BLS Bashers

[EMT19053]

Hi everyone. I'm sure this thread will open up a huge hornet's nest, however, I just have to say that all the bashing of bls providers is getting a little old already. I have not been a member here for very long but have noticed that somebody is always turning the original posters question into a bls lack of competence issue. The people asking these different questions are just trying to better themselves and instead end up getting made out to be some kind of lackey because they chose to become an EMT-B. The way I see it is that you have to start at the bottom and work your way up. The system may be broken due to lack of education and all the other things the bashers will gladly point out, but for some people, becoming a basic may be the first step in a career or just someone that wants to volunteer for their local service to help in the community. I could go on but why beat a dead horse. I will leave it with this, those of you that think that an EMT-B has no place on this earth can all gather here on this thread (just for you) and do your bashing and all the other people that ASK questions to LEARN or ANSWER questions to TEACH can enjoy the rest of the threads on this forum for which it was so intended. No offense is intended here but if you are offended than may I suggest you take your complaints to the National Registry for I am sure they will revamp the entire system to the way you think it should be.

Hope for your sake they send a medic when you fall off that high horse because I'm sure a basic is not capable of doing c-spine correctly.

Thanks for the vote of incompetence.:sad:

 

[reaper]

You have my vote!

 

[Zanerd]

Hope for your sake they send a medic when you fall off that high horse because I'm sure a basic is not capable of doing c-spine correctly.

A Doc & PA told me a few months ago that some studies suggest that all our C spine precautions really aren't worth that much. AAAAHHH!

Oh, and being an EMT-B: Kudos

 

[JPINFV]

A Doc & PA told me a few months ago that some studies suggest that all our C spine precautions really aren't worth that much. AAAAHHH!

Oh, and being an EMT-B: Kudos

I can't find the study now, but there was a study comparing patient outcomes (controlled for injury severity) regarding trauma patients in a US city with a strong EMS system (and, by virtue near 100% spinal immbolization) and a major city in another country (I want to say India, but don't quote me on that) with virtually no prehospital care. There wasn't any difference between outcomes in terms of paralysis.

There's also the mass validation of prehospital selective spinal immobilization rules (such as the Canadian C-spine rule).

Then there's this review article (I'll be happy to post the entire thing upon requrest).

Abstract

The acute management of potential spinal injuries in trauma patients is undergoing radical reassessment. Until recently, it was mandatory that nearly all trauma patients be immobilized with a back board, hard cervical collar, head restraints, and body strapping until the spine could be cleared radiologically. This practice is still recommended by many references. It is now clear that this policy subjects most patients to expensive, painful, and potentially harmful treatment for little, if any, benefit. Low-risk patients can be safely cleared clinically, even by individuals who are not physicians. Patients at high risk for spinal instability should be removed from the hard surface to avoid tissue ischemia. Understanding the rationale for these changes requires knowledge of mechanisms of injury, physiology, and biomechanics as they apply to spinal injuries.
...
Conclusions

Like much of medicine, spinal immobilization is a concept that became the standard of care based on common sense rather than research. There are convincing biomechanical arguments and some preliminary research that suggest that spinal immobilization may not be necessary, even in many trauma patients with unstable injuries. Until further research clarifies which injuries, if any, truly benefit from immobilization, immobilization will remain the standard practice. The clinician's goal should be to apply it only to those patients predicted to be at risk for unstable injury and to do as little harm from immobilization as possible.

-Spinal immobilization in trauma patients: is it really necessary?
Current Opinion in Critical Care. 8(6):566-570, December 2002.
Hauswald, Mark MD *+; Braude, Darren MD, MPH +++

 

[daedalus]

OP, you are absolutely correct! While EMTs are not educated properly, its not our fault. We HAVE to start at EMT. Where I will go to medic school, you must have 6 months of 911 as an EMT under your belt to be accepted into the program.

And I agree with you. There are plenty of posts here on topics such as BLS using this device or that assessment tool or this medication. My solution is to increase education by strengthening our representative organizations, than demanding a formal national education standard far above what we have now.


If you study at home and keep learning there is no reason why a BLS provider cannot make a difference. There are people here who I suspect would rather staff and ambulance with a CNA just to bash EMTs. It shouldnt be like that.

