Emt-i

[KEVD18]

You do realize that the same can be said of medics on the bus instead of EM residents or emergency nurses?

thats the most asinine thing thats been written on this thread, hands down.

theres no way you could ever have docs(100k+/yr) and nurses(75k+/yr) staffing all ambulances. thats just not reasonable.

thats why there are paramedics. people with adequate(let it be, thats a topic for another thread) training to do the job.

 

[VentMedic]

You do realize that the same can be said of medics on the bus instead of EM residents or emergency nurses?

Are you comparing Paramedics to doctors? or even ER RNs? Yes, both of which may be required to go with the paramedics who can not do certain procedures or medications but what is your rational for that comparison? There are a few hundred hours of training difference for EMT-I and EMT-P and not a few years.

 

[bstone]

thats the most asinine thing thats been written on this thread, hands down.

theres no way you could ever have docs(100k+/yr) and nurses(75k+/yr) staffing all ambulances. thats just not reasonable.

thats why there are paramedics. people with adequate(let it be, thats a topic for another thread) training to do the job.

And now you understand the huge importance of a robust and expanded Intermediate program.

 

[KEVD18]

And now you understand the huge importance of a robust and expanded Intermediate program.

yeah, a paramedic program!!

 

[bstone]

yeah, a paramedic program!!

Yeah, those medic programs which are in places where there is no medic instructor, no medical school or ALS service. aka 80%+ of the USA.

 

[KEVD18]

wow, increase the scope of -i's? to what end?

 

[VentMedic]

Yeah, those medic programs which are in places where there is no medic instructor, no medical school or ALS service. aka 80%+ of the USA.

There lies the problems and making up band-aide cert fixes is not the answer. Haven't you been paying attention to how EMS got into this mess?

 

[bstone]

There lies the problems and making up band-aide cert fixes is not the answer. Haven't you been paying attention to how EMS got into this mess?

How can the answer possibly be to keep 80% of the USA only with BLS service and no possibility of ALS?

 

[VentMedic]

bstone,

Do you plan to stay an EMT-I? If so, why? It doesn't take that much more to get the Paramedic patch.

 

[bstone]

bstone,

Do you plan to stay an EMT-I? If so, why? It doesn't take that much more to get the Paramedic patch.

I am quite happy with EMT-I. I simply haven't the time to sit through a full year of medic school when I shall soon be starting medical school. I am looking forward to the day when my NREMT card reads "bstone, NREMT-I, MD" (or possibly DO)

 

[VentMedic]

How can the answer possibly be to keep 80% of the USA only with BLS service and no possibility of ALS?

Show your numbers. States like Florida are nearly 100% ALS. California also carries high percentages. Major cities almost all have some ALS capabilities.

Do you believe people shouldn't strive for something better and not just settle for something half-arsed?

 

[bstone]

Show your numbers. States like Florida are nearly 100% ALS. California also carries high percentages. Major cities almost all have some ALS capabilities.

Major cities do not cover a huge geographical area. Recall, middle America (where I grew up) is *huge* and keeps going for many, many miles. It seems down right wrong to limit EMS service in those areas (which is heavily volunteer) to basically BVMs and driving fast. Especially when patients are having MIs, anaphylactic shock and bleeding out.

 

[KEVD18]

Especially when patients are having MIs, anaphylactic shock and bleeding out.

and what is an i going to do? liter after liter of crystalloid, acquire a III lead and beam it to the H an hour away, damn near kill the concious alert and orientated anaphylaxis patient with a gag reflex?

 

[VentMedic]

I am quite happy with EMT-I. I simply haven't the time to sit through a full year of medic school when I shall soon be starting medical school. I am looking forward to the day when my NREMT card reads "bstone, NREMT-I, MD" (or possibly DO)

If you aren't staying in EMS, why are you so insistent on keeping it at a less than optimal level? Keep your EMT-I but don't drag the rest of the system down which is striving for higher standards.

Why go for your MD? Just get a PA certificate or degree.

 

[bstone]

and what is an i going to do? liter after liter of crystalloid, acquire a III lead and beam it to the H an hour away, damn near kill the concious alert and orientated anaphylaxis patient with a gag reflex?

I dunno, perhaps allow for interventions which save lives, use some SC/IM epi 1:1000 in a patient with full blown anaphylaxis and is on death's door. Ya know, that sort of stuff- the stuff that saves lives.

 

[bstone]

If you aren't staying in EMS, why are you so insistent on keeping it at a less than optimal level? Keep your EMT-I but don't drag the rest of the system down which is striving for higher standards.

Why go for your MD? Just get a PA certificate or degree.

You have a very interesting way of looking at things. I am arguing for higher standards of requiring medics to have ALS experience and high requirements of certification as a pre-req for medic school and you see this as harmful. Are you in favor of a 3 month medic mill? I surely am not.

I am not going for PA as I have always wanted to be and will be a physician. I plan on going into emergency medicine and focusing a great deal of my time on EMS related issues. I am your next medical director and I argue and work on behalf on EMS workers, not against them. I heavily in favor of expanding scope and autonomy but with that must come much higher standards of training, such as no direct entry into medic school after getting your Basic, and required ALS experience before being allowed into medic school. This also includes a heavily expanded and more robust Intermediate scope for 80% of America which lacks ALS service.

 

[KEVD18]

well you coverend one. not bad odds.

and this is direct from mass protocols. i dont see sub q epi listed anywhere. weird.

INTERMEDIATE PROCEDURES
1. INTERMEDIATE STANDING ORDERS
a. If patient presents in Severe Distress, as defined in Assessment Priorities, and if
patient age is between 5 and 65 years: administer epinephrine by auto-injection.
b. A second injection may be administered, if available, in 5 minutes if necessary.
2. Provide advanced airway management, if indicated.
3. Initiate IV Normal Saline (KVO) enroute to the hospital.
If patient’s BLOOD PRESSURE drops below 100 systolic: Administer a 250 mL
bolus of IV Normal Saline, or titrate IV to patient’s hemodynamic status

 

[KEVD18]

oh and basics can use epi pens, so waving that flag isnt really an argument now is it?

 

[bstone]

well you coverend one. not bad odds.

and this is direct from mass protocols. i dont see sub q epi listed anywhere. weird.

INTERMEDIATE PROCEDURES
1. INTERMEDIATE STANDING ORDERS
a. If patient presents in Severe Distress, as defined in Assessment Priorities, and if
patient age is between 5 and 65 years: administer epinephrine by auto-injection.
b. A second injection may be administered, if available, in 5 minutes if necessary.
2. Provide advanced airway management, if indicated.
3. Initiate IV Normal Saline (KVO) enroute to the hospital.
If patient’s BLOOD PRESSURE drops below 100 systolic: Administer a 250 mL
bolus of IV Normal Saline, or titrate IV to patient’s hemodynamic status

I am not licensed in MA nor will I be. I got my Intermediate training in New Hampshire in 2006 and have been duly certified by the NREMT since soon after. I did my clinicals in New Hampshire at the Elliot Hospital (Level 1 trauma center) and in Manchester and Nashua on ALS ambulances.

 

[VentMedic]

If you are arguing to accept the EMT-I as a standard over the Paramedic, I hope you do not ever become a medical director in EMS.

If you only going to get the job done half way, stay away!

Your ideas will set EMS back another 20 years. I guess you have not seen how healthcare has evolved or know how other professions became professionals.

Good luck with your career as an EMT-I!