# EMT-B to EMT-P... A Bad Idea?



## Cory (Sep 7, 2009)

So, I have been reading a lot about getting hired as an EMT, and I know that areas around me have either stopped hring or are making their requirements impossibly high for the majority of people. 

Now, yes, I am still far away from even an EMT-B course, but I was just wondering (because as far as I know, I do have the intention to get EMT-P certified some day) Is it a bad idea to go straight from EMT-B class into a medic class? Is it discouraged to go into a medic class without time on a job? For some reason, I get the notion that most people get EMT-B, work as an EMT for a year or two, THEN go to Paramedic class. But in times where EMT jobs are far and few between (I know of a department where I have been told numerous times that I could be hired at when I'm 18 or older, but things could change in 3 or 4 years time) it seems like getting a medic cert. would be better before trying to get hired at an over-staffed department.

Anyway, my basic question: Is it a bad idea to go straight from EMT-B into EMT-P without job experience, if it could potentially make you more likely to get hired?

Just questions, not really trying to relate them to me yet, just trying to get an idea here.


-Cory-


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## EMTguy69 (Sep 7, 2009)

I don't know what the requirements are in Ohio for getting into Paramedic School, but here in California you must have 6 months to 1 year experience before you can even apply for Paramedic training.  Good luck to you.


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## terrible one (Sep 7, 2009)

can of worms on this site. 
I personally believe you need a minimum of 1 year experience riding with an ALS unit before applying. Medic school (IMO is also wayyyyyyy too short, and needs to be atleast 2 years with 6months-1 year in the field as an intern)

A lot of others on here don't agree. I'd talk to the people who run the school and see what they suggest


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## kecpercussion (Sep 7, 2009)

EMTguy69 said:


> I don't know what the requirements are in Ohio for getting into Paramedic School, but here in California you must have 6 months to 1 year experience before you can even apply for Paramedic training.  Good luck to you.



Actually there are many schools in California where you don't need any experience.

But anyways I think you should definitely have plenty of EMT B field time on ALS before going for EMT P. So many go straight for Medic with no experience and as result have no clue what to do when they actually get into the field.


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## JPINFV (Sep 7, 2009)

So, remind me, why don't RNs have to be CNAs or LVNs first? Why don't MD/DOs have to be PAs first? Why don't PhDs have to get a masters degree first? Why don't DMDs have to be dental hygenists first?


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## Sasha (Sep 8, 2009)

JPINFV said:


> So, remind me, why don't RNs have to be CNAs or LVNs first? Why don't MD/DOs have to be PAs first? Why don't PhDs have to get a masters degree first? Why don't DMDs have to be dental hygenists first?



Because they realize that this "street experience" is just something that makes those who waited feel superior to those who didn't, and that it has no real say in if you will be a good or bad provider.


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## kecpercussion (Sep 8, 2009)

Much better medics are produced if they have been an EMT for a while. This doesn't mean a fresh medic with no experience cannot be a good provider, just might take some time.


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## Akulahawk (Sep 8, 2009)

JPINFV said:


> So, remind me, why don't RNs have to be CNAs or LVNs first? Why don't MD/DOs have to be PAs first? Why don't PhDs have to get a masters degree first? Why don't DMDs have to be dental hygenists first?


Simple... those professions train the student those skills as part of the program. Paramedic... doesn't. If a Paramedic program could incorporate EMT-B stuff into their curriculum and ensure good BLS competency along the way, I'd be OK with that. I've talked to more than a few Paramedic Preceptors who absolutely do NOT want to have to teach their students how to do BLS... they should already know.


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## Sasha (Sep 8, 2009)

kecpercussion said:


> Much better medics are produced if they have been an EMT for a while. This doesn't mean a fresh medic with no experience cannot be a good provider, just might take some time.



I disagree. That is your opinion. My opinion is that those who spent time "in the streets" are usually the ones who have a hard time losing bad habits they picked up from their "street time". 

I like working with medics who didn't spend a lot of time getting "Experience" taking blood pressures and driving trucks prior to medic school. In my experience they are generally more into their job, and aren't looking to cut corners as quickly as "Street" medics.


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## Sasha (Sep 8, 2009)

Akulahawk said:


> Simple... those professions train the student those skills as part of the program. Paramedic... doesn't. If a Paramedic program could incorporate EMT-B stuff into their curriculum and ensure good BLS competency along the way, I'd be OK with that. I've talked to more than a few Paramedic Preceptors who absolutely do NOT want to have to teach their students how to do BLS... they should already know.



That is what EMT school is for. If you take a year to master blood pressures and pulse taking... you really should rethink the career choice.


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## JPINFV (Sep 8, 2009)

Akulahawk said:


> Simple... those professions train the student those skills as part of the program. Paramedic... doesn't. If a Paramedic program could incorporate EMT-B stuff into their curriculum and ensure good BLS competency along the way, I'd be OK with that. I've talked to more than a few Paramedic Preceptors who absolutely do NOT want to have to teach their students how to do BLS... they should already know.



So basically those schools suck and those instructors are lazy. There's no two ways around it then. It'd be like a physician complaining that they have to teach medical students how to take a blood pressure.


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## Cory (Sep 8, 2009)

If you were an employer, would you be more inclined to hire a paramedic that was an EMT for a year before getting medic certified, or would you just as quickly hire someone who has a paramedic cert. but hasn't had any job experience?

I guess I can answer that question easily, but I still think the discussion against such reasoning is convincing...I guess I'm a little indifferent seeing as I have no REAL room to talk.


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## ResTech (Sep 8, 2009)

> bad habits they picked up from their "street time".



I'm trying to think of a bad habit I picked up over the past years and cant really think of any.... Im sure there have been some but nothing dramatic. I agree, experience counts before Paramedic. I would hate to think of devouring all of this knowledge and skills without any experience or exposure to it. Just makes the process easier. 

And as I have said before... very, very evident who has experience in class and who doesnt.


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## Sasha (Sep 8, 2009)

Cory said:


> If you were an employer, would you be more inclined to hire a paramedic that was an EMT for a year before getting medic certified, or would you just as quickly hire someone who has a paramedic cert. but hasn't had any job experience?
> 
> I guess I can answer that question easily, but I still think the discussion against such reasoning is convincing...I guess I'm a little indifferent seeing as I have no REAL room to talk.



I would hire the one without job experience. Easier to mold them the way I want them to work as an employer.

I have been getting "EMT Experience" while I was in medic school. I was in medic school prior to getting an EMT cert. I don't feel like I am any worse off then those who got street experience before medic, and I feel that I am a better EMT than the EMTs who have been EMTs for years and are not in medic school, because while they have been an EMT longer than I have, I have furthered my education farther than they have.


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## TransportJockey (Sep 8, 2009)

Here in NM time spent on the street as a basic doesn't matter. I've said it before, my medic class' top student was someone who has never worked a day in the field. He started medic right after he got his basic license. 

I see no point in requiring street time or time spent in a lower licensure


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## Sasha (Sep 8, 2009)

ResTech said:


> I'm trying to think of a bad habit I picked up over the past years and cant really think of any.... Im sure there have been some but nothing dramatic. I agree, experience counts before Paramedic. I would hate to think of devouring all of this knowledge and skills without any experience or exposure to it. Just makes the process easier.
> 
> And as I have said before... very, very evident who has experience in class and who doesnt.



Without any exposure? Does your school not require clinical and ride times?


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## kecpercussion (Sep 8, 2009)

Anyone can be top in their class, that isn't always the best indicator of how well they will perform in the field.


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## TransportJockey (Sep 8, 2009)

kecpercussion said:


> Anyone can be top in their class, that isn't always the best indicator of how well they will perform in the field.



Best performer in internships. Beat out our 'seasoned' field veterans in every evaluation.


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## ResTech (Sep 8, 2009)

The exposure and experience I am speaking of is different than the "learning" mode and what is achieved as a student. As a student with no experience, when your on the Paramedic Unit for the first time, your in a whole 'nother world that you never visited before. 