 

[JPINFV]

As to the OP, I think you're confusing critising a system that considers someone with slighty more education than a boy scout with first aid and high school biology a medical provider and bashing the people who make up that level. Saying that the EMT-B level is pathetic and should be done away with as a primary provider because of x, y, z is not the same as saying that EMT-Bs are pathetic.

Part of the way change occurs, though, is by educating members of a profession on the issues (EMS tends to be the least politically active of the 3 big emergency services (fire suppression and law enforcement)), as well as the public who thinks that everyone on an ambulance is a paramedic that can do all sorts of procedures.

As far as "The way I see it is that you have to start at the bottom and work your way up," are you refering to the entire 'work as a basic before medic' and 'BLS before ALS' mantra? If so, why is it that you don't see it in other fields? Why are physicians not required to be PAs before going to medical school? Why are RNs not required to be LVNs before nursing school? Why is it that in other health care fields patient care is patient care and not divided in to ALS care or BLS care?

 

[JPINFV]

If you study at home and keep learning there is no reason why a BLS provider cannot make a difference. There are people here who I suspect would rather staff and ambulance with a CNA just to bash EMTs. It shouldnt be like that.

How about we leave that topic in it's own thread? I suspect, after all, that some people would rather staff nursing homes and hospitals with EMT-Bs just to bash CNAs. It shouldn't be like that.

 

[BossyCow]

Hey, lets face it... there are some real bone-head EMTs out there. There are also some really annoying EMT-Ps, Nurses, Docs, MFRs, Firefighters, Private Ambulances, Grocery Clerks, Accountants, Mobile Home Manufacturers, Mechanics, Daycare Providers, (...insert profession of choice....)

A solid work ethic is going to mean that whatever job you do, you will do it well. A crap work ethic will make a lazy EMT, an arrogant medic, a sloppy nurse or a crummy janitor.

It is important to get to a national standardization of education. It is important that we are all accountable for what we do and how we do it. Within that framework, there's a lot of room for some to shine and others to crawl around in the dark.

The key in discussion though, is to remember, that because a certain level of certification, or a particular model of care doesn't work well in your area, doesn't mean that those who do it are morons, or that the model should be tossed out entirely. Global statements like... "all EMTs are......" or "all systems should....." are going to be inaccurate based on the wide variety of demographics, funding procedures and geographic locations of the systems. There are a lot of different types of communities in which we respond. Not all systems are going to work in all areas.

Remember, your personal experience is just that.... subjective and anecdotal, both sides of any opinion can quote studies to support their position. I would like to see more of what works for you in your system and in your area instead of who, in your opinion is to blame for what doesn't work.

 

[daedalus]

I apologise for sparking that up. And I do agree, it is not a standard practise to work as a PA before MD or LVN before RN. I have no choice but to work with the system right now, I live in ventura county and work in LA county. Both UCLA and Ventura College require background as an employed EMT. Its unfortunate but to look at the positive, it keeps paramedic schools from admitting people who just want to try EMS out. Instead all of us will have prior work exp.

 

[Jon]

...As far as "The way I see it is that you have to start at the bottom and work your way up," are you refering to the entire 'work as a basic before medic' and 'BLS before ALS' mantra? If so, why is it that you don't see it in other fields? Why are physicians not required to be PAs before going to medical school? Why are RNs not required to be LVNs before nursing school? Why is it that in other health care fields patient care is patient care and not divided in to ALS care or BLS care?

Physicians spend 1+ year as a medical student, and 4+ years as a resident in clinicals. To an extent, they do function as a "lower level" provider for some of that time, and a PA in the ED is similar to a 3rd or 4th year resident - at the least, they still have to have an attending sign off on whatever they do. Additionally, you wouldn't expect a med student to preform cardaic surgery on you... (s)he has to learn the basics about the body, learn more about the heart, and then spend lots of time working in surgery before (s)he gets to crack your chest and bypass your clogged vessels.

RN's spend 2 years of school, balancing school and lots of clinical hours. The RN's do, to an extent, start with CNA-level skills of basic patient moving, bathing, etc, and then advance past that.

A plumber may go to school to be a plumber... but they they usually work as an apprentice for a while, before they can say they are a "master plumber"

It is unfortunate that, although most EMT programs spend lots of time on "practical education" there is little or no EMT clinical time, and exposure to patients. Even programs that have clinical time... it is only a shift or two in an ED or an ambulance.

