be finishing this year with my BS in Bio.


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## daedalus (Dec 25, 2008)

Ill tell you what, I am going to take your word on the bio degree. I'm also going to challenge you to get through EMT school and than Paramedic school and ask yourself honestly, in my practice as a paramedic do I do better because of my lower and upper division knowledge of chemistry and biology?

I'm willing to put money on it that you will be far ahead of the game with a BS in biology.


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## Xueyon (Dec 25, 2008)

daedalus said:


> Ill tell you what, I am going to take your word on the bio degree. I'm also going to challenge you to get through EMT school and than Paramedic school and ask yourself honestly, in my practice as a paramedic do I do better because of my lower and upper division knowledge of chemistry and biology?
> 
> I'm willing to put money on it that you will be far ahead of the game with a BS in biology.



Alright, yes of course I'll know more then the average joe cuz of my degree but I won't say I'm a better medic just cuz o that. And if I offended you by my post I apologize. I didn't mean anything by it.


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## VentMedic (Dec 25, 2008)

FF894 said:


> Okay, I appologize for getting the age of EMS wrong. I was way off. I still don't know that this was answered though. What do you propose an EMTP have for an education right now, in this era of EMS, to be a "professional?"
> 
> MERRY CHRISTMAS!!


 


VentMedic said:


> Making the Paramedic a Bachelors degree might be a little unrealistic at this time. However, the Associates degree should be within reach. Oregon was successful in making it a requirement for licensure.


 
An Associates of Science degree is now the minimun for licensure in several Allied Health professions as well an nursing. It shouldn't be unreasonable to obtain that since there are many colleges that have already offered the degree since the mid 1970s. 

I would *first propose* that all Paramedic instructors hold at least an Associates degree. The teachers must be prepared to teach. 

Other professions require at least one degree higher or a Bachelors degree at minimun with a Masters preferred for a teaching position. Not only should you know the material you are teaching, you should be able to present it and recognize feedback from the students as to whether you are effective in the classroom. Many Paramedic instructors know their stuff but don't know how to teach or to read a class.

This is a decent *A.S. program* at Miami-Dade CC.
http://www.mdc.edu/medical/AHT/EMS/ems_curriculum.asp

I would prefer a Pharmacology class included.

Here's another example from St. Petersburg Community College
http://www.spcollege.edu/program/EMS-AS

To see how it compares to another Allied Health program such as *Respiratory Therapy* and to see what classes a Paramedic would still need to become an RRT.
http://www.spcollege.edu/program/RESC-AS

*Nursing:*
http://www.spcollege.edu/program/NURSE-AS

Compare any of the A.S. healthcare programs at a community college.
http://www.mdc.edu/medical/AHT/NMT/default.asp

If you want to see examples of *Bachelors programs for EMS and others,* here's Loma Linda University.
http://www.llu.edu/llu/sahp/prog.html

Once you start comparing what others EXPECT one to have to enter their profession and what EMS has gotten by with, you will begin to see what has been missing.


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## daedalus (Dec 25, 2008)

Xueyon said:


> Alright, yes of course I'll know more then the average joe cuz of my degree but I won't say I'm a better medic just cuz o that. And if I offended you by my post I apologize. I didn't mean anything by it.



Yes, you will be a better medic for it. I do not think you understand yet but I think that you will once you start reading the principals of pathophysiology in the front of the paramedic text.


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## Xueyon (Dec 25, 2008)

daedalus said:


> Yes, you will be a better medic for it. I do not think you understand yet but I think that you will once you start reading the principals of pathophysiology in the front of the paramedic text.



Yeah I borrowed a buddies critical care book and it talk about pathophysiology. Are you in medic. School rite now? If so what school are you going thru? I'll be moving down to Irvine and the only medic progam I saw was the one in Riverside NCTI. p


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## daedalus (Dec 25, 2008)

I am a little more careful about revealing certain things online for my own protection and future employment, but I will tell you my program is based in Ventura, California.