As an EMT with experience, you know what its like to apply cricoid pressure to assist with an intubation, to work a code, insert airways, see the intubations and other advanced modalities, see how they affect patients, get feedback from Paramedics on the call, learn how to operate the monitor and do so on a frequent basis, apply 12-leads, take hundreds of hours of continuing education over the years, run several hundred calls or so a year as a 911 provider, be the lead provider, hone your patient assessment skills, learn lung sounds, learn how to manage an incident scene, learn how to operate within an EMS system... the list goes on and on. 

While the above seems like minor things.... it is an accumulative effect that better prepares one for more advanced learning. Im not saying in the absence of.... one cannot succeed, Im just saying it makes it easier.


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## daedalus (Sep 8, 2009)

Sorry, driving a van with pretty lights, pushing a gurney, and hooking up a monitor does not prepare you to learn anatomy and physiology, pathology, and the field diagnosis and management of emergencies. College level education and a proper paramedic program do. Field experience as an EMT is certainly not needed or even desirable in the making of a good paramedic. 

I say restrict the EMT to first response and non transport so we do away with this debate altogether. The only BLS education you need before a Paramedic program is a AHA BLS for the healthcare provider class. 

Preparatory requirements for paramedic school in Daedalus's utopia:
Proved competency in math and algebra; or college math course completion
Proved competency in college level reading and writing; or English 1
Medical Terminology (college level course)
Biology 
Chemistry
Human Gross Anatomy
Human Physiology
Microbiology
CPR for the Health Care Professional


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## ResTech (Sep 8, 2009)

Experience as an EMT provides a foundation to build upon. Obviously you guys experience as an EMT is different than what is achieved where I'm from.


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## kecpercussion (Sep 8, 2009)

daedalus said:


> Sorry, driving a van with pretty lights, pushing a gurney, and hooking up a monitor does not prepare you to learn anatomy and physiology, pathology, and the field diagnosis and management of emergencies. College level education and a proper paramedic program do. Field experience as an EMT is certainly not needed or even desirable in the making of a good paramedic.
> 
> I say restrict the EMT to first response and non transport so we do away with this debate altogether. The only BLS education you need before a Paramedic program is a AHA BLS for the healthcare provider class.



This is dumb. I can't even argue with it


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## fortsmithman (Sep 8, 2009)

JPINFV said:


> So, remind me, why don't RNs have to be CNAs or LVNs first? Why don't MD/DOs have to be PAs first? Why don't PhDs have to get a masters degree first? Why don't DMDs have to be dental hygenists first?




In order to get a doctorate with exception of MD you do have to have a masters, and to get a master you need a bachelors.  That is how it works here in Canada.


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## Sasha (Sep 8, 2009)

ResTech said:


> The exposure and experience I am speaking of is different than the "learning" mode and what is achieved as a student. As a student with no experience, when your on the Paramedic Unit for the first time, your in a whole 'nother world that you never visited before.
> 
> As an EMT with experience, you know what its like to apply cricoid pressure to assist with an intubation, to work a code, insert airways, see the intubations and other advanced modalities, see how they affect patients, get feedback from Paramedics on the call, learn how to operate the monitor and do so on a frequent basis, apply 12-leads, take hundreds of hours of continuing education over the years, run several hundred calls or so a year as a 911 provider, be the lead provider, hone your patient assessment skills, learn lung sounds, learn how to manage an incident scene, learn how to operate within an EMS system... the list goes on and on.
> 
> While the above seems like minor things.... it is an accumulative effect that better prepares one for more advanced learning. Im not saying in the absence of.... one cannot succeed, Im just saying it makes it easier.



I learned all of that during my EMT and paramedic clinical ride times.


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## daedalus (Sep 8, 2009)

kecpercussion said:


> This is dumb. I can't even argue with it



A straw man statement is not an acceptable response to a valid argument.


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## ResTech (Sep 8, 2009)

Doing a skill or performing something a few times during clinicals is different than doing it hundreds of times over and over and over. Were you taking EMS command and controlling an incident scene during your clinicals? Were you running the code and making patient care decisions without a fallback during your clinicals? No to all the above.

Run for a few years on a 911 BLS truck with 2 EMT's and your learning curve is greatly different.


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## kecpercussion (Sep 8, 2009)

Haha I know. EMTs gain way more experience than just driving and gurney pushing. You should know that. Just because they can't do so many skills doesn't mean they don't learn them


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## Sasha (Sep 8, 2009)

ResTech said:


> Doing a skill or performing something a few times during clinicals is different than doing it hundreds of times over and over and over. Were you taking EMS command and controlling an incident scene during your clinicals? Were you running the code and making patient care decisions without a fallback during your clinicals? No to all the above.
> 
> Run for a few years on a 911 BLS truck with 2 EMT's and your learning curve is greatly different.



While I had a "fall back" as in someone who wasn't going to let me kill the patient, I also had preceptors who allowed me to lead the call and run the scene, etc. I ran some codes, too. Pity you don't! 

Run a 911 BLS truck?? And what will you learn? How to apply oxygen, take a blood pressure and give glucose?


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## daedalus (Sep 8, 2009)

How can one criticize the preceptor-intern relationship? This shows a lack of knowledge in medical education. Medical Doctors are supervised by a preceptor for 8 years of their training. 4 years of medical school, and than 4 years of residency supervised by upper level residents and attendings. Nurses are always precepted in school, and then even a few months into their initial employment by a senior nurse.


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## EMTinNEPA (Sep 8, 2009)

daedalus said:


> A straw man statement is not an acceptable response to a valid argument.



His statement was not a strawman.  A strawman is a deliberate misrepresentation of your opponent's position that is easy to defeat that you create because you can't defeat their real one.

"You just hate EMTs!" would be an example of a strawman he might use.

His response would actually be an appeal to ridicule, an informal fallacy and a type of appeal to emotion, where he presents or responds to your argument in a way to make it seem ridiculous without actually offering a counter argument.

All that being said, you're still right about the original topic and he's still wrong.


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## ResTech (Sep 8, 2009)

> I also had preceptors who allowed me to lead the call and run the scene, etc. I ran some codes, too. Pity you don't!



Ever since I began Paramedic clinicals I have been running every call we had! Because my preceptors could tell the experience level and I wasnt just some new EMS student and that I have been in the field for some time. 



> Run a 911 BLS truck?? And what will you learn? How to apply oxygen, take a blood pressure and give glucose?



This shows your ignorance a bit. You still perform a GOOD patient assessment... make transport decisions, call for air medical, and make treatment decisions on your own. Its called developing a process and systematic approach to handling patient conditions and situations.


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## EMTinNEPA (Sep 8, 2009)

Sasha said:


> Run a 911 BLS truck?? And what will you learn? How to apply oxygen, take a blood pressure and give glucose?



AND how to drive an ambulance and hand things to the paramedic!


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## ResTech (Sep 8, 2009)

> How can one criticize the preceptor-intern relationship?



No one is criticizing preceptors. Its much different to be in the field by yourself rather than have a preceptor standing over your shoulder guiding you. That's the point.


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## Sasha (Sep 8, 2009)

ResTech said:


> Ever since I began Paramedic clinicals I have been running every call we had! Because my preceptors could tell the experience level and I wasnt just some new EMS student and that I have been in the field for some time.
> 
> 
> 
> This shows your ignorance a bit. You still perform a GOOD patient assessment... make transport decisions, call for air medical, and make treatment decisions on your own. Its called developing a process and systematic approach or handling patient conditions and situations.



Which can be done in school. It does not take years of BLS work to master those skills.


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## ResTech (Sep 8, 2009)

Ok... so Paramedic students who cant even do a trauma assessment obviously could use some additional BLS experience!


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## daedalus (Sep 8, 2009)

Sasha said:


> Which can be done in school. It does not take years of BLS work to master those skills.



Add to that, an EMT cannot do a good assessment. They simply do not know enough to do so.


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## Sasha (Sep 8, 2009)

ResTech said:


> Ok... so Paramedic students who cant even do a trauma assessment obviously could use some additional BLS experience!



