Mr BROWN AND RESCUE99:
Rescue, 15 years ago our equivalent of basics, called Ambulance Officers at the time, were required to have more education than what brown mentions to practice at a lower level than he has detailed. What he's suggesting sounds perfectly reasonable as far as educational requirements go.
Brown, how is the 911/IFT divided over your way? When I talk to these yanks about education I forget that the IFT side of it gets included in EMS. Here non emergency IFT is a completely separate world of small privately run organizations similar to the US and education requirements for the "NEPT officers" are significantly lower. That is acceptable to me. You don't need a degree to drive a dialysis pt to a clinic or taxi olds too their medicals. If you required it the system would go down the toilet. But the idea that NEPT officers (slightly better educated than EMT-Bs
) would ever be involved in 911 work is pretty abhorrent (although they are sometimes in incidents involving many casualties with minor injuries, but simply as extra transports).
TO the rest of the thread: It seems whenever you guys have these BLS/ALS arguments the "you don't need to tube every pt so why do you want blanket ALS", and "pts deserve well educated professionals so they need ALS level providers". It seems to me that this is indicative of the American attitude towards EMS, its all about the skill sets and not about the clinical decision making. Like the only choices you guys have are uneducated EMT-Bs and well educated paramedics who have a long list of 'skills'. Here we spend 3 years at uni to practice at the lower tier. In all that time we don't do any ALS (that's a higher qualification) because we're not learning skills, we're learning how to be clinicians. Why does the ALS skill set HAVE to come with a good education.
Its like with doctors. Not every patient needs a thoracic surgeon, but when you see your run of the mill, every day GP or primary care doctor, about that cough that won't go away, you still expect them to be educated enough to be able to evaluate you medically and know difference between the cough that's simply a cold that won't go away and a cough requires a thoracic surgeon because its lung cancer. But to have that GP be a good clinician he doesn't need to be a heart surgeon. That's a specific skill set that is occasionally needed, but its not required to be a good clinician, and requiring all doctors to be heart surgeons before they can become GPs would be ridiculous. Now sub in EMT for GP and Paramedic for heart surgeon.
Why can't you extricate the skills from the education? All pre-hospital professionals should be well educated in their craft, just like any other health-care professional. Then some may chose to learn extra skill sets and do their cool ALS stuff.
To be an "EMT" here you go to uni for 3 years..to be educated.
To be a "Paramedic" you return to uni for a year to do your cool skills and more book learnin. But all pre-hospital practitioners must be well educated.
In the US, "EMTs" go to institution X for a few months and learn some skills. Then your "Paramedics" go to institution Y for, at most, 2 years where they learn more skills and just enough book learnin to get by using those skills.
I suppose if you feel that EMTs/Paramedics are the eyes, ears and hands of a medical control doc then that's okay, but it sure seems topsy turvey to me.
