Do most EMTs get their EMTP

[46Young]

I take issue with this post - how are they not being much use to the patient? And what is wrong with wanted to be in the action? :unsure:

As an EMT, your hand are tied in many respects. I'll argue that most of our pts don't really need EMS. The ones that do, will usually need ALS care. Other than lifting and carrying those that are too weak or otherwise unable to do it themselves, the basic isn't really doing much that can't be done by the lay person. Most pts call 911 for things that don't require an ambulance such as sick calls, fever, a laceration that is controllable,. A car ride to the urgent care is all that's needed. I'll give you psych calls, true traumatic neck/back pain, EDP's, etc. Orthopedic injuries, due to the potential need for pain management, require a paramedic's assessment rather than a basic's. The balance of 911 calls that have legitimate need for EMS are the diff breathers, CPR's, the unconscious, cardiac conditions, stat ep, etc. EMT's aren't of much benefit for these types of calls.

EMT's can be of benefit to their pts, but with the vast majority of 911 calls I ran as a basic on an EMT/EMT ambulance for three years in the NYC 911 system, the outcome would have been no different had they taken themselves to the hospital instead. On numerous occasions, the family followed behind us with their car. A good number of ALS patients wouldn't have turned out much differently without us either, but the potential for the pt to deteriorate was much greater. On one job the medic recommended to me that I become a medic sooner, rather than later like he did. He said "You can do much more for your pt." It was at that point that I realized my shortcomings and limitations as a basic. The better international systems don't have a professional basic level of provider as we know it. It's all varying levels of ALS as we understand it here.

I have to sigh and shake my head every time someone says "Medics save lives, and EMT's save medics." I don't get that statement. I got along just fine as a medic with my medic partner on the many jobs we ran by ourselves. The medic can do everything a basic can. If I skip over basic interventions, then I'm just a lousy medic.

 

[46Young]

Yeah just because someone is an EMT does not mean that they don't know as much as a paramedic. Someone I worked with the other day, when we did a critical care transfer, he knew what albumin was and ejection fraction.

Careful with that. If you have someone like JP or Vene who have much more advanced medical education, that's one thing. They're more than an EMT to begin with. The problem arises when you have what I call (EMT) armchair medics thinking they know more than what they do. The EMT supervisor that interviewed me for one hospital I worked at told me that he worked the streets for many years (as an EMT only) and knew my protocols verbatim, so he knows what we're supposed to be doing. I didn't know how to respond to that (without blowing the interview). Prior to meidc class, I read both the Mosby and Brady medic books cover to cover, Dubin's EKG book, and some other EKG materials as well. I worked with medics on IFT calls, and also backed them up on 911 jobs as well. I was educated piecemeal on a good many subjects and conditions, but I still knew that it was no replacement for a paramedic program. I didn't have A&P or pharm at the time, either. But if I did, the above would still hold true.

It's one thing if the EMT helps you out if you forgot to do something, but it's a whole other matter if they question your treatment decisions because they think they know more than you. There was a whole thread on that not too long ago.

 

[Shishkabob]

I have to sigh and shake my head every time someone says "Medics save lives, and EMT's save medics."

I cringe at that saying, especially whenever a Paramedic says it.


An EMT doesn't save a Paramedic. The general EMT will not catch a medic giving Adenosine instead of Amiodarone. The general EMT will not catch the needle going in to the wrong intercostal space.


No, an EMT doesn't save a Paramedic.... a more attentive partner saves a partner, regardless of certification levels.



While I loved many of my partners, I wouldn't bet my own Paramedic certification on their objections on a call.

 

[46Young]

No, an EMT doesn't save a Paramedic.... a more attentive partner saves a partner, regardless of certification levels.

That's money right there. I'm going to use that whenever I hear that tired old line. My old response was corny, and went like this: I don't know how my paramedic partner and I got through all those calls together without EMT's to watch us.

Like you, I generally respect EMT's. I know where I come from. I empty my own trash and will also help clean their bus if I jumped on for a messy call. The problem is when you have A type control freak EMT's whose need to be the dominant player in any situation. This manifests as questioning the authority and decisions of higher level providers. These are the same people who like to say "That dumb nurse doesn't know anything, blah blah blah."

Another thing, most any medic I came across that was fresh out of school and awaiting the upgrade to ALS at their job, typically say that the paramedic class has made them a much stronger EMT. That alone shows that the basic's assessment and such leaves much to be desired.

 

[jgmedic]

Yeah just because someone is an EMT does not mean that they don't know as much as a paramedic. Someone I worked with the other day, when we did a critical care transfer, he knew what albumin was and ejection fraction.

Actually, isn't that exactly what it means?

 

[46Young]

Actually, isn't that exactly what it means?

That's actually a good point. I can explain how compound interest works, why bond prices fall when interest rates go up, what percentage based portfolio rebalancing is, etc. etc. but that, in no way, shape, or form, implies that I know more than a professional financial advisor with a Masters.