Many volunteer companies, at least in my area, have an extensive "precepting" program for new EMT-B's, that must be completed before they are cut loose to work on an ambulance without supervision.

Unfortunately, most employers only give the EMT-B a shift or two to get to learn the area and their job before cutting them loose. To an extent, it is a cost-saving measure... how do you justify spending 2-4 weeks (at least) teaching an EMT to be an EMT? This is also why, around here, most EMT's need to be experienced before they can get a full-time job in 911 EMS, and most EMT's working full-time 911 rigs are decent providers, becuase they have extensive experience.

***I'm not trying to argue the paid/volunteer thing... at all... so PLEASE don't go there!***

Paramedics are a little better.... in the paramedic program I went through, we did LOTS of clinical hours working in the ED, as a "Free" ED Tech, occasionally getting to do things that were inside the medic scope of practice, but not the ED tech's (IV/IM medications, electrical therapy, etc). Then the last 2-3 months were a "field internship" where the student spend 6-8 weeks, 40 hours a week, on an ALS unit with an experienced EMT-P... and it was sink or swim. (I sank... big time). The field was a different environment from the classroom... and getting 70% right wasn't good enough.

I agree that EMT-B isn't a tough certification to get... but it is difficult to be a good EMT. I try to be a good EMT. The state requires that I get at least 24 hours of con-ed every 3 years, and EMT-P's need 18 a year. I had 60+ hours on my last recertification. I enjoy learning new and different things, and I enjoy talking with medics, Docs, and RN's about my patients, so as to learn more.

I'm currently working on starting Nursing School this fall... I'm on the waiting list for an open seat. I'm taking Anatomy and Physiology, and learning a lot.

 

[JPINFV]

Physicians spend 1+ year as a medical student, and 4+ years as a resident in clinicals. To an extent, they do function as a "lower level" provider for some of that time, and a PA in the ED is similar to a 3rd or 4th year resident - at the least, they still have to have an attending sign off on whatever they do. Additionally, you wouldn't expect a med student to preform cardaic surgery on you... (s)he has to learn the basics about the body, learn more about the heart, and then spend lots of time working in surgery before (s)he gets to crack your chest and bypass your clogged vessels.

To be accurate, it's 4 years as a medical student (2 years of lectures, 2 years of clinical rotations. The lines do blur a bit with the interviewing and physical exam courses though) and 1 year of residency (internship) to become licensed as a physician. Total residency length, though, depends on the specality and may or may not include the intern year. Emergency medicine is 3-4 years depending on the program (some include the intern year (PGY* 1-3 and 1-4), some don't (PGY 2-4). I'll also bet that any academic center will have their medical students participate in cardiac surgery as well.

Yes, the point is taken that when you're looking at at least 7 (generally after a 4 year degree) years of medical education and training prior to being allowed to function completely by yourself (ignoring moonlighting, but that's not completely solo either) is slightly different than functioning after a 1000 class hour paramedic program

That said, shouldn't that be an argument for increasing course time? Get all of that anatomy, physiology, chemistry, and so forth done and ensuring plenty of clinical experience before releasing providers to the streets at any level.

*PGY=Post Graduate Year

 

[Ridryder911]

Hi everyone. I'm sure this thread will open up a huge hornet's nest, however, I just have to say that all the bashing of bls providers is getting a little old already. I have not been a member here for very long but have noticed that somebody is always turning the original posters question into a bls lack of competence issue. The people asking these different questions are just trying to better themselves and instead end up getting made out to be some kind of lackey because they chose to become an EMT-B. The way I see it is that you have to start at the bottom and work your way up. The system may be broken due to lack of education and all the other things the bashers will gladly point out, but for some people, becoming a basic may be the first step in a career or just someone that wants to volunteer for their local service to help in the community. I could go on but why beat a dead horse. I will leave it with this, those of you that think that an EMT-B has no place on this earth can all gather here on this thread (just for you) and do your bashing and all the other people that ASK questions to LEARN or ANSWER questions to TEACH can enjoy the rest of the threads on this forum for which it was so intended. No offense is intended here but if you are offended than may I suggest you take your complaints to the National Registry for I am sure they will revamp the entire system to the way you think it should be.

Hope for your sake they send a medic when you fall off that high horse because I'm sure a basic is not capable of doing c-spine correctly.

