# Out of options NREMT-P wise, need help



## d3653je (Sep 6, 2010)

If something like this is posted somewhere I missed it. I feel like it is unique and applies to me so I chose to start a new thread.

1996 I complete and graduate from a DOT Standard EMT-P Class. Pass the NREMT-P skills. Fail the written by one question, twice, in OB. For whatever resaon I walk away from it with a cert that I completed the course but no State or NREMT-P.

I remain involved in EMS but inside the hospital. I maintain BCLS, ACLS, and PALS. I work as a emergency room technician. Do some als stuff like IV's and EKG's. Don't officially intubate but am able to maintain the skill. I stay involved with ER-Tech work / skills.

Leave it all for a year or two to join the dot com world. Say 2000

Dot com bubble bursts and I return to being an ER Tech. Get ACLS PALS and BCLS current.

2005 I walk away again to go work as a vet tech in an animal er. Different kind of patient but same skills. However in addition to what I could do in people medicine, I can push drugs of any kind, advanced airway to RSI. Basically in the animal world I function as a Medic, An ICU Nurse, a PA. Yeah it is animals but to pet owners it is their babies. All the skills the medic RN and PA I can now do.

Still do animal but want to start running people again. Plan, challenge the NREMT-P. 14 years since finishing EMT-P, figure I should take courses to catch up. BCLS ACLS PALS ITLS done. Need to be an EMT-B, go and complete that and get state vert and NREMT-B. Final class I take is EMT-P refresfer 48 hours DOT approved, this class covers the scope of the classes all ready taken but most of the class is about what is missing from those classes like cric, dropping chests and so on. 

I am now current yet need to take that final test, written and skills to become a lic emt-p. States seem to want current NREMT-P to take the state test. NREMT says unless i maintained EMT-P state wise within two years, I can test NREMT-P. 

If it has been greater than i think either two or five years from EMT-P course completion, I must take EMT-P over again.

Re-entry NREMT-P standards I meet minus the ever being a NREMT-P or State EMT-P. I ask NREMT to take into account the classes I have taken from June to now, all the classes required to re-enter, plus i sit through EMT-B and don't take one note, pass course with a 98% average. State test score is 97% Skills Passed. EMT-P 48 hour refresher done, can i please take the CBT for NREMT-P. Answer is no, you have to repeat the class even though you have taken all these courses, we cannot process you without State EMT-P Lic. State, may I take your EMT-P written and skills test...no. Why not, cause you are not an NREMT-P.

I am at my wits end. With the economy, work, bills, and so on, i need a job as a Paramedic. Taking a 14 month course over again, what for? Everything that has changed since 1996 has been updated through the classes I have taken in 2010.

State, can I take your EMT-P Test to prove I am competent to you but we do this test off the record. The purpose is for you to come to bat with me for NREMT. A letter is needed from State for re-entry that i am good to go. State I live in PA, says no. Maryland says No. States that don't affiliate with NREMT, they all say no. 

Local Congressman says he cannot help me, out of his area of authority, contact this Congressman for help. Correct Congressman says sorry i cannot help.

State Senator to US Senate, I cannot help you. Sends me the pages he downloads from NREMT

Only one left, President of the United States, Obama, have not heard from him. State of PA says Obama is powerless to help me. Maybe right maybe wrong, don't know yet. Will I ever hear from Obama, highly unlikely.

Try to meet halfway, can I test EMT-I and go from there...NO

See three possible options:

1.) Re-take EMT-P
2.) File an appeal with NREMT to test.
3.) Take legal action against State or NREMT, not very versed on the law, do I have a case, do I seek arbitration?
3a) I am sure there is some lawyer some where who would take the case. Will a court hear the case? What will the court say? OJ Simpson killed two people but a jury set him free. So Court and arbitration if options, may be wild cards  at most.

NREMT use to let people challenge their tests, what happened that caused that to change?

Is there any State in the USA that will let me challenge their EMT-P test?

