# Education levels



## fortsmithman (Apr 22, 2009)

I've been thinking and this is what I think the education requirements should be for the following

EMT                      2 Year diploma (Canada) Associates degree (USA)

Paramedic             Bachelors degree

Critical Care Paramedic             Masters Degree


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## fortsmithman (Apr 22, 2009)

I put the last option in the poll for those who do not want to improve.  When in fact we need to be constatly improving the profession.  Upgrading our education so that we could be the best we can be and the pt's will have the best care possible.  That's just my opinion and I'm only a student on board with my service.


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## dodgemt (Apr 22, 2009)

If you think all that should happen, there would have to be a drastic pay raise.  I mean, look at the EMT-B's now, most of them aren't getting as much pay as a person flipping burgers at McDonalds.


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## fortsmithman (Apr 22, 2009)

If the profession is better educated then there should be higher pay for higher education.  With higher educational standards we would be considered without any hesitation by other health care groups as a bona health care profession.


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## VentMedic (Apr 22, 2009)

dodgemt said:


> If you think all that should happen, there would have to be a drastic pay raise. I mean, look at the EMT-B's now, most of them aren't getting as much pay as a person flipping burgers at McDonalds.


 
The person flipping burgers at McDonalds may actually have more "hours of training" than an EMT-B. However, ambulance services and McDonalds both realize this for what it is and do practice the turnover prinicple to keep costs low. They know many will either move on and a few ambitious people might actually move up with education to take on more responsibility. Of course, some prefer to be EMT-Bs just like some prefer to flip burgers.  They assume no extra responsibility or are just waiting for something else better to come along.


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## medic417 (Apr 22, 2009)

Instead of CC how about Doctor with Pre Hospital Medical Specialty?


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## JPINFV (Apr 22, 2009)

^
MD/DO specialized in prehospital medicine with enough members to do more than the most critical of crticial CCTs (which are already done in some areas) would be cost prohibitive.


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## DV_EMT (Apr 22, 2009)

Im not so sure about a 4 yr. Here's my theory, and it may just be because I'm younger

1. 4 years of school... for what. advanced math classes and things that you probably won't ever need in the field. I've met so many pharmacists that took ridiculous amounts of math and English and have never used it in the pharmacy setting. I have yet to meet a technician or a pharmacist that needs calculus or trig to solve a basic algebra question. its all ratios, multiplication, and division. ya don't need 6 years of math you'll probably forget. 

2. In SB, I currently make more as an RX tech than i would as a medic... this is absurd of course as being a medic is much more intense and requires more skills. And I got my license by just studying a book and working as a clerk in a pharmacy. I took the PTCB (same deal as the NREMT) and passed. No formal schooling was required. medics need to be paid higher than myself. they should at least have a nurses salary.. which is about 30-35 bucks an hour... but AMR and other agencies surely dont want to pay that!

3. Being a medic is like being a nurse... you shouldnt have to get a 4 yr or 2 yr to have to get into school. It's a specialized course... just like someone who is in radiology, or lab, or RT, or pharmacy (exception to pharmacists). all ya need is some pre reqs and specialized schooling. skip all the BS classes and get right to it.


then again... i do believe that schooling is important and that everyone should have the best education possible. But sometimes, i just look at things and wonder why things are done the way they are

p.s. - please don't eat me alive on this one. remember im still young here and have some wisdom to be gained :blush:


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## VentMedic (Apr 22, 2009)

DV_EMT said:


> 3. Being a medic is like being a nurse... you shouldnt have to get a 4 yr or 2 yr to have to get into school. It's a specialized course... just like someone who is in radiology, or lab, or RT, or pharmacy (exception to pharmacists). all ya need is some pre reqs and specialized schooling. skip all the BS classes and get right to it.


 
I disagree with you here.

While each area has its specific focus, the foundation each profession builds enhances that specialty.

Nurse: requires a 2 year degree with a Bachelors preferred and the understanding that is only the beginning of their training/education. 

Nurse Practitioner: Masters with a doctorate soon to be required.

Respiratory Thereapy: Associates degree required with Bachelors preferred in several areas as it may become the entry level requirement in a few years.

Radiology, Lab: Minimum of two year degree with a Bachelors or Masters preferred.

Speech, OT: Minimum of a Bachelors with Masters preferred

Physical Therapy: Minimum of a Masters with Doctorate preferred.

Paramedic: a few "hours of training" at a votech school with the job ready "skills" emphasis and little education.


There are not BS classes. Every class taken serves a purpose if none other than for reading comprehension. 

Without a well rounded and solid foundation or just relying on specialized training, one will be dependent on the skills of that training and lack the knowledge to be flexible in the ever changing world of medicine. We have already seen this in EMS.


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## DV_EMT (Apr 22, 2009)

I think what should happen is that they need to remove the title of a medic as EMT-P... because the T in that states that they are a technician. generally tech positions are supposedly lower on the "totem pole". If they want to bump up the standards and education of paramedics, then they should just give them a different title.  something like PMD or idk. In doing so, it would be like completely renovating the idea(s) of what it means to be a medic


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## fortsmithman (Apr 22, 2009)

DV_EMT said:


> I think what should happen is that they need to remove the title of a medic as EMT-P... because the T in that states that they are a technician. generally tech positions are supposedly lower on the "totem pole". If they want to bump up the standards and education of paramedics, then they should just give them a different title.  something like PMD or idk. In doing so, it would be like completely renovating the idea(s) of what it means to be a medic



I thought in a few years the EMT-P would be called Paramedic with the EMT dropped from the title.


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## rhan101277 (Apr 22, 2009)

fortsmithman said:


> I thought in a few years the EMT-P would be called Paramedic with the EMT dropped from the title.



You are right, there will be new national standards coming.  Incorporating more training for pulse oximetry for EMT-B's and additional training for medics.

The pay is sad though, I make much more than a paramedic and all I do is fix cell phone equipment, pull and replace parts and troubleshoot DC systems and a variety of other stuff.  I do have a associates degree, but you can get the same degree for paramedic. 

Only one state requires a paramedic to have a two year degree and this is Colorado, they need to make it nationwide.  I don't know what people are looking for to increase pay, but something needs to happen or the brightest paramedics will move on.

What I would like to know is how come paramedics can't make what a RN does.  I know medics are trained on total care like RN's but still.


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## Mountain Res-Q (Apr 22, 2009)

So if the issue is that some people believe that EMT's are under-trained and that something more is needed than a 3 week accelerated course... no disagreements here!  That is my biggest problem with EMT's in my area.  They take their 150 hours and BOOM they are EMT's and can start treating patients.  But if you work EMS with only that knowledge... well I am afraid.  More is needed IMHO...  BUT NOT A 2 YEAR COURSE AND A DEGREE!  it's not practical for the field.  My suggestion has always been that all EMT students are required to take a series of classes, including:

A&P (50 Hours)
Basic Cardiology (50 Hours)
ICS 200 (8 Hours)
EVOC (24 Hours)
Ride Time with a Preceptor (50 Hours)
Hospital Time (25 hours)
in addition to the Standard EMT Course, which would be expanded to 200-250hours to accomadate the addition of Multi-Lumin Airways, pulse oximetry, and several other meds (ASA, benadryl, epi, to name a few) to our Scope.
Plus you could throw in some awarness level classes that I believe all Emergency Respondes should have (like HazMat awareness, Water Rescue Awareness, etc...) so that they are not a liability on these types of calls.

