ALS for BLS

[Jon]

Originally posted by rescuecpt+Feb 10 2005, 10:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (rescuecpt @ Feb 10 2005, 10:31 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Feb 10 2005, 10:11 PM
If I ever have an "EMT" like that as a partner on a MICU when I'm the ALS provider, they will be off the truck and back with an FTO on a BLS truck so fast.....

He has been sent to the "EMT breaker" shift... and his replacement on our shift, a probie with no EMT experience surpassed him within the first month! She's a smart girl and a quick learner... she gets to do all sorts of fun stuff on the ambulance. :lol: [/b][/quote]
I have no problem training those willing to learn

It is those who MUST know better, but act like they don't I have a problem with.


Jon

PS - What is an EMT-Breaker Shift - that the single BLS truck 12a-12p that does the ED take-homes up 3flights of steps?????

 

[ffemt8978]

Originally posted by MedicStudentJon@Feb 10 2005, 08:34 PM

It is those who MUST know better, but act like they don't I have a problem with.

That statement can and should be applied in both directions.

I, as a BLS and then ILS provider, have seen plenty of ALS units make mistakes. I have sometimes mentioned it to them at the appropriate time and in an appropriate manner and usually have had my head handed to me. :angry:

I may not have all the cool letters after my name, but I do pay attention to what I see and tend to remember it. I guess some people just can't stand having their mistakes pointed out by somebody "junior" to them.

On the other side of this, I personally used to have a problem with one of our EMT's. I would try very hard not to let this person within 10 feet of my patient. One day, our EMS Administrator pulled me aside and reminded me that I used to be junior once and that I need to stop riding this person and start teaching them. Since that day, this EMT's skills have improved dramatically, although I can't take credit for it.

My point is that even if you are ALS, ILS or just BLS, you should be able to take constructive criticism from both directions. That's what makes you a better EMS provider.

Thus endeth the sermon.

 

[PArescueEMT]

EMT's do BLS, Parajokes do ALS. that is how things should always start. it doesn't matter if the EMT has experience on an ALS rig or not.

BTW... how's your back doing Erika?

 

[rescuecpt]

Originally posted by PArescueEMT@Feb 11 2005, 02:47 AM
BTW... how's your back doing Erika?

Eh, I'm alive. Thanks for asking!

The EMT Breaker shift consists of a bunch of 20 year members (two of whom are/were chiefs) who don't take any shizzle. They are "evaluating" this member... he has not finished his probie requirements and after 1 year you can get booted for that... They are making sure we don't want to keep him around before they kick him out.

 

[Summit]

Originally posted by MedicStudentJon+Feb 10 2005, 10:11 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Feb 10 2005, 10:11 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Summit@Feb 10 2005, 01:16 AM
RESCUECPT

I agree with coloradoemt.

Around here basics with training start IVs and you only have a select few you trust to spike a bag?

Yeah - Around here we have basics who call themselves "Paramedic Assistants" who THINK they can intubate, start IV's, and play PARAGOD with a 8-hour con-ed class under their belt.

On the other side of the coin, I recognize that there are quite a few ALS-skills that any semi-trained monkey (No Offense, Chimpie) could preform flawlessly - hooking up a monitor, preforming an accu-check (Yeah - DOH says medics are only allowed to do that), and spiking a bag.

From an ALS standpoint, I would want to be sure that the person spiking the bag / hooking up the monitor, etc. knew what they were doing, watched them closely the first few times, and always double-check them, but I would expect any GOOD BLS provider on a MICU to be able to preform these skills, set up the IV start stuff and set up nebs and code meds for me. [/b][/quote]
Never heard of a "paramedic assistants" around here but in this state EMT-Bs can take a ~40 hour course solely on IV therapy that has a clinical requirement. I don't think that is undertraining. The skill improves by experience. I know a lot of paramedics who very much like that fact that there are EMT-B/IVs because they are bored with IV starts after 10 years and because on serious calls they can arrive to a critical patient who already has a line ready for paramagic drugs.

As far as semitrained monkeys, I was told that they have trained lab monkeys to put in ET tubes Seriously! You could have a paramonkey in your jump bag! OTOH i dont think this is a basic skill nor should be, but combitubes on the other hand I think should be a basic skill as others have said in the combitube thread (and they are for me at my job).