For God's sake I am not asking for a card or a license, I am asking for the chance to take the written test, take the skills test, to prove by passing, that I can be and EMT-P

Retaking EMT-P, why should I have to?
I am unemployed and have used savings to take all these classes to get up to date with the standards of care.
I need an EMT-P job, I need to work, I need medical for my family.
The Volunteer Fire I run with has no Medics at all. Closet Medic is 20 minutes away by ground. Sometime longer if they are on calls.

Bottom line I am a Paramedic. I completed the course. I have earned the right to say I am a Paramedic. I am an unlicensed Paramedic. I am not a NREMT-P certified.

NREMT says it is a state issue. State says it is a NREMT issue.  A Governor in theory would have say over that State they run, right? Who has oversight of NREMT? Most States tend to follow NREMT for issues like this. Yes EMS is different from State to State, can cric in State A but not in State B. Can do RSI in State B but not in State A. 

All I want to do is test somewhere, anywhere. i will go to any State in the Union that would allow me to challenge. Again not asking for a card only asking for a chance to test to prove and earn a card.

So a lesson to all of you no matter what level of training you have, don't ever let in lapse for you may find yourself in the same boat as me.

Anybody got any ideas that might work?

Thanks for reading this, was long and very much exposed my ADD. I am to tired and fed up to do a spell check so sorry.


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## Veneficus (Sep 6, 2010)

d3653je said:


> If something like this is posted somewhere I missed it. I feel like it is unique and applies to me so I chose to start a new thread.
> 
> 1996 I complete and graduate from a DOT Standard EMT-P Class. Pass the NREMT-P skills. Fail the written by one question, twice, in OB. For whatever resaon I walk away from it with a cert that I completed the course but no State or NREMT-P.
> 
> ...



Take the class again. The curriculum will have changed 2 times since 1996


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## d3653je (Sep 7, 2010)

I see your point, yes things change. Look at CPR...few years back stacked shocks were the protocol. A few years later it is 2 minutes of CPR then shock.

Compressions without ventilations is what the public is taught. Ten years ago you would have been like...what?

Two years from now they may change their minds again and say here use a preloaded epi pen that will deliver 1 mg epi IM. Then do compressions for one minute then use an aed.

Four years from now they may say here use this an epi/atropine pen with a long and strong enough needle to inject intra-cardiac, follow by stacked shocks with three pads, same way as now plus a a/p pad that does something new, then cpr.

The way things were done in 1996 are different than the way things are done now. I get current with the 2010 ways through a refresher course, the same way a Medic from the same class would, only difference would be the guy who stayed current will have been told 5 years ago do this like this. 5 years later he is taught to disregard the way it was 5 years ago, this is what we want you to do now. 2010 things change again, now they want you to do it this new way. he and I learn this new way in a refresher. Only difference is I didn't have to go through the changes like he did over the years but in the end, we both are on the same page for how they want us to do it now. The NREMT-P exam will be about how we do things now. So my friend gets his new card for several more years while I go and test everything based on what the current standards are and if I pass...then he and I are on the same page with the powers that be...right?


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## Shishkabob (Sep 7, 2010)

> I completed the course. I have earned the right to say I am a Paramedic.



No, you have not.


 You earned the privilege 14 years ago to test, and failed. 



If you truly believe you know enough to pass the test, and you really "need"to have a job, go to a few week long medic mill then take the test.


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## Veneficus (Sep 7, 2010)

d3653je said:


> then he and I are on the same page with the powers that be...right?




Maybe, but he had a mandatory A&P section which included cell biology and a intro to biochemistry along with more basic science focus in medic class, so unless you had something like General chemistry, cell bology, organic or biochemistry, and a&P you will have the same skills but not the same knowledge.

One of the biggest changes in EMS is the push towards educated decision making and less on protocol or cookbook treatments. The new curriculum for this year has even more basic science requirement.

Even at most colleges if you are 3 years out of date on your sciences you have to redo them.

Medicine constantly changes over time. There have been more improvements in the last 10 years than in the history of medicine. Stuff I learned last year is already changing.


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## firetender (Sep 7, 2010)

*Brother, what a pickle!*

What I've read says that you made a technical error that came back and bit you in the butt. Your STARTING PLACE needed to be this question to the State: "Given my background, AFTER I complete all the courses I list here, will you let me take the test?"