Once we complete all these courses (400 hours-ish) then we can test to a national standard.  CEU's should be 24 a year, minimum.


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## JPINFV (Apr 22, 2009)

^
Err, Oregon requires an AA as well.


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## VentMedic (Apr 22, 2009)

rhan101277 said:


> Only one state requires a paramedic to have a two year degree and this is Colorado, they need to make it nationwide. I don't know what people are looking for to increase pay, but something needs to happen or the brightest paramedics will move on.


 
When did Colorado start requiring a 2 year degree? The last time I looked it was still 1000 hours.   If the two year degree, hopefully in EMS,  is now required it would be cause for celebration as now 2 or 50 states require a degree.




rhan101277 said:


> What I would like to know is how come paramedics can't make what a RN does. *I know medics are trained on total care like RN's but still*.


 
Not even close. Two very different focus of care. The Paramedic is primarily limited to emergent events for a short period of time in the prehospital area. 

Paramedic training can also be as little as 500 hours or done in just 3 months in some states which is just 1/3 of the clinical hours some RN programs require and that doesn't include all the book learning stuff.


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## fortsmithman (Apr 22, 2009)

Here in Canada namely in Ontario the program length for Primary Care Paramedic (which is the same as the EMT-I in the USA) is 2 yrs.


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## Foxbat (Apr 22, 2009)

JPINFV said:


> MD/DO specialized in prehospital medicine with enough members to do more than the most critical of crticial CCTs (which are already done in some areas) would be cost prohibitive.


Not only CCTs. Some cities inthe US have physicians responding in fly-cars to certain 911 calls.


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## JPINFV (Apr 22, 2009)

^
It's rare and a lot of times those are EM residents or EMS fellows.


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## Ridryder911 (Apr 23, 2009)

rhan101277 said:


> You are right, there will be new national standards coming.  Incorporating more training for pulse oximetry for EMT-B's and additional training for medics.
> 
> The pay is sad though, I make much more than a paramedic and all I do is fix cell phone equipment, pull and replace parts and troubleshoot DC systems and a variety of other stuff.  I do have a associates degree, but you can get the same degree for paramedic.
> 
> ...



There are actually many states that require an associcate degree. In fact Kansas does and has for a few years. 

As well, the new titles have taken effect, as my new National Registry card no longer has te title EMT-Paramedic; rather just Paramedic.... Yea! No, more of this .. You are an EMT!
Nope...


R/r 911


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## VentMedic (Apr 23, 2009)

Ridryder911 said:


> There are actually *many states* that require an associcate degree. In fact Kansas does and has for a few years.
> 
> 
> R/r 911


 

Many states?

Oregon and Kansas (forgot that one for the MICT) are just two. 

Texas offers a license for degreed but it is not required. 

What other states?


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## Ridryder911 (Apr 23, 2009)

VentMedic said:


> Many states?
> 
> Oregon and Kansas (forgot that one for the MICT) are just two.
> 
> ...



I will have to look it up, but at the NREMT meeting I believe we came up with at least 5 or 7 with some others that are in the process and allowing time before mandation.  

R/r 911


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## VentMedic (Apr 23, 2009)

Ridryder911 said:


> I will have to look it up, but at the NREMT meeting I believe we came up with at least 5 or 7 with some others that are in the process and allowing time before mandation.
> 
> R/r 911


 
Florida has been in the "process" since 1978 but that doesn't mean it will happen anytime soon. Others also made proposals to change around 1999 when OR did but few followed through. NM is another but again, anyone can summit a proposal, it just depends on how far it travels or not. 

Florida and California are probably positioned better then any of the states in terms of EMS degrees already present in the colleges but I doubt if either will make the move toward it being a requirement anytime soon. TN had the almost all of their Paramedic programs in Colleges but have now started to allow a FDs do their own training. A few other states have also started to allow more programs again in the FDs. Granted the motive might be to mass produce before the NREMT accreditatoin requirements. Many of the other states would first have to petition for increased education funds which may be a stretch after meeting the standards for accreditation. Becoming accredited and offering a degree still has a gap between them.

I would love to see it happen but I've been waiting since 1978 when I read the memo to get a degree because that was the future of EMS. Thirty years later, I'm still waiting for the future but I have my degree.


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## UKEMT (Apr 23, 2009)

I will admit i can't comment on your levels of training in the USA as im still looking into it but i can give you a comparison to what the training levels are required over here in the UK.

Until recently (about 1 year ago) 90% of the training up to the level of Paramedic was done via in house training and certified by the Institute of Health Care Development (IHCD), one year ago they developed a foundation degree program (3 years in length with one year dedicated gap working for a ambulance trust) which is a direct entry level qualification to become a state registered Paramedic whith the Health professions council (HPC) as it is now classed as a professional title and therefore is required to have regular checks of all personnel registered to practice as a Paramedic.

The link below is to a current job spec for the london ambluance service showing the in hoiuse training level and has further links to various universities whom offer the degree program.

This is the way things are going over here with regard to becomming a Paramedic as they are overhauling the service to provide better responce and patient care by ensuring that all category-1 calls are responded to by Paramedics.

http://www.londonambulance.nhs.uk/w...ancies/ambulance_staff/student_paramedic.aspx

This is just in contrast to what i have gleaned from your various educational requirements.


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## xlq771 (Apr 23, 2009)

How exactly would a 4 year paramedic program be organized?  Would it be organized along the same lines as the Bachleor degree program offered by Centennial College/University of Toronto, where the student only graduates as a Primary Care Paramedic / BLS level, or would the program be similar to the Bachleor degree program offered at Medicine Hat College, Alberta, where the student graduates as a Advanced Care Paramedic / ALS level?  

As for an EMT/PCP/BLS program, I would like to see the same number of course hours of a 2 year program put into a 1 year program.  I don't know about other areas, but the college programs at my area community college apparently don't spend enough hours in class, since they repeatedly trash the streets around the college during every drunken party.  A few years ago they even had a homicide (a student was stabbed).  Maybee if they were forced to spend more hours in their studies, they wouldn't wreck the neibourhood.


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## 45ACP (Apr 25, 2009)

I agree with DV EMT. I have a real problem with paying 500 to 1000 bucks to take English 101/102 in University. If someone is not "literate" as someone mentioned by 18 years of age then they might need those courses, but for me it is and incredible waste of money and time. 

A semester three months of time and all you get is three credits and a book report on Shakespeare _AGAIN_

We DO have a big problen IMO with our current state of Education.  IMO _most_ General Studies should be done in High School. Time would better be spent after High School learning the actual skills you need to do your job well and make a living. 

Understand Universities are in the Bussiness of Making money and if they can waste 50% of your time on getting a "Well Rounded" education they will darn well be happy to.


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## Ridryder911 (Apr 25, 2009)

45ACP said:


> I agree with DV EMT. I have a real problem with paying 500 to 1000 bucks to take English 101/102 in University. If someone is not "literate" as someone mentioned by 18 years of age then they might need those courses, but for me it is and incredible waste of money and time.
> 
> A semester three months of time and all you get is three credits and a book report on Shakespeare _AGAIN_
> 
> ...



Apparently, you have not taken English 101 as it is not about Shakespeare as it is about the usage of English grammar, writing skills and composition and even spelling (hint..). 

