CA EMT changes?

[JPINFV]

negative, California is currently looking to change our state regulations. they want to bring EMT up the the current national standard, and scope of practice. they are also trying to add the AEMT level as we currently do not license intermediates in this state. they would like to add the AEMT level at its current national scope and standards. there is some opposition to this because some areas let their paramedics do barely more than an AEMT does, and this will cause them to have to increase their paramedic scope or revert to AEMT, the tax payers will not be happy that they have been getting ripped off for so long.

I think this is more tweaking than anything else. Technically we went to EMT-AEMT-Paramedic under the EMT2010 project last July.

 

[Akulahawk]

To clarify: when I last checked (before the AEMT testing) there were only about 200 EMT-II personnel in the entire state. Most counties were/are EMT/Paramedic only. Only one or two still were certifying the II's as of about 7 or 8 years ago.

I think the AEMT is a good idea. I also like the idea of critical care and advanced practice paramedics. Care must be taken to NOT fall into the same trap that Oregon did... at one time they had around 6 or so different types of paramedics all with differing scope of practices that didn't build on each other like the system they have in place now.

 

[JPINFV]

how about making AEMT a stepping stone requirement for EMT-P.

I haven't heard any good reason for time at any level before paramedic besides as a band aid for poor education standards.

right now i work in a dual medic configuration, there is no reason i cannot work with an AEMT to provide over site and guidance for when they promote (career ladder...) or they can be the first responders. I can tell you the firemedics i work with, however good they are almost never get past IV, NTG, EPI, LIDO before I get there, would our tax dollars be better spent sending them to 1/2 the schooling? this is an idea that WOULD be effected positively by the regional model, one which I had not previously thought about.

I think that's another valid use. If a level gets trained in just the psychomotor skills with the caveat that they can only do so under direct observation/orders from a paramedic, then that's fine with me. Sort of like a nurse/physician relationship.

while I agree that an AA would be nice, I can tell you that a paramedic AA means nothing. I have one and am still going back to city college to get my transfer classes out of the way. all that was required for my aa-ems was HS algebra, english, art, history. there where no requirements for bio, micro-bio, pharm, patho, anatomy, physiology (which I got on my own thankyou). if we want to make a paramedic AA we need to standardize it to at least be equal to a BIO degree (or nursing...). how about we make a requirement for a 4 year health science/bio degree to be a CCP/APP if that ever passes and then encourage it down the line.

At the very least, it's a start. ...and yea, I'm with ya on making AAP/CCP a complete undergrad. Really, though, at this point I'd try anything that might shoehorn more education into EMS.

I feel that is exactly what the regional system would be working to get rid of. make all services in one region the same SOP/protocol. while a medical director is required to order supplys, provide a license to work under (kinda, not really. I work under the county medical director). right now I cannot tell you what my agency medical director does, he has no office, I have seen him once and he signed my 4 hour CE cert after the first hour and left, he did tell us to stay for 3 more hours and practice intubating though... I feel as though with the proper resources a regional office through the use of nurse educators:unsure:, PCCs, senior paramedics, ect could provide much more consistent oversight and training.

I think the big thing here is just getting rid of the absentee landlords. I know that there already is some variations between services inside the LEMSAs. The problem is when the medical director is just a signature and nothing more.

wow, jp we are having an actual conversation. I like it.

Discussions? On a discussion board? It's more likely than you think!

 

[socalmedic]

yes, there was only one county utilizing the EMT-II. it was up in the "coastal valleys ems" there have only been 600 emt-ii licensed in the state and only 200 currently. knowing how our great state loves to screw things up. kinda like how not a single county has used the state protocols which where developed in an attempt to get everyone on the same page. here are the 1996 California uniform treatment protocols. nothing they are trying to do is new, just new people at the helm trying to reinvent to wheel and call it something else.

 

[socalmedic]

I haven't heard any good reason for time at any level before paramedic besides as a band aid for poor education standards.

I have worked with people who where EMTs prior to medic school and those who where not EMTs prior to medic school. there is a BIG difference in the first year or two. this is where our 1080 hours is longer than just paper. with my 4 years experience prior to medic school I was able to see almost every patient presentation that I would learn about in medic school. I could use these experience to visualize and learn. an inexperienced provider has to wait till their 480 hours of field time to try to cram in all those missing assessments and presentations. I feel that there should be a minimum experiences level prior to medic school.

 

[JPINFV]

Yet physicians don't work as PAs for years nor do RNs have to work as CNAs. If the problem is cramming in the assessments into 480 hours, why not expand the 480 hours?

What makes EMS intrinsically different from other health care fields?

 

[Ramathorn90]

while I agree that an AA would be nice, I can tell you that a paramedic AA means nothing. I have one and am still going back to city college to get my transfer classes out of the way. all that was required for my aa-ems was HS algebra, english, art, history. there where no requirements for bio, micro-bio, pharm, patho, anatomy, physiology (which I got on my own thankyou). if we want to make a paramedic AA we need to standardize it to at least be equal to a BIO degree (or nursing...). how about we make a requirement for a 4 year health science/bio degree to be a CCP/APP if that ever passes and then encourage it down the line.

I agree with JP.

We wont be able to advance as a white collar job until we break away from the post-secondary training that we receive now. Whether it has an immediate effect on medics now or not, making the jump towards an AA program will definitely help us out as a profession in the long run. It seems that in the 21st century the public tends to favor and trust people who have degrees. Until we all make the push for requiring an AA/AS for paramedicine, we'll forever remain blue collar workers.

 

[Akulahawk]

Yet physicians don't work as PAs for years nor do RNs have to work as CNAs. If the problem is cramming in the assessments into 480 hours, why not expand the 480 hours?

What makes EMS intrinsically different from other health care fields?

That's exactly what makes EMS different from other healthcare fields. We fight tooth and nail to keep that field time to just twenty 24 hour shifts. Do you think you can learn to be a PA or a Physician or an RN in 640 hours internship time?

The main reason I want someone entering medic school with some experience is that when they get to their field time, I don't want them having to learn the basic skills, advanced skills , and the critical thinking skills all at the same time. Their time as a Basic solidifies their basic skills. Their clinical time should get their "advanced skills" up to par. Then they just need the guided time to mesh all that together without having to worry about the skills. Personally, I think that if we're going to propose taking someone from zero to provider in one course, the clinical and field times need to be increased to about double or triple the current amount.

 

[socalmedic]

the new paramedic iniatives are up, cant post links from here but go to emsa.ca.gov then click public comment on the left. the info will be up till the end of september. looks like they are actually serious about adding CC-P and APP. although they will still be up to the LEMSA to administer and make protocols...

 

[JPINFV]

http://www.emsa.ca.gov/about/Public_Comment.asp

The APP is a new category that would be useful on
air ambulance flight crews because of the expansion of the scope of
practice.

Sigh. I thought they wanted to introduce a real APP, not a glorified CCT medic.


Edit: I love how, for a time, apparently EKGs were out of the scope of practice for paramedics in California. Opps.

Edit 2: CCT nurses are basically out of a job for the most part with the CCP option. The APP really is just OTC meds, surgical crics, and RSI. I honestly fail to see how California EMSA would be able to get their panties in a bunch if a medical director already was trying to have his/her medics do alternative destinations. However, at least it's codified now.