EVERYBODY right now seems quite clear on the answer. You may have been able to save a lot of trouble for yourself by asking first. I'll gamble the truth of this: Even the guys who are the ones that get "favors" done, the Politicians, even they can't say, "Sure, I can squeeze this lemon for you a little!" When influence won't turn the lock, there ain't no key!

Unfortunately, it looks like you backed yourself into a corner. It doesn't look like you'll get what you want unless you start from scratch. The welfare of your family won't wait. Make your choices accordingly.

The question I'd like you to ask yourself is will the energy you spend trying to "put this right", "Get them to listen.", "Sue their...", "Get the law changed." jeopardize the stability of you, therefore your family? You can either spend your energy defending or growing.

Make use of what you have right now to get the family thing on an even keel; EMS or otherwise. Make sure your base is solid, THEN pick up on EMS again, but this time having done the research to know exactly what you're to do.

Thanks for coming here and sharing. You'll get a lot of reality thrown back at you, but maybe that's what you came for.

Good fortune!


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## Jon (Sep 7, 2010)

d3653je said:


> If something like this is posted somewhere I missed it. I feel like it is unique and applies to me so I chose to start a new thread.
> 
> 1996 I complete and graduate from a DOT Standard EMT-P Class. Pass the NREMT-P skills. Fail the written by one question, twice, in OB. For whatever resaon I walk away from it with a cert that I completed the course but no State or NREMT-P.
> 
> ...


Alright fella.

You seem to be somewhere in PA. That means you have one more recourse.

Talk with the PA OEMS. There have been some cases where folks have managed to meet PA standards, but not NR standards. They still take the NR tests... but don't get a NR card... they only get the state cert.

It's possible. One example I know of was someone that missed the 2 year window by about a week because they scheduled, then pushed back the test date. NR refused to give the cert, but the state flexed and gave the cert.

If you are in the southeastern corner of the state, I might be able to suggest some schools, if you need to go through again.


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## bstone (Sep 7, 2010)

You're in a tough position. Call your state's Bar Association and ask about a lawyer who specializes in "Professional Licensure" issues.


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## MrBrown (Sep 7, 2010)

You could always go to the 12 week Houston Fire Department Paramedic patch factory for the barely homeostasasing and those with low synaptic ACh transfer rates.

Ondansetron, quick.


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## medic417 (Sep 7, 2010)

bstone said:


> You're in a tough position. Call your state's Bar Association and ask about a lawyer who specializes in "Professional Licensure" issues.



Why?  He failed the test and walked away w/o trying again during the time specified in black and white.  The abc courses do not equal a Paramedic.  Why not sue the board of nursing because they won't let him test RN even though he has experience and all the abc courses?  Makes no sense.  He made a bad choice and now must live with the consequences.  

Now to the op since you are experienced etc look at the 10 week Paramedic course at http://www.teex.com/teex.cfm?pageid...=ESTI&Course=EMS135&templateid=14&navdiv=ESTI


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## WTEngel (Sep 7, 2010)

You are probably not going to like this, but I am going to say it anyway...

You were not a paramedic. Even though you may have been allowed to practice some paramedic skills at various different jobs, you failed to become a certified paramedic, to "re certification" as a paramedic is impossible, since you were never certified. 

The card classes are great to augment a paramedic education and certification, but they are virtually worthless without the paramedic cert to back them up.

I personally would not want someone treating one of my family members who had a congressman or the president step in and make an exception for him so he could take the exam. The NREMTP exam is not an exhaustive test of your knowledge. It is a basic gauge of your retention of random samplings of knowledge you should have gained during your paramedic course.

With all of this being said, it sounds like you need to retake the paramedic course. If everyone is telling you something (you can't take the exam) then it is likely you are incorrect and they are right. Your sense of entitlement worries me a bit. The attitude that your previous experience working with animals and doing a tech job, with gaps in between is equal to being a PA, RN, paramedic, etc. indicates to me that you need some perspective that may be easily gained by taking a full paramedic course.