We have way too many of those that attend Career Technology or Vocational Technical Schools then attempt to be in medicine. In reality, there is far more in life than the "skills" one would learn in a blue collar trade school. Training and becoming educated is two different modalities. 

If one wants to pursue being a professional, then one needs to learn and grow academically as well. Way too much emphasis is placed upon "just knowing the essentials". Part of the problem with industries and the work force within the U.S. EMS is much more than just skills and what is contained within one book training. Hence, the reason EMS needs to get OUT of training and instead become educated. 

Sorry, just ask a typical Paramedic to write a formal or technical letter then tell me how those within it does not need additional education. 

Let's not water it down anymore than it is. Again, if one wants to be a professional with all the benefits, then one has to go the same pathway of other professionals. There is a reason one does this approach.

R/r 911


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## VFFforpeople (Apr 25, 2009)

I agree EMTs need more than just 150 hours (120 in cali). I think it should be done 3 times a week 4hours a night for a full semester. That would be a good about of training I think. Maybe even 4-5 days a week and hours. Two year degree for it I think would be a little much. Plus you won't see a pay raise in it for your time.

I dont know much for Medic so I won't go to deep into it. I know here in Cali, in my area it is 5days a week 9-10 hours a day, plus weekends at 9hours plus clinical hours. and you are about 10 credits short of a 2yr degree. It is a lot to take on in a 1year but if will show you if you really want it. Even if you pass the class for Medic, the teacher can still fail you from taking NREMT. That all I know from my area.

Rider I was wondering if you could elaberate more on your meaning of blue collar because I may have misread it or didn't understand it the way you meant it to be said. I don't want to go off and sound like and idiot.


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## Aidey (Apr 25, 2009)

Rid, what do you consider to be equal professions? Saying one has to go the same pathway as other professions is too general considered there a huge difference in education between different types of professions.


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## VentMedic (Apr 26, 2009)

VFFforpeople said:


> I dont know much for Medic so I won't go to deep into it. I know here in Cali, in my area it is 5days a week 9-10 hours a day, plus weekends at 9hours plus clinical hours. and you are about 10 credits short of a 2yr degree. It is a lot to take on in a 1year but if will show you if you really want it. Even if you pass the class for Medic, the teacher can still fail you from taking NREMT. That all I know from my area.


 
Where?

California still only requires just over 1000 hours to be a Paramedic.  While there are programs as you describe, most run just for a short period of time to get one through those 1000 hours quicker and on a truck.  These schools are also usually associated with a private ambulance service or FD.  Even the college programs stretch their courses out and many no longer rerquire the standard college A&P and sciences that are required for other health degrees. 

The only thing I will say about California is that it requires all of its Paramedic programs to be CAAHEP/CoAEMSP accredited.  Other than that, I would be hard pressed to use California as an example of excellence when it comes to Paramedic education.  I believe their state's (and counties) scope of practice reflect that.


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## VentMedic (Apr 26, 2009)

Aidey said:


> Rid, what do you consider to be equal professions? Saying one has to go the same pathway as other professions is too general considered there a huge difference in education between different types of professions.


 
If you look at almost any college catelog you will see that just about every healthcare pathway starts with the same initial sciences, maths and English classes as well as Psychology, Sociology and statistics before they are even allowed to apply for their program. Unfortunately the college degrees for Paramedics are accepting the watered down version of A&P while the tech schools require very little for prerequisites except the ability to sign the loan check over to the school.


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## Aidey (Apr 26, 2009)

That wasn't really what I was asking Vent.


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## VFFforpeople (Apr 26, 2009)

VentMedic said:


> Where?
> 
> California still only requires just over 1000 hours to be a Paramedic.  While there are programs as you describe, most run just for a short period of time to get one through those 1000 hours quicker and on a truck.  These schools are also usually associated with a private ambulance service or FD.  Even the college programs stretch their courses out and many no longer rerquire the standard college A&P and sciences that are required for other health degrees.
> 
> The only thing I will say about California is that it requires all of its Paramedic programs to be CAAHEP/CoAEMSP accredited.  Other than that, I would be hard pressed to use California as an example of excellence when it comes to Paramedic education.  I believe their state's (and counties) scope of practice reflect that.



Like I said I don't know much on the ALS side of Cali. What I can say is that both Northern California colleges up here require A&P. Also, as for a standard I think we do well against other states and hold our own. Each county has its own rules it must follow, it is never the same where you go. Up here in the real Nor Cal, it is difficult to just "Jump" on a truck. I would ask have you ever been to Cali? or live or worked here?


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## Sapphyre (Apr 26, 2009)

VFFforpeople said:


> I would ask have you ever been to Cali? or live or worked here?



Oh,VFF, you just stuck your foot in your mouth.   Vent spends quite a bit of time in the Bay Area.

BTW, she's right about the state of EMS in California.


:this post brought to you by a BLS 911 rig, sitting in a random parking lot, in the land of Johnny and Roy:


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## Ridryder911 (Apr 26, 2009)

Aidey said:


> Rid, what do you consider to be equal professions? Saying one has to go the same pathway as other professions is too general considered there a huge difference in education between different types of professions.



Easy. Look at any other medical profession i.e. respiratory therapy, nursing, physical therapy, occupational therapy, medical school. Again, referring to what our main and only goal should be .. medical. 

Blue collar type work is based upon skills not education. Training is emphasized rather than educational pathway. For example factory workers or those that require direct supervision and performance is based upon their physical activity. Hypothetical or analyses thinking is not required. Even Fire Services is considered to be blue collar. As their primary job is under supervision, physical activity is their primary role in lieu of making hypothetical decision making. Unfortunately, many attempt to place EMS within this type of performance; as placing skills as the main emphasis of our performance, when in reality if done properly would recognize the skills are just secondary. 

EMS is a division of Emergency Medicine which is science. We need to quit diversifying it as it becomes something else or looses its main focus and intent. 

R/r 911


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## VentMedic (Apr 26, 2009)

It is technical training when your program and state scope of practice reads like a check off list. Other professions will have statements like "skills and medication related but not limited to the cardiopulomonay systems" as an open ended scope. It would be difficult to even begin to list the many "skills" an RN, RRT or any other healthcare professional can provide as well as the interventions that their medical directors can put into their protocols. Again, it is largely derived from education. If you have the knowledge, a "skill" is not too difficult to learn especially if you already know the reasons to why that skill is being done to that patient. 

Example of California's "list" for Paramedic: (When listed out, it is really not that impressive and definitely not when you get to what CA considers "CCT" for the Paramedic. But, that is why they have MICNs.)

This is also a combined list for all 3 levels. 

http://www.emsa.ca.gov/personnel/files/emt/ems_prog.pdf

Patient assessment​ 
Advanced first aid​ 

Use of adjunctive 
breathing aid &​ 
administration of 
oxygen​ 
Automated External 
Defibrillator​ 
Cardiopulmonary 
resuscitation​ 

Transportation of ill
& injured persons​ 

EKG monitoring 
Defibrillation & 
Cardioversion​

Antishock trousers​ 
Intravenous infusion​ 
Esophageal airway​ 
Obtain venous blood​ 
9 medications (scope of
practice varies by area)​ 

Laryngoscope​ 
Endotracheal (ET)​ 
intubation (adults, oral)​ 
Glucose measuring​ 
Valsalva=s Maneuver​ 
Needle thoracostomy​ 
and cricothyroidotomy​ 
Nasogastric intubatio​ 
(adult)​ 
· *21 medications*​


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## DV_EMT (Apr 26, 2009)

yeah... here in the big CA, every county has their own rules... which keeps us on our toes. unfortunately, Sb county has really tightened up on their EMT-B's. o2 and po glucose are the only allowable medications to be dosed. forget about aspirin, nitro, activated charcoal, or epipen. i'd like to see what LA county's rules are


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## JPINFV (Apr 26, 2009)

^
Still more than Orange County.

