Critical Care Paramedic: Should this exist?

[unleashedfury]

Yeah, there is no question that paramedics can learn critical care well enough to work alone (see Merck's post above).

The question is, why go to the time and expense to implement that extensive training when there are other professionals (RN's and RRT's) who already have the knowledge and experience to do CCT?

I don't care what letters you have behind your name, if you have the experience to do the job, knock yourself out. The problem is, it takes a lot of experience to do CCT. If you have a way to gain that experience, great. But I just don't see the rationale for developing a lengthy, expensive training program for paramedics when there are others who can already do the job without the lengthy, expensive training program.

True, that.


I think the two biggest yielding factors is 1. If you want to lengthen the paramedic program, and limit the "I'm just here for the card" its a matter of AAS minimum and we need to be focusing much stronger on the skills we already have rather than a minimal education of those skills.

As far as CCP that's a specialty course if you have the capabilities to maintain your level of skill and knowledge in such a environment sure go ahead. But how many paramedics work for fire depts. Municpal based EMS systems and 911 only systems that will never need or use this education? Allow the ones who want to be CCP's become one, and ones that will use the skills on a IFT truck or in a hospital obtain this certification.

 

[mycrofft]

Hip-shots:
1. Rid, I agree mostly. There are strong societal pulls to continue the current model. (Remember how in the Eighties "HMO"'s would be villages of proactive health, and all they basically are now is medical conglomerates with advanced case management office facilities?). Hospitals will fight to remain the center of care, and employers will strive to keep jobs at tech levels and techs "illiterate, barefoot and pregnant" or whatever the educational equivalent is. And risk management will want to bring care under the physical plant of the hospital since they have no control over "The Outside". (e.g., places which customarily d/c field IV's and restart their own "just because"…just because if a field start gets infected they get hit for something they didn't start).

2. To all: the EMT-Ambulance and EMT-Paramedic model I think is still viable if the mission is to quickly spread trained and systematic EMS through the land, including rural and maybe frontier/wilderness areas. Tweaking it up requires new extension (paradigms?) of the community care and support infrastructure ($$$$$$$$$$$$$$$ and recruiting) which we have failed so far to meet.*

3. I agree with knowing about various classes of patients so we can meet their needs generically, but remember anytime you get more skills you have to not only take your biennial CEU's, but actually use them, under supervision, successfully.


*I remember when hospitals had their own helicopters, mobile ICU's, (and in one case almost got a converted Army riverine BOAT) as intake modes for high acuity patients….then quit it because those are money losing patients.ALso they die and skew your stats down.

 

[MonkeyArrow]

I agree with all of the posters before me as to the ineffectiveness of this model for the current EMS system as some people are just not willing to work to train to the level needed to actually be called a CCT unit and others, as much as they read their textbooks and practice on the manikins, will not get the field time to be properly exposed to these scenarios to keep their skills on real pts fresh. Similar to the whole rural paramedic not getting high intubation success rates and some suggesting removing it from the scope, but I digress…

What I think is of interest in the CCT model is whether CCT should become a part of the 911 response matrix. For example, any time a peds call comes in, roll a CCT unit Code 3 to the scene or anytime a code comes in or whatever, make them the new ALS providers. House them in the fire stations or in the parking lots or whatever and allow them to be available to respond to emergency calls as well as the usual IFTs. If you don't agree with the above model, do you see our system headed down that path? With the widespread scope reductions or already dismal, insulting scopes (EMT-Bs in some states) etc., do you see the current system headed that way where eventually, the paramedics aren't getting proficient in the ALS skills and they get replaced with CCT rigs.

 

[18G]

There is definitely a need for critical care paramedics. I don't think there is much dispute in that especially for inter-facility transport. Where I work, the Paramedic is the primary critical care provider. Rarely, do we require an RN. It would be nice if there was a standard curriculum for critical care paramedics. The UMBC course is very elementary and offers nothing more than an introduction to inter-facility transport for the 911 Paramedic. Anyone who has done IFT will already know the majority of the info in the UMBC course.

 

[MGretz70]

I think there is a need for Critical Care Paramedics. I don't think it should be added to the curriculum of Paramedic class though as we have enough to learn, remember and practice already with adding all of critical care transport stuff thrown in on top of that. It's my personal belief that you should have a minimum of 5 years of being on a busy service before attempting Critical Care Curriculium and start getting involved .