I know it doesn't taste good, but I think it is some medicine you are going to have to swallow if you want to become a paramedic and be successful in EMS.


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## rescue99 (Sep 7, 2010)

MrBrown said:


> You could always go to the 12 week Houston Fire Department Paramedic patch factory for the barely homeostasasing and those with low synaptic ACh transfer rates.
> 
> Ondansetron, quick.



:lol: Mr. Brown...that's just wrong. Funny but wrong...


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## ExpatMedic0 (Sep 7, 2010)

Ok there was a lot to read so correct me if I am wrong here.

You where never a Paramedic, you never passed the NREMT-P and you never where licensed/certified as a Paramedic in any state?

Why in the world do you think the NREMT would allow you to challenge there test 12 years after your EMT-P course? NREMT gives you 2 years from the time of your Paramedic course to pass, even that is a very long time and pretty nice of them.


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## bstone (Sep 7, 2010)

medic417 said:


> Why?  He failed the test and walked away w/o trying again during the time specified in black and white.  The abc courses do not equal a Paramedic.  Why not sue the board of nursing because they won't let him test RN even though he has experience and all the abc courses?  Makes no sense.  He made a bad choice and now must live with the consequences.
> 
> Now to the op since you are experienced etc look at the 10 week Paramedic course at http://www.teex.com/teex.cfm?pageid...=ESTI&Course=EMS135&templateid=14&navdiv=ESTI



Because at this point legal advice from an attorney is the only avenue for definitive resolution. Some states, like NH, allow for a lawyer to appeal to the state's Dir of DOH for an "EMS Waiver" due to hardship or exceptional circumstances. It's written into the statute but you often need a lawyer to look through it.

My honest opinion is it's too late. A 1996 medic course that resulted in no cert or license is long over and dead. But a lawyer might have a different way of going about it.


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## firetender (Sep 7, 2010)

I just wonder why, when a guy posts a three foot long original post people who answer one sentence of it are compelled to put the whole original up?

And at what point do you stop talking to someone who is no longer in the room?


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## bstone (Sep 7, 2010)

firetender said:


> I just wonder why, when a guy posts a three foot long original post people who answer one sentence of it are compelled to put the whole original up?



They do it for you, out of love.



> And at what point do you stop talking to someone who is no longer in the room?



When I am done with what I have to say.


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## Veneficus (Sep 7, 2010)

firetender said:


> I just wonder why, when a guy posts a three foot long original post people who answer one sentence of it are compelled to put the whole original up?
> 
> And at what point do you stop talking to someone who is no longer in the room?



Hoping he will see how outrageous his position is.

I am not trying to be mean, but based on the fact he took a handful of overview courses and had some clinical experience as a tech somewhere, I doubt very much he could pass today's NREMT. 

He could spend an aweful lot trying to figure that out. Especially when you get a lawyer involved. (their time is valuable)

Everyone talks about EMS being a respected profession. Valuable and dignified.

If I called a state or country medical board and asked them if I could test out of medical school because I am a paramedic, they would laugh at me. 

If I went to a nursing school and wanted to test out of nursing school because I have a paramedic cert, they would laugh at me.

I teach most of those cert classes and you could learn more from an episode of House than you can in all of them added up. I can sum up all 16 hours of ACLS in 342 words. (less than some of my posts on this forum)

Some guy who failed out 16 years ago and went over the basic guidlines of varous care scenarios without even completing current curriculum should be laughed right out of any state or ems body just as he would nursing or medicine.  

What precedent would it set for EMS if somebody did make this exception? Would anyone goto or take their family to a doctor that failed out, worked in healthcare and got his senator to pull some strings to get a medical licence?

Nobody would accuse me of being a defender of the "system," but we can't let every hard luck story start taking care of people with the toys and procedures we have today without the formal knowledge behind it.

I cannot imagine why anyone in EMS would entertain any possible exception to the requirements to enter the field.

I beat a traffic ticket once myself, does it qualify me for the Bar and to represent others?


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## Shishkabob (Sep 7, 2010)

Veneficus said:


> Especially when you get a lawyer involved. (their time is valuable)





Expensive?  Yes.  Valuable?  That's debatable...


