ER Tech vs Rig Work

[Miscusi]

" someone with only a 120 hour course "

I see that alot here, but I think that we, as human beings, dont have that much to go wrong when it comes to emergencies. 120 hours should cover more than enough for what the EMT-basic job requires. Sure you can add hours, double the hours why dont they? but if they do, it would just be 120 hours of instruction and 120 hours of sitting doing nothing...

Just IMHO !

 

[Tigger]

" someone with only a 120 hour course "

I see that alot here, but I think that we, as human beings, dont have that much to go wrong when it comes to emergencies. 120 hours should cover more than enough for what the EMT-basic job requires. Sure you can add hours, double the hours why dont they? but if they do, it would just be 120 hours of instruction and 120 hours of sitting doing nothing...

Just IMHO !

That is one of the more illogical things I have seen posted on this board. It is just not possible to address.

 

[DrankTheKoolaid]

I give up. You guys completely missed me saying they have to be self motivated.

And who is a new EMT going to bounce questions off of on a BLS or IFT rig? Another EMT doing IFT? Sure if he wants to know how to push a wheel chair more effectively, not, higher learning type questions. At least in a ED you can be 99% sure the Doc knows what he/she is talking about, usually. Can you honestly tell me that about all the Paramedics and EMT's he can be partnered with.

Anyways my favorite Un-PC show of all time is on, Family Guy.

 

[Handsome Robb]

How is that NOT happening in the field if you're doing your job? Do patient medications just not exist until a patient crosses the threshold of the ER? Do ED providers learn medications just by reverse osmotic pressure, or do they themselves ALSO have to be motivated enough to learn about the medications?

I'm not dispelling the benefits of working in one place over another, but "learn medications" in the ED over in the field is not one. Seeing the meds used in more variety, more often, in off box uses? Sure. But not just learning patient meds, where in both avenues, you have to care enough to learn what they are and what they do.


Yay Epocrates.

I'd be willing to bet that unless you work in a really slow ER you have more time on the truck to look up and research meds.

Like corky said though, it's up to the provider to take the initiative to extend their education and take the time to look meds up.

 

[Tigger]

I give up. You guys completely missed me saying they have to be self motivated.

And who is a new EMT going to bounce questions off of on a BLS or IFT rig? Another EMT doing IFT? Sure if he wants to know how to push a wheel chair more effectively, not, higher learning type questions. At least in a ED you can be 99% sure the Doc knows what he/she is talking about, usually. Can you honestly tell me that about all the Paramedics and EMT's he can be partnered with.

Anyways my favorite Un-PC show of all time is on, Family Guy.

I guess I missed the part about the techs also having to be self motivated.

Also I don't push wheelchairs, not every call I do is an emergency but I am not a wheelchair van. And yes if I do have a higher level question, I will ask my partner. They may be like me and have already asked it, and if that fails I'll find someone else to ask like a doctor or a medic or a nurse or gasp, the internet.

 

[Handsome Robb]

or gasp, the internet.

Where did you get your medical degree?

WebMD...duh!!!

 

[hibiti87]

if working out in the field is your end goal i think working on a BLS rig would be more beneficial if given the choice between an ER tech position or rig work. While ER tech positions can provide you with a wealth of knowledge, you are pretty much spoon fed the patients history instead of obtaining it yourself through questioning and assessment.

 

[Cindigo]

Once you master that, IV's on a veinless cabbage in a well lit room with the bed at whatever level you want it to be will be cake......

I just spit milk out of my nose.....and, I'm not even drinking milk.

 

[Tigger]

Where did you get your medical degree?

WebMD...duh!!!

Is it bad that when my patients ask "how did you learn that" I answer "wikipedia?"h34r:

 

[Miscusi]

That is one of the more illogical things I have seen posted on this board. It is just not possible to address.

with all due respect, I think that makes perfect sense. IF 120 hours is not really enough for the emt B job, then it wouldnt be currently 120 hours....

 

[Miscusi]

And who is a new EMT going to bounce questions off of on a BLS or IFT rig? Another EMT doing IFT? Sure if he wants to know how to push a wheel chair more effectively, not, higher learning type questions. At least in a ED you can be 99% sure the Doc knows what he/she is talking about, usually. Can you honestly tell me that about all the Paramedics and EMT's he can be partnered with.