Now quick question. In the past year, how many times did you have a patient where you would have administered an epipen, charcoal, ASA, or nitro?


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## Mountain Res-Q (Apr 26, 2009)

Just one question:

WHO WOULD ACTUALLY VOTE THAT WE DON'T NEED TO IMPROVE THE PROFESSION?  You know who you two are and so do we.

Anyone that sees the way EMS is organized (or disorganized sometimes) and the inconsistancies in training/scope realizes that there is much to be done to improve our profession.  On a personal level, every medical provider MUST continue to expound on their knowledge and improve their skills.  Anyone that doesn't agree is not someone I would wnat treating a family member.  Anyone who is content to keep the profession and their personal education where it is ned top leave medicine and get a nice fast food gig... the pay is probably better anyway.

P.S. Yes California sucks in the way we have EMS set up.  Anyone that has worked out here knows it and if they denies it and is content with the way California EMSA operates needs to likewise get out of EMS or take a trip to a state/country where things are done right (I could make you a list, but just fingure through an atlas.)


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## Aidey (Apr 26, 2009)

Rid I think you missed the intent of my question. I'm not talking about equal medical professions, I'm talking about equal professions period. Maybe using level of autonomy and responsibility as comparison factors.

If you had to pick *one* medical profession you think paramedic is most equal to which one would it be? I ask you to pick one because you listed medical school, but there is no way being a doctor is equal to being a paramedic. Saying that the education requirements for paramedics and EMTs should be increased because the education requirements for doctors are so much higher is kind of like saying that the education for flight attendants should be increased because the education requirements for pilots is so much higher.


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## 45ACP (Apr 26, 2009)

Ridryder911
Apparently, you have not taken English 101 as it is not about Shakespeare as it is about the usage of English grammar, writing skills and composition and even spelling (hint..). 

Apparently_ you _only have a grasp on sarcasm when it comes to your own posts. I was making the point that Composition, Literature etc. all have there place certainly, but I am of the opinion that reviewing these in university are simply a way for the college to make more money, waste the students time, and set the student further back into debt. None of which, pertain to learning medicine. 

We have way too many of those that attend Career Technology or Vocational Technical Schools then attempt to be in medicine. In reality, there is far more in life than the "skills" one would learn in a blue collar trade school. Training and becoming educated is two different modalities. 

What is wrong with people going to a career technology field to be a CNA or other equivalent? If they choose to become something demanding a greater degree of education they will have to obviously meet the same standards anyone else would.

If one wants to pursue being a professional, then one needs to learn and grow academically as well. Way too much emphasis is placed upon "just knowing the essentials". Part of the problem with industries and the work force within the U.S. EMS is much more than just skills and what is contained within one book training. Hence, the reason EMS needs to get OUT of training and instead become educated. 

I agree with what you've said here. I just don't see why the other "book" should be  "Thus Spoke Zarathustra".  If people want to make themselves more worldly that's great! I support and encourage that. What I am saying is that the time could be spent delving deeper into medicine or whatever it is that one is studying in pursuit of a career. I am not suggesting that one book be utilized at all. I am saying that in the same amount of time, & for the same amount of resources ones knowledge of their respective craft could be deeper if it were not for the time spent on, what in many cases is a review of High School Academia. 

Sorry, just ask a typical Paramedic to write a formal or technical letter then tell me how those within it does not need additional education. 

If this is something that is hindering their ability to do their job effectively then yes they might, but they probably don't need 22 credits of electives. So proper composition Medical or otherwise can certainly be argued as to it's pertinence to the Medic, But Universities  argue that "Music Appreciation" helps him relate to his patients better. Well a conversation about Jazz just cost him a thousand bucks and three months of his time.

Let's not water it down anymore than it is. Again, if one wants to be a professional with all the benefits, then one has to go the same pathway of other professionals. There is a reason one does this approach.

Agreed, Again my comments were more about feeling that the educational system has more to do with business, than it does with helping people  achieve Financial and Practical Mastery of a chosen field.

BTW I will continue to have the errant spelling mistake, as I have little inclination to go back to correct every typo, it only proves my laziness to press a spellcheck. If you have an assumption to make, better to do it out in the open. 
R/r 911


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## daedalus (Apr 26, 2009)

DV_EMT said:


> yeah... here in the big CA, every county has their own rules... which keeps us on our toes. unfortunately, Sb county has really tightened up on their EMT-B's. o2 and po glucose are the only allowable medications to be dosed. forget about aspirin, nitro, activated charcoal, or epipen. i'd like to see what LA county's rules are



In SBC, EMTs on the engines can administer a few more medications. Also, all 911 transport units are ALS, so there is no need for EMTs to be able to give meds. The Fire EMTs have a samll increase in scope, which is understandable because SB county is massive and some parts very rural.


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## daedalus (Apr 26, 2009)

> Apparently you only have a grasp on sarcasm when it comes to your own posts. I was making the point that Composition, Literature etc. all have there place certainly, but I am of the opinion that reviewing these in university are simply a way for the college to make more money, waste the students time, and set the student further back into debt. None of which, pertain to learning medicine.


 45ACP, you could not be any further from the truth. I am shocked by your statements. Writing research papers, reading studies, doing original research and finding secondary sources, critical thinking, analysis, and perspective are all critical to the medical field, and are all taught in English. Almost every class you take in college will make you a better paramedic. Chemistry, what do you think the krebs cycle is? Biology, the basis of the human body. Anthropology, learning about the evolution and behavior of the human being. I could go on and on.



> What I am saying is that the time could be spent delving deeper into medicine or whatever it is that one is studying in pursuit of a career. I am not suggesting that one book be utilized at all. I am saying that in the same amount of time, & for the same amount of resources ones knowledge of their respective craft could be deeper if it were not for the time spent on, what in many cases is a review of High School Academia.


Again, I find these statements shocking. If you want to delve deeper into medicine, you need to have a strong education background. Go ahead and crack open Robbin's Pathologic Basis of Disease. It is a blue book, and the "bible" of pathology. Pathology is essential to the study of disease. However, to study from this book, you will need a solid grasp on graduate level reading ability, chemistry and organic chemistry, pharmacology, biology, human anatomy, and physiology. To delve deeper in your studies beyond the paramedic text written at the high school level, you need a full college education. No wonder medical school requires a four year degree...


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## Ridryder911 (Apr 26, 2009)

You will usually only find those that will criticize education or requiring much more than the "business" portion is those that never attended anything more than just that. 

Then how could one really make an educated comparison if they did not receive such? 

There is a reason professionals require an education that contains more than just their "job" skills. We could list a whole site of the importance of Psychology beyond the high school level, or the need of English and Composition and of course Biological Sciences. 