Thanks for the vote of incompetence.:sad:

Okay, let get real. Many post on here acclaiming that they want "to be educated" but in reality, when one attempts to; the whining begins as "they are "bashing us!"

Can one imagine going to a Nursing Forum and reading that nurses aides did not like the way they were tested, the way they did treatment only to criticized by the RN or they were not allowed to do this or that.. waaagh..waaah! In turn, they would be answered quickly and discreetly; if they did not like the position they were in, then go to school and change it. Period.

Should I even take the complaints and whining about being bashed seriously? Especially when one does not even know who is even responsible for EMS standards, or what constitutes the EMS profession ? For example when one professes "I suggest you take your complaints to the National Registry for I am sure they will revamp the entire system to the way you think it should be". Again another prime example if one really knew EMS Systems they would know that NREMT does not the authority nor ever have anything to do with the "system" as in per standards or EMS development. They only test on the standards presented by the authority of EMS; which is the National Highway Traffic Safety Administration (NHTSA) formerly known as D.O.T. This is taught in every Basic EMT text, yet most appearantly did not read the first chapter. Really even when discussing the general basics of the profession many do not even know or aware if they are certified or licensed, what test they should take, yet then I am to take them seriously?

Many acclaim they want to be educated: that is only if they do not have to go school, attend any additional classes, or even pick up a book and read it. For example what I have described about EMS standards is printed in the first chapter in every Basic EMT text. It is most do NOT really read the text or investigate anything further past the Basic EMT text. Yet, you want my respect and empathy and to acclaim you should be treated as an equal?

In fact instead of taking the obligation of going the full extent, we have placed substitute levels with numerous titles, again all patterned off the gold standard of the Paramedic. Still you want me to treat you as an equal?

I am sure many would be surprised that the only Basics at my service prefer to work with me. I teach and allow them to gather experience. I do know what Basics are capable of doing. As an EMS Educator for over 25 years, I am quite aware of the education level of each of the EMS providers. As well, I am very quite aware of their general knowledge of medicine, which the Basic EMT have is usually very little to none. Yet, they want and demand to be treated as an equal, when in reality they are not. Even not realizing that there is an hierarchy in medicine, demonstrates the lack of knowledge of medicine. Even suggesting that there is such a label for patient care as BLS or ALS is asinine when in reality patient care is not divided into segments except for in EMS, did you ever consider why?

As one that has been in the medical field, I will assure you I have been "put in my place" more than once. There is a place and time, and appropriateness on when to complain. If I was to complain about not being able to perform surgery to a surgeon, he would tell me to go to school then. If I was to brag about holding C-spine (really how hard is it to hold a head?) or that I applied oxygen, or even started an IV on the patient, I am assured he/she would inform me "what I am wanting a medal? That was my job, I was supposed to do that!"

Now, back to the original post. I was always taught before asking a question one should attempt to seek and find the answer. This is for multiple reasons, first one usually remember the answer longer, second : while investigating the answer I will usually will find a ton of information. Also the method of knowing how and where to find answers to your question is really the educational point.

I am definitely NOT against asking question but for example how many posts are made at upon in regards on testing before they even contacted their local area? You want more education in regards to EMS systems, patient care, even pathophysiology yet you have not even attempted to seek the answer for yourself?

I attempt to answer the questions as appropriately and to the best I can, as well I will correct myself if found to be wrong. Alike anyone else, I can make mistakes too. I can say that my opinions and answers are based either upon facts I have read, or experience. That I attempt to look each situation at more than one angle or at least recognize there is such.

You again say you want to be respected for your level. I do that. Unfortunately, your expectation may not be the same or accurate as what your level really is. I describe that the Basic is just more than the Advanced First Aid because it is just that. It is not bashing, it is what it is. Sorry, that is what the curriculum is developed upon and is alike, you did not cause such, nor did I. But the facts are facts. It is not bashing, just because it is not what you like to hear. It does not make you less professional, but part of being professional is knowing one's limitations and restrictions. Again, back to the nursing analogy, if one does not like their current level, then change it and go back to school.

I just ask the same in return. Do not be offended when the question has been answered, or an opinion is different than what you want or expect. There are many career EMT's and Paramedics that are just as upset that EMT's are whining about their situation, when in reality they could and can change it.