I know some MDs who should be plucking veggies in a farm. but in all fairness, If an EMTB is in medical school, trying to be something higer up the medical care field, then of course the ER Tech job would be more beneficial...

but for those not in school, with no intention of taking more classes, knowing more than what the EMTB should know holds no real job value as the emt b is prohibited from doing more than what the standard of care is anyway. these emtbs are better off in the truck, perfecting the art of the perfect stair chair grip, and etc..

we are all given a place in life, a role to play, if it is to be an EMTB, then I rather learn to do the best and fastest AED application rather than to take the time to learn the EKG which I will never use anyway.

IMHO

 

[Tigger]

with all due respect, I think that makes perfect sense. IF 120 hours is not really enough for the emt B job, then it wouldnt be currently 120 hours....

One day, when you're working on that FDNY BLS ambulance you'll have a really sick patient and no medics will be available and you'll have to treat them by yourself. And all you will be able to do is give them a pillow and a hand to hold. Then you'll understand.

 

[Miscusi]

One day, when you're working on that FDNY BLS ambulance you'll have a really sick patient and no medics will be available and you'll have to treat them by yourself. And all you will be able to do is give them a pillow and a hand to hold. Then you'll understand.

OK.. i know im new, but I understand that we are to never go beyond our scope of practice.

I know that if I work BLS, and the patient is really sick and no medics are avail, then yes indeed I will do everything I can for him, which is everything an EmtB is allowed to do, and I will do that to the best of my ability.

I will put him in the most comfortable of all positions of comforts, turn the 02 up to as high as can be, ( 15 LPM here in NY ), and do every intervention that is known to the emtB.

I know that I cannot give him our baby asprin for his pain, even if I really wanted to I cannot, it is only for AMIs... If I did give, and a review happens, there goes my cert...

Even if I happen to have a IV and morphine in my back pocket for whatever reason, and I have learned how to administer it at the er tech job, I can not give it. We just cant.. unless, you know something I dont about what our scope of practice is....

 

[dmc2007]

OK.. i know im new, but I understand that we are to never go beyond our scope of practice.

I know that if I work BLS, and the patient is really sick and no medics are avail, then yes indeed I will do everything I can for him, which is everything an EmtB is allowed to do, and I will do that to the best of my ability.

I will put him in the most comfortable of all positions of comforts, turn the 02 up to as high as can be, ( 15 LPM here in NY ), and do every intervention that is known to the emtB.

I know that I cannot give him our baby asprin for his pain, even if I really wanted to I cannot, it is only for AMIs... If I did give, and a review happens, there goes my cert...

Even if I happen to have a IV and morphine in my back pocket for whatever reason, and I have learned how to administer it at the er tech job, I can not give it. We just cant.. unless, you know something I dont about what our scope of practice is....

You've just proved his point, as well as the point that the EMT curriculum needs to be longer. It may seem like there is a lot we can do while we're in school, but once you get out into the field, you'll quickly realize that the list of "every intervention that is known to the emtB" is extremely short, and covers only a small portion of the patients you'll actually encounter. Further, you'll find that the limited A&P knowledge you get in EMT school doesn't leave you feeling nearly prepared enough to deal with many of the highly sick patients you'll encounter-hence the need for more than the 120 hours.

 

[Ackmaui]

I know some MDs who should be plucking veggies in a farm. but in all fairness, If an EMTB is in medical school, trying to be something higer up the medical care field, then of course the ER Tech job would be more beneficial...

but for those not in school, with no intention of taking more classes, knowing more than what the EMTB should know holds no real job value as the emt b is prohibited from doing more than what the standard of care is anyway. these emtbs are better off in the truck, perfecting the art of the perfect stair chair grip, and etc..

we are all given a place in life, a role to play, if it is to be an EMTB, then I rather learn to do the best and fastest AED application rather than to take the time to learn the EKG which I will never use anyway.

IMHO

If you are comfortable being an EMTB and decide you don't want to learn more than that is up to you. But In the ER I can attach pads faster than any nurses, doctors or,other techs, and whip out an EKG in less than 30 seconds and that's counting putting on the leads in the correct place. I took the time to learn EKGs because I wanted to learn more. Why do just your job when you can do your job and learn more. Being the best at any job you do should always be your goal, and learning everything you can will only help you be a better EMTB.

 

[Level1pedstech]

if working out in the field is your end goal i think working on a BLS rig would be more beneficial if given the choice between an ER tech position or rig work. While ER tech positions can provide you with a wealth of knowledge, you are pretty much spoon fed the patients history instead of obtaining it yourself through questioning and assessment.