Or a better instructor perhaps?


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## Shishkabob (Sep 8, 2009)

daedalus said:


> Add to that, an EMT cannot do a good assessment. They simply do not know enough to do so.



QUIT MAKING BLANKET STATEMENTS.







Work as an EMT while going to medic school, be it 6 months, 1 year, or 2 years.  Everyone wins


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## ResTech (Sep 8, 2009)

What is up this you guys thinking an EMT is stuck only with what they learned in their initial program???? Were you guys the ones who never went above and beyond?


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## EMTinNEPA (Sep 8, 2009)

ResTech said:


> Ok... so Paramedic students who cant even do a trauma assessment obviously could use some additional BLS experience!



Or enrollment in a decent paramedic school.


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## EMTinNEPA (Sep 8, 2009)

ResTech said:


> What is up this you guys thinking an EMT is stuck only with what they learned in their initial program???? Were you guys the ones who never went above and beyond?



I have gone above and beyond.  It's called enrolling in medic school.


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## Sasha (Sep 8, 2009)

ResTech said:


> What is up this you guys thinking an EMT is stuck only with what they learned in their initial program???? Were you guys the ones who never went above and beyond?



I did go above and beyond. Above and beyond EMT right into paramedic school. I think that is a far better service to patients then spending a year doing first aid!


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## ResTech (Sep 8, 2009)

> Or enrollment in a decent paramedic school.



No, this was in the very beginning of the Shock-Trauma course... an EMT SHOULD be able to do this. Of course, this was a brand new EMT with NO experience doing a trauma assessment on an actual patient.


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## JPINFV (Sep 8, 2009)

ResTech said:


> As an EMT with experience, you know what its like to apply cricoid pressure to assist with an intubation, to work a code, insert airways, see the intubations and other advanced modalities, see how they affect patients, get feedback from Paramedics on the call, learn how to operate the monitor and do so on a frequent basis, apply 12-leads, take hundreds of hours of continuing education over the years, run several hundred calls or so a year as a 911 provider, be the lead provider, hone your patient assessment skills, learn lung sounds, learn how to manage an incident scene, learn how to operate within an EMS system... the list goes on and on.



Strange, I've never worked with a paramedic, yet I've met the entrance experience requirement for the vast majority of paramedic schools. I'm also not impressed with the vast majority of CMEs designed for EMT-Bs.


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## JPINFV (Sep 8, 2009)

fortsmithman said:


> In order to get a doctorate with exception of MD you do have to have a masters, and to get a master you need a bachelors.  That is how it works here in Canada.



So when I was working on my masters thesis one of the people who rotated through my lab was a PhD student. She failed to find a lab (in addition to failing a second class which is an instant separation) and she ended up with a masters degree instead of a PhD.


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## daedalus (Sep 8, 2009)

Ok, is it a blanket statement to say that an EMT cannot do a quality history and physical exam? Yes, I would say so. However, the reality is that the state in which you work in does not mandate or test to a higher standard than it does for EMT. That means, you may learn a clinical pearl such as how to listen to heart sounds, but you are not tested on it nor expected to know it, and your confidence in the skill will be low, so it will not change your treatment or benefit your patients.

Remember that most disease processes can be diagnosed from the history and confirmed by the physical. An EMT will not have the needed background knowledge of a broad based medical education to identify diseases by history. A physical exam requires an extensive knowledge in functional anatomy and physiology, as well as pathophysiology. Want to see the level of information presented to medical students on the topic of edema alone? Compared to the few sentences about it in an EMT book. Triple the education an EMT receives in preforming a physical and it still does not come fill a drop in the bucket to what is being taught in some paramedic schools that require a separate text on the topic of H&Ps.


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## EMTinNEPA (Sep 8, 2009)

ResTech said:


> No, this was in the very beginning of the Shock-Trauma course... an EMT SHOULD be able to do this. Of course, this was a brand new EMT with NO experience doing a trauma assessment on an actual patient.



An EMT who, like all the other EMTs/EMT-P candidates, SHOULD have been lectured in the performance of a rapid trauma assessment prior to partaking in any type of practical lab.


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## ResTech (Sep 8, 2009)

Like I said, its not a determining factor of success, it just makes it a little easier on the student. That's all I am saying.


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## Shishkabob (Sep 8, 2009)

The CORRECT statement would have been "EMT's are generally not expected to have as much in depth knowledge as a higher provider"... not something akin to "All EMTs are stupid"




But, aside from that:  Are you not an EMT while in paramedic school?   You can be an EMT AND have an education of a higher level, can you not?


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## JPINFV (Sep 8, 2009)

Linuss said:


> QUIT MAKING BLANKET STATEMENTS.
> 
> 
> 
> ...



Blanket statement: Under the NHTSA's National standard Curriculum, which is the model still used in most states for their EMT-B level, basics do not have enough knowledge. to do a good assessment. It takes more than 2 hours of A/P to understand what an assessment is telling you.


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## daedalus (Sep 8, 2009)

If one needs to work as an EMT to learn how to place electrode stickers, that person is a few tacos short of a combination plate.


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## EMTinNEPA (Sep 8, 2009)

ResTech said:


> Like I said, its not a determining factor of success, it just makes it a little easier on the student. That's all I am saying.



Or a little harder because of bad habits they picked up.


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## ResTech (Sep 8, 2009)

> Want to see the level of information presented to medical students on the topic of edema alone?



Um, we are EMS providers... not med students. EMS is just that, EMS! Its not definitive care. As a Paramedic, you try hard, study hard, learn always, and do the best you can to better your patient during the 20mins you have them! If you want to do more than you should go to Med School.


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## JPINFV (Sep 8, 2009)

ResTech said:


> What is up this you guys thinking an EMT is stuck only with what they learned in their initial program???? Were you guys the ones who never went above and beyond?



Oh, damn. I guess I should have gone to paramedic school to get invaluable experience reading "***Acute MI suspected***" on 12 leads before going to medical school.


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## Shishkabob (Sep 8, 2009)

EMTinNEPA said:


> Or a little harder because of bad habits they picked up.



I hear this every single time this debate pops up, and I have yet to be shown the "bad habit" that all EMTs fall prey to if they work as a basic before a medic.  

Red herring?


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## daedalus (Sep 8, 2009)

JPINFV said:


> Oh, damn. I guess I should have gone to paramedic school to get invaluable experience reading "***Acute MI suspected***" on 12 leads before going to medical school.



And don't forget about intubation. God forbid you start an EM residency without  getting you required tube for paramedic school.


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## EMTinNEPA (Sep 8, 2009)

ResTech said:


> Um, we are EMS providers... not med students. EMS is just that, EMS! Its not definitive care. As a Paramedic, you try hard, study hard, learn always, and do the best you can to better your patient during the 20mins you have them! If you want to do more than you should go to Med School.



Medicine is medicine... it makes no difference whether you have MD, DO, PA, RN, CRNP, LPN, CNA, EMT-P, or EMT-B after your name.  And what about situations like cardiac arrests where definitive care _IS_ within our capabilities?


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## JPINFV (Sep 8, 2009)

ResTech said:


> Um, we are EMS providers... not med students.



::coughs::


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## ResTech (Sep 8, 2009)

daedalus... do you even like EMS? You seem to be very condescending of it in many of your post on differing topics.


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## daedalus (Sep 8, 2009)

ResTech said:


> daedalus... do you even like EMS? You seem to be very condescending of it in many of your post on differing topics.



I like enough to wish to raise standards high enough so that you, restech, are respected by your peers in other fields of medicine. 

EMTinPEA is absolutely correct, medicine is medicine, and I have enough respect for paramedics to believe that they deserve better than a dumbed down version of it.


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## Shishkabob (Sep 8, 2009)

Are the mods hiding my post?


I feel left out


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## ResTech (Sep 8, 2009)

My standards for clinical care are very high. I just don't buy into some of this "holier than you" BS that gets touted by many on here.


