# paramedic students



## uselessmedic (Aug 24, 2008)

Students, just a word of advise, practice your bls skills before going to boards believe me, it will help in the long run! Today at boards 75% of the students failed their bls skill station which was KED. ALS skills are important, but the bls skills are important too!!!! Ok I've ranted enough.


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## KEVD18 (Aug 24, 2008)

see this is where it gets tough for me.i dont feel that paramedic students shuld be tested on bls skills. i've already taken the course, been examined by the school and deemed competant, then independantly examined by the state deemed competant and licend to perform said skill. not to mention, every two years during my refresher i have to proves once again that im still competent. its ridiculous.

then, i read articles like this and wonder.....


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## Ridryder911 (Aug 24, 2008)

KEVD18 said:


> then, i read articles like this and wonder.....




No, this type removes all doubt. In fact one wonders why we may not have to start retesting every quarterly a year. 
R/r 911


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## Sparky79 (Aug 24, 2008)

KEVD18 said:


> see this is where it gets tough for me.i dont feel that paramedic students shuld be tested on bls skills. i've already taken the course, been examined by the school and deemed competant, then independantly examined by the state deemed competant and licend to perform said skill. not to mention, every two years during my refresher i have to proves once again that im still competent. its ridiculous.
> 
> then, i read articles like this and wonder.....



If the medic isn't competent to pass a basic test of BLS skills, how can they be expected to pass an advanced test on more advanced skills?

To me this is a no brain-er!


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## Epi-do (Aug 24, 2008)

Sparky79 said:


> If the medic isn't competent to pass a basic test of BLS skills, how can they be expected to pass an advanced test on more advanced skills?
> 
> To me this is a no brain-er!



I think it goes back to the fact that while in class, along with filling our heads with additional information to make us better providers, you spend pretty much all of your time practicing your new skill set.  I am getting ready to take the registry in a couple weeks, and we have already been told that most people that fail a station will fail the BLS one.  Because of that, my class has made it a point to practice those stations a bit more than we probably would have.  

Different programs vary in how they prepare their students for the practical exam.  Add to that, the nerves that go along with taking the exam, I don't think that it is that they can't pass the BLS skills.  I think it is more a case of being so focused on doing the ALS skills properly, that they are making "silly" mistakes when it comes the the BLS skill station.  

My class just did a PHTS course yesterday and the day before.  On the first day of class, while doing skill stations, we all took the opportunity to use the LSB station as another chance to practice for registry, and went through that station exactly as if we were doing it according to the registry's check-off sheet.


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## FireResuce48 (Aug 24, 2008)

Ridryder911 said:


> No, this type removes all doubt. In fact one wonders why we may not have to start retesting every quarterly a year.
> R/r 911



Test 4 times a year? No thanks. 
I'll stick to working and volunteering with places that put an empathize on continuing education and mastering skills.


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## firecoins (Aug 24, 2008)

FireResuce48 said:


> Test 4 times a year? No thanks.
> I'll stick to working and volunteering with places that put an empathize on continuing education and mastering skills.



testing 4 times a year is putting an emphasis on continuing education and mastering skills.


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## firecoins (Aug 24, 2008)

Sparky79 said:


> If the medic isn't competent to pass a basic test of BLS skills, how can they be expected to pass an advanced test on more advanced skills?
> 
> To me this is a no brain-er!



clealy it isn't  

As I finish medic school the same thing happaned. everyone did well on ALS skills but failed most people failed KED. It wasn't that everyone didn't know how to use a KED.   It was nobody practised actually using it. Everyone put time into learning new skills.  Most people failed for excess movement.


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## Sparky79 (Aug 24, 2008)

firecoins said:


> clealy it isn't
> 
> As I finish medic school the same thing happaned. everyone did well on ALS skills but failed most people failed KED. It wasn't that everyone didn't know how to use a KED.   It was nobody practised actually using it. Everyone put time into learning new skills.  Most people failed for excess movement.



This is just an observation, and I'm in no position to judge (I've only been an EMT-B for about 6 months, so my experiance is laughable), but it seems to me that the use of a KED should not need to be a skill that has to be practiced by a would be medic. That was my point. If you can't do Basic skills in your sleep, how can you expect to be able to do ALS skills. I am not trying to be a smart a$$, just an outsider making an observation.


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## Ridryder911 (Aug 24, 2008)

Here's the problem. I probably have the chance to place the Hare traction on a patient about once every three or four years. I know of medics that have never delivered a baby, or placed a tourniquet on someone. Why? Because call volume and types of calls to use those are unusual and if ever occur. 