Is that a first hand observation or just an assumption on your part. Depending on the ER and of course all are a little different in what your scope of practice allows,you can indeed use your assessment and patient history skills. Its a pretty safe bet you could if motivated and on the ball use them much more than you would in the field. Let me offer up an example.

The triage nurse brings back a patient and gives you the reason your patient is here today. Your going to get about the same amount of information you would receive with a field dispatch,basically the patients chief complaint. Knowing as a good tech does that you want to be one step ahead of your RN's you would do a brief history focusing on todays visit,obtain vitals and do an assessmet. All this is done so you can form a basic treatment plan to help you and your RN in the rapid treatment and diposition of this patient. Of course your RN will repeat the assessment process for the PA or MD.

Just like in the field your next step would be thinking about what interventions you could get started monitor,O2,EKG and basic comfort measures come to mind. You should be thinking about what additional resources and supplies may be needed to help speed up the delivery of care to your patient this would include lines,labs,RT and radiological studies. Within minutes your RN walks in the room and you give them the same information you would if you rolled in from the ambulance bay. Just like in the field you want to work quickly so you keep the system moving.

Looks to me like you have used and applied the same patient history and assesment skill set you would use in the field especially as a basic on a BLS rig. You also had the chance to practice some hand on skills some you would never do as a basic in the field. Of course this would not be possible in an ER where techs are used more as CNA 's or in an ER where your practice level is extremely limited.

 

[Miscusi]

re: #34 and #35.

I can see your point, you think 120 hours is not enough for the best prehospital care, and it isnt. Here in NY we have two kinds only. BLS and ALS. one is the EMT-B and the other is EMT-P. nothing in between.

the EMTB is allowed to only do what is allowed for EMTB, and the P is allowed to do what the P is allowed.

I can honestly say, I wish every bus out there was a moving ED complete with diagnosis machines and surgery compartments, Portable X-Ray and MRI, Full Lab and pharmacy, yada yada and with 2 MDs and a surgeon per bus. But we cant have everything we want...

So we have the EMTB, and the EMTP.. anything else goes to the hospital.

The current EMT-B Class, if done correctly, and the student learns all of it, then that 120 hours worth of training is plenty enough to do the job of the EMT-B.

If you add more hours to the class, then these people would end up being a higher level and not a Basic anymore. which is not my agrument.

I know you might think that they should get rid of the EMTB rank, and start letting people on the street starting at AEMT or maybe even a all paramedic force, but that is not reality, the goverment decided that emtB is good for the street. I think the current class is more than adequate for the skills an EMT B must peform, and only perform, and if he performs more than that he gets fired.

 

[Ackmaui]

re: #34 and #35.

I can see your point, you think 120 hours is not enough for the best prehospital care, and it isnt. Here in NY we have two kinds only. BLS and ALS. one is the EMT-B and the other is EMT-P. nothing in between.

the EMTB is allowed to only do what is allowed for EMTB, and the P is allowed to do what the P is allowed.

I can honestly say, I wish every bus out there was a moving ED complete with diagnosis machines and surgery compartments, Portable X-Ray and MRI, Full Lab and pharmacy, yada yada and with 2 MDs and a surgeon per bus. But we cant have everything we want...

So we have the EMTB, and the EMTP.. anything else goes to the hospital.

The current EMT-B Class, if done correctly, and the student learns all of it, then that 120 hours worth of training is plenty enough to do the job of the EMT-B.

If you add more hours to the class, then these people would end up being a higher level and not a Basic anymore. which is not my agrument.

I know you might think that they should get rid of the EMTB rank, and start letting people on the street starting at AEMT or maybe even a all paramedic force, but that is not reality, the goverment decided that emtB is good for the street. I think the current class is more than adequate for the skills an EMT B must peform, and only perform, and if he performs more than that he gets fired.

I never said 120 hours isn't enough. I think it's good for what EMTBs can do. I get to do more because I also work in the ER. We are the only ER on this island and I get to see just about everything. The nurses know me and trust in my skills and I even got our nurses excited about using an IO when they can't get a line on priority patients.
My point is that I learn more because I want to..if you are happy being a EMTB and don't want to learn more..that's your choice.

 

[Miscusi]

you as an EMT in the ER is allowed to go IO ? There must be something I am missing about scopes of practice, or maybe its a NY thing...

 

[Miscusi]

it must be a NY thing, here, the Basic dont include any phlebotomy training / certs at all.