# Eager to Learn



## jnsangel33 (Apr 12, 2013)

I was curious if there is a way for me to begin studying to become a medic BEFORE I have the hours I need to get into medic school??  I finally started working as an EMT 1 1/2 mos ago and would love to get a jump on medic school though it is still probably at least a year away.  Any suggestions such as websites, books, etc that I can start with?


----------



## STXmedic (Apr 12, 2013)

Ask tons of questions

Look up every medication you see

Learn the medications you will be using

Walravens Basic Arrhythmias

Dubin's Rapid Interpretation 

Ask tons of questions


----------



## Medic Tim (Apr 12, 2013)

If you haven't already .... Take an a and p course with lab. There are others that will help but that it probably the one that will make medic school much easier.


----------



## Achilles (Apr 12, 2013)

Medic Tim said:


> If you haven't already .... Take an a and p course with lab. There are others that will help but that it probably the one that will make medic school much easier.



Pharmacology


----------



## Medic Tim (Apr 12, 2013)

Achilles said:


> Pharmacology



I would also suggest microbiology, pathophyaiology and chemistry in addition to the above mentioned.


----------



## Merck (Apr 12, 2013)

All of the above are true however I would like to suggest that the best studying you can do is seeing patients and doing calls at the EMT level.  What you learn there - how to talk to people, touch them, run a call, deal with other rescue personnel, is invaluable.


----------



## ExpatMedic0 (Apr 12, 2013)

Medic Tim said:


> If you haven't already .... Take an a and p course with lab. There are others that will help but that it probably the one that will make medic school much easier.



ya +1 to this. If I could only choose 1 course for you to take that will help the most, it would be A&P. Many programs require either A&P 1  or "Human Bio/ Physiology"(200 level) as a pre-req.


----------



## Amber2313 (Apr 18, 2013)

I am 4 weeks from finishing the didactic portion of my paramedic program. I would absolutely suggest focusing on field experience. Textbooks and classes are a plus, but you can't replace field experience. I was an EMT for 3 years before my medic program and sometimes still wish I'd gotten more experience before starting. (I didn't work the full 3 years - I was a full-time college student and didn't work EMS consistently for a while). By no means am I struggling in class, but field experience is ABSOLUTELY the most important thing going in. To be completely honest, I think you should wait longer than you plan to.


----------



## Household6 (Apr 18, 2013)

PoeticInjustice said:


> Ask tons of questions
> 
> Look up every medication you see
> 
> ...



I was gonna say that too.. That's been a time consuming skill for me to learn.


----------



## Christopher (Apr 18, 2013)

Amber2313 said:


> I am 4 weeks from finishing the didactic portion of my paramedic program. I would absolutely suggest focusing on field experience. Textbooks and classes are a plus, but you can't replace field experience. I was an EMT for 3 years before my medic program and sometimes still wish I'd gotten more experience before starting. (I didn't work the full 3 years - I was a full-time college student and didn't work EMS consistently for a while). By no means am I struggling in class, but field experience is ABSOLUTELY the most important thing going in. To be completely honest, I think you should wait longer than you plan to.



I would recommend against delaying entry unless your EMT experience is of high quality or your Paramedic program is of poor quality. There is no need to gain field experience prior to Paramedic school unless it is to supplement a poor didactic and clinical experience.

Field experience merely helps you drive, use a radio, operate a stretcher, and find things on the truck. These are not items which make a good paramedic.

I'd much rather have a new Paramedic who lacks operational experience than one who lacks education.

Front load Paramedic school with A&P, pathophysiology, pharmacology, and more A&P and more pathophysiology, and more pharmacology, and more...


----------



## Christopher (Apr 18, 2013)

jnsangel33 said:


> I was curious if there is a way for me to begin studying to become a medic BEFORE I have the hours I need to get into medic school??  I finally started working as an EMT 1 1/2 mos ago and would love to get a jump on medic school though it is still probably at least a year away.  Any suggestions such as websites, books, etc that I can start with?



I enjoyed the following books (they have meat and they lack "tricks", these are good things):

- Emergency Pathophysiology: Clinical Applications for Prehospital Providers
- The Art and Interpretation (both 12-Leads and Arrhythmias, please skip Dubin's. Please.)
- Brady's Pharmacology (either the spiral bound or the 7ed textbook)


----------



## STXmedic (Apr 18, 2013)

Christopher said:


> I enjoyed the following books (they have meat and they lack "tricks", these are good things):
> 
> - Emergency Pathophysiology: Clinical Applications for Prehospital Providers
> - The Art and Interpretation (both 12-Leads and Arrhythmias, please skip Dubin's. Please.)
> - Brady's Pharmacology (either the spiral bound or the 7ed textbook)



I've also heard good things about Jeffrey Guy's Prehospital Pharmacology, though I've never used it personally. It's got a podcast that follows the book to help with reenforcement as well.