I personally have never said the Basic EMT has no place. What I do say is that they have no place on EMS units as the primary care giver. That their place is what the current level is; that as a first responder. That patients deserve to be evaluated by a Paramedic with ALS capabilities. Will there be communities that will never deliver such, yes; but those are not the norm.

I highly suggest before arguing and attempt to defend against a higher level of education, license, or experience and then only being dissatisfied by the responses given, one should investigate first, be able to cite references (able to defend their answers). If not, quit whining about being picked on.

R/r 911

 

[Jon]

To be accurate, it's 4 years as a medical student (2 years of lectures, 2 years of clinical rotations. The lines do blur a bit with the interviewing and physical exam courses though) and 1 year of residency (internship) to become licensed as a physician. Total residency length, though, depends on the specality and may or may not include the intern year. Emergency medicine is 3-4 years depending on the program (some include the intern year (PGY* 1-3 and 1-4), some don't (PGY 2-4). I'll also bet that any academic center will have their medical students participate in cardiac surgery as well.

Yes, the point is taken that when you're looking at at least 7 (generally after a 4 year degree) years of medical education and training prior to being allowed to function completely by yourself (ignoring moonlighting, but that's not completely solo either) is slightly different than functioning after a 1000 class hour paramedic program

That said, shouldn't that be an argument for increasing course time? Get all of that anatomy, physiology, chemistry, and so forth done and ensuring plenty of clinical experience before releasing providers to the streets at any level.

*PGY=Post Graduate Year

JPINFV... what I was trying to say was 1+ year in clinicals during medical school - a friend of mine is in Medical School... and, from what I understand from him, the clinical rotations don't really get going strong until midway through the third year.

My cardiac surgery comment wasn't do they participate in... it was, do they RUN the surgery... and the answer is NO.


I do think that there needs to be a clinical/precepting element to the EMT program, significantly more than there is now. On the same token, there are so many places that have EMT as part of the job requirements, when the position only needs someone with MFR level skills (Security, Police, etc).

Okay, let get real. Many post on here acclaiming that they want "to be educated" but in reality, when one attempts to; the whining begins as "they are "bashing us!"

Can one imagine going to a Nursing Forum and reading that nurses aides did not like the way they were tested, the way they did treatment only to criticized by the RN or they were not allowed to do this or that.. waaagh..waaah! In turn, they would be answered quickly and discreetly; if they did not like the position they were in, then go to school and change it. Period.
<SNIP>

Rid... I assume a Nursing forum is dedicated to RN's and perhaps LPN's. CNA's aren't nurses... they are Certified Nursing Assistants - so that argument doesn't quite work when compared with this site.

This isn't a paramedic forum.. it is an EMS forum, that looks to represent the whole spectrum of prehospital provider, from the MFR or student, all the way through an EMS Physician (I don't think we've got one of them *that admits to it* but it would be cool). As a Paramedic AND RN, you are on the top end of the forum's education spectrum, However, most Paramedic's still have EMT - "Emergency Medical Technician" in their certification title (an exception being the LP - Licensed Paramedic).

<SNIP>
I am sure many would be surprised that the only Basics at my service prefer to work with me. I teach and allow them to gather experience. I do know what Basics are capable of doing. As an EMS Educator for over 25 years, I am quite aware of the education level of each of the EMS providers. As well, I am very quite aware of their general knowledge of medicine, which the Basic EMT have is usually very little to none. Yet, they want and demand to be treated as an equal, when in reality they are not. Even not realizing that there is an hierarchy in medicine, demonstrates the lack of knowledge of medicine. Even suggesting that there is such a label for patient care as BLS or ALS is asinine when in reality patient care is not divided into segments except for in EMS, did you ever consider why?

As one that has been in the medical field, I will assure you I have been "put in my place" more than once. There is a place and time, and appropriateness on when to complain. If I was to complain about not being able to perform surgery to a surgeon, he would tell me to go to school then. If I was to brag about holding C-spine (really how hard is it to hold a head?) or that I applied oxygen, or even started an IV on the patient, I am assured he/she would inform me "what I am wanting a medal? That was my job, I was supposed to do that!"