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## medic417 (Sep 7, 2010)

Linuss said:


> Expensive?  Yes.  Valuable?  That's debatable...



Don't know why but made me think of Larry the Cable guy:

"The real reason that we can't have the Ten Commandments posted in a courthouse is this -- you cannot post 'Thou Shalt Not Steal' 'Thou Shalt Not Commit Adultery' and 'Thou Shall Not Lie' in a building full of lawyers, judges and politicians, it creates a hostile work environment."


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## EMTinNEPA (Sep 8, 2010)

Veneficus said:


> If I called a state or country medical board and asked them if I could test out of medical school because I am a paramedic, they would laugh at me.
> 
> If I went to a nursing school and wanted to test out of nursing school because I have a paramedic cert, they would laugh at me.



And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?


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## TraprMike (Sep 8, 2010)

Hoops,,, not only for basketballs, but for jumping threw also


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## TraprMike (Sep 8, 2010)

EMTinNEPA said:


> And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?



but the nurse is not a EMT-P,, right?,, she's a pre hospital nurse thingy...


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## BandageBrigade (Sep 8, 2010)

Veneficus said:


> I teach most of those cert classes and you could learn more from an episode of House than you can in all of them added up. *I can sum up all 16 hours of ACLS in 342 words. (less than some of my posts on this forum)*



Challenge.


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## Ewok Jerky (Sep 8, 2010)

*From the NREMT website*

OP-did you check the requirements before starting this process?


Individuals applying for Paramedic certification must meet the following requirements:

18 years of age or older.
-Possess current National Certification at the EMT-Basic level or current state certification at the EMT-Basic level or higher.
-Successful completion of a state-approved Paramedic course that meets or exceeds the U.S. Department of Transportation (DOT) Paramedic National -Standard Curriculum. You must have completed the course within the past two years. Your Program Director must verify your successful completion of the course on the NREMT web site. 

   If your initial Paramedic educational program was completed more than two years ago and you have maintained state licensure at the Paramedic level, you must submit documentation verifying completion of a Paramedic refresher training program within the past two years. If your initial Paramedic education program was completed more than two years ago and you never gained state licensure at the Paramedic level, you must complete an entire state-approved Paramedic course prior to applying for certification.
-Verification from the Program Director that you hold a current CPR credential for health care providers and have demonstrated competence in Paramedic skills.


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## citizensoldierny (Sep 8, 2010)

TraprMike said:


> but the nurse is not a EMT-P,, right?,, she's a pre hospital nurse thingy...



Not all nurse's are she's


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## medicRob (Sep 8, 2010)

MrBrown said:


> You could always go to the 12 week Houston Fire Department Paramedic patch factory for the barely homeostasasing and those with low synaptic ACh transfer rates.
> 
> Ondansetron, quick.



I laughed so hard I think I peed a little.


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## Veneficus (Sep 8, 2010)

EMTinNEPA said:


> And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?



In Ohio, a physician can test out of paramedic school as well.

I think the problem is rather simple. EMS providers have lobbied to hold on to "technician" and "certification" status. As such, other "educated" "licensed" providers can demonstrate quite clearly and effectively that they posess all the core education requirements. Some brief examples to illustrate my point.

for a paramedic certification according to the curriculum, A&P can be incorperated into paramedic class. However, the total hours of paramedic education do not change. That lead to a little less paramedicine being taught and a little less a&p being taught usually. In many anecdotal cases, I have seen a lot less a&p being taught. Usually preceded by the phrase "this stuff makes no difference on the street."

In nursing, they require a seperate a&p class. Often with a lab. Nursing can demonstrate they exceed the EMT-P curriculum. When you exceed the curriculum in a apples to apples comparison, in academia and usually for the purpose of certifications, you can "overlay" your credentials.

In any medical discipline "special education" suffices for psycho motor skills. For example, a nurse can take special education classes to care for wounds, insert a PICC line, intubate, the list goes on. 