 

[Jon]

Originally posted by Summit@Feb 11 2005, 11:39 AM
Never heard of a "paramedic assistants" around here but in this state EMT-Bs can take a ~40 hour course solely on IV therapy that has a clinical requirement. I don't think that is undertraining. The skill improves by experience. I know a lot of paramedics who very much like that fact that there are EMT-B/IVs because they are bored with IV starts after 10 years and because on serious calls they can arrive to a critical patient who already has a line ready for paramagic drugs.

That is fine by me. I just disagree with the attitude that "I can do lines and push drugs and tube if the medic is watching me" after they take an 8 hour course.

as i said, IV's can be dangerous, but are also easy......

Jon

 

[lilbeddoe]

where did you buy your orange rocker paramedic assisstant??

 

[lilbeddoe]

I am oficially a "Paramedic Assistant" I even have the orange rocker to prove it. I got it from using common sense too. Work a code with a pre-hospital MD, he calls DOH, I get rockers and cert in the mail.


cheated me out of con-ed

where did you get the orange rocker?? itook the class and dont know where to get one

 

[MJordan2121]

I was lucky to learn in my Basic class how to place 3/4/12 leads, as well as setting up IV bags, learning the equipment, preparing neubulizers and med preparation. My class was taught by a teacher who also works as a medic and has been one for the last 20 years. I found that my class was very beneficial. I look forward to starting my paramedic classes in January. I feel that I am going into my paramedic classes a step ahead.

 

[VentMedic]

I was lucky to learn in my Basic class how to place 3/4/12 leads, as well as setting up IV bags, learning the equipment, preparing neubulizers and med preparation. My class was taught by a teacher who also works as a medic and has been one for the last 20 years. I found that my class was very beneficial. I look forward to starting my paramedic classes in January. I feel that I am going into my paramedic classes a step ahead.

Was this a normal part of the course curriculum or did the instructor just show this to you? How long was the course? If it was still the 110 hours, what was skimmed over to include the extras? Were you tested on the material for your certification exam?

 

[BossyCow]

Here there is a two day class available that teaches EMT-Bs how to assist a paramedic during a code. Called ACLS for EMT-Bs. Doesn't make us medics, doesn't certify us to perform ALS but provides a working knowledge of how a code is run, why and how to help.

It may be 'trained monkey' skills, but wouldn't you rather have the trained monkey in the back of the rig with you than one untrained and flinging poo?

 

[MJordan2121]

Yeah it was the normal cirriculum. Our total class hours were over 160 hours. We went into pretty good depth during our course. I had a great instructor. I am looking forward to the paramedic cirriculum next semester and hope to advance my career to the next level.

 

[KEVD18]

its pretty simple stuff. ive worked with medics that had every view point on the matter. expected me to do these thing without being asked, when they asked, never just stay out of my way. ive had medics that expected me to be able to start lines, prepare meds etc.

it all comes down to your working environment. if you've been working with the same medic(s) for quite some time, they trust you to do more. if they dont know you, they dont trust you.

 

[VentMedic]

Yeah it was the normal cirriculum. Our total class hours were over 160 hours. We went into pretty good depth during our course. I had a great instructor. I am looking forward to the paramedic cirriculum next semester and hope to advance my career to the next level.

Your class is slightly longer than average but still not long enough for good depth in any area of medicine.

Too often an instructor, especially those with "experience", will get off the curriculum because they themselves may find it boring and also believe that a lot of book learnin' is useless. They end up telling their own field stories and showing "cool stuff" when they actually should be teaching the Basic stuff. Thus, you get people in the field who can brag about hanging an IV bag or putting stickies on someone's chest but still don't know proper assessment or basic level A&P.

While the knowing how to assist advanced levels is important, it should come after one has mastered skills and knowledge at their own level. And yes, hearing scenarios is a great way to keep the class interesting, often the case in point may be something that shows extraordinary events and may not even be a practical situation or even a little enhanced by the person telling his/her story. There are too many instructors in this profession that have little education themselves in teaching methods and may use the classroom for their own benefit. This is one of the few professions that one can graduate from a medic mill on Friday and be teaching a class by the next Friday.

 

[Jon]

where did you get the orange rocker?? itook the class and dont know where to get one

The PA classic "rocker" was simply a solid orange fabric patch above the EMT patch. You will occasionally see an "old head" with the rocker over their patch on their winter coat, or similar.

As far as I know... the state hasn't issued that certification in a long time (if ever) and the rockers aren't common anymore.

PA DOES NOT have an ALS Assistant certification. Some places will run an "assisting ALS" course and get con-ed for it... but it is VERY limited.