I'll +1 Garcia's also. Excellent for practice and repitition.


----------



## Ace 227 (Apr 18, 2013)

Just snagged a used copy of Walraven's BAsic Arrhythmias from Barnes and Nobles online for $6. Lets hope its readable, lol


----------



## NomadicMedic (Apr 18, 2013)

It'll be readable. It's jut a pulp paper book o' strips.


----------



## VFlutter (Apr 18, 2013)

Once you get a grasp on basic cardiac rhythms I would suggest Amal Mattu's _ECGs For the Emergency Physician_ books as well as his youtube videos.


----------



## Amber2313 (Apr 19, 2013)

I strongly disagree. Field experience is MUCH more than driving, radio, and cots. It's putting what you learned in class to the streets and learning how things are really done. I had both a fantastic EMT and paramedic program, but class doesn't cover everything. You can practice a million trauma scenarios in class and try to make them as realistic as possible, but nothing can compare to working with a FD to extricate a patient and managing them in the meantime. Sure, you know what to do, but there is a sort of fluidity, for lack of a better term, that comes with working in the field. You can't be a good medic if you're not a good basic first- and no basic is a pro from day one. There is a significant amount of learning that takes place on the job.
...in my opinion.


----------



## Ace 227 (Apr 19, 2013)

What are you talking about? Did you even read the original question?


----------



## STXmedic (Apr 19, 2013)

Amber2313 said:


> You can't be a good medic if you're not a good basic first- and no basic is a pro from day one. There is a significant amount of learning that takes place on the job.
> ...in my opinion.



Umm... So... I call BS. What is so terribly difficult about a skill set that only takes 120hrs to obtain? And correct me if I'm wrong, but isn't everything that's taught in basic covered again in paramedic, but in more depth? Assuming your paramedic program isn't horrible, you should have plenty of internship hours to get down "the basics".

I know plenty of excellent paramedics that never worked as a basic (myself included). Also realize that most basics will not get the opportunity to sit with a critical patient while fire extricates, because they'll be too tied up playing the dialysis derby. The "skills" a basic performs is not something that takes years (or a year) to master. If they do, you may want to find a new line of work. Don't get me wrong, I'm not hating on basics. I think they are an invaluable member of the team. But learning how to be a "good basic" is not a prerequisite to being a good paramedic.


----------



## Amber2313 (Apr 19, 2013)

*Hmm..*



PoeticInjustice said:


> Umm... So... I call BS. What is so terribly difficult about a skill set that only takes 120hrs to obtain? And correct me if I'm wrong, but isn't everything that's taught in basic covered again in paramedic, but in more depth? Assuming your paramedic program isn't horrible, you should have plenty of internship hours to get down "the basics".
> 
> I know plenty of excellent paramedics that never worked as a basic (myself included). Also realize that most basics will not get the opportunity to sit with a critical patient while fire extricates, because they'll be too tied up playing the dialysis derby. The "skills" a basic performs is not something that takes years (or a year) to master. If they do, you may want to find a new line of work. Don't get me wrong, I'm not hating on basics. I think they are an invaluable member of the team. But learning how to be a "good basic" is not a prerequisite to being a good paramedic.



Maybe that's an "in my area"-thing. It's something that's preached on around here. "You can't be a good medic without being a good basic first"  Idea being that BLS should always come before ALS. Every patient doesn't need drugs and electricity. Sometimes simply opening an airway does wonders -I'm sure you're aware. I didn't say basic skills are difficult. I did say I was in a great EMT and currently finishing a great paramedic program. I am a good EMT and take offense to your statement that I should find a new line of work because I believe in field experience. You can assess as many patients in basic class scenarios as you want, but nothing compares to assessing an actual patient. And that can only happen with experience. Sure, you get experience in medic class, but you should have experience before going in, too.


----------



## Amber2313 (Apr 19, 2013)

Ace 227 said:


> What are you talking about? Did you even read the original question?



Was replying to a reply to Christopher. My bad. Forgot to click "quote".