I have heard good things about NCTI, but I would recommend taking A&P in college instead of their A&P for paramedics class. Its better to get to see and cut through a pleural membrane than to read about one and see animated pictures.


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## Xueyon (Dec 26, 2008)

daedalus said:


> I am a little more careful about revealing certain things online for my own protection and future employment, but I will tell you my program is based in Ventura, California.
> 
> I have heard good things about NCTI, but I would recommend taking A&P in college instead of their A&P for paramedics class. Its better to get to see and cut through a pleural membrane than to read about one and seecha.
> 
> Oh ok I gotcha. Yeah I had already taken my a&p courses. Good point bout the info and online protection thnx.


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## JPINFV (Dec 26, 2008)

Xueyon said:


> Yeah I borrowed a buddies critical care book and it talk about pathophysiology. Are you in medic. School rite now? If so what school are you going thru? I'll be moving down to Irvine and the only medic progam I saw was the one in Riverside NCTI. p



There's a paramedic program at Saddleback Community College and Riverside Community College as well. 

http://www.saddleback.edu/hs/paramedic/

http://www.rcc.edu/academicPrograms/ems/

Although I've heard mixed reviews about RCCs program because they take the entire academy idea over the top (I personally have issues with the idea of uniforms for students, but that's for a different thread).


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## Xueyon (Dec 26, 2008)

JPINFV said:


> There's a paramedic program at Saddleback Community College and Riverside Community College as well.
> 
> http://www.saddleback.edu/hs/paramedic/
> 
> ...



Oh nice, yeah I saw the saddleback program. And the whole uniform deal I totally agree.


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## BossyCow (Dec 27, 2008)

The fire department jobs have become so competitive that four year degrees are being recommended. They are required if you are going to advance past entry level to any kind of officer position. 

Think about it, you have 30 applicants for 2 openings.... out of that you end up with 4 or 5 who pass the written, physical and orals. Having that piece of paper puts you ahead on points. 

No, Vent, they are not insisting on a degree in paramedicine but they are seeing a lot more applicants showing up with degrees in biology, public administration, healthcare management, fire science and the like.


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## danguitar12345 (Dec 27, 2008)

*answer kind of!!!*

i would think not although i may not be right


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## VentMedic (Dec 27, 2008)

BossyCow said:


> Think about it, you have 30 applicants for 2 openings.... out of that you end up with 4 or 5 who pass the written, physical and orals. Having that piece of paper puts you ahead on points.


 
I do think about this. We have 200 applicants for 1 Flight Paramedic position and over 6000 for 20 FF/Paramedic positions. 

For my area, there are other things that must be considered such as labor and employment issues as well the number of languages you speak. A person holding FF and Paramedic certs who is bilingual may be viewed as more valuable than someone who speaks only English but has a degree in Business Adminstration or even Paramedicine.

For Flight, I am always amazed at how little prep work with actual education some put into preparing for the job. Many think it will all be OJT which some of it is if one has the proper educational foundation to work with. However, if the most you have done is keep your Paramedic and ACLS certs updated, then you may not be ready to keep up with the requirements of a specialty team.


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## Xueyon (Dec 27, 2008)

VentMedic said:


> I do think about this. We have 200 applicants for 1 Flight Paramedic position and over 6000 for 20 FF/Paramedic positions.
> 
> For my area, there are other things that must be considered such as labor and employment issues as well the number of languages you speak. A person holding FF and Paramedic certs who is bilingual may be viewed as more valuable than someone who speaks only English but has a degree in Business Adminstration or even Paramedicine.
> 
> For Flight, I am always amazed at how little prep work with actual education some put into preparing for the job. Many think it will all be OJT which some of it is if one has the proper educational foundation to work with. However, if the most you have done is keep your Paramedic and ACLS certs updated, then you may not be ready to keep up with the requirements of a specialty team.



Yeah this is so true. My instructor told me that when they were recruitin they came down to 2 medic applicants  n one had military experience n one spoke 3 Lang. So the one that got the job was the bilingual medic cuz of that.


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