We wonder why EMS has not reached the age of maturity? We should be asking ourselves why we would one ever question the reasoning of advancing our education levels or mandating it? It is doubtful that any other medical profession has to fight to become educated! Why would one want those involved within their profession would not to have at the least the minimal accepted level of professional academia? 

Vocational education is for the development of a trade and does not usually require academia as part of their training development. Education methodology emphasizes utilizing academic and accompanying skills if necessary and does not utilize the training method. Yes, there is a difference and if you do not understand that ... chances are you are trained and not educated. 

There are far more things one learns than just within the EMS course itself. The reason I require thesis even in a Basic EMT course. One needs to develop the ability to reason and justify and be able to defend your thoughts per accurate writing and in a formal presentation. 

For the same reason many become upset or lack the knowledge to understand that there are many ways of accepted treatment that are never contained within their little textbook. In some circumstances they maybe the best or the worst dependent upon the given situation. One cannot make the rationalization if one is only taught one method. 

Look at the EMS and one will see that it still lacks credibility. Credibility only comes from  research and proven methods per educated and scientific methodologies. One cannot be or develop being a professional just by being good at their job. Skills alone does not make it become distinguished. 

R/r 911


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## VentMedic (Apr 26, 2009)

Aidey said:


> Rid I think you missed the intent of my question. I'm not talking about equal medical professions, I'm talking about equal professions period. Maybe using level of autonomy and responsibility as comparison factors.
> 
> If you had to pick *one* medical profession you think paramedic is most equal to which one would it be? I ask you to pick one because you listed medical school, but there is no way being a doctor is equal to being a paramedic. Saying that the education requirements for paramedics and EMTs should be increased because the education requirements for doctors are so much higher is kind of like saying that the education for flight attendants should be increased because the education requirements for pilots is so much higher.


 
Medical school? 

All the professions Rid listed can have a high level of autonomy and responsibility depending on where they work. In fact, the Paramedic as it is now pales in comparison to any of those professions if you wanted to just list skills, autonomy and responsibility. The one factor that all of these profession have in common that the Paramedic doesn't is reimbursement as a professional. (Some SCT being the exception.) Education is what has gotten them that recognition. 


45ACP,



> what in many cases is a review of High School Academia.


Do you have any education beyond high school or are you still in high school?


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## daedalus (Apr 26, 2009)

Ridryder911 said:


> You will usually only find those that will criticize education or requiring much more than the "business" portion is those that never attended anything more than just that.
> 
> Then how could one really make an educated comparison if they did not receive such?
> 
> ...


What can we expect from skills based, vocational blue collar Technicians who want to keep themselves at that level when there is a huge opportunity to move themselves up. It is akin to shooting one's own foot! WHy will they not pick their heads off the floor and look to the sky?


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## Aidey (Apr 26, 2009)

I haven't expressed an opinion on the education levels one way or another, so please don't assume I feel one way or another. I'm simply curious as to what Rid thinks are equal professions. 

I also have to wonder if the skills list has come about because of the vocational/technical roots of Paramedicine, or if it has more to do with the way physician sponsors base standing orders on specific skills.


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## daedalus (Apr 26, 2009)

Aidey said:


> I haven't expressed an opinion on the education levels one way or another, so please don't assume I feel one way or another. I'm simply curious as to what Rid thinks are equal professions.
> 
> I also have to wonder if the skills list has come about because of the vocational/technical roots of Paramedicine, or if it has more to do with the way physician sponsors base standing orders on specific skills.



I would imagine that after paramedics are educated to high levels in medical science, that the scope would not be a skill set, but rather something like "To provide emergency medical care to the sick and injured with sound clinical judgement and with the portable equipment made available to the paramedic based on geographic need". Perhaps an enterprising paramedic, when stuck seemingly out of options, would than call a physician (not an RN representative, I never understood this..) and the two of them could come up with a plan based on the assessment and the equipment available.


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## VFFforpeople (Apr 27, 2009)

I agree, the more I read on about what rid and dael been saying. I agree Basic should require more from the student. I push my-self to learn more even beyond what I am allowed to do. I run critical thinking drills and have people question me on all I did in my drill. I heard a quote I finally took to heart. (I don;t remeber who it was said/written by). "Live as if you were to die tomorrow, Learn as if you were to live forever." Take that for what it is worth and keep pushing on. We all can get complacent withn our own levels, if we do not keep learning how are we helping the sick,injured. We can't and we end up failing them. Again take what you will from my words. I already enrolled in higher education. This forum helped me decided it.


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## fortsmithman (Apr 27, 2009)

xlq771 said:


> How exactly would a 4 year paramedic program be organized?  Would it be organized along the same lines as the Bachleor degree program offered by Centennial College/University of Toronto, where the student only graduates as a Primary Care Paramedic / BLS level, or would the program be similar to the Bachleor degree program offered at Medicine Hat College, Alberta, where the student graduates as a Advanced Care Paramedic / ALS level?
> 
> As for an EMT/PCP/BLS program, I would like to see the same number of course hours of a 2 year program put into a 1 year program.  I don't know about other areas, but the college programs at my area community college apparently don't spend enough hours in class, since they repeatedly trash the streets around the college during every drunken party.  A few years ago they even had a homicide (a student was stabbed).  Maybee if they were forced to spend more hours in their studies, they wouldn't wreck the neibourhood.



The 4 yr would be ALS and he 2 yr would be BLS.


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## AJ Hidell (Apr 29, 2009)

fortsmithman said:


> The 4 yr would be ALS and he 2 yr would be BLS.


Or we could just eliminate BLS from EMS, which seems to be the smarter choice.


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## VFFforpeople (Apr 29, 2009)

AJ Hidell said:


> Or we could just eliminate BLS from EMS, which seems to be the smarter choice.



I would agree in a way and disagree. I have a few Medics I have been talking too the past couple weeks. So, far what I have gathered is they said, "The best ALS starts with BLS." Everything always goes to the basics, it is a learning foundation and the building block. (I know you know this. I am not speaking down to you, or being smart. What you said just made me think of it.) That is just the stance I take you can't really say your ALS until you have done BLS and the grunt work to make sure you know the basics.


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## Aidey (Apr 29, 2009)

Again, without commenting on the overall educational requirements, I think that a 2 year degree for BLS is a bit overkill when someone can become an RN with a 2 year degree. (Yes, I understand there are usually pre-recs for a 2 year RN, which makes it more like a 3 year RN, but the degree is still an Associates.)


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## JPINFV (Apr 29, 2009)

Well, Canada some how pulls it off. Besides, there are so many paramedics out there that think that their "skills" makes them superior to nurses. Wouldn't it be time for us to put our money where our collective mouths are?


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## Aidey (Apr 29, 2009)

My impression was that Canada's BLS has significantly more skills than our BLS?


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## JPINFV (Apr 29, 2009)

I'm willing to put money down that if EMT-B was a 2 year degree that the scope of practice for basics would  be expanded too.


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## VentMedic (Apr 29, 2009)

VFFforpeople said:


> I would agree in a way and disagree. I have a few Medics I have been talking too the past couple weeks. So, far what I have gathered is they said, "The best ALS starts with BLS." Everything always goes to the basics, it is a learning foundation and the building block. (I know you know this. I am not speaking down to you, or being smart. What you said just made me think of it.) That is just the stance I take you can't really say your ALS until you have done BLS and the grunt work to make sure you know the basics.