Hospital nursing administrations take great advantage of this not only for themselves but also for the "certified" technical levels. For example, sending EMT-Bs to phlebotomy, having ED techs (aka medics) trained on how to insert foley catheters, etc.

In all of education, skills are considered secondary to knowledge. I am not saying it is right, simply stating what I observe. A Chemist can learn to weld with a couple of classes, a welder cannot learn to be a chemist without years of education.

Take it one step farther. I have spent 440 hours in Human gross anatomy class. 200 hours of Medical physiology. At 640 hours of graduate level education for my A&P (not even counting undergrad) I far exceed even the level nursing has.

Everything a paramedic does is already a part of nursing. A nurse can follow standing orders. A nurse can follow premade algorythms that require clinical decision making.

A nurse has more comparable education than a paramedic. A paramedic cannot equal even 1/2 of what a nurse has. (Don't forget they also have chemistry and biology prereqs) which increases the level of detail they can be educated at in their comparable classes.

Now I don't think it should be this way, I think that a paramedic should have at least the same prereqs as nursing. After all, it is much easier to understand and work with PH when you learn the many theories behind acid/bases.  

a majority of EMS agencies and providers of all stripes have chosen to limit themselves. It is one of the reasons EMS has become a stepping stone. When EMS persons can demonstrate an apples to apples comparison of why thier education is equal to nursing, then they will be able to test out of nursing too. The same thing with nurses pretending to be physicians.


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## Veneficus (Sep 8, 2010)

BandageBrigade said:


> Challenge.



ACLS does not make you an expert at resuscitative medicine,  it gives you the guidelines to follow until an expert can be brought to bear or efforts terminated. (28)

All patients are to have oxygen, IV, and a cardiac monitor. (11)

Assess Airway, breathing, circulation, mental status. Obtain clinical data. (9)

All patients are either stable or unstable by mental status or blood pressure. (13)
There are 5 major heart rhythms. (6)

Normal, Brady, Tachy, vfib/no pulse vtach, Asystole/PEA (9)

Normal will not be covered. (5)

Unstable patients need help fast. Electricity is fast. (8)

Asystole/PEA receive no electricity (5)

Unstable brady is paced, unstable tachy is synchonized cardioverted, vfib/o pulse VT unsynchronized cardioverted. (13)

Stable patients are treated from least invasive treatment working towards most invasive. (12)

Brady: 0.5 atropine, consult expert, pace if become unstable. No atropine in high order blocks. (15)

Tachy subdivided into wide and narrow. (6)

Stable wide: 150mg amiodarone over 10 minutes. Consult expert (9)

Stable SVT: vagal, adenosine 6 mg, repeat at  12 mg, and 12 mg, elective cardiovert.(15)

Other narrow: supportive care consult expert. (6)

Vfib/0 pulse vt: begin CPR, defibrillate at 200J biphasic continue CPR for 2 minutes. Check pulse check rhythm. If same defib 200J, Continue 2 minutes CPR and administer vasoactive agent.  After 2 minutes check pulse, check rhythm, if same defib 200J continue 2 minutes of CPR and consider administering Antiarrhythmic agent. (48)

Asystole/PEA: Start CPR, administer vasoactive agent. After 2 Minutes CPR check pulse, if rhythm the same and rate <60 administer atropine 1.0 mg (24)

The best chance for resuscitation is to identify and treat reversible causes. The specific treatments may be different from the basic guidelines listed here and are dependent on medical judgment, scope of practice, and available resources. (36)

Your agency will determine the criteria for termination of efforts. (10)

(288 total count) beat my own record.


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## rhan101277 (Sep 8, 2010)

Well over here in Mississippi you must have real college A&P I and II with labs, that is a whole 2 semester of nothing but anatomy.  Then you have the built in anatomy in the medic class, which in no way compares to real college A&P.

I think nurses and paramedics are apples and oranges.  With enough training/education nurses can be paramedics and vice verse. 

Also here at RN, MD. etc. can't challenge the registry unless they have passed an approved paramedic program.

Also I have had others tell me that fresh new MD's without any internship or residency behind them, do not know how to treat patients.  They learn all of this first hand.