----------



## chaz90 (Apr 19, 2013)

I don't think that it's a requirement, but IMO it can help and does shorten the learning curve. I worked as a basic on a 911 truck for three years, and I feel it absolutely helped me in becoming a medic. Feeling comfortable with interviewing patients, running calls, and managing scenes is something I was grateful I didn't have to learn at the same time as the paramedic portion. This is by far the more valuable experience than the 120 hour class. YMMV. As you stated, I know many outstanding paramedics that weren't a basic first, but I've also seen some that I think may have benefited from the EMT experience before diving into the deep end. It all depends on the individual, and perhaps more importantly, what kind of experience the EMT is getting.


----------



## Ace 227 (Apr 19, 2013)

Amber2313 said:


> Was replying to a reply to Christopher. My bad. Forgot to click "quote".



My fault. Carry on.


----------



## STXmedic (Apr 19, 2013)

Amber2313 said:


> Maybe that's an "in my area"-thing. It's something that's preached on around here. "You can't be a good medic without being a good basic first"  Idea being that BLS should always come before ALS. Every patient doesn't need drugs and electricity. Sometimes simply opening an airway does wonders -I'm sure you're aware. I didn't say basic skills are difficult. I did say I was in a great EMT and currently finishing a great paramedic program. I am a good EMT and take offense to your statement that I should find a new line of work because I believe in field experience. You can assess as many patients in basic class scenarios as you want, but nothing compares to assessing an actual patient. And that can only happen with experience. Sure, you get experience in medic class, but you should have experience before going in, too.



Please show me in my post where I singled you out as needing to find a new line of work. Also, that statement was not targeting your belief for needing experience first. 



PoeticInjustice said:


> The "skills" a basic performs is not something that takes years (or a year) to master. If they do, you may want to find a new line of work.


Please, allow me to paraphrase: If it takes you years to become proficient in taking vitals and holding c-spine, prehospital medicine may not be for you. I stand by my original statement. Again, this is not directed at you, so there is no need to take offense.

I've heard that mentality preached down here as well. I now run circles around the medics that preached that BS to me.

If you can find somewhere to get good, quality experience (not dialysis derby and discharges all day) then by all means, especially if you feel uncomfortable with the idea of being in charge or making decisions. However, for most I don't see it necessary.


----------



## VFlutter (Apr 19, 2013)

Amber2313 said:


> I am a good EMT and take offense to your statement that I should find a new line of work because I believe in field experience.



If it takes a person a year of experience to become a competent EMT then something is seriously wrong. The EMT skill set is simple and requires very little education. What do you think is so difficult that a person should work years to master before going to paramedic school? 

Sure experience helps but I think you are overestimating by how much. If a paramedic class had half its students who worked previously as EMTs and half who did not I am willing to bet that they would all be at the same level upon graduation. Sure the previous EMTs may have an advantage in the beginning but that advantage will quickly fade as the class progresses. 

I never worked as a Nurse Assistant does that mean that I can not be a good Nurse? Arrogance aside, I am an exceptional RN and run circles around my fellow new grads most of whom were techs for years before going back to school. But N=1



PoeticInjustice said:


> I've heard that mentality preached down here as well. I now run circles around the medics that preached that BS to me.



I was already typing my reply before you responded. Don't want to steal your line h34r:


----------



## Amber2313 (Apr 19, 2013)

PoeticInjustice said:


> Please show me in my post where I singled you out as needing to find a new line of work. Also, that statement was targeting your belief for needing experience first.
> 
> 
> Please, allow me to paraphrase: If it takes you years to become proficient in taking vitals and holding c-spine, prehospital medicine may not be for you. I stand by my original statement. Again, this is not directed at you, so there is no need to take offense.
> ...



I'm glad you run circles around those medics. I know plenty of fantastic medics that believe that and can't believe anyone would argue it, honestly. Basics work all the 911 around here. For at least the 75mile radius I'm very familiar with. I am absolutely comfortable with being in charge and making decisions or I wouldn't be an EMT in the field, but that doesn't mean experience wasn't invaluable to me as a soon-to-be medic. That doesn't mean I am or was a bad EMT. I'm not. This discussions is going nowhere though, so I'll bid you a good night here.


----------



## Amber2313 (Apr 19, 2013)

Chase said:


> If it takes a person a year of experience to become a competent EMT then something is seriously wrong. The EMT skill set is simple and requires very little education. What do you think is so difficult that a person should work years to master before going to paramedic school?
> 
> Sure experience helps but I think you are overestimating by how much. If a paramedic class had half its students who worked previously as EMTs and half who did not I am willing to bet that they would all be at the same level upon graduation. Sure the previous EMTs may have an advantage in the beginning but that advantage will quickly fade as the class progresses.
> 
> ...