 

[Aerin-Sol]

I'm not really sure how becoming a medic means doing more for the patient, as it is not like the system is choosing between sending someone as a basic or sending that same person as a paramedic. If someone goes through paramedic training, that just means a different basic will replace them. Someone might be individually able to do more for a patient and feel psychologically better, but unless you work for a very, very small system, becoming a paramedic isn't going to change the level of care provided on a significant, macro level.

 

[Shishkabob]

I'm not really sure how becoming a medic means doing more for the patient, as it is not like the system is choosing between sending someone as a basic or sending that same person as a paramedic. If someone goes through paramedic training, that just means a different basic will replace them. Someone might be individually able to do more for a patient and feel psychologically better, but unless you work for a very, very small system, becoming a paramedic isn't going to change the level of care provided on a significant, macro level.

Using that logic, we should just stop going after criminals. Take one down and another pops up, right?


So, just because someone else MIGHT do it, is all the reason in the world for you to never do it, correct?

 

[46Young]

I'm not really sure how becoming a medic means doing more for the patient, as it is not like the system is choosing between sending someone as a basic or sending that same person as a paramedic. If someone goes through paramedic training, that just means a different basic will replace them. Someone might be individually able to do more for a patient and feel psychologically better, but unless you work for a very, very small system, becoming a paramedic isn't going to change the level of care provided on a significant, macro level.

I'm not sure what you're getting at with this post. Of course the medic can do more for the pt. Tiered systems do in fact choose between sending a basic or a medic unit. It's not about the provider feeling psychologically better, it's about having the capabilities to do be of the most benefit to the pt, not just the air & chair, and maybe a bandage or two.

How about superior assessment capabilities? The medic's knowledge of A&P, pharm, pathology/pathopysiology, etc. far exceed that of the basic. EMT's are taught to treat signs and symptoms. See A, do B. The better systems encourage their medics to use protocols as guidelines rather than as a recipe to be followed to the letter. Patients have the habit of not conforming to a signle, narrow protocol. If the vacant EMT position is being filled by another EMT, then that EMT will still run all the low acuity BLS call types. When I upgraded to medic (NYC 911 system) my job types went from sick, EDP, injury, abd pain, intox to diff breather, unconscious, cardiac condition, stat ep, etc.

 

[EMT11KDL]

I have to sigh and shake my head every time someone says "Medics save lives, and EMT's save medics." I don't get that statement. I got along just fine as a medic with my medic partner on the many jobs we ran by ourselves. The medic can do everything a basic can. If I skip over basic interventions, then I'm just a lousy medic.

As a Basic who is getting ready to get into a Medic class, I look at that statement a little different. They way I view this statement is, no offense to any medics, but some of them have the "Paragod" Syndrome and forget basic skills. So the EMT in the statement is not talking about an actual EMT, its talking about the Skills/procedure (BLS) that they provide.

For example: We all know that sometimes medics miss placing a tube and they get frustrated, so they decide guess what I AM GOING TO GET THIS TUBE I AM NOT GOING TO FAIL and determined to do it but they forget that the patient needs to be BVM. (This is an EGO Paragod Problem) and that is when that statement can save a Medic, by remembering there BLS Skills

 

[WARR]

Kind of related to what I was going at- didn't realize it until recently when I was looking around

http://www.emtlife.com/showthread.php?t=20743

 

[jgmedic]

As a Basic who is getting ready to get into a Medic class, I look at that statement a little different. They way I view this statement is, no offense to any medics, but some of them have the "Paragod" Syndrome and forget basic skills. So the EMT in the statement is not talking about an actual EMT, its talking about the Skills/procedure (BLS) that they provide.

For example: We all know that sometimes medics miss placing a tube and they get frustrated, so they decide guess what I AM GOING TO GET THIS TUBE I AM NOT GOING TO FAIL and determined to do it but they forget that the patient needs to be BVM. (This is an EGO Paragod Problem) and that is when that statement can save a Medic, by remembering there BLS Skills

Yeah, there are medics like that. There are also "lifer" EMT's who think just because they've been doing it for so long, it somehow negates the education needed to actually provide quality patient care. Most EMT's I've heard make this comment, are also the ones who have no desire to move up the EMS ladder. There are morons everywhere. I hate this BLS/ALS crap, how about we do what's right for the patient, we are the only medical field with such delineated division of care.

 

[Aerin-Sol]

Using that logic, we should just stop going after criminals. Take one down and another pops up, right?


So, just because someone else MIGHT do it, is all the reason in the world for you to never do it, correct?

Yes, clearly that's exactly what I'm saying. /eyeroll. There are plenty of reasons to become a medic, but "I'm a bad person and my patients are suffering because I haven't completed paramedic training" is not one of them.

 

[Shishkabob]

But it's true.