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## JPINFV (Sep 8, 2010)

Veneficus said:


> for a paramedic certification according to the curriculum, A&P can be incorperated into paramedic class. However, the total hours of paramedic education do not change. That lead to a little less paramedicine being taught and a little less a&p being taught usually. In many anecdotal cases, I have seen a lot less a&p being taught. Usually preceded by the phrase "this stuff makes no difference on the street."



Quick devils advocate. No medical school in the US requires A/P before matriculation. Furthermore, depending on how the curriculum is designed (e.g. PBL or organ systems based in contrast to traditional course work), there may or may not be a stand alone "physiology" course (among specific other courses). As such, how could a strict "course hour" count matter?

Now my reply to my own DA. While there is a legal hour minimum for medical school length (4000 hours with 80% attendance in California) and only a broad list of categories to cover with the only requirement that those subjects have "adequate instruction," unlike medical schools, paramedic courses have shown themselves to be unable to have the maturity to provide adequate instruction on their own to have the for the type of latitude that other health professions programs have over their curriculum.


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## d3653je (Sep 9, 2010)

*Thanks for the advice*

Some of you made some really valid points and I thank you. I can say this much...in here at least I am among people who do the job for a living and not people who just push papers. 

When you believe in something so strongly. sometimes stopping and smelling the roses can mean the world. 

I still am doing to try and see my way through it. 

The person or persons who said I would not pass the current NREMT-P, you may be very right or wrong... I'd like the chance to prove it and find out.

If I came across as a seen it all done it all kind of person, well then I did come across wrong.  That is what is so hard about all this and posting in a forum. Anybody can say anything and there is no way to back it up. I am sure everyone is here has walked away from a course and thought...I can't believe that person passed, would not want them working on me. Is it fair or right to judge that person before they see any action? Most Agencies with good Medic Programs take on the new Medic and put them on probation. I think it is during that time you prove your worth. How one gets to that point...as un-orthodox it may seem, now it is time to prove you are a Medic. 

There are some people in here who want to crack jokes and stuff, well we are what we are. Words are just words... face to face and not from behind a keyboard with some random name... guess that is just the way it is. I think face to face people have to be more civil to one another.

So all that being said, thanks to all for taking the time to respond to my post.


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## medicRob (Sep 9, 2010)

d3653je said:


> Some of you made some really valid points and I thank you. I can say this much...in here at least I am among people who do the job for a living and not people who just push papers.
> 
> When you believe in something so strongly. sometimes stopping and smelling the roses can mean the world.
> 
> ...



Good luck, either way.


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## 8jimi8 (Sep 9, 2010)

EMTinNEPA said:


> And yet, in Pennsylvania, an RN can "test out" of paramedic school and become a "Pre-Hospital Registered Nurse"... what's wrong with this picture?



Because the registered nurse has had enough education to test through EMT-P curriculum as a module.  The   research that I've done in this area has shown that to challenge the test, you have to hold EMT-B and take a Paramedic Refresher  course prior to sitting for examination.


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## Veneficus (Sep 9, 2010)

Obviously I attend a school that is measured in course hours. However, they are broken down into 4 subgroups.

lecture (where you listen to somebody talk at you)
lab (hands on simulators, microscopes, etc.)
seminar (small group interaction and problem solving, comparable to US PBL)
clinical (live people or functioning pathology labs)

So you have anatomy lecture, lab, seminar, and clinical, adding up to 440 hours. (not including "open" lab time of which there is a lot, but as it is not required I didn't include it.) 



JPINFV said:


> Quick devils advocate. No medical school in the US requires A/P before matriculation..



And they don't need to. Why require something that you will go over in more detail. Medic and nursing aren't required to take a&p prior to a gross anatomy course. It is their anatomy course. The other nice thing about medical school is between undergrad and the graduate portion, the classes are to use an educational term "scaffolded" you take gen chem an Ochem in undergrad but do not repeat them. You move into bochemistry. Just as you do not have to take genetics in undergrad or cell bio.

Also I would just like to point out, A&P is not "pure" or complete "anatomy" (forget who posted that) it is exacly what it says. Anatomy and physiology.




