12 week accelerated Paramedic Program!!??

[chaz90]

For instance i wonder when paramedics will be putting serious ill patients into chemical comas? Is it the future?

Umm...Are we still being serious? Since this seems to be an honest question, I'll give it an honest answer. We do this right now. I won't make any argument about where RSI is or isn't necessary prehospitally, but this very instant, a paramedic from a 12 week program with no previous medical or basic science background could be preparing to paralyze someone (hopefully post sedation) and take control of their airway. This is probably as much a failure of the individual agencies and the overly lax medical director as the patch mill that produced this medic, but is this where you want to see EMS? Adding more procedures with less education will lead to us rightfully being ostracized from the medical community and tossed back into the shadows of being taxi drivers with lights and sirens. Skills don't make the provider. Again, no one is arguing that the technical skills can be taught in 12 weeks. The reasoning behind choosing to perform an intervention or not is the single most important part of being any kind of competent healthcare provider, and it is something you seem to be glossing over.

 

[Pond Life]

Hi Pondlife
So SW ambulance don't hire the IHCD FPOS

Hello Jimmy,

FPOS - First Person On Scene (First Aider).

Our commercial division teach these and a number of other courses for other agencies.
We also put our unpaid Community Responders an FPOS courses.

This is a 3 day course and doesn't reflect in content or duration an EMT B/I course that the US have. FPOS is a first aid course.

Community Responders have to sign a contract with SWAST to ensure they comply with patient confidentiality, policies and protocols.
But they are not employed ie paid. They are civilians or existing non-ambulance agencies who help us out in their own time free of charge.

They are not EMTs by any stretch of the imagination.

 

[Pond Life]

Perhaps you could enlighten me as to what else you do other than assess,treat and transport?

I do understand that different paramedic systems have different transport rates. I can only give you insight into my system I'm afraid.

In my county paramedics have a treat and release rate of over 65%. That means that 65% of all calls we go to we do not transport. We either treat on scene or refer to other health care professionals.

We do this by an expanded scope of practice within our service and where appropriate additional education. Those with additional education have a treat and release rate of between 80% and 91%. Mine is 86%.

Due to the increased pressure on UK EDs the government are trying very hard to give us more powers and freedoms to treat patients in the community.

This is nothing new - The Red River Project published in JEMS in the early 90s were allowing paramedics to assess, X-ray, treat and release muscular skeletal injuries. They also did wound care and suturing. It was from here that the UK ECP programme got the concept of expanded scope paramedicine.

 

[jimmylesaint]

Umm...Are we still being serious? Since this seems to be an honest question, I'll give it an honest answer. We do this right now.
Really, you put patients into chemical comas on scene? I did not know this-is this just USA, or UK to?

Pondlife-thankyou for the response, i unfortunately have been led to believe that otherwise. However i know it is a matter of time before all are degree trained-lots being done in Hertford.
When i say assess,treat and transport i obviously understand there are more subheadings under these. Perhaps there is a need to compartmentalise paramedics into a 4yr doctor of trauma? Are paramedics being asked to do more above their remit so hospitals/doctors can avoid big law suits-this is common in USA i believe(lawsuits)Does this medicolegal implication have a bearing on education level/practical level.
I think i am looking at this from to biased a perspective as opposed to you guys in the US. My view is from a 3rd world country-where expectations and finances are limited. Training is in short supply and the extent to which a paramedic may operate is strictly adhered to unless the medical director says otherwise- in short the scope of practice is smaller- whereby a 12 week course would be ample.
If you guys are using chemical comas- i certainly wanna be on the next course in Jan if possible.
Won't be long before "beam me up Scotty" handheld MRI/doppler/mass spectrometer machines are used.

 

[Pond Life]

Very interesting question here.

I think you are right. Paramedics (certainly in the UK) are being asked to go well beyond their level of education. As a profession we think this is dangerous but the implementation of practice is by workshops and one day courses. There is a sense of advancement of clinical care in a creep style education programme. Sort of like - this year we will teach all paramedics about tissue viability. It then enters our norma practice.

I am concerned about this as a lot of what we are being taught doesn't have the clinical oversight and safety netting that should be in place. With the exception of the ECPs and PPs who have this from the get go.

As far as I am aware all UK paramedics are degree level nowadays (exception being existing paramedics who have grand parenting rights). To become an ECP, PP or CCP you need to take a minimum of a BSc Hons or more commonly nowadays an MSc programme often in Medical School. Hertfordshire is one among a dozen or so institutions.

The ambulance service legally supports all activities that paramedics et al apply. Problem is that unlike the USA we are not protocol driven. We have a scope which is dependent upon personal education, and we can practice up to that level as long as it is countersigned by the medical director. Sometimes this leaves the practitioner very vulnerable.
Conscious sedation being an example of one of the recent remits.

I spend a lot of time in third world countries as a paramedic and it can be frustrating the limitations of clinical care I can implement. But I realise I must adhere to the local laws and in the back of my mind I know I can come back to a decent system - albeit falling apart.

 

[VFlutter]

I think a 12 week paramedic program is overkill. Personally, I think I could get by with a 4 week. But I am totally awesome and on another level h34r:

 

[Pond Life]

hahaha nice one :rofl:

 

[DrankTheKoolaid]

I think a 12 week paramedic program is overkill. Personally, I think I could get by with a 4 week. But I am totally awesome and on another level h34r:

***bow***

We're not worthy!

 

[jimmylesaint]

I think a 12 week paramedic program is overkill. Personally, I think I could get by with a 4 week. But I am totally awesome and on another level

So that's how the Premium+Members roll on this forum? Hmm.
Perhaps you are Michael Kearney?Graduate at 10yrs old!:wacko:

 

[jimmylesaint]

Too many to count. Most of who I work with, actually. Just not as used to seeing it here, I guess (so adamantly at least).

