EMT Education

[mikeylikesit]

Rid i have a feeling that you had a hand in this article for some reason.

http://www.fieldmedics.com/articles/Jems_Article.htm

 

[Guardian]

I run with a service with a lot of EMTs and I appreciate their presence a great deal. I must take exception to this statement tho - when the EMT-B program was first implemented, it held great promise for the future of our profession. The program has been progressively diluted, with less and less hours allocated. Rather than trying to make the emt-b more, I think most of us would like it to return to where it was originally going - before the requirements of EMT-B were "dumbed down" to make it attractive to vollies.

I've looked at the old AAOS "emt - ambulance" textbooks and they're not that much different than the "emt - basic" textbooks of today. True, the textbooks of today are a little more "dumbed down," but is this a bad thing? The old way was to give people a little more of a foundation so that their transition to ALS wasn't as hard. This idea sounds good on paper, but the truth is people don't need any foundation to go on to ALS. People also don't need an apprenticeship in BLS. The human mind is smart enough to learn BLS and ALS care together (paramedic care) without any roadblocks or wasted time in between. The real need was and is for large amounts of people who have training in emergency first aid and the use of BLS ambulance equipment in providing that first aid. That’s all the old EMT-As could do anyway. They might have had a little more knowledge than the emt-basics of today, but it was pointless. I read through the emt-basic textbooks and talk/work with current emt-basics. They know enough to function in a BLS role, and that's all we should ask them to do. If a person wants to learn more, they are free to take ALS paramedic classes.

A problem does arise when emt-basics start taking on responsibilities out of their scope of practice. But that's not an education issue; it's a leadership issue. And that's really another topic all together.

 

[Onceamedic]

It is a problem because what was good enough 20 - 30 years ago is not good enough today. No other endeavor or profession would claim that "hey - its about the same as it was back 30 years ago" and find that acceptable. The whole idea was a progression; a development of skills and education to deliver better care to all the people in the US, not just the ones lucky enough to afford paramedic care.
There are people dying and/or suffering unneccessary morbidities because advanced education requirements for entry into the profession are not implemented. The fact that most of the public doesn't know the difference between BLS and ALS makes improvement even more difficult to attain.

It is a leadership problem, but the problem is that many people in a position to make the necessary changes refuse to accept that they are required or even desireable. It's enough to make me weep.

 

[daedalus]

I was crushed after the course. I expected to be a confident provider of emergency medicine.

 

[Ridryder911]

Rid i have a feeling that you had a hand in this article for some reason.

http://www.fieldmedics.com/articles/Jems_Article.htm

Yes...


The problem is simple. When DOT now commonly known as NHTSA first introduced EMT curriculum and the EMT Paramedic curriculum as well, majority of the personnel was already employed in EMS. For example for me to be in my Paramedic course, I had already had to be employed as one.. yeah, confusing as heck but that was the pretty norm. Most EMT courses were filled with ambulance jocks, who went to courses while on duty so it was more a OJT and re-enforced issue rather than teach from the ground level up.

This is where we dropped the ball and continue to. For some reason, we feel we must rather subject our patients to a lesser trained individual than to those that may not have experienced. Even here it has been posted and re-posted of how they rather have a experienced non-educated EMT than a well knowledgeable Paramedic. Although "that not be in the best interest for the patient"... Wow!

It was expected for one to..... "know the business before they went into the business"...
It was to be assumed that one know the routine basics of patient movement, lifting, oxygen administration, etc.. before one even entered the class. Again, the course development was based upon improving the ambulance attendants job.

Unfortunately, we never changed that mentality. Now most assume one cannot perform this job without going through stages. Again, a fallacy. EMT training and even performances has very LITTLE common with being a Paramedic. Yes, they both usually arrive in a ambulance, but that is about it. Assumption being made that one would enter and s-o-m-eday they would complete a Paramedic level program and by that time the community would be prepared for ALS and support it. Yes, a nice dream.. unfortunately again, we just placed a band-aid on an arterial bleed situation...along the way making excuses developing titles to... "make do until we can afford the real thing"..only that day may never come.. but; we almost have the real thing!..

Most in EMS bought into that gimmick. Instructors that teethed upon the philosophy of that, as well most themselves probably never completed any formal education or "going all the way through" the Paramedic program have installed the complacent theory. The old .. "well it is better than nothing".. when in reality, if there was not a choice or option then we would have ALS throughout the country.

Can we blame the public? Really? Should it not be our responsibility to ensure the best care will delivered by our profession? Do we demand the public to screen who can advertise as a Cardiologist or even an RN or do we rely upon their profession to ensure that quality, licensed, and knowledgeable physicians & nurses are provided... no excuses allowed. No bean dinners to keep the nursing staff. I do believe sometimes that we are our worst enemies by being talked into how we are not really needed and others can and could do a better job. Even more irritating that this is usually from those that are not even qualified to make such a decision. Just read the posts...