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## MMiz (Sep 8, 2009)

Linuss said:


> Are the mods hiding my post?
> 
> 
> I feel left out


I'm not sure what you're talking about.  We're not hiding any posts.


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## Shishkabob (Sep 8, 2009)

I was being facetious


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## EMTinNEPA (Sep 8, 2009)

Linuss said:


> I hear this every single time this debate pops up, and I have yet to be shown the "bad habit" that all EMTs fall prey to if they work as a basic before a medic.
> 
> Red herring?



When you take a blood pressure, do you put your thumb on the head of the stethoscope?  Do you do anything more to assess your patient's mental status than "A&Ox3"?  When you place EKG electrodes on a patient, do you put them in generalized places or actually pay attention to anatomical landmarks?  Same question for auscultation of lung sounds.  Do you set up pre-filled syringes of medications for medics?  If so, do you push out the air before you hand it to the medic?  When you check a patient's pupils, do you just check their reactivity to light?  Or do you also note their sizes compared to each other, the speed at which they react to light?  Do you also check the eyes for discoloration, foreign bodies, or signs of blood in the anterior chamber?  Or do you just write "PEARL" on your trip sheet?  Do you check the rate of capillary refill on nausea/vomiting/diarrhea patients?  

Should I go on?


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## ResTech (Sep 8, 2009)

Your just an EMT... you cant use the word "facetious "... its too complex.


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## EMTinNEPA (Sep 8, 2009)

daedalus said:


> EMTinPEA



I'm in PEA?!?

*quickly checks himself for carotid and distal pulses*


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## Shishkabob (Sep 8, 2009)

Oh yes, please go on. 


Also, please elaborate as to how ONLY Basics can perform bad things.  Because right now, it seems like you think there is no such thing as a lazy medic who listens to one zone on a lung and calls it clear.

Or how about the medic who doesn't check to make sure the air is out before they administer the drug?  Why aren't they double checking for themselves anyway?



Or heck, what about the countless stories we hear of medics pronouncing someone on scene, leaving, then getting called back out for signs of life with the pt still very well alive?


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## daedalus (Sep 8, 2009)

ResTech said:


> My standards for clinical care are very high. I just don't buy into some of this "holier than you" BS that gets touted by many on here.



Negative. I am not better than anyone else on this forum. Like I said, I believe in making my profession better.


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## EMTinNEPA (Sep 8, 2009)

Linuss said:


> Oh yes, please go on.
> 
> Also, please elaborate as to how ONLY Basics can perform bad things.  Because right now, it seems like you think there is no such thing as a lazy medic who listens to one zone on a lung and calls it clear.
> 
> ...



Firsly, I NEVER said that ONLY EMT-Bs can pick up bad habits.  Did you hurt your back setting up a strawman so huge?

Yes, there is such a thing as paramedics with bad habits.  But how many of those paramedics would do things correctly if they hadn't spent 10 years as an EMT doing it wrong while "assisting" paramedics?  If an EMT with no experience touching ANYTHING ALS goes in, they are either taught the correct way and stick to that way, or they are taught the incorrect way because they're attending a second or third rate medic mill.


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## Shishkabob (Sep 8, 2009)

Never said there aren't bad habits to learn... but if you, or anyone for that matter, are going to spew something such as "THEY WILL LEARN BAD HABITS!" you need to back it up.




As I say in every single one of these threads:  Don't do blanket statements that you can't back up.


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## Akulahawk (Sep 8, 2009)

Funny you should mention that... I'll respond from my perspective inline, in red for easier responses... from when I was an EMT...


EMTinNEPA said:


> When you take a blood pressure, do you put your thumb on the head of the stethoscope?
> No.
> Do you do anything more to assess your patient's mental status than "A&Ox3"?
> Yes.
> ...


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## EMTinNEPA (Sep 8, 2009)

Linuss said:


> As I say in every single one of these threads:  Don't do blanket statements that you can't back up.



So "field experience will make paramedic school easier" isn't a blanket statement?


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## daedalus (Sep 8, 2009)

Akulahawk said:


> Funny you should mention that... I'll respond from my perspective inline, in red for easier responses... from when I was an EMT...


He was not talking to you as a paramedic, but to EMTs preforming assessments.


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## Akulahawk (Sep 8, 2009)

daedalus said:


> Negative. I am not better than anyone else on this forum. Like I said, I believe in making my profession better.


Then back off from the condescending attitude. You do not help the profession by doing that. EMS has (for quite a long time) been known for eating it's young. The other medical professions have learned that lesson as well. I'm all for increasing the baseline educational level of EMS providers in general. You don't improve the baseline education of everyone by smacking them upside the head and then telling them that they're dumb.

I'm very much in agreement that EMT school is severely lacking in a lot of areas, especially medical assessment. That can be rectified...


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## Akulahawk (Sep 8, 2009)

daedalus said:


> He was not talking to you as a paramedic, but to EMTs preforming assessments.


That was how I did my assessments... before I became a Paramedic...


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## EMTinNEPA (Sep 8, 2009)

Akulahawk said:


> Funny you should mention that... I'll respond from my perspective inline, in red for easier responses... from when I was an EMT...



Now, did you do all that because your EMT course taught you to, or because a paramedic showed you the proper way?  Or did you learn to do all that during paramedic school?


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## EMTinNEPA (Sep 8, 2009)

Akulahawk said:


> Then back off from the condescending attitude. You do not help the profession by doing that. EMS has (for quite a long time) been known for eating it's young. The other medical professions have learned that lesson as well. I'm all for increasing the baseline educational level of EMS providers in general. You don't improve the baseline education of everyone by smacking them upside the head and then telling them that they're dumb.
> 
> I'm very much in agreement that EMT school is severely lacking in a lot of areas, especially medical assessment. That can be rectified...



You also don't improve the baseline education by allowing first-aiders masquerading as medical professionals who think that their 120 hour class was enough education to continue to think this way without opposition.


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## daedalus (Sep 8, 2009)

Akulahawk said:


> Then back off from the condescending attitude. You do not help the profession by doing that. EMS has (for quite a long time) been known for eating it's young. The other medical professions have learned that lesson as well. I'm all for increasing the baseline educational level of EMS providers in general. You don't improve the baseline education of everyone by smacking them upside the head and then telling them that they're dumb.
> 
> I'm very much in agreement that EMT school is severely lacking in a lot of areas, especially medical assessment. That can be rectified...



Can you point out where I have been rude or called somebody dumb on this forum? I invite you to search my post history. I have always refrained from calling any individual names or resorting to rude behavior to make my point. You have now decided to make this a personal debate rather than a professional one, I do not see how that is helpful. 

However, I will stop posting on this forum before I decide to water down the harsh reality of where we are at right now. If you take the time, you will see that when I became a member of this forum I constantly took offense to what respected providers on this forum said about EMTs. I fought them and called them rude. Than, I did my own research and opened my ears and mind a little bit. I thank them for giving it to me straight, and now I try and return the favor. 

We will not become the colleagues of our peers in the hospital if we keep making excuses.


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## ffemt8978 (Sep 8, 2009)

Rather than wake up in the morning and have to ban everyone involved in this thread, it's getting a 24 hour time out.


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## Jon (Sep 9, 2009)

We'll give this another shot. I'm going to open the thread again.
If we have to close it again - there will be infractions issued.

Well... I see both sides of this - If the program is designed well... you don't need experience. If the program is designed to accommodate the student who's been working as an EMT for a while, likely with some contact with ALS providers... the student with no experience seems to have a tougher time. It can be a lot, all at once.


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## JPINFV (Sep 9, 2009)

Jon said:


> If the program isn't designed to accommodate the student who's been working as an EMT for a while, likely with some contact with ALS providers... the student with no experience seems to have a tougher time. It can be a lot, all at once.



Welcome to college, graduate, and professional school. Medical school has a lot of material quickly (try taking histology and biochemistry at the same time), but few schools require undergrad biochem and fewer require cell biology. It's been a long time since I've been in an EMS classroom, but for my own sanity, I hope that EMS students don't need to be spoon fed every little detail.