The least I've seen required (or recommended, I believe was how some worded it) to apply for a medic program is 1 year. The majority 2. Like I said, maybe it's my area. But I've never heard anyone preaching jumping from EMT straight to medic is better than getting field experience first. Once again, I never said anything basic is difficult. I never said someone needs field experience to master EMT skills. They're easy. We all know that. But you should get field experience because it's that -experience. Experience working calls, assessing actual patients, learning to lead efficiently, seeing all the crazy things we see. Can it be done in a year? Absolutely. But in my opinion (and to be honest, I've never been in a situation where this wasn't the majority opinion) I think you should spend some more time as a basic before jumping into medic. Agree or not, that's your opinion. This is mine.


----------



## JPINFV (Apr 19, 2013)

There is no benefit from EMT experience that can't, and shouldn't, be fixed with an appropriately long clinical and field internship period. 

As a medical student, I learned to do medicine assessments on my internal and family medicine rotations. I learned to do surgical assessments on my surgery rotation. I learned to do psychatric assessments on my psych rotation. I learned to do gyncological and obstetrical assessments on my OB/Gyn rotation. I learned how to do pediatric assessments on my pediatric rotation. 

How? By being pointed in the direction of a door with a patient in it (real patients) and told to go in there. If I ended up going back and forth 2 or 3 times between the attending physician and the patient's room, than so be it. However, by the end of those 4 week (full time... I spent 90 hours in the hospital my first week on surgery) I had no issue interviewing surgical patients, gyn patients, medicine patients, etc. 

Supervised experience working at the level you're training for >>>>>> experience at a lower level. It's also the same reason we don't have fluff courses like medical terminology. Don't know what that word that's being used 20 times in a lecture is? That's what Google is for. However, by constantly using appropriate terminology in an actual conversational setting, you learn it better. I know my Spanish has definitely improved over the past 10 months, despite it being almost a decade since my last Spanish course.


----------



## Amber2313 (Apr 19, 2013)

JPINFV said:


> There is no benefit from EMT experience that can't, and shouldn't, be fixed with an appropriately long clinical and field internship period.
> 
> As a medical student, I learned to do medicine assessments on my internal and family medicine rotations. I learned to do surgical assessments on my surgery rotation. I learned to do psychatric assessments on my psych rotation. I learned to do gyncological and obstetrical assessments on my OB/Gyn rotation. I learned how to do pediatric assessments on my pediatric rotation.
> 
> ...



Right. I've done my paramedic clinical hours in those parts of the hospital, too. And they're great. Yes, you get experience during medic class. Yes, yes, yes. Again. 
I still believe it is beneficial to the student to be proficient (including field experience) in those assessments before their paramedic program and add their new paramedic knowledge to their assessment during class.
You will never convince me that most people wouldn't benefit from field experience prior to their paramedic program. Why would having more experience NOT be a good thing? 
I still stand by my statement that you have to be a good basic before you can be a good medic. I never said you must have 1+ years' experience working as a good basic to be a good medic. I just said that you have to be a good basic. If you're a good basic the minute you pass cert tests, good for you. You should be a good basic. 
But being a good basic and having experience working as one are two different (though related) things.


----------



## STXmedic (Apr 19, 2013)

Ever thought of just being a good provider? A good provider doesn't have to break it down into basic and advanced. Know what the patient needs, and do it. Basic, intermediate, advanced, it doesn't matter. Never do I think "what basic skills do I need to apply to this patient. Okay, now what advanced skills." No. Understand what's going on, and fix it. A paramedic should (emphasis on should) be able to do this more effectively than an EMT. There is no need for basic and advanced.


----------



## JPINFV (Apr 19, 2013)

Amber2313 said:


> Right. I've done my paramedic clinical hours in those parts of the hospital, too. And they're great. Yes, you get experience during medic class. Yes, yes, yes. Again.



Were you doing appropriate assessments and presenting your findings and treatment plan to a physician or just watching other people work while doing tech chores like hooking up monitors and starting IVs? We had paramedic students on L&D. They weren't the ones doing the physical exams and presenting to the residents (since the hospital I rotated through had an OB/Gyn residency). 



> I still believe it is beneficial to the student to be proficient (including field experience) in those assessments before their paramedic program and add their new paramedic knowledge to their assessment during class.
> You will never convince me that most people wouldn't benefit from field experience prior to their paramedic program.



Do you have to be a CNA to become an RN? No.

Do you have to be a PA to become a physician? No.