 
Yes, everyone should start out with the basics like any other profession which are covered in their first semesters of college.  But, that doesn't mean there must be a basic level or at least not the one the U.S. has. The entry EMT should at the very least be no less than one college year or 3 full college semesters.


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## Ridryder911 (Apr 29, 2009)

VFFforpeople said:


> I would agree in a way and disagree. I have a few Medics I have been talking too the past couple weeks. So, far what I have gathered is they said, "The best ALS starts with BLS." Everything always goes to the basics, it is a learning foundation and the building block. (I know you know this. I am not speaking down to you, or being smart. What you said just made me think of it.) That is just the stance I take you can't really say your ALS until you have done BLS and the grunt work to make sure you know the basics.



Only EMS has BLS and ALS levels.. Wonder why? Ego's. Sorry, we have call the treatment basics do something?.. Therefore the BLS wording was invented.

Medicine is medicine. Albeit in the jungle or the surgical theatre in a large metro hospital. You don't read in other health care perform the BLS then be satisfied with that. Part of the problem is we never teach or enforce that Basic EMS is just a first step and crucial one but tiny, tiny step in treatment. One cannot perform adequate advanced care without performing great initial care (as some prefer to label as BLS). It can't happen! It's impossible! Prove me wrong. 

It always amazes me of those that love to spout of the old saying ...."_BLS before ALS"... or ..."I much rather have good BLS instead of crappy ALS"...._ horse poo! 

Treatment modalities are continuous. There is always a progression from initial care to definitive therapy. Can one imagine to describe an ER is the BLS and Surgical intervention is the advanced? No. One would and should realize there is a different intervals of care. Levels? If you need to have label. Apparently EMS loves them and titles.  

R/r 911


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## 45ACP (Apr 29, 2009)

45ACP,


Do you have any education beyond high school or are you still in high school?[/quote]

I have my Bachelors.

 Just because I am of the opinion that a great number of classes in your average students first 2 years of University a waste of money doesn't mean I don't support education.  I want to reiterate, I don't support some sort of one book approach that keeps getting mentioned.  The "General Studies" could certainly afford to be condensed considerably leaving more room for medical related study. 

It's unfortunate that some folks assume an opinion that is different to theirs has to come from someone who is uneducated.


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## AJ Hidell (Apr 30, 2009)

VFFforpeople said:


> I would agree in a way and disagree. I have a few Medics I have been talking too the past couple weeks. So, far what I have gathered is they said, "The best ALS starts with BLS." Everything always goes to the basics, it is a learning foundation and the building block. (I know you know this. I am not speaking down to you, or being smart. What you said just made me think of it.) That is just the stance I take you can't really say your ALS until you have done BLS and the grunt work to make sure you know the basics.


I certainly don't disagree with any of that.  And no offense taken.  I think you are right on with your assessment.  BLS is a foundation.  ALS is nothing more than advanced ways of achieving BLS, which is the ABCs.  But a foundation alone does not a house make.  As you say, you have to build upon that foundation to create a competent practice.  And a more competent practice could be built by an educational approach that integrated all facets of patient assessment and care into a single synergistic process.  That means eliminating the BLS-only level of EMT from EMS, so that we avoid the disjointed, segregated, dysfunctional process that requires us to turn one level of provider into a completely different provider.  It's much better to simply build that provider from the ground up, without half-steps.


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## daedalus (Apr 30, 2009)

Like rid/ryder has pointed out, no other area of medicine splits BLS and ALS. If a doctor is bandaging a wound, is she preforming BLS or ALS? Neither. She is applying her education in treating a patient. Her in depth knowledge of the way wound healing occurs guides her in her technique. Sure, actually applying the bandage may be a "basic skill", but to the doctor, it is just part of the vast amount of clinical education she has received, and is no more or no less important than other treatments she can provide. 

One does not have to have been an EMT to master the basics. The basics can be taught and mastered in paramedic school. Therefore, there would be no BLS or ALS, just comprehensive out of hospital medicine.


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## Aidey (Apr 30, 2009)

Maybe no one else splits it into BLS and ALS, but traditionally there have always been people trained at a lower level to assist the provider. In an ED for example there are doctors, RNs, techs etc etc etc. The doctor doesn't perform every single task himself, certain tasks and procedures are done by the other people.

While the choice of ALS and BLS may not be the best terms in the world, I see no problem with there being 2 levels of pre-hospital care.


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## AJ Hidell (Apr 30, 2009)

Aidey said:


> While the choice of ALS and BLS may not be the best terms in the world, I see no problem with there being 2 levels of pre-hospital care.


I don't either, so long as only the top level is allowed on ambulances.  Anything less is appropriate only in a first responder role.  People call for EMS because they need help.  They do not expect you to show up and have to call yet someone else for help.  Although many of our patients require only basic supportive care, the purpose of EMS is to be prepared for the worst case.  And those who need that advanced care are the last people we need to be making wait for an intercept.  Providing anything less is a failure to observe the meaning of the E in EMS.

The problem with the less than ideal terminology is that it serves only to fracture and confuse both the clinical and educational processes.  Too many people are mistakenly using BLS and ALS as synonyms for EMT and Paramedic, which they are not.  ALS and BLS refer to types of care rendered, not to a level of care provider.  And EMTs often provide ALS care, just as Paramedics often provide BLS care.  Consequently, the labels are meaningless and divisive, and need to go away for the good of the profession.


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## Aidey (Apr 30, 2009)

AJ Hidell said:


> I don't either, so long as only the top level is allowed on ambulances.  Anything less is appropriate only in a first responder role.



See, here is where I disagree. I think that EMTs (as the lower level in this discussion) do belong on ambulances. Yes, it is silly when someone calls 911 to have an ambulance show up only to have that ambulance have to call another ambulance. But that isn't a fault of the level of care, that is a fault in the tiered response system (which is a system I dislike). 

I'm perfectly ok with a 2 man ambulance crew having 1 paramedic and 1 EMT. I don't think that 2 paramedics are needed. The second person is going to be assisting on scene and then driving, and I think the EMT role is acceptable for that position. 

I also don't have a problem with an EMT only IFT ambulance. Someone does not need a parmedic assessment when they are being transfered from St. Sent-Here-To-Die's care facility to the local hospital to have their skin rash re-assessed. Especially when the only reason they are going by ambulance because they can't sit up on their own, so the wheel chair transport won't take them. Or because they have mild dimentia and need to be watched, or any other number of the approved medicare reasons for ambulance transport.


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## AJ Hidell (May 1, 2009)

Aidey said:


> But that isn't a fault of the level of care, that is a fault in the tiered response system (which is a system I dislike).


But the current allowance of EMTs on ambulances is what perpetuates that flawed system.  Take away the option and you take away the problem.



> I'm perfectly ok with a 2 man ambulance crew having 1 paramedic and 1 EMT. I don't think that 2 paramedics are needed. The second person is going to be assisting on scene and then driving, and I think the EMT role is acceptable for that position.


How long have you been a paramedic?  Do you know one of the primary reasons that medics stay in EMS for such short careers?  Burn-out.  Do you know one of the number one reasons for paramedic burn-out?  The overwhelming stress associated with having 100 percent of the responsibility for 100 percent of the patients you pick up every shift.  When you have no partner (an EMT is not a partner.  It's just a helper.), you have no one to share responsibilities with, and you burn out twice as fast.  Studies show that medics in dual-medic systems have significantly longer longevity than those in mixed systems.