JPINFV said:


> Furthermore, depending on how the curriculum is designed (e.g. PBL or organ systems based in contrast to traditional course work), there may or may not be a stand alone "physiology" course (among specific other courses). As such, how could a strict "course hour" count matter?



Strict course hour is just easier to compare quantitatively.

In PBL as I understand from my trip over to LECOM. PBL meets specific learning objectives. The same objectives that are outlines in "course hour" outlines. 

I have no experience at all with organ system based learning, but I would imagine that it also uses similar course objectives. 

Looking at it from a broad perspective, all have some sort of time to objective ratio. 

Are you suggesting that paramedic school meets the same basic and clinical science objectives as Nursing school or Medical school? (I really don't think so as the DA  ) 

At the same time though, would you compare the depth or breadth of learning objectives in a dedicated A&P to "included in 750 clock hours in this state?" Would you compare a 200 level(sophmore undergrad as we know it) A&P with your gross anatomy, system based learning, or PBL? Considering if it was comparable, you could finish medical school in 750 hours.


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## CAOX3 (Sep 10, 2010)

JPINFV said:


> (4000 hours with 80% attendance in California)



Really only 80% attendance required?

Whats funny, I took a Western Civ survey class and 100% attendance was required, the prof didnt care if you were sleeping just that you made the effort to show up.


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## JPINFV (Sep 10, 2010)

CAOX3 said:


> Really only 80% attendance required?
> 
> Whats funny, I took a Western Civ survey class and 100% attendance was required, the prof didnt care if you were sleeping just that you made the effort to show up.



Dirty secret of medical school. Most medical schools record their lectures and post them online for their students. As such, most students don't attend lectures. I'll be fully honest, watching the recording of lectures at variable speed (normally 1.8 to 2 speed) with the ability to rewind and pause at will is a much better study environment than sitting in a lecture hall for 3-4 hours straight. Now lab courses and clinicals are always required, but those are different situations than straight lectures.


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## CAOX3 (Sep 10, 2010)

JPINFV said:


> I'll be fully honest, watching the recording of lectures at variable speed (normally 1.8 to 2 speed) with the ability to rewind and pause at will is a much better study environment than sitting in a lecture hall for 3-4 hours straight.



Understood, I also wasnt a big fan of standing up in the middle of lecture and stating can you repeat that or can you speak up.  We didnt have the oppurtunity or access to recorded lectures, that seems like a great idea.


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## MrBrown (Sep 10, 2010)

Veneficus said:


> If I called a state or country medical board and asked them if I could test out of medical school because I am a paramedic, they would laugh at me.



Hmm so thats what I was doing wrong!  



Veneficus said:


> In Ohio, a physician can test out of paramedic school as well.



Here you can take the week long "operational ambulance induction" and do a couple short courses taught by the Ambulance Service and viola, you can get a bright garment with "DOCTOR" writtten on it and an Ambulance pager.




Veneficus said:


> for a paramedic certification according to the curriculum, A&P can be incorperated into paramedic class. However, the total hours of paramedic education do not change. That lead to a little less paramedicine being taught and a little less a&p being taught usually. In many anecdotal cases, I have seen a lot less a&p being taught. Usually preceded by the phrase "this stuff makes no difference on the street."



Our Paramedic (ILS) students have to take the standard two class (one per semester) anatomy and physiology class.  Nursing has to only take a one semester class.  I have read the Marieb A&P book back to front twice (it's a great book) and think the knowledge that our University educated Paramedics have is very good.

Having said that, I realise now how inadequate my education is given that a 200 hour combined A&P course is ... 



JPINFV said:


> Dirty secret of medical school. Most medical schools record their lectures and post them online for their students. As such, most students don't attend lectures. I'll be fully honest, watching the recording of lectures at variable speed (normally 1.8 to 2 speed) with the ability to rewind and pause at will is a much better study environment than sitting in a lecture hall for 3-4 hours straight. Now lab courses and clinicals are always required, but those are different situations than straight lectures.



I did most of my undergraduate degree in my PJ's and didn't make an appearance at a class for over a year ... it was great, I loved it!


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