Do you have to be a... I guess CNA... to become an RT? No. 

What's defective about paramedic education that you need experience as an EMT first? What makes EMS different? 


> Why would having more experience NOT be a good thing?


More time to learn bad habits. 

Being forced to unlearn thought patterns as expectations change and your fund of knowledge and scope of practice increases. 

Lost potential income.


----------



## Amber2313 (Apr 19, 2013)

PoeticInjustice said:


> Ever thought of just being a good provider? A good provider doesn't have to break it down into basic and advanced. Know what the patient needs, and do it. Basic, intermediate, advanced, it doesn't matter. Never do I think "what basic skills do I need to apply to this patient. Okay, now what advanced skills." No. Understand what's going on, and fix it. A paramedic should (emphasis on should) be able to do this more effectively than an EMT. There is no need for basic and advanced.




You're right. That is how it should be. No one said anything about thinking what basic interventions a patient may need vs. advanced ones. I know what you were trying to say. I think maybe you misunderstood what we were discussing.
On scene, a medic should absolutely just see what needs done and do it. I still believe "BLS before ALS" is a fair thought process, too. But when talking about things you can do to prepare yourself before jumping into a paramedic program, I think experience is the most important. Experience should (SHOULD) shape a person into a good basic if they make the most of it. And before you can be great at ALS skills/knowledge, you need to 100% understand the basics. That's all. 

Note: When I say "BLS before ALS", understand that I don't mean you should go on a call worrying about whether you're performing advanced interventions or basic. That's irrelevant at that point, so long as you're properly providing the care your patient needs. I mean you should go on a call and if BLS is sufficient in caring for your patient, that's what they get. There's no need to ALS them if BLS will appropriately meet their needs.


----------



## VFlutter (Apr 19, 2013)

Amber2313 said:


> And before you can be great at ALS skills/knowledge, you need to 100% understand the basics. That's all.



Except EMT class does not teach you the basics of ALS knowledge. It is so over simplified that is almost detrimental for future education. If you ever take an advanced college course you will realize that half the battle is trying to forget all the crap you thought you knew or were taught wrong.


----------



## Amber2313 (Apr 19, 2013)

JPINFV said:


> Were you doing appropriate assessments and presenting your findings and treatment plan to a physician or just watching other people work while doing tech chores like hooking up monitors and starting IVs? We had paramedic students on L&D. They weren't the ones doing the physical exams and presenting to the residents (since the hospital I rotated through had an OB/Gyn residency).



*Absolutely assessing my patients both in the hospital and on the ambulance during clinicals and performing the necessary interventions. In the ER, we did IV's, blood draws, 12-leads, meds, yes. We also had nurses to supervise. We would carry out everything they needed for a patient (within paramedic scope). They supervised assessment and would add things when necessary, we monitored the patient and reported our findings, We would discuss what we thought was going on and what our treatment would be and they would provide feedback and direction. We had the opportunity to speak with at least 2 ER Dr's on any shift about any patient any time we wanted to. (You'd be crazy not to take advantage of that, and we did.) Occasionally, a code would come in and docs would allow students to intubate, lead, work thel monitor, etc. 
In the OR, we performed supervised intubations, like any program.
In L&D, we sat in on c-sections, assessed and monitored newborns, and yes, delivered them, too.
In ICU, and peds, similar situation. We did everything within medic scope that needed done under direct supervision. *


> What's defective about paramedic education that you need experience as an EMT first? What makes EMS different?


 *Fair point, but I don't think it should be considered a negative thing to have experience first, by any means.*


> More time to learn bad habits.


 *So a medic with 1-year of experience is superior to a 20-year vet because they've had more time to develop bad habits?*


> Being forced to unlearn thought patterns as expectations change and your fund of knowledge and scope of practice increases.


*In every medic program in my area, being a basic is a prerequisite to taking the paramedic program. I believe this is true everywhere. Correct me if I'm wrong. Do you think, then, that it would be better to jump directly into paramedic rather than going through basic first? To avoid having to "unlearn thought patterns"? *


> Lost potential income *Amen.*.


----------



## Amber2313 (Apr 19, 2013)

Chase said:


> Except EMT class does not teach you the basics of ALS knowledge. It is so over simplified that is almost detrimental for future education. If you ever take an advanced college course you will realize that half the battle is trying to forget all the crap you thought you knew or were taught wrong.