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## Akulahawk (Sep 9, 2009)

Jon said:


> We'll give this another shot. I'm going to open the thread again.
> If we have to close it again - there will be infractions issued.
> 
> Well... I see both sides of this - If the program is designed well... you don't need experience. If the program isn't designed to accommodate the student who's been working as an EMT for a while, likely with some contact with ALS providers... the student with no experience seems to have a tougher time. It can be a lot, all at once.


Believe it or not, I actually have a similar view on this. 

If a Paramedic Program is designed to incorporate all the skills at the EMT level and provide sufficient experience performing those skills that then becomes a SOLID foundation to build ALS upon, I have zero problems with that type of school. 

Some Paramedic programs require that their students arrive with some prior experience. The idea behind those schools is that someone else trained their student to do BLS, so all they have to do is verify the knowledge and skills of the EMT and get into the teaching of Paramedicine. 

Preceptors that primarily work with the 2nd type of school do NOT want to have to teach their students how to be an EMT. Preceptors who primarily work with the 1st type of school are able to work with their students and teach them how to do all the skills and integrate all the knowledge along the way. 

Both types of schools can turn out quality Paramedics... but the person who is most responsible for the quality is the student.


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## Akulahawk (Sep 9, 2009)

JPINFV said:


> Welcome to college, graduate, and professional school. Medical school has a lot of material quickly (try taking histology and biochemistry at the same time), but few schools require undergrad biochem and fewer require cell biology. It's been a long time since I've been in an EMS classroom, but for my own sanity, I hope that EMS students don't need to be spoon fed every little detail.


Medical School also exposes the Medical Student gradually to patients. The student isn't expected to be able to diagnose and treat extremely complex patients on the first day they're sent out to begin their clinical time, as might be expected of an attending... Yes, the amount info presented to you is great, and much like trying to sip from a 2.5" line... 

I suspect that as you reach your PGY-2/3 years, you're likely going to feel like all those Med Students under your tutilage _need _to be spoon-fed...


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## Achromatic (Sep 9, 2009)

And then you have the 'odd one out' situations that no-one's blanket statements will be able to cover.

Take me, for example. I'm an EMT-B student, who has, as I've stated, no misunderstandings about the fact that when I finish my training, I will be qualified to give _Basic. Life. Support._. What's more, I even work as a volly (quelle horreur!).

So, some might say "you don't have enough knowledge to know whether what you're doing is the best thing for the patient under the circumstances" (the 'raise the bar' refrain, which I actually happen to agree with). What do you do then when I tell you that I went through medic(al) school? Actually, that's not quite accurate, I did biomedical science in Australia.

For those not in the know, medicine in Australia used to be exclusively an undergraduate degree (albeit a six, then five year one). Around 15 years ago, the biomedical science course was introduced, similar, but not identical, to a more U.S. system of "pre-med", with post-grad medicine as an option.

So I have no experience in the field at the moment, and I got no practical medicine experience (no rounds, etc) at school.

But while many are assured and confident in the belief that an EMT-B couldn't possibly know (as a great generalization) "just how much they don't know", a brief list of my studies: biomedical chem, cells tissues and organisms, medical biophysics, human neurobiology, molecular biology, A&P, biochemistry in human function, body systems, genetics, microbes in health and disease, bioinformatics, molecular medicine and biotech, biomedical basis of disease, nutrition, embryology, immunology, and pharmacology. Assumption, as they say ...

`Tis sad to see something that we can all agree on, I believe (after all, who would argue that less education is a good thing), be such a source of tumult.


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## JPINFV (Sep 9, 2009)

Just checking. You do know what an outlier is and how it affects statistics, right? Sure, I'm still an EMT-B (at least according to the State of Massachusetts and the NREMT), but I don't consider the body of knowledge that I work off of to be the standard body of knowledge that other basics are working from. In terms of EMT-Bs, we're high end outliers and you don't make policy off of the high end outliers.


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## Achromatic (Sep 9, 2009)

JPINFV said:


> Just checking. You do know what an outlier is and how it affects statistics, right?



Touche. Hence the "as a great generalization" qualifier, but yes, to be clear - I am by no means living under the misapprehension that your average EMT-B student has the education that you or I do 

That being said, I've been surprised within my EMT-B class by the number of questions asked of our instructors that far exceed the "body of knowledge" specified or required.

"All generalizations are evil. Including this one."

You aren't required to become a PA to become an MD, nor an LPN to become an RN, so many wonder why "EMT-B to become EMT-P", but that analogy conveniently ignores that you don't walk into med school off the street (although as I pointed out in my original post, medicine is still an undergrad degree in Australia, but with structured pre-reqs). Those that require a year of experience as an EMT-B, I believe, have a lot to do with the concern over the "lack" of education you receive in EMT-B school. You want someone who meets a pre-req body of knowledge. 120 hours and a 70% on the NREMT has a lot of scope for inadequacy, so the presumption (and the validity thereof is another argument altogether) is that this, combined with you being able to provide care for a body of patients (and from all I've seen with this pre-req, the number of patient contacts is required, sometimes with a breakdown, just to be sure your 'one year of experience' isn't 'I vollyed 8 hours a month in a far rural region that had 100 BLS calls per annum') for a period of time without being fired, dismissed for negligence, etc, etc, is more of an assurance of a baseline knowledge that can then be applied to your training as an EMT-P without having to spend the first week of medic class doing vitals, etc. All of this is of course subject to statistics, deviations, and, yes, outliers.


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## Akulahawk (Sep 9, 2009)

JPINFV said:


> Just checking. You do know what an outlier is and how it affects statistics, right? Sure, I'm still an EMT-B (at least according to the State of Massachusetts and the NREMT), but I don't consider the body of knowledge that I work off of to be the standard body of knowledge that other basics are working from. In terms of EMT-Bs, we're high end outliers and you don't make policy off of the high end outliers.


I think that there are a number of us "outliers" on this forum... which partly accounts for some of the tenor of recent discussions. My own knowledge base is, while not to the level of having gone through Medical School, is quite extensive in it's own right and is far beyond what any garden variety US Paramedic gets. I would put it like this: the more you know, the more you realize what you don't know...

I know a lot... therefore I seek more knowledge.


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## Achromatic (Sep 9, 2009)

Akulahawk said:


> I would put it like this: the more you know, the more you realize what you don't know...
> 
> I know a lot... therefore I seek more knowledge.



Precisely. I have a thirst for medical knowledge (well, knowledge in general) - trick is knowing what you know and what you don't, and knowing what you can apply, and what you can't (both within a generalized perspective, as well as statutes and protocols).

Most of my biomedical science course ran parallel to the first three years of med school, so we had the same lectures, and like the professor who stood up on the first day said, "Remember this, and remember it well. You're going to get friends, and family, ask you to diagnose them as party tricks, as novelties. You - you ain't a doctor til you have a bit of paper that says you are, and /then/ you'll realize just how much you've got to learn."

I think you've made a good point. A lot of the people here, -B's, -P's, etc, are here because we have a PASSION for this, and an understandable pride. By definition, we are the outliers, and I think that in turn has a lot to do with how personally many people take slights, perceived or otherwise, about education, about superiority or inferiority, when really, most people's belief is that "more education is a good thing", and the debate is "/how/ much more". Because even if you extend things from, say, a 120 hour training course to EMT-B and say "well, no, a 1 or 2 year AAS medic course should be the baseline" (for example - no side fires on whether 1 year is sufficient, or whatever), there's always another step - "Well, what should that AAS cover?", witness the oft-heard complaint about many medic schools lack of A&P, etc.

If someone believes that they will be better rounded by spending some time as a practicing EMT-B before heading to medic school, I think that's great, and any arguments to the contrary should consist of more than vague "more bad habits to un-teach you"-like remarks.


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## Cory (Sep 9, 2009)

Well, my main thing is that private companies don't run emergencies in Cincinnati, but all ff's have to be EMT's. So only paramedics are JUST EMS, and I'm not interested in being a firefighter.