Now, you described yourself as competent.. by who's standard? Your school? Your State's certification? Again, remember the pass only means you meet the* minimal * standards. As well, the NREMT itself has no skill testing. Do you really trust the testing system? So let's say you decide to go back to Paramedic school, after five years of being an EMT. How well do you see all your basic skills? You haven't placed a Sager on since your EMT class. Beginning to see my point? 

Now, answer quickly.. What is the lowest score on the APGAR score? Did you respond in <  5 seconds? See?... and you just got out of school. If you don't use it, you may loose it. 

That is why I teach, and believe in reviewing and retesting all clinical skills at every level. It makes one study and review, keeps everyone on their toes and held accountable. 

R/r 911


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## fma08 (Aug 25, 2008)

R/r you may be able to answer this... For becoming a PALS instructor, is it a standard to need X amount of field experience before going through the instructor class? The service I'm at requires 3 years of experience before becoming an instructor. (pretty random question yes, but your comment about teaching made it pop into my head)


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## Ridryder911 (Aug 25, 2008)

I don't believe there is a "set" standard on requirement of clinical experience. It is only recommended that the instructor have some experience in that area. I do know of ACLS/ BLS/ PALS instructors that have never worked in critical care or emergency settings. They of course are well known as textbook instructors and usually refer any questions in clinical practice to those that work in those areas. 

It sounds like your area has set their own requirements to prevent such an occurrence. In a way, it is good to know that the instructor should have some minimal exposure. Yes, one can have the technical knowledge for the course and standards but having the clinical exposure adds to the credibility of the instructor. 

R/r 911


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## FireResuce48 (Aug 25, 2008)

firecoins said:


> testing 4 times a year is putting an emphasis on continuing education and mastering skills.



So does drilling on a regular basis. Not only, but its allot more convenient and you can make a much more life like environment and scenario in my opinion. 

People start studying just to pass a test not to gain more knowledge. That's where the problem lies.

If you are in the ems business or even in the fire service as it pretty much is the ems business these days and you don't put forth the effort to hone and learn new skills on a regular basis you are either in a not so great system or are not putting forth any effort and have no business in the field.


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## firecoins (Aug 25, 2008)

FireResuce48 said:


> So does drilling on a regular basis. Not only, but its allot more convenient and you can make a much more life like environment and scenario in my opinion.


 So what is it you have against Rid's suggestion of continually drilling BLS skills?   



> People start studying just to pass a test not to gain more knowledge. That's where the problem lies.


you are going to have to pass a test some point.  



> If you are in the ems business or even in the fire service as it pretty much is the ems business these days and you don't put forth the effort to hone and learn new skills on a regular basis you are either in a not so great system or are not putting forth any effort and have no business in the field.


Okay so you have keep drilling the BLS skills while learning the ALS ones.  Right.


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## FireResuce48 (Aug 25, 2008)

my response was mainly to the test 4 times a year comment. 

I agree with ALS providers knowing their BLS skills and I don't see a problem with throwing in a bls station during an als test. What good are ALS interventions if you can't do the BLS interventions.


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## Sasha (Aug 25, 2008)

KEVD18 said:


> see this is where it gets tough for me.i dont feel that paramedic students shuld be tested on bls skills. i've already taken the course, been examined by the school and deemed competant, then independantly examined by the state deemed competant and licend to perform said skill.



This kind of thought reminds me of a rescue of nothing but medics I saw roll into the hospital.

Pt is in cardiac arrest, they have him intubated, pushing drugs, bilateral large bore IVs started, can't figure out why he isn't coming around. Then the doctor asks why no one is doing compressions.

Never forget your BLS skills or take them for granted.


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## firecoins (Aug 25, 2008)

FireResuce48 said:


> my response was mainly to the test 4 times a year comment.
> 
> I agree with ALS providers knowing their BLS skills and I don't see a problem with throwing in a bls station during an als test. What good are ALS interventions if you can't do the BLS interventions.



Several points

We are EMT-Bs  We all work as EMT-Bs while going through the paramedic programs None of "forgot" the BLS skills.  None of can not do the BLS skills. 
As you said this is a test.  We focused on the new skill set.  Are ability to conduct a KED on a test has no bearing on our ability to intubate, give medications or start IVs.  

I can not see how anyone would forget compressions on CPR becuase they are medics. People who failed the KED didn't do so because they "forgot" how to use it.  It was a lack of practising doing the station. This is in a testing situation where the helper and patient are not as copperative as they would be in real life. If we had been doing something along the lines of Rid's suggestion, no one would have "failed" that station.


