A call to educators.

[medic417]

Here our paramedics are EMERGENCY medical technicians.

[/QUOTE]

Seems that is no longer to be the case. Under the new Paramedics are .............Paramedics. EMT's are basics. Perhaps as the change takes place the public will finally begin to understand the difference in possible care based on the title with the responders name.

 

[AnthonyM83]

Should the rest of the US be held back because CA doesn't utilize EMTs r medics to the full capacity?

I think your clarification went off on a tangent. I was explaining why it would be hard to get students to pay for certification programs with significantly harder and higher standards that took longer and were more expensive. I did that because it's the thing that's stopping many of the suggestions in your original post from happening. - Identifying problem -

If you don't have those problems in all other areas, then identify whatever is slowing it from happening there. There was no suggestion of using local problems as an excuse to slow progress in other areas if feasible. Though I imagine there are problems to identify in other regions, also.

 

[Veneficus]

I think your clarification went off on a tangent. I was explaining why it would be hard to get students to pay for certification programs with significantly harder and higher standards that took longer and were more expensive. I did that because it's the thing that's stopping many of the suggestions in your original post from happening. - Identifying problem -

If you don't have those problems in all other areas, then identify whatever is slowing it from happening there. There was no suggestion of using local problems as an excuse to slow progress in other areas if feasible. Though I imagine there are problems to identify in other regions, also.

yes, tangent, sorry, i was thinking of too many replies to multiple messages at the same time and I think I botched them all.

 

[dudemanguy]

Seems that is no longer to be the case. Under the new Paramedics are .............Paramedics. EMT's are basics. Perhaps as the change takes place the public will finally begin to understand the difference in possible care based on the title with the responders name.[/QUOTE]

Yes Paramedics in the US have significantly more training and responsibility than EMT-Bs or Intermediates. I'm not arguing that.

 

[Veneficus]

tangents

Ok,

I used the local CA explanation, which I did not articulate very well to point out the that because a small area (Any Area. but I felt lke picking on CA, you know, they seem to have issues with just about everything from herbs to fiscal responsibility, and they do really give a bad impression of EMS systems to me) does not utilize the universal education of a provider, does not make obtaining that education less valuable except for that area.

In a private reply I pointed out, but would like to here, that a flawed measurement is not better than no measurement. I gave the example of earlier scientific practice of using skull volume to quantify mental ability.


Somewhere, I mentioned that the US cannot continue with EMS running as it has so far economically.

Please forgive me as I mixed all these replies up I think.

Anyway this whole thread is a tangent now, because the purpose was to ask educations why we don't require our students to buy higher level textbooks for classes now and settle for lesser quality ones that cost the same or more?

If you could buy an astin martin (cause i can spell that) for the same price as a ford, why on earth would you settle for the ford?

 

[MrBrown]

Here our paramedics are EMERGENCY medical technicians. They are trained for that role

Until you stop focusing on the emergent patient and getting them to the hospital quickly nothing will change.

Why? Because you do not need an overly labarious education to shock somebody in VF, give some salbutamol to an asthmatic or infuse some fluid into a trauma patient and drive them to the hospital.

The US systems does not seem interested in stepping out of the "public safety" realm of lights and sirens and "saving" sick patients by transporting them to the hospital quickly. The rest of the world is developing models of care which expand the education and options for Paramedics away from the minority of ambulance work towards better assessment, referral and disposition of patients.

Until the attitude of the US changes away from "emergencies" to dealing with the other 90% of the workload in an effective, meaningful way there will be little need for increased education and supporting materials.

Why? Because the patient will always end up at the hospital.

 

[mycrofft]

MrBrown. after that now I can go cook supper in peace.

Yes. Yes. Yes.*
Quit with the "Ricky Rescue" mindset. Maybe we need to set NHTSA to work again, give them three years in private, then they announce the new universal standards, undermining of which gets your DOT and other federal monies cut off.
1. Two degrees, period. No more little additions and optional proficiencies. EMT-B wants to intubate, get a certificate, but don't create a new variety of EMT to justify it. Want to do IV's and intubate? Get your
EMT-P. Want to crack chests and suture? Get your MD, PA, or FNP.
2. Create a big primary care and indigent care sector and put people into it, don't keyhole them through ED's trying to discourage them. The first time a patient dies in your ER who was there longer than twenty minutes without care, the ED and facility administrators should be arrested, booked and arraigned for manslaughter, or third degree murder. The grand jury cracks open your books like a watermelon at a summer picnic. And if your county gets topheavy with plastic surgeons and podiatrists but deficient in OB/GYN and primary care docs, they can start doing mandatory work in clinics or they can move themselves out.
3. Mandate pay and benefits for EMS workers which can attract and hold professionals.
4. Medical transport companies, small, impoverished or rural areas...make exceptions, but no BS. If plastic surgeons start flocking to Juneau Alaska and they builld a new luxury resort and longer runway, kick out the jams and drop the hammer.

And about EMS district protocols etc? In most areas, heck YES they are not based on science. They are based on what others are doing so they are "reasonable" in "the community", and arrived at through a political process including undue influence by current shareholders.

Is my fifteen minutes up yet?

*Well, almost yes. Prompt transport makes sense if it is needed. We need to quit trying to do "Single Combat With Death" in someone's living room if transport time versus urgency of care can't be reconciled by care in route or a definitive treatment allowing the time factor to recede and the urgency to abate.