Time to clean the slate. Start at the beginning. Hire only teachers that are really educators not just instructors. Stop promoting mediocre is okay.. it's not! That excellence and excelling within the profession should be the "normal standard" and anything is less than acceptable. This profession is that .. a profession. Although it may be used as a springboard, but it should be considered a profession first and utmost.

Patient care is patient care. No ALS or BLS divisions. You will be medically educated (yeah, one has to know some of that Dr. stuff) and will be expected to realize that this profession will always require one to be top notch and anything else is failure. Remove the technician phrase as they are truly performing a diagnostic hypothesis and perform interventional therapy. Paramedic not EMT-P

Those that do not want to pursue it as a medical profession but job or situation requires some emergency care should be at the technician level (EMT). Those would still be required to be up to date on basic care, but since most of the care is at a level where changes rarely occur, certification could be extended but as well limited. Course level would focus upon improvising rather than transporting. Making do with limited resources until Paramedic intervention or to assist in the care with Paramedic care.

This would improve relations knowing each other limitations, as well as increasing enrollment for those that have no desire to go in depth. Those that do would not have to jump through stages because they want to go more in-depth. Two separate professions and ideologies with the same goals.

R/r 911

 

[Guardian]

The whole idea was a progression; a development of skills and education to deliver better care to all the people in the US, not just the ones lucky enough to afford paramedic care.

So your suggestion is to give emt-basics a few more hours of training because not everyone is lucky enough to afford paramedical care?

My suggestion is to push for paramedic level care everywhere and not try and pawn off the emt-b as something it was never designed to be. There is already an option in existence to increase emt-basic training, it's called emt - intermediate and paramedic. By pushing for more emt-basic training, you are the one holding our profession back. I seriously doubt going back to the emt-ambulance curriculum or even increasing it a little from there would decrease “unnecessary morbidities” as you insinuate.

 

[Onceamedic]

So your suggestion is to give emt-basics a few more hours of training because not everyone is lucky enough to afford paramedical care?

god no - I didn't mean to give that impression at all. I'm sure I didn't say it. I think we need to abolish EMT-B and all vollie squads. Amateurs are not needed.

Paramedic should be the entry level into the profession and it should be an associate degree - two year minimum. Advancements after that for critical care, cct, etc.

 

[mikeylikesit]

god no - I didn't mean to give that impression at all. I'm sure I didn't say it. I think we need to abolish EMT-B and all vollie squads. Amateurs are not needed.

Paramedic should be the entry level into the profession and it should be an associate degree - two year minimum. Advancements after that for critical care, cct, etc.

and then since all medics require a ton of clinicals and ride alongs you will have a lot more experience going into the field than before.

 

[Capt.Hook]

god no - I didn't mean to give that impression at all. I'm sure I didn't say it. I think we need to abolish EMT-B and all vollie squads. Amateurs are not needed.

Paramedic should be the entry level into the profession and it should be an associate degree - two year minimum. Advancements after that for critical care, cct, etc.


And you're to be the one that will present this "new" scenario to townships and towns/cities that this is "the way" ? Good luck. You can start here.

Don't get me wrong, I'm all for further education and advance patient care, but it is all too easy for ANYONE to say such words.

Again, ALS is the way, in my opinion. This is coming from a basic trained First Responder. I'm pretty low in the pole, I realize, but my feelings are strong in that our rural, low budget America has to have something. I know there are long term solutions, but it's just plain not feasible to propose full time ALS for many, many folks in remote areas. At least not in the near now.

Wishful thinking, at best, in my opinion. Til then, we do what we need to do. Provide whatever care our public allows and move on.

 

[crash_cart]

It was fairly difficult, but I made it through by studying the books harder and through a lot of extra time of practicing on skills. When I first started my course, I thought it would be a cakewalk, and then I got pasted on a few tests that got into the national registry type of questions. Being in education as opposed to medicine, it was quite a switch in regards to how to study and how to think through some of the questions. Physically, I dropped 30 pounds and got in better shape. I did that after the instructor had us raise and lower the stretcher repeatedly. That drill with fellow students strapped on, soundly convinced me that I had to get better in all respects. I also put in a lot of time, usually about an hour and a half after each class working with the equipment. A lot of the students already were firefighters and were familiar with them-I was like the guy off of the street, I had no clue at all. My training adequately prepared me for being an EMT and by no means, was it a joke or a walk through the park. We had some good students and the instructor knew her stuff.

 

[upstateemt]

I guess it depends what level you are asking about. I found EMT-B to be fairly easy but reading and studying were definately a must.

Intermediate was a real work out, I studied non-stop and really sweated the class. My Critical Care was "studying required" but not nearly as scarey as the intermediate, maybe that was because much information was repeated between Intermediate and Critical Care. My expectation would have been that the courses were progressively harder but I found that not to be the case.

I also have found, at all levels, that the amount of time and effort you put into the class is your choice. You can breeze through and come out with just enough to pass the test or you can spend time and effort and pass the test AND KNOW WHAT YOU ARE DOING!!!!