<SNIP>

You again say you want to be respected for your level. I do that. Unfortunately, your expectation may not be the same or accurate as what your level really is. I describe that the Basic is just more than the Advanced First Aid because it is just that. It is not bashing, it is what it is. Sorry, that is what the curriculum is developed upon and is alike, you did not cause such, nor did I. But the facts are facts. It is not bashing, just because it is not what you like to hear. It does not make you less professional, but part of being professional is knowing one's limitations and restrictions. Again, back to the nursing analogy, if one does not like their current level, then change it and go back to school.
<SNIP>

The "Advanced First Aid" courses I can find are between 8-24 hours. The PA State First Responder class is 40 hours minimum, the EMT-B course in PA is 130-140 hours minimum, and the EMT-P course, from what I can find, requires 240+ classroom and 240+ clinical hours... most programs go WAY beyond that. So the Advanced First Aid class is significantly shorter than my EMT class was, and I can do more. I can assist with nitro. I can assist and administer Epi-Pens... and I can assist with albuterol inhalers. Most importantly, I've met the minimum requirements to staff a BLS ambulance as the primary care provider in my state. Someone with Advanced First Aid or First Responder can't do that... the most they can do is drive and/or assist an EMT in patient care.


I agree that "EMS" is the care we should provide... But our systems have leveled out as being BLS+ALS(sometimes) but the system hasn't ever been 100% ALS... and that is an unrealistic SHORT-TERM goal. In the long term, it is a GREAT goal. But we won't be there for years. If you want to change this... you need to spend time with legislators to make it happen.

Further... I acknowledge that there were ALS providers in the 1970's... but from what I understood, they were similar to the EMT-I's of today... they knew the HOW, but not the WHY of prehospital treatment. That is partially why on-line medical command was much more heavily used then, and now, we almost never call command to ask permission to do something. As the years have gone on, the Paramedic's training has grown significantly.

In PA, a First Responder can do almost all the same things that an EMT can... except administer an epi-pen that is carried ON THE AMBULANCE. A First Responder cannot serve as the primary EMS provider for an ambulance transport, and they cannot serve as the BLS side of an ALS ambulance... it must be EMT and EMT-P (or 2 EMT-P's). Really, many EMT-B's are doing stuff a First Responder could do... so why not advance the "basic" level of training... or get rid of First Responder and call the First Responders EMT-B's... and then have a different intermediary level? Like an EMT-I or IV? Give them some significantly increased training and clinical time, and give them some additional skills?

 

[mikie]

The "Advanced First Aid" courses I can find are between 8-24 hours. The PA State First Responder class is 40 hours minimum, the EMT-B course in PA is 130-140 hours minimum, and the EMT-P course, from what I can find, requires 240+ classroom and 240+ clinical hours... most programs go WAY beyond that. So the Advanced First Aid class is significantly shorter than my EMT class was, and I can do more. I can assist with nitro. I can assist and administer Epi-Pens... and I can assist with albuterol inhalers. Most importantly, I've met the minimum requirements to staff a BLS ambulance as the primary care provider in my state. Someone with Advanced First Aid or First Responder can't do that... the most they can do is drive and/or assist an EMT in patient care.

I must agree. Advanced First Aid might have taught how to control the bleeding, or splint an extremity, but the EMT learns far more about patient care (ie- assessment, some physiology, etc).

And as for the assisting with nitro/epi, etc, around here, a Basic can administer nitro, epi-pen, albuterol (NS Aerosol), aspirin, glucose, and even IM glucagon (per written protocols)- prescribed or not. . First Aid courses don't teach that.

There are EMTs that do and don't take it seriously. It seems on this forum there are some EXTREMELY dedicated basics (Jon, whom I quoted) that take their own efforts, beyond the required CEUs. And like an earlier poster stated, there are good and bad EMTs- I believe its a personal choice though: are they just doing it for the job, or are they taking it as a serious profession and perhaps one day continue -to perhaps even an MD.

-just my few thoughts.

 

[Ridryder911]

If we increased the "Basic" into more advanced then they would no longer be basic, would they? I agree the Basic curriculum is a joke. Although, they did increase the number of hours, they decreased amount that was taught. Increased things to be taught but decreased the content to be taught.

One usually cannot find ARC Advanced First Aid Courses due to many have went to occupational or to the MFR courses. In theory they were about 120 hours in length (some had additional training in oxygen therapy, AED, etc).
Again, what the last revisions went back to for comparison of.