Perhaps STXmedic- your attitude is too abrasive and bullying to anyone else who doesn't share your opinion(whether your opinion is right or wrong...i don't think you really care.Just so long as it is your opinion.) They wouldn't want to continue on this forum.

 

[VFlutter]

I think a 12 week paramedic program is overkill. Personally, I think I could get by with a 4 week. But I am totally awesome and on another level

So that's how the Premium+Members roll on this forum? Hmm.
Perhaps you are Michael Kearney?Graduate at 10yrs old!:wacko:

No not all Premium+ Members, just me.

Perhaps STXmedic- your attitude is too abrasive and bullying to anyone else who doesn't share your opinion(whether your opinion is right or wrong...i don't think you really care.Just so long as it is your opinion.) They wouldn't want to continue on this forum.

I like STXmedic and usually agree with him. That's MY opinion.

 

[jimmylesaint]

I like STXmedic and usually agree with him. That's MY opinion.
Figures.ANd you're sticking with your opinion even though it's wrong. Right?
Besides with your one line only repertoire i'd hope the patients under your care were unconscious.

 

[NomadicMedic]

Folks, this conversation stays civil, or I'm coming back with my moderator hat on.

 

[Carlos Danger]

Umm...Are we still being serious? Since this seems to be an honest question, I'll give it an honest answer. We do this right now.
Really, you put patients into chemical comas on scene? I did not know this-is this just USA, or UK to?

I don't know what you mean by "chemical coma".

If you mean sedation and neuromuscular blockade (paralysis) for the purposes of airway management, then yes, that is very commonly done in the US.

If you mean a barbiturate-induced coma to suppress the EEG with the intention of reducing cerebral oxygen demand to near zero until intracranial pathology resolves, then no, that doesn't happen in the field.

 

[jimmylesaint]

Apologies, i think both views are now at the point of the :deadhorse:

 

[jimmylesaint]

I don't know what you mean by "chemical coma".

If you mean a barbiturate-induced coma to suppress the EEG with the intention of reducing cerebral oxygen demand to near zero until intracranial pathology resolves, then no, that doesn't happen in the field.

Hi Halothane the above is what i meant-thank you for clarifying.

 

[Medic Tim]

I like STXmedic and usually agree with him. That's MY opinion.
Figures.ANd you're sticking with your opinion even though it's wrong. Right?
Besides with your one line only repertoire i'd hope the patients under your care were unconscious.

Do you have any experience in US EMS? If not it can be difficult to understand the system. I work/have worked in it and I still have trouble understanding it.

what is EMS like in your area? provider levels/names? time it takes to complete? do they work on their own or under a doctor etc.

Without at least a base line knowledge of where each is at, it can be hard to compare the systems. If they are very different, it can be hard to comprehend why as it doesn't fit into your personal experiences.

If in your country a person is expected to just scoop and run with little to no intervention, than a 12 week program is probably overkill and you would have no need to learn advanced skills as you would not be performing them. If it is a system with a large amount of responsibility and you are expected to be a clinician and not a technician, then a 12 week program is no where near appropriate.

As it stands now in the US. The scope of practice and skill set (standards of care if you will) IMO far outweighs the base formal education that is provided. Hell my 3 years of formal EMS education is not enough for my current skillset.

 

[STXmedic]

Perhaps STXmedic- your attitude is too abrasive and bullying to anyone else who doesn't share your opinion(whether your opinion is right or wrong...i don't think you really care.Just so long as it is your opinion.) They wouldn't want to continue on this forum.

Quite the opposite, actually- I'm very open to new information and new points of view. I didn't finish paramedic school and instantly have the views and beliefs I have today. However, to sway me takes a strong argument, ideally backed up with some kind of evidence.

Unfortunately, your point of view is not new to me, and shared by many of the outstanding paramedics that I work with. These paramedics, who believe that their job is as simple as you describe, treat it as such. I wouldn't trust these paramedics to touch my dog. Not because they feel they are a taxi, but because they don't take the time to continue their education, or even care to remember the basics. These medics make mistakes on a daily basis, and it makes me cringe.

Strangely enough, the paramedics I work with that take their job seriously and realize that "assess and treat" actually takes some knowledge to be proficient at, and paramedics that consider themselves more than a glorified taxi are more often good or exceptional medics.

But you're right, I really dont care. I'm sure I can be abrasive at times- oh well. If you don't like it, nobody is twisting your arm to argue with me. I'm usually pretty laid back and enjoy educating in a non-hostile way. However, I'm not going to go back and rehash very valid points, only for you to shoot them down blindly because they don't align with your preconceived notions. Abrasive? Maybe. Bullying? If you say so. Do I care? Not a chance.

 

[jimmylesaint]

It appears you are doing exactly what you are accusing others of doing
You're right i am- i suppose i wasn't expecting that kind of myopic response in a forum of this standing.
Thankyou for reading through my posts before just responding in a set preconceived way.I notice how you picked up on a number of things about me- a good skill.
You are right there are huge differences between countries and even cultures-for some of you who have worked in Africa. It is not uncommon for the people/family to change their mind and not want Grandad suffering from an MI to go to hospital in the ambulance. They then carefully lift him out and carry him to the local witchdoctor.
The fact here is a 12 week course would be the same as saving easily 600 people out of a 1000!

 

[VFlutter]

Besides with your one line only repertoire i'd hope the patients under your care were unconscious.

Ya most of them are vented and sedated. Lucky them.