I agree that EMT class is oversimplified, but it is still the foundation. Basics effectively serve a purpose using the information and skills presented to them in EMT class. I don't agree that EMT class doesn't teach the basics of ALS knowledge, however. Maybe you'd like to elaborate on that point and we can discuss it? Maybe we mean two different things? 
I have taken plenty of advanced college courses. I've never been in a situation where I had an issue learning new information because of poor prior instruction -and absolutely not in my EMS classroom experience. I had a fantastic basic instructor and equally fantastic paramedic instructors. Of course there were some things I had to adjust to, but I can't say that prior knowledge ever held me back.


----------



## JPINFV (Apr 19, 2013)

Amber2313 said:


> *
> In the OR, we performed supervised intubations, like any program.*


*
*
So no pre-op anesthesiology assessments? Discussing airway options, indications of a difficult airway, etc? 





> In L&D, we sat in on c-sections, assessed and monitored newborns, and yes, delivered them, too.


So no obstetrical assessments when the expecting mothers first showed up on L&D? 



> *So a medic with 1-year of experience is superior to a 20-year vet because they've had more time to develop bad habits?*



Apples and oranges. A medic with 1 year experience as a medic is superior to a medic with zero years experience as a medic and 1 year experience as an EMT. 

A medic with 20 years experience as a medic is going to be superior, to the medic with 19 years experience as a medic and 1 year experience as an EMT. 

Why is this argument never made with equal number of years experience? Why is it always the fresh out the gate medic being compared to the one with 20 years of EMS experience... with that experience never being broken down? 

*



			In every medic program in my area, being a basic is a prerequisite to taking the paramedic program. I believe this is true everywhere. Correct me if I'm wrong. Do you think, then, that it would be better to jump directly into paramedic rather than going through basic first? To avoid having to "unlearn thought patterns"?
		
Click to expand...

*
Provided paramedicine pulls their heads out of their rear ends and looks at something besides "how can I get through school the fastest", then yes. It's better to jump into paramedic directly. You don't need to think of "ALS" or "BLS" because it's all paramedicine. There's no "as an EMT we did ____" while failing to take into account the greater fund of knowledge, assessment scope, and treatment scope of paramedics when compared to EMTs. Things are different when all of a sudden that lights and sirens altered mental status patient becomes a patient who AMAed on scene after having his glucose repleted.


----------



## Amber2313 (Apr 19, 2013)

JPINFV said:


> [/B]
> So no pre-op anesthesiology assessments? Discussing airway options, indications of a difficult airway, etc?
> So no obstetrical assessments when the expecting mothers first showed up on L&D?


 Yes, we assessed those patients, too. Yes, we discussed airways and had plenty of access to anesthesiologists before, during, and after the actual intubation  should any questions arise outside of their instruction. We spent PLENTY of time with expecting mothers assessing, monitoring, and caring for them prior to delivery (and post-delivery, as well.) Of course we assessed our patients. OF COURSE we did. 



> Apples and oranges. A medic with 1 year experience as a medic is superior to a medic with zero years experience as a medic and 1 year experience as an EMT.
> 
> A medic with 20 years experience as a medic is going to be superior, to the medic with 19 years experience as a medic and 1 year experience as an EMT.
> 
> Why is this argument never made with equal number of years experience? Why is it always the fresh out the gate medic being compared to the one with 20 years of EMS experience... with that experience never being broken down?


I suppose I could have clarified. I meant a provider with one year of experience as a paramedic (post-EMT), then 20 years as a paramedic post-EMT. I was only applying your logic.
Although on a side note you seem to be of the opinion that someone with more total experience in EMS will be superior to someone of the same certification level or licensure, but less total experience.  Yes? Or did I just read too much into that? Out of curiosity.



> Provided paramedicine pulls their heads out of their rear ends and looks at something besides "how can I get through school the fastest", then yes. It's better to jump into paramedic directly. You don't need to think of "ALS" or "BLS" because it's all paramedicine. There's no "as an EMT we did ____" while failing to take into account the greater fund of knowledge, assessment scope, and treatment scope of paramedics when compared to EMTs. Things are different when all of a sudden that lights and sirens altered mental status patient becomes a patient who AMAed on scene after having his glucose repleted.


The "how can I get through medic school the fastest" mindset frustrates me to no end. That we can agree on.
Say we allowed jumping straight into paramedic - that would not eliminate basics (advanced, intermediate, whathaveyou). Or do you have other thoughts on the different levels in EMS, as well? And I ask that because there would still be a need to think BLS/ALS. Not in terms of "how do I treat this person? If I start an IV, I have to ALS them", but in terms of "can a basic handle this or do I need to care for this patient?" 
Again, I'll say that I don't agree that having EMT knowledge prior to paramedic hinders learning as a paramedic in any way, but for the sake of my curiosity and this discussion...


