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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.
When you have a job as an EMT, the deficiencies in your training will come to light, as they have for everyone else. Every job is going to have a certain degree of "on the job" learning, but there is to much of it going on in EMS, especially with basics.
You could certainly add hours to the EMT-B class without adding any skills or interventions. Much more time should be spent learning anatomy and physiology beyond "this is the femur, it hurts when you break it." More time could be spent on proper lifting techniques (bed to bed, chair to stretcher, etc). Documentation is very important in EMS yet how long do we spend learning to write narratives? I could go on but I hope you get the point, even with the current basic scope 120 hours is still not enough.
And despite working on a BLS ambulance, I am wholly in favor of their elimination from American EMS.
it must be a NY thing, here, the Basic dont include any phlebotomy training / certs at all.
Many times in the hospital you will find that techs have an expanded scope of practice authorized by the ER's medical director.