In all actuality, CNA and the EMT are usually equivalent to each other in training length. (CNA 75 class hours and the CNA requires 100 hours of clinical time, EMT 120-150 classroom and anywhere from 0 to 36 hours of clinical). In regards to assisting to administration of Epi pens, med.'s, NTG (the common laymen can do that as well, without any training) Heck, we even teach that to people in CPR training. Really, the Basic Level should be the minimal of one year, alike the LPN.

In regards to ALS in the 70's; you are right, we did not know much about the reason or etiology of why we are doing. That is why many of us changed it in the '80's with degree Paramedics.

In regards to ALS becoming a norm, why not? Even the 70's television show "Emergency" they provided more care than many EMS still does today. This is progress?

As well, attempting to change thing. I spent 8 hours with my legislation at the State Capitol to change things yesterday. How about you?
(bills I worked upon http://ok-emscoalition.org/legislation).

I am the type to put my money where my mouth is. I don't whine about things, rather I take action. Unfortunately, the majority of EMT's are all lip service, than rather to make a change. If they devoted as much time taking action than attempting to get those L/S on their personal vehicles, or whine about things, then things would change.


R/r 911

 

[mikie]

In all actuality, CNA and the EMT are usually equivalent to each other in training length. (CNA 75 class hours and the CNA requires 100 hours of clinical time, EMT 120-150 classroom and anywhere from 0 to 36 hours of clinical). In regards to assisting to administration of Epi pens, med.'s, NTG (the common laymen can do that as well, without any training) Heck, we even teach that to people in CPR training. Really, the Basic Level should be the minimal of one year, alike the LPN.

48 hours here!

I do feel that more clinical time should be established for Basics (I was happy with the 48, but anything LESS than 10 just doesn't cut it, heck, I think it should be at least 20+)

 

[skyemt]

case in point: at this very moment, a thread is going on, the proponents of which are arguing that a basic need only know ABC's.

yes, there is a small percentage of basics who will exceed the minimum standard, be more skilled.

but for the majority... well, let's just call a spade a spade...

if every basic on this site was polled as to whom they would want to respond to their own family emergency, you know what the answer is...

if you are still not sure, just peruse the other threads... if you can spell ABC you are a fine basic... Yikes!

 

[LucidResq]

Although I believe it's obvious that in general the EMT-B course with no further education is pretty pathetic, I do feel that some medics do make personal attacks or subtle snubs towards basics. "Levelism", if you will, definitely exists.

Yes, some EMTs will be basics forever, try to run code in their POVs as much as possible, provide awful care, and never make an effort to learn much of anything beyond what they were taught in their 120 hour class. They will never try to improve the industry or become involved in the political or educational aspects of EMS.

Is this because they are EMT-Bs or because they are morons? It is because they are morons and always will be morons. Believe it or not there are paramedics that operate on this level as well, except they have drugs which makes them even scarier. There are doctors, scientists, lawyers, architects, etc that despite the alphabet soup after their names and their big degrees, are still unsavory morons.

I think that personal attacks based on someone's status as a basic are relatively rare, but I definitely feel a condescending air and a tone of disrespect on a regular basis, occasionally on this forum.

Just try to remember that many, many EMT-Bs consider themselves a work in progress and will pursue education passionately throughout their career.

If this wasn't true there wouldn't be any paramedics, because the last time I checked you have to be a basic before you even apply for p-school.

 

[certguy]

This is an EMS forum . That means all of us , from students to medics . As pointed out before , systems vary in different areas , but the common thread is , we're all here to save lives . Many areas don't have the financial means to support full time paid ALS . This is a fact , so what value is it to put down people who are providing services in these areas ? You want them to be proactive and make change , but it all boils down to cash . If it's just not there , the system won't change . I'm with the OP , this is well past getting real old . Medics , if you want to share knowledge , do so without being condecending and help us basics learn WITHOUT THE PUTDOWNS !!!! As I said before , we're all family , let's be one that's not divided .


IF YOU WANT TO BE A TRUE PROFFESIONAL , BE A LEADER AND A TEACHER , NOT A CRITICIZER !!!!!!!!!!

 

[mikie]

This is kind of an aside, but...

I think a lot of 'good' EMTs are on this forum and active here. If they didn't care about what their passion in EMS, they wouldn't be here to argue/defend/teach/etc it. That is the making of a good EMT.