----------



## Christopher (Apr 19, 2013)

Amber2313 said:


> *So a medic with 1-year of experience is superior to a 20-year vet because they've had more time to develop bad habits?*



Since Kelly Grayson isn't here to steal his own thunder, I'll paraphrase his paraphrasing of a paragraph from somebody...

I'd much rather have the medic with 1 year of good experience than a veteran who repeated 1 year of experience 20 times.

The issue is not that you did well by spending extra time as an EMT. I'm a huge advocate for "basic" level procedures and the importance of knowledgable BLS providers (you'll find no bigger advocate for EMT's).

The issue is the assumption that this actually helps you be a good Paramedic.

I stand behind my statement that the only reason field experience as an EMT or EMT-I would help in a Paramedic program is if the program has a really poor didactic or clinical process.

If what you're actually saying is 1200 hours is not enough to be a "good" Paramedic, you'll find we're all on your side. Just don't focus so much on the field experience, your preceptors can round out whatever rough edges you still have left after school.

Hairless monkeys are taught to start IVs every day. Focus on education, not on On-the-Job-Training.


----------



## Amber2313 (Apr 19, 2013)

Christopher said:


> Since Kelly Grayson isn't here to steal his own thunder, I'll paraphrase his paraphrasing of a paragraph from somebody...
> 
> I'd much rather have the medic with 1 year of good experience than a veteran who repeated 1 year of experience 20 times.
> 
> ...



I've come to the conclusion through this thread that you're right. One year is probably good enough experience at a minimum, but I still don't believe you should jump straight into paramedic with no field experience as a basic first. \
One year is okay, I still think more than one would be beneficial, but not necessary. 
I suppose we'll have to agree to disagree.


----------



## Sublime (Apr 21, 2013)

Amber2313 said:


> I've come to the conclusion through this thread that you're right. One year is probably good enough experience at a minimum, but I still don't believe you should jump straight into paramedic with no field experience as a basic first. \
> One year is okay, I still think more than one would be beneficial, but not necessary.
> I suppose we'll have to agree to disagree.



Going to add myself to people on here that disagree with the "must have EMT-B experience prior to working as a medic". I am one of those who now works as a medic in a 911 system and had no 911 experience as a basic prior to working here. Granted I did work in a hospital, particularly a busy level 1 trauma center before coming here as a medic, but I know those who didn't have that experience either and do fine now. 

What do you think clinicals are for? Why does every 911 service have an FTO period? Why do 911 services (all the ones I know of) have a "secondary" medic position? 

Waiting for basic experience prior to going to medic school is a waste of time.


----------



## Ace 227 (Apr 25, 2013)

As a follow up, I just received my copy of Walraven's Basic Arrhythmias($6 well spent!) and I'm wondering if anyone has any advice for going through the text since they claim it to be a "self-teach" program. Thanks!


----------



## Sublime (Apr 25, 2013)

Ace 227 said:


> As a follow up, I just received my copy of Walraven's Basic Arrhythmias($6 well spent!) and I'm wondering if anyone has any advice for going through the text since they claim it to be a "self-teach" program. Thanks!



Dude that book breaks everything down and makes it really simple. Read it and look down at the answers to the missing spots in the text, then try to read over it until you don't need to look down at the answer. Then just study the hell out of those strips.


----------



## ethomas4 (Apr 30, 2013)

I agree that the sooner you start medic school the better. Coming from someone who was thrown into an ALS rig from day 1 and into an ER in a very busy, sometimes war like environment ( I was not in the military but worked in a country that was going through a drug war) EMT B experience here is generally not going to help much, it helps some but not much in my opinion. You have a good attitude. Keep pushing the limits and learn as much as you can as quick as you can. If you want really good experience go abroad for a bit, you will be able to touch as many patients as you want nad you will be forced to raise you intellectual and clinical level.


----------



## the_negro_puppy (Apr 30, 2013)

Watch bringing out the dead


----------



## Medic Tim (Apr 30, 2013)

the_negro_puppy said:


> Watch bringing out the dead



lol nice


----------



## sweetpete (Apr 30, 2013)

Merck said:


> All of the above are true however I would like to suggest that the best studying you can do is seeing patients and doing calls at the EMT level.  What you learn there - how to talk to people, touch them, run a call, deal with other rescue personnel, is invaluable.



I couldn't agree more with Merck's comment above! You'll learn plenty of "book medicine" in school. 