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## Shishkabob (Sep 9, 2009)

It may be my morning induced stupor, but what does that have to do with the conversation at hand?


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## medic417 (Sep 9, 2009)

Cory said:


> So, I have been reading a lot about getting hired as an EMT, and I know that areas around me have either stopped hring or are making their requirements impossibly high for the majority of people.
> 
> Now, yes, I am still far away from even an EMT-B course, but I was just wondering (because as far as I know, I do have the intention to get EMT-P certified some day) Is it a bad idea to go straight from EMT-B class into a medic class? Is it discouraged to go into a medic class without time on a job? For some reason, I get the notion that most people get EMT-B, work as an EMT for a year or two, THEN go to Paramedic class. But in times where EMT jobs are far and few between (I know of a department where I have been told numerous times that I could be hired at when I'm 18 or older, but things could change in 3 or 4 years time) it seems like getting a medic cert. would be better before trying to get hired at an over-staffed department.
> 
> ...



It is actually smart to go straight to Paramedic.  Many colleges now include basic as the first part of their Paramedic degree programs.  

Your patients benefit more because you will be higher educated.  The only ones that benefit from basics is company's saving money hiring basics instead of Paramedics.


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## Sasha (Sep 9, 2009)

Jon said:


> We'll give this another shot. I'm going to open the thread again.
> If we have to close it again - there will be infractions issued.
> 
> Well... I see both sides of this - If the program is designed well... you don't need experience. If the program isn't designed to accommodate the student who's been working as an EMT for a while, likely with some contact with ALS providers... the student with no experience seems to have a tougher time. It can be a lot, all at once.



I disagree entirely, and my experience was just the opposite. The students who had experience had a tougher time adapting to how it was REALLY done, because they had already developed the bad habit "don't need no book learnin'" mentality that is pawned off by so many. 

Also you assume they will get experience with ALS providers yet many areas still run basic trucks. I'm sorry but there is nothing you learn as a basic on a basic truck that A) is useful or B ) cannot be learned during your medic school clinicals.

If it really takes you an additional year to let all the first aid sink in and become comfortable with it, then how do you expect to learn more "advanced" medicine??


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## VentMedic (Sep 9, 2009)

The other thing is some do not take the opportunities presented to them to learn. They get into the "BS" or "you call, we haul" mentality and just say, "I'm just doing my time until I can be a Paramedic". They go through the motions and believe getting a Paramedic patch will change everything including their attitude towards patient care.  

In California I have had the opportunity of seeing CCTs with 2 EMT-Bs and one RN doing seriously sick patients. I do have a problem with this especially since the participation from some (not all) of the EMT-Bs is to hang out in nurses' break room while their nurse gets report. When it is time to move the patient, they show up. When I've asked why they don't listen to report their response is sometimes along the lines of "It's just another IFT only with a few more gadgets attached", "I'm an *Emergency* Medical Technician and this isn't emergency stuff" or "I don't have to worry about do any of that stuff until I'm a Paramedic". 

Thus, EMT-B seriously does not foster the need to learn medicine. In fact, the EMT-B should be titled Ambulance Attendant and revised with more concentration on medical issues. Then maybe there wouldn't be the expectation that everything will be an emergency or a cool trauma. At least CNAs get a truer viewer of their profession and what to expect when they become a nurse. They have no illusions of grandeur when they get their CNA patch but they definitely know the importance of their job as do others because they accept it for what it is. Some EMT-Bs fail to see their job as being part of patient care in the vast world of medicine and only look for the emergency excitement while believing everything else is BS. To continue with this belief for 1 - 3 years without furthering one's education they fail to see where their lack of medical knowledge can be the harming patients they are supposed to be helping.


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## bunkie (Sep 9, 2009)

In my area, we're required a year active B and sponsorship from your agency to get into the medic programs here. I want to be a paramedic, not a basic for life, so it kind of annoys me that I have to do a step process and wait. I wont be where I want to be for a few years, pending I get hired immediately after I finish school. With a family, its kind of difficult to follow this "process" they have. But I'll make it work.


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## Jon (Sep 9, 2009)

Vent - I would have killed for the opportunity to get onto a CCT truck as you talk about - in PA, CCT's are EMT + RN, EMT + RN + RN, or EMT + EMT-P + RN

I would have LOVED the learning opportunities inherent in such an environment.


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## VentMedic (Sep 9, 2009)

bunkie said:


> In my area, we're required a year active B and sponsorship from your agency to get into the medic programs here. I want to be a paramedic, not a medic, so it kind of annoys me that I have to do a step process and wait. I wont be where I want to be for a few years, pending I get hired immediately after I finish school. With a family, its kind of difficult to follow this "process" they have. But I'll make it work.


 
They can not restrict you from taking prerequisites like A&P, Pathophysiology, Psychology and English or some writing classes before you enter the Paramedic program.   *ALL* of the other healthcare professions require prerequisites before they are allowed to enter the core portion of their degree.    Hence with the wording or the lack of prerequisite requirements for some Paramedic programs, some believe one can not get *ANY* education for that year.  Taking college classes in the sciences or general education should be considered part of a Paramedic program.   One should not look at the Paramedic class itself as the end all to all education.   It is time those in EMS start thinking about being a medical professional and not just a "medic".


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## bunkie (Sep 9, 2009)

VentMedic said:


> They can not restrict you from taking prerequisites like A&P, Pathophysiology, Psychology and English or some writing classes before you enter the Paramedic program.   *ALL* of the other healthcare professions require prerequisites before they are allowed to enter the core portion of their degree.    Hence with the wording or the lack of prerequisite requirements for some Paramedic programs, some believe one can not get *ANY* education for that year.  Taking college classes in the sciences or general education should be considered part of a Paramedic program.   One should not look at the Paramedic class itself as the end all to all education.   It is time those in EMS start thinking about being a medical professional and not just a "medic".



I'm aware of that. After I finish my EMTB, I'm starting those courses as I intend on getting a degree in paramedicine. Not just certification.


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## VentMedic (Sep 9, 2009)

Jon said:


> Vent - I would have killed for the opportunity to get onto a CCT truck as you talk about - in PA, CCT's are EMT + RN, EMT + RN + RN, or EMT + EMT-P + RN
> 
> I would have LOVED the learning opportunities inherent in such an environment.


 
It is truly what you make it to be.

In the past we have hired EMTs and Paramedics as our drivers for Specialty but have since gone to using qualified drivers from the Security/Transport department. 

The EMT(P)s were told up front that they could assist with equipment but would be very limited when it came to hands on skills. They could still get knowledge and some experience in an area of medicine that they normally would not see. This frustrated many, especially the Paramedics, and then there was the lights and sirens thing as they wanted to drive with L&S and really fast every time we got a sick baby which was always. The concept of a real mobile intensive care team was difficult to comprehend. 

However, those that did understand the depth of the learning process for these very complex situations and babies/kids who needed expertise at a very high level got a great experience. They were also inspired to set their goals higher be it in EMS or in some other profession.


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## Jon (Sep 9, 2009)

Vent - My one company provides drivers and trucks for the Children's hospital and one of the other large hospitals (with a big cardiac and burn program). I've subbed at both places at one time or another, and some of the staff just want us to be drivers and stay out of their way. Its a shame.


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## VentMedic (Sep 9, 2009)

Jon said:


> Vent - My one company provides drivers and trucks for the Children's hospital and one of the other large hospitals (with a big cardiac and burn program). I've subbed at both places at one time or another, and some of the staff just want us to be drivers and stay out of their way. Its a shame.


 
It is but if you knew the hours some of these teams have spent training and educating together, it is sometimes hard to bring in outsiders into the patient care aspect. Also, remember the bystander and EMS thread we had on this forum recently and the attitudes about "outsiders" trying to offer information, ask questions or help even for CPR? 

They may also have been given attitude by those before you which spoiled the atmosphere. There have been Paramedics who challenge team members with the "I can intubate and start IVs. It's in my scope." However, few can ever say they have intubated or started IVs on a 23 week preemie and not more than 100 times in the past year. 