> I also don't have a problem with an EMT only IFT ambulance. Someone does not need a parmedic assessment when they are being transfered from St. Sent-Here-To-Die's care facility to the local hospital to have their skin rash re-assessed. Especially when the only reason they are going by ambulance because they can't sit up on their own, so the wheel chair transport won't take them. Or because they have mild dimentia and need to be watched, or any other number of the approved medicare reasons for ambulance transport.


I completely agree.  In fact, I don't believe that non-emergency transfer ambulances should be required to have ANY medically trained personnel on board.  If anything, they need nurses aide training, not EMT training.  But that isn't EMS, so it's not even relevant to this discussion.


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## daedalus (May 1, 2009)

AJ Hidell said:


> I completely agree.  In fact, I don't believe that non-emergency transfer ambulances should be required to have ANY medically trained personnel on board.  If anything, they need nurses aide training, not EMT training.  But that isn't EMS, so it's not even relevant to this discussion.



Perhaps it is relevant to our discussion only because so many enter EMT school hoping to get a career in EMS, and instead end up on a BLS IFT rig. It is not totally the fault of the EMT that she has to endure such a cruddy education and work a dead end job bringing grandpa home from the hospital, being spit on by everyone including other medical providers and the public. The budding EMT student may have a passion to enter EMS, and we do that student a great disservice by allowing EMTs to work IFTs. Instead, anyone with a real drive to work in EMS should be welcomed into our fold, because we need people like that, and be made to endure a proper education (paramedic school). I agree with your assessments, CNAs with lifting/moving and gurney education should work IFTs. We lose many good potential EMS providers who burn out in these jobs, I see it every week at my service. Some of the brightest and coolest guys I have ever known, who would have made amazing paramedics, instead have gone to nursing, physical therapy, etc. They are going to make amazing RNs and PTs, but we also need a slice of that amazing individual pie in EMS too. We are hemorrhaging our best human capital because of medicare fraud committing greedy private IFT ambulance providers who burn them out of EMS in a period of a few years.


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## AJ Hidell (May 1, 2009)

daedalus said:


> Perhaps it is relevant to our discussion only because so many enter EMT school hoping to get a career in EMS, and instead end up on a BLS IFT rig. It is not totally the fault of the EMT that she has to endure such a cruddy education and work a dead end job bringing grandpa home from the hospital, being spit on by everyone including other medical providers and the public.


Again we mostly agree.  But I do believe that it _IS_ their fault.  Anyone who jumps into something without first doing an intelligent job market analysis  is responsible for the disappointing results.  Going to EMT school to be a hero in an area where there are no EMS jobs is simply not smart.  In fact, it is an epic fail that clearly illustrates a serious lack of common sense, so I'm not at all sorry that those people don't end up responsible for human lives.


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## daedalus (May 1, 2009)

AJ Hidell said:


> Again we mostly agree.  But I do believe that it _IS_ their fault.  Anyone who jumps into something without first doing an intelligent job market analysis  is responsible for the disappointing results.  Going to EMT school to be a hero in an area where there are no EMS jobs is simply not smart.  In fact, it is an epic fail that clearly illustrates a serious lack of common sense, so I'm not at all sorry that those people don't end up responsible for human lives.



Touche. It just breaks me to see my friends burn out and leave for greener pastures. Its actually a coincidence I got employed at a transport company at all. While volunteering at a free clinic, it was recommended by my physician mentor that I complete the semester long course so I would have a foundation in vital signs and simple auscultation so that he could allow me to examine his patients with him. After the course, the ice cream store I worked for closed down, so I applied to a private ambulance in the San Fernando valley and got initially bit by the EMS bug, but than depressed by the work I was doing. Now, hopefully, I will continue my EMS education and than education as a physician or PA and continue to advocate for EMS. Not all EMTs in this area are fails, but certainly a lot are.


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## marineman (May 1, 2009)

AJ Hidell said:


> Again we mostly agree.  But I do believe that it _IS_ their fault.  Anyone who jumps into something without first doing an intelligent job market analysis  is responsible for the disappointing results.  Going to EMT school to be a hero in an area where there are no EMS jobs is simply not smart.  In fact, it is an epic fail that clearly illustrates a serious lack of common sense, so I'm not at all sorry that those people don't end up responsible for human lives.



If we ever meet I'm going to buy you a drink. 

Now back to your regularly scheduled education argument...


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## Aidey (May 1, 2009)

AJ Hidell said:


> But the current allowance of EMTs on ambulances is what perpetuates that flawed system.  Take away the option and you take away the problem.



You can't blame the EMTs for the system. When a politician or some fear-mongering anti-tax nazi convinces everyone that having a tiered system is really better, that isn't the fault of the EMTs. 




AJ Hidell said:


> How long have you been a paramedic?  Do you know one of the primary reasons that medics stay in EMS for such short careers?  Burn-out.  Do you know one of the number one reasons for paramedic burn-out?  The overwhelming stress associated with having 100 percent of the responsibility for 100 percent of the patients you pick up every shift.  When you have no partner (an EMT is not a partner.  It's just a helper.), you have no one to share responsibilities with, and you burn out twice as fast.  Studies show that medics in dual-medic systems have significantly longer longevity than those in mixed systems.



This may be true for high volume systems where an individual ambulance consistently runs 12 or 15 calls in a 12 hour shift, and in that case it does make sense to have a dual paramedic car. In slower systems were an individual ambulance works 6 or 8 runs in a 12 hour shift only one paramedic is needed IMO. In those 2 examples, the paramedics are all running about the same number of calls due to the variance in run volume. 

I've run into a number of medics have big egos and get into this mindset that "oh any call where death isn't imminent is beneath me" and I think attitudes like that contribute to burn out significantly also.


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## subliminal1284 (May 1, 2009)

I have an idea, why not just make all paramedics go to med school.


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## daedalus (May 1, 2009)

subliminal1284 said:


> I have an idea, why not just make all paramedics go to med school.



No need. Paramedics educated in the basic sciences (a strong prerequisite foundation taking at least two full time semesters) and than an optimal paramedic program (ie not a medic mill, but a year long program not measured in hours but in competencies) leading to an A.S. degree, with graduates required to take an pass the national registry in all states, would be at a adequate level of competency without medical school. 

Wishful thinking.


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## subliminal1284 (May 1, 2009)

I was being sarcastic


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## VFFforpeople (May 1, 2009)

Re-reading, I see what you were saying now more clearly. I agree with what you are saying, and see what point you were making. Removing a 2level system would help cut down on the "ego" or the down talking, making it more fluid and easier running.


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## Aidey (May 1, 2009)

Gah, we should not need to eliminate a 2 level system just to get rid of big egos and bad attitudes.


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## mperkel (May 1, 2009)

*hmmm*

I definitely clicked the yes button.

Personally, I am one of those "users of the EMT certificate" I have plans for medical school and am currently working on my bachelor's of science degree.
I could not fathom a career in EMS, mainly because of the many flaws of the system.

Obviously, it would be a long process, and you must start from the ground up to change a broken system.

Here's just some of my idea I have thought about:

If there is a total revamp of the EMS system, many current EMT-B's and paramedics will expect themselves to be "grandfathered" into the new system.
This obviously would not work, because their level of training would be inadequate for the new positions.