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## Sasha (Aug 25, 2008)

firecoins said:


> Several points
> 
> We are EMT-Bs  We all work as EMT-Bs while going through the paramedic programs None of "forgot" the BLS skills.  None of can not do the BLS skills.
> As you said this is a test.  We focused on the new skill set.  Are ability to conduct a KED on a test has no bearing on our ability to intubate, give medications or start IVs.
> ...



Sorry, should have clarified. The medics didn't do compression because they forgot how to do them, they were just so wrapped up in doing all their ALS skills, they forgot to initiate the very BLS skill of compressions. That's what they told the doc anyway. Never take BLS skills for granted, one can never be too proficient in them!


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## reaper (Aug 25, 2008)

I don't buy that. They may have stopped because they had ROSC, or stopped while coming through the doorway. Never seen a medic forget to do CPR, because they were worried about ALS skills.


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## Ridryder911 (Aug 25, 2008)

Sasha said:


> Sorry, should have clarified. The medics didn't do compression because they forgot how to do them, they were just so wrapped up in doing all their ALS skills, they forgot to initiate the very BLS skill of compressions. That's what they told the doc anyway. Never take BLS skills for granted, one can never be too proficient in them!




In all seriousness, it probably would had not matter. Now, with that statement they probably should had not started resuscitation efforts to begin with. Yes, if one is going to really attempting to resuscitate a patient then be sure all treatment are being performed correctly. 

A word of suggestion though.. until you have *really* ran a code by yourself or be in charge of one, it is very easy to armchair quarterback; anyone can do that. I say the same to the Doc, where the busiest part is crossing one's arms. 

R/r 911


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## Katie (Aug 25, 2008)

uselessmedic said:


> Students, just a word of advise, practice your bls skills before going to boards believe me, it will help in the long run! Today at boards 75% of the students failed their bls skill station which was KED. ALS skills are important, but the bls skills are important too!!!! Ok I've ranted enough.



I've been told that.  There's a tendancy to focus on the advanced aspects of the course and neglect the base that it's built on.  That's why our school has practice days and dedicated to just bls skills in addition to having labs open for extra practice on anything we're having trouble with


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## Ridryder911 (Aug 26, 2008)

Again and again ..* THERE IS  NO SUCH THING AS ALS TREATMENT OR BLS TREATMENT!* Medical care is medical care. Only in EMS is there such a thing...


R/r 911


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## Sasha (Aug 26, 2008)

Ridryder911 said:


> Again and again ..* THERE IS  NO SUCH THING AS ALS TREATMENT OR BLS TREATMENT!* Medical care is medical care. Only in EMS is there such a thing...
> 
> 
> R/r 911



But since we ARE in EMS.....

Practice your BLS skills ^_^


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## Ridryder911 (Aug 26, 2008)

Sasha said:


> But since we ARE in EMS.....
> 
> Practice your BLS skills ^_^



Prehospital care is just one *small *portion of EMS. Unfortunately, most EMT's are not educated on the formal EMS System. Assuming ambulances and  Fire Rescue is the whole thing, when in fact it is just a very, very small portion. Even if it was so this does *NOT* make it right. As well, if we assume this attitude we now know why that the EMT text is written at a grade school level and the Paramedic at a junior high school level. Still want to use the use the lame analogy? 

Patient care is patient care. Medicine is medicine, rural, urban, city, prehospital to surgery. The only reason we separate the two is because many EMS providers lack the educational knowledge (dumbing down) to perform a thorough assessment and treatment plan. We  (EMS) have made excuses of *NOT * providing adequate care to the citizens of the U.S. Shame that we still can only provide the so called (BLS=first aid) to many of the U.S. homes. We may have started the trend but we dropped the ball and others have successfully succeed to provide more advanced care to their citizens. 

Whenever someone attempts to categorize patient care into segments; it easily demonstrates that they have little knowledge in medical treatment and very little to no experience in the healthcare system. 

R/r 911


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## Emtgirl21 (Aug 26, 2008)

i'm going to elect to sit quietly in the corner....so i dont get sent to time out for my mouth again


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## Ridryder911 (Aug 26, 2008)

Your welcome and encouraged to speak up!.. This is what a forum is all about. To share and learn. I learn off many that posts here.. even if I may disagree, I respect their opinion as long as there is factual basis to refer the correctness. This is how professional people grow realizing there is more than one way to skin a cat.. heck, the cat may not even have to be skinned! 

R/r 911


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