Some states now specify the minimum requirements for EMS/Specialty teams as in the past some BLS and ALS trucks transported patients they were not qualified for. Florida is also making specific requirements of the medical director and having the facility deemed as the higher level of care that the baby/child is being transported to determine what team is needed. But yes, it does make it difficult for EMT(P)s to be part of these teams as their education does not prepare them or allow them to work in NICUs to gain the hours needed.


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## daedalus (Sep 9, 2009)

Achromatic said:


> And then you have the 'odd one out' situations that no-one's blanket statements will be able to cover.
> 
> Take me, for example. I'm an EMT-B student, who has, as I've stated, no misunderstandings about the fact that when I finish my training, I will be qualified to give _Basic. Life. Support._. What's more, I even work as a volly (quelle horreur!).
> 
> ...


That is an awesome education to have for yourself before going into EMS. However, in the United States, 120 hour course is all that is needed for certification as an EMT. That means anyone from a high school drop out to your level of education can get an EMT card. Your statements are as if a janitor in a major legal practice told one of the partners that he did pre legal education at UCLA. Doesn't matter, he is still the buildings janitor...


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## Shishkabob (Sep 9, 2009)

But to say all janitors are high school drops outs would be wrong, wouldn't it?


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## daedalus (Sep 9, 2009)

Linuss said:


> But to say all janitors are high school drops outs would be wrong, wouldn't it?



Yes, I do not believe that all janitors are high school drop outs. What I am saying is that it doesn't matter what kind of background education you have, if you are hired as a janitor, you are a janitor. Same with EMT, if you are certified as an EMT, you are an EMT. Not a super dooper EMT just because you have a degree in biomedical science.


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## Akulahawk (Sep 9, 2009)

daedalus said:


> Yes, I do not believe that all janitors are high school drop outs. What I am saying is that it doesn't matter what kind of background education you have, if you are hired as a janitor, you are a janitor. Same with EMT, if you are certified as an EMT, you are an EMT. Not a super dooper EMT just because you have a degree in biomedical science.


The same applies to you... and me. You are an EMT. You may utilize the scope of practice of a Paramedic while you're in training to be one, but you're still "just" an EMT. That does NOT mean that while working as an EMT you can't utilize what you've learned in assessing patients. In fact, it would behoove you to do so... as long as you don't exceed your authorized EMT scope of practice while doing so.

From previous training, I gained knowledge and skill that go way beyond anything that any US Paramedic can do in the field. That would most likely also go beyond what most RN's can do. I'm "just" a Paramedic... That doesn't mean that I can't bring my clinical knowledge into play on certain patients... it enhances my decision-making abilities for those patients. 

It just means that I can not exceed my authorized scope of practice... 

Med Students are in the same boat. They may be licensed in another field of healthcare, and the knowledge they gain while in school is incredible... but until they get their Medical License...


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## Achromatic (Sep 9, 2009)

daedalus said:


> Yes, I do not believe that all janitors are high school drop outs. What I am saying is that it doesn't matter what kind of background education you have, if you are hired as a janitor, you are a janitor. Same with EMT, if you are certified as an EMT, you are an EMT. Not a super dooper EMT just because you have a degree in biomedical science.



No, and that is a valid point to make.

As I said in my original comment, "I realize that my qualification is one that allows me to provide basic life support", not "I'm an EMT-B but since I've done this and that you should allow me to do -P tasks", definitely not. More that "you can't say it's impossible for you to know how ignorant you are" ('you' in the generic sense, not you specifically).

And whilst I'm aware that my experience is far from the norm, I think akulahawk's comment bears repeating, that people who care enough about this topic to discuss it here are far from the norm in at least that regard.


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## Shishkabob (Sep 9, 2009)

Not all Muslims are terrorist.  Not all Doctors are smart.  Not all NRA members want to shoot anything that moves.  Not all Vegans hate meat eaters.



To classify all people as the same thing, simply because they share a title, is weird.


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## daedalus (Sep 9, 2009)

Linuss said:


> Not all Muslims are terrorist.  Not all Doctors are smart.  Not all NRA members want to shoot anything that moves.  Not all Vegans hate meat eaters.
> 
> 
> 
> To classify all people as the same thing, simply because they share a title, is weird.



Your posting behavior is bizarre to me. This is not an insult, but a request for clarification. I say one thing and you find an irrelevant aspect of it, twist up, and than question it. I am hard pressed to see how your last two posts have contributed to this thread.

I did not call Janitors high school drop outs, nor did I make any sort of sweeping generalizations other than to say an EMT is an EMT.


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## Shishkabob (Sep 9, 2009)

Yea, I'm pretty random in my rants.


My one and only point I've been trying to make in all my post in this thread is this:


Don't make sweeping generalizations about a title.  Not everyone in a group is the same.  Even though with some generalizations, more often than not they hold true, but it's still an insult to the people that it is not true.

Yes, there are idiotic EMTs, but to say all EMTs are uneducated is laughable, if for no other reason than you and I are both EMTs and we're in medic school.


The exception disproves the rule.


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## daedalus (Sep 9, 2009)

Linuss said:


> Yea, I'm pretty random in my rants.
> 
> 
> My one and only point I've been trying to make in all my post in this thread is this:
> ...


True! However, would you agree to this:
The harder it is to become an EMT, the less idiots we will have?

For example, if EMT meant taking college a&P, microbio, bio, chem, med terminology, and english, do you think that a lot of the idiots might fall through before making it to EMT?

But, idiots always make it through, even to medical school. I give you that. Just a lot less idiots are doctors than EMTs.


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## Shishkabob (Sep 9, 2009)

I've always been for more education (says the medic student who hasn't taken A&P).  I'm all for making the EMT-B level harder to obtain because of the education required.


Never going to argue on more education.  Just going to argue on people labeling me as not knowing anything simply because my patch is blue and not red.


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## daedalus (Sep 9, 2009)

Linuss said:


> I've always been for more education (says the medic student who hasn't taken A&P).  I'm all for making the EMT-B level harder to obtain because of the education required.
> 
> 
> Never going to argue on more education.  Just going to argue on people labeling me as not knowing anything simply because my patch is blue and not red.


reeeeelaxxx. I know you are pro-education.

If anything, making EMT harder equals more money in my pocket, and less people with cards in their wallets to compete for jobs with.


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## JPINFV (Sep 9, 2009)

Linuss said:


> Don't make sweeping generalizations about a title.  Not everyone in a group is the same.  Even though with some generalizations, more often than not they hold true, but it's still an insult to the people that it is not true.
> 
> Yes, there are idiotic EMTs, but to say all EMTs are uneducated is laughable, if for no other reason than you and I are both EMTs and we're in medic school.
> 
> ...



...but you take outliers as outliers, especially (in terms of education level) outliers to the right. You don't make policy, protocols, procedures, and scopes of practice based on the minority of basics who take college level courses. You don't make policy based on what courses a provider has the opportunity to take. You make those based on what the provider is required to take (either in order to pass a local certification exam or to be eligible to take state/nation certification exams) while considering your average to somewhat below average providers (defensive protocols). 

As my saying goes, it's EMT-B, not EMT-JPINFV.


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## EMS_Junkie (Sep 9, 2009)

Im an EMT-B with only a few months experience but Ive been on my ambulance service as a drive for a year and a half and I just started my Paramedic Specialist training last month.


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## audreyj (Sep 10, 2009)

I do agree that there needs to be more pre-reqs to a paramedic program.  I have college level A&P and microbiology and chemistry in high school.  I can't imagine taking the paramedic program without the A&P, there is just SO much to learn and so little time afforded by a lot of programs.  When I tested for the program that I'm currently in the coordinator said that those who are fresh out of the EMT-B course will probably have a better shot at getting in because they haven't gotten into any bad habits and they haven't forgotten the information.  There are a lot of students in my class who are fresh outta EMT-B.  I am one of those students.