To fix this, the following should happen;
-EMT-B's should become the level of First Responder, functioning in the same capacity as before.
-EMT-Paramedics should be allowed to function as EMT's with a required "transition course", enabling them to function in their current positions.
These changes would allow current EMTs to keep their jobs, and current pay levels.

For new EMTs, wanting to enter the EMS career, they would have to do the following.
-To be an EMT, you must go to a community college and receive an AS degree in "Emergency Medical Technician". This would include specialized courses, first year being basic science, mathematics, and english courses. Second year being more specific to medicine, with pharmacology, skill sets, clinical hours, ride-along, and testing. Much to the functioning of our current EMT-Paramedic level. These EMT's will be paid current paramedic salaries and function in the capacity of a paramedic.
-Those wanting a "simple" Emergency Medical quick course should take the a First Responder course, which would be about 150 hours of specific training like current EMT-Basic courses. They would receive wages similar to current EMT-Basic pay. They can function in the current capacity like an EMT-B.
-To become a Paramedic, a decent paying career, would be similar to nursing training. You would be require to take the Paramedic major, and get a degree preferably in Bachelor's of Science. You would go though basic undergraduate courses: math, science, anatomy, english, psychology, humanities, etc. Your last two years would consist of emergency pharmacology, specialized skills, internships, clinicals, field tests, and ride-alongs. All very similar to doing an ASN for 2 years and attending nursing school after. They will be paid similar to standard nurse's salary, and function in the field.

Overall, there would be 3 levels in EMS:
>EMR- Emergency Medical Responder, working on IFTs, driving ambulance, helping out. Ideal for someone wanting entry-level experience in an EMS job.
>EMT- Emergency Medical Technicians, working on ambulances, doing 911, standbys, events, etc. Limited drug education-similar to current Paramedics. Follows protocols, or direction of EP/Medical Director.
>EP, Emergency Paramedics (or something else), working on ambulances, called in for true Emergencies (911), obviously less positions than EMTs. Would have advanced medical knowledge, similar to Nurses, but specific to Emergency Medicine. Could make clinical judgements on patient care and confers with Medical Director.

In essence, a lot of people would be "downgraded", but keeping their current pay salaries and enhancing current Emergency Medicine.
Pre-hospital care would become respected and actually be another step to providing complete medical care.
Obviously, this would take a lot of time and reform to initiate.

Just my suggestions to take the professions of the EMS to the next level.
Comments and criticism welcomed!


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## VFFforpeople (May 1, 2009)

Aidey said:


> Gah, we should not need to eliminate a 2 level system just to get rid of big egos and bad attitudes.



Not getting rid of lack of better term "BLS" or care like that. It is simply making people that want to do EMS work be top notch. I see it as a FF can't enter a house without Fire control 1,2,3. So, I am FC1-3, but my partner that maybe going with me is only FC1 or 1-2. Now we have a problem. It is like that in EMS, EMT is the lesser scope now how am I doing a full service to my community by being EMT? I am not , I am not the "best" I can be for them. That is really all it is about, what is best for the community, even if they only need a band-aid, never know what can happen in that time frame that could require a medic level.


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## fortsmithman (Jun 6, 2009)

xlq771 said:


> How exactly would a 4 year paramedic program be organized?  Would it be organized along the same lines as the Bachleor degree program offered by Centennial College/University of Toronto, where the student only graduates as a Primary Care Paramedic / BLS level, or would the program be similar to the Bachleor degree program offered at Medicine Hat College, Alberta, where the student graduates as a Advanced Care Paramedic / ALS level?
> 
> As for an EMT/PCP/BLS program, I would like to see the same number of course hours of a 2 year program put into a 1 year program.  I don't know about other areas, but the college programs at my area community college apparently don't spend enough hours in class, since they repeatedly trash the streets around the college during every drunken party.  A few years ago they even had a homicide (a student was stabbed).  Maybee if they were forced to spend more hours in their studies, they wouldn't wreck the neibourhood.



I checked the Centennial College web site and with that program after they graduate from the Centennial College portion they are eligible for licensing as primary care paramedics.  I think after they complete the portion at U of T in Scarborough and get the Bachelor of Science in Paramedicine they may be eligible for advanced care paramedic licensing.


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## HotelCo (Jun 6, 2009)

Geeze. I thought we were done with this thread.


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## VentMedic (Jun 6, 2009)

HotelCo said:


> Geeze. I thought we were done with this thread.


 
fortsmithman was responding to a question. 

The Canadians take their discussions on education very seriously.


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## Mzcr (Jun 6, 2009)

Just a little different perspective:

I have a BA, Business Mgmt. Got through part of my MBA years ago and decided I'd rather eat glass. I currently work in a senior professional level job in field related to my degree. I don't love it, but it pays the bills. 

I've been interested in EMS for several years but couldn't afford the time/energy/money it would take to get the education required, minimal though it might be. I also cannot afford to quit my job to do EMS full time, now or probably ever. 

But since I want to do something other than make decisions involving the specific gravities of Acrylobutilestyrene vs. polycarbonate/acrylobutilestyrene, I decided to go for it and get the education and do the job part time on the side. And I'm glad I did.  

The training I took for a Basic certificate was two semesters at a Community College. Two and then three days a week, 4 hours class, and 72 hours of clinical rotations. I feel completely unprepared to do the job right now, but I'm not sure what else they could have taught me in school..I just need to do it. 

Maybe its because I live in a rural area, but a big percentage of the people I know in EMS do it part time, volunteer, not as a full time job. 

While I agree with the need for those in any profession at all to be able to string words together, and for EMS to understand how the human body works, if you are talking about adding one or two more A&P/Pharm/Biology type classes, no problem. If you're talking about adding the whole "Gen Ed" requirement, I don't agree. There's no way that taking a Fine Arts class is going to improve someone's EMS skills. 

Why not just have a basic level of reading/writing/math and science that must be met to start a program? Those who do need the brush up will be required to get it. Those who can already do the basics can focus their limited time and energy on the subjects that really do matter. 

EMS is a relatively low paying job in general, Basic especially so. If I'd been required to go through the whole AA/AS degree, there's no way I'd have done it and I think a lot of people would have made the same decision. It's just not worth it financially or time-wise for people who are working volunteer positions.

FWIW, I don't think my degree helps me in my day job either..it allowed me to get the job, but I learned next to nothing in 124 credit hours that I actually use. Most of what I know is based on experience. I have to think EMS will be the same way, except that the things I learned in class actually pertain to the job.


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## VentMedic (Jun 6, 2009)

Mzcr said:


> Just a little different perspective:
> 
> I have a BA, Business Mgmt. Got through part of my MBA years ago and decided I'd rather eat glass. I currently work in a senior professional level job in field related to my degree. I don't love it, but it pays the bills.
> 
> ...


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## fortsmithman (Jun 7, 2009)

fortsmithman said:


> I checked the Centennial College web site and with that program after they graduate from the Centennial College portion they are eligible for licensing as primary care paramedics.  I think after they complete the portion at U of T in Scarborough and get the Bachelor of Science in Paramedicine they may be eligible for advanced care paramedic licensing.



This is the path I will be taking starting in 2010-2011 academic year.  I picked that time to start instead of the coming academic year because I need to get into shape.  instead of a few months to get in shape I will have a year and a few months to do it.


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