However, your interaction with your pts and fire crews and hospital staff is truly what will set you apart from other medic students. 

I've worked with medics who truly seemed to be near-geniuses, but their "bedside" manor was awful or they had no tact in dealing with the fire side or ER side of pt care. 

On the other hand, I've met medics who weren't necessarily brilliant, but they were so good at dealing and talking with people, you couldn't help but respect them. 

So, take advantage of the time in the back of the ambulance or at clinicals to really develop good pt contact qualities. 

And most important...ENJOY YOURSELF!!!

Take care,


----------



## STXmedic (Apr 30, 2013)

sweetpete said:


> You'll learn plenty of "book medicine" in school.



Is there a different kind of medicine that I'm not aware of? 



sweetpete said:


> On the other hand, I've met medics who weren't necessarily brilliant, but they were so good at dealing and talking with people, you couldn't help but respect them.



Maybe it's just me... but I'd rather have a competent medic who was a **** work on me, than an incompetent one that made me feel all warm and fuzzy inside.

Not saying bedside manner and good rapport are not important; it just seems like your priorities may be slightly askew...


----------



## sweetpete (Apr 30, 2013)

PoeticInjustice said:


> Is there a different kind of medicine that I'm not aware of?
> 
> Maybe it's just me... but I'd rather have a competent medic who was a **** work on me, than an incompetent one that made me feel all warm and fuzzy inside.
> 
> Not saying bedside manner and good rapport are not important; it just seems like your priorities may be slightly askew...



Agree to a point. Only pointing out that there's the stuff you learn in school (the "book" part) and then there's the stuff you learn on the street (like bedside manners and stuff).

Also, a pt deserves a medic who knows what they're doing. I agree with you. But, I'd prefer working with someone who knows tact than someone who is a genius but rubs everyone (including the pt) the wrong way. So, I don't really think my priorities are "askew" at all. :rofl:

Good points though!


----------



## TheLocalMedic (Apr 30, 2013)

Agreed!  You can be the best medic in the world, but if you're a **** then people will still complain about you.  You think any of the patients we treat know the difference between a STEMI and a stroke?  They don't, and they don't care either.  They just want someone to take care of them.  You gotta be nice, compassionate and professional if you're going to earn a patient's trust.  Then, even if you're a second rate hack, the patient doesn't even care because they feel like you are taking care of them and looking out for their well being.  

Not that that should give you license to actually be a hack...  Plus, ask anyone who's familiar with medical lawsuits what the common denominator is in most suits brought against providers.  Guaranteed it initially had less to do with any actual malpractice and more to do with the provider being a jerk...


----------



## chaz90 (Apr 30, 2013)

Personally, I'd rather have a competent jerk take care of me than a saint with the medical knowledge of a mushroom. I'd happily take the quality treatment with the occasional snide remark than have shoddy medicine thrust upon me. My opinion isn't reflected by most of our patients though. As LocalMedic said, most patients don't know the difference between a stroke or a STEMI and are just looking for a comfortable ride, kind words, and a hand to hold. In the ideal world, this shouldn't be even be a dilemma. The truly great providers know there's no need to be cruel to anyone and can practice good medicine while still being a decent human being.


----------



## MountainMedic (May 2, 2013)

Sorry you're getting all that "EMT-B first or straight to medic" debate crap. Like most arguments, it doesn't matter either way.

I was an EMT while in college for pre-med and got my medic while studying for the MCAT. The "book knowledge" is, IMHO, pretty pathetic. A good medic needs to know MUCH more than what they learn in their program. That noted:

1. Spend as much time as possible in a busy ER. You will see MANY more patients, and doctors and nurses will likely be able to explain much more about the patient's state than a field preceptor, and they'll have more time to do so. Focus on how the patient is worked up - a true history is way beyond "SAMPLE," and many medics never even really learn how to do a real exam. ABOVE ALL ELSE - go into medic school with the ability to take a great history and do a great exam, and then form logical differential diagnoses based on your findings. 
2. Hamilton and Trott "Emergency Medicine." Written for med students/residents doing their ER rotations. Very well organized. Contains lots of extraneous info, but teaches the "clinical decision-making" you will need.
3. Dubin for EKGs is pretty great. The more in depth texts (I used Grauer) put your findings in a better clinical context.
4. Lippincott Pharmacology. Don't focus on specifics, but learn the different classes of drugs and how they work. Learn to recognize suffixes (-lol for beta blockers, -pam for benzos, -pine for ACEIs, etc)


----------