Before becoming an EMT I was a CNA so I'm not totally green in the health care world but taking the biology's I have it definitely helps.


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## EMSLaw (Sep 10, 2009)

daedalus said:


> For example, if EMT meant taking college a&P, microbio, bio, chem, med terminology, and english, do you think that a lot of the idiots might fall through before making it to EMT?.



Which, incidentally, are just about the requirements for most health care professional schools.  BSN post-bac programs require that, plus maybe stats or calculus.  Add organic chem and math, and you have the requirements for medical school.

PA programs are weird, I think they have lots and lots of pre-reqs, but don't quote me on that. 

But yes, you'd exclude some idiots.  You'd also get new, improved, college edjumicated eejits.


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## JPINFV (Sep 10, 2009)

Err. I can't think of a single US medical school (MD or DO) that requires A/P or medical terminology. Few require microbiology (a lot more recommend it) or English (although there's a verbal section on the MCAT).


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## Cory (Sep 10, 2009)

I think there should just a be another level. You can't raise the EMT B course to a harder curriculum because so many ff's (and other professions) have to take it now, and it wouldn't make sense for them to take such an exstensive class.


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## TransportJockey (Sep 10, 2009)

Cory said:


> I think there should just a be another level. You can't raise the EMT B course to a harder curriculum because so many ff's (and other professions) have to take it now, and it wouldn't make sense for them to take such an exstensive class.



Why should we cater to firefighters? Keep EMT-B just to make them able to justify getting so much money? For EMS to grow and actually become a prfession and a career that is respected by other divisons of medicine (of which we are closer to rather than public safety) we need to expand our education levels and raise the bar to get into EMS


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## Cory (Sep 10, 2009)

jtpaintball70 said:


> Why should we cater to firefighters? Keep EMT-B just to make them able to justify getting so much money? For EMS to grow and actually become a prfession and a career that is respected by other divisons of medicine (of which we are closer to rather than public safety) we need to expand our education levels and raise the bar to get into EMS



I completely agree. Just the other day I was talking to college student who was getting ready to take an RN course in a few months (knew him from high school), and he beasically tried to tell me that EMS just wrap you up and drive you to the real heroes. then he went on to say that EMS looses way too many people to even be credible. Of course, none of this is true, but it does refelct a fresh view on EMS.

But the EMT-B course has been overrun by all sorts of small-time non EMS professions. 

What is the deal with EMT - I? Do you even have to take a class for that? Maybe something can be done there, harder curriculum, required to work in EMS maybe? Just ideas...


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## Akulahawk (Sep 10, 2009)

jtpaintball70 said:


> Why should we cater to firefighters? Keep EMT-B just to make them able to justify getting so much money? For EMS to grow and actually become a profession and a career that is respected by other divisons of medicine (of which we are closer to rather than public safety) we need to expand our education levels and raise the bar to get into EMS


Firefighter and Police Officer positions often do NOT require a degree of any sort, just a HS Diploma (or equivalent). You want to become either? Just attend an academy... The agencies that might hire you might require a degree (associates or higher) but that's on them... That's Public Safety.


Cory said:


> I completely agree. Just the other day I was talking to college student who was getting ready to take an RN course in a few months (knew him from high school), and he basically tried to tell me that EMS just wrap you up and drive you to the real heroes. then he went on to say that EMS looses way too many people to even be credible. Of course, none of this is true, but it does reflect a fresh view on EMS.
> 
> But the EMT-B course has been overrun by all sorts of small-time non EMS professions.
> 
> What is the deal with EMT - I? Do you even have to take a class for that? Maybe something can be done there, harder curriculum, required to work in EMS maybe? Just ideas...


Adding in a bunch of classes that are actually clinically relevant, takes the entry level knowledge base to that of what is required by other health professions. The problem is that EMS follows the Academy-like entry into the profession like Public Safety, but "wants" to be recognized as a Medical Profession. Take Nursing as an example: a CNA needs but one class... They're a dime a dozen. LVN/LPN programs typically last one year and have much higher base knowledge than a CNA does. RN programs typically have similar prerequisites but about 2 years of didactic & clinical time...

Where did EMS "go wrong" with this? Well, you take the "academy approach" and pretty much everyone doing their own thing... unlike the other public safety professions... AND Nursing... where they pushed as a group for recognition and higher status...

Well, that's where we are.


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## Ridryder911 (Sep 10, 2009)

With accreditation will also come screening. Part of the accreditation process is to be able ensure a certain percentage of the students enrolling will finish the whole course. That a percentage of those students that do pass the program will pass the board the first time. 

Alike other professions to ensure quality students that apply. As we are now seeing more and more enter the EMS profession (our enrollment for my school EMS programs is up >30% this semester) due to the instability economy. We must also be very aware that at least 70% must pass the courses and of those at least 70% must pass the boards the first time. 


So yes, we will see more and more prerequisites, interview, testing and selection process coming into EMS programs. Soon will be gone the days of many institutions philosophy of ....."_you got the money, we got the time_"...... Hopefully, states will soon not honor graduates of non-credentialed programs or states without certain requirements.


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## squrt29batt12 (Sep 12, 2009)

In my opinion, it is best to jump right into Paramedic school right after you finish EMT. Basically the first semester of medics is a review of EMT skills anyway. And remember, you might think getting "work experience" is good, it all depends where you work before medic school, remember....if you don't use it, you lose it.B)


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## TransportJockey (Sep 12, 2009)

Ridryder911 said:


> With accreditation will also come screening. Part of the accreditation process is to be able ensure a certain percentage of the students enrolling will finish the whole course. That a percentage of those students that do pass the program will pass the board the first time.
> 
> Alike other professions to ensure quality students that apply. As we are now seeing more and more enter the EMS profession (our enrollment for my school EMS programs is up >30% this semester) due to the instability economy. We must also be very aware that at least 70% must pass the courses and of those at least 70% must pass the boards the first time.
> 
> ...



NM already has the policy that if you graduate from a non-accredited school and pass the NR test, you then have to take another written (maybe practical I'm not sure) exam to be certified to work in NM as a medic. 

My school is the only one exempted because we are for all intents and purposes accredited, just waiting for one last bit of paperwork to be processed by the state (and we're still at something like 90% first time pass rate at NR)


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## fiddlesticks (Sep 12, 2009)

why not work as an emt first then think about the rest later get good at your skills b4 adding to them.


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## JPINFV (Sep 12, 2009)

fiddlesticks said:


> why not work as an emt first then think about the rest later get good at your skills b4 adding to them.



Would you rather have a tire that is fully reinforced or only have half of it reinforced?


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## Ridryder911 (Sep 12, 2009)

fiddlesticks said:


> why not work as an emt first then think about the rest later get good at your skills b4 adding to them.



Seriously, how long does it take to master splinting, CPR & oxygen administration? Those skills are not rocket science and in academia-education rating are considered very, very basic (hence the reason they are included in the basic portion). 

It is well known in the educational system if one practices long enough, one should be able to master them without difficulty (unless they have a learning disability)

Let's stop placing the emphasis on basic skills as being as so difficult to master when most Boy Scouts has demonstrated that it can be achieved easily.

R/r 911


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## Cory (Sep 12, 2009)

Well, I think the only way I would consider working as an EMT is with the local department in my tiny little city, because they don't have any ALS medic units. And I have some family that works there. But in the city (where I want to work) I probably would hold off until I have a medic cert. That is my opinon.


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## SanDiegoEmt7 (Sep 12, 2009)

JPINFV said:


> So, remind me, why don't RNs have to be CNAs or LVNs first? Why don't MD/DOs have to be PAs first? Why don't PhDs have to get a masters degree first? Why don't DMDs have to be dental hygenists first?



Because they have longer clinical/internship periods where they can acquire the skills to be good at their job.


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## JPINFV (Sep 12, 2009)

SanDiegoEmt7 said:


> Because they have longer clinical/internship periods where they can acquire the skills to be good at their job.



...and EMTs (B/P) shouldn't have longer clinical periods?


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