Hat's off to EMT-B's

[Ridryder911]

Surely you are not implicating we should not become more professional requiring at least above high school level equivalency for our profession. Again, medicine is changing and we have to keep up with it, there is no choice. As well responsibities of the EMT will be increasing as those with experience can attest to. These will only becoming more and more as the generation ages increase and hospitals become more taxed.

Sorry, voluteer or paid that is really irrevelant.. the system should be about the patients sake not the rescuers ability to go to school or not. One does not see other professions maintianing status quo or regressing because the inabilty to attend school, etc.

FYI many states are adopting CEU's for RN's and other health professions due to EMS personal has set an example, as well some are requesting they have to be currently employed or associated with a healthcare facility. P.A's has to take CEU's plus retake the whole board over every 6 years.

The old "we won't have enough volunteers" should not even enter the subject, again if people are really interested then they will attend. This is why a competent, good qualified First Responders, and Basic levels are essential for those communities.

Just because a physician, nurse, or any other health care provider decides to work in a rural or less populated area, does not excuse them from having to attend courses like the rest of their peers. One is expected to know, perform, and treat just like those that want to work in a high call volume, and in fact one has to be better prepared due to less exposure. There is not a difference in standards of one that gets a salary or volunteers, professionally and legally all are compared equally.

People afford other healthcare, clinics, hospitilzation, even nursing homes so EMS should be able to maintain and have just as qualified individuals to provide for their care as well. All hospitals still require RN's, even nursing homes do, no matter where and how remote it is some how; they always find a way.. maybe we should look at see if there is a way for EMS to get substainal funding and support as well.

Sorry, the only progression for EMS to become substainal to expect revenue and reimbursements for the betterment of the medical community is for the education level of the EMS personel to increase. We are one of the very few if not only healthcare profession that requires such a limited courses.

We can only better ourselves off with increasing education, and as well as patients can expect to recieve better care.

R/r 911

 

[oldschoolmedic]

I have a question, and unfortunately it will probably stir up a hornet's nest. What would happen if there were no more volunteer services? What if everything had to become paid/professional services? My reasoning is this... there are no volunteer nurses or doctors. Respiratory therapists and x-ray techs don't have volunteer services.

If we expect to be treated as healthcare professionals (that we are) then we must take our educational process seriously, that means college level education at a minimum, nothing less than an Associate's degree to start. This is the lowest acceptable degree for a RN. If it means cutting out the less intellectually inclined, so be it. And please no commentary on "The best paramedic I ever knew only got as far as third grade walking uphill both ways to school." We have enough rhetoric to go around.

Other aspects of healthcare are continuously raising the bar academically to meet the challenges of their field. On the other hand we (EMS) are willing to let our standards deteriorate to allow more people become certified, or because we are unwilling to hurt someone's feelings. This is the "meat in the seat" or "pulse and a patch" mentality we need to do away with. We as a profession need to stop being concerned with the alphabet courses which teach the "what", but not the "why" a procedure is performed. By raising the educational requirements we will eventually move past simply being technicians. With that being done, pay and respect will follow. No longer will you have to hear, "Hey, the ambulance guys are here..." Ok, maybe that last part is wishful thinking.

And please before anybody says anything I like EMTs, I like them enough that I married one. Even she agrees the educational requirements need to be raised.

 

[jeepmedic]

Ok here goes I hope this comes out right.

As well responsibities of the EMT will be increasing as those with experience can attest to.

This is true. As an EMT-A we could do less and had a longer class, and were tought more.

People afford other healthcare, clinics, hospitilzation, even nursing homes so EMS should be able to maintain and have just as qualified individuals to provide for their care as well. All hospitals still require RN's, even nursing homes do, no matter where and how remote it is some how; they always find a way.. maybe we should look at see if there is a way for EMS to get substainal funding and support as well.

Look at medicad and medicare

I have a question, and unfortunately it will probably stir up a hornet's nest. What would happen if there were no more volunteer services? What if everything had to become paid/professional services? My reasoning is this... there are no volunteer nurses or doctors. Respiratory therapists and x-ray techs don't have volunteer services.

This is becoming an increasing problem in all areas of the country. The county I live in which is the largest in VA with over 950 square miles has just hired a third party paid service to cover the calls that the Volunteer stations could not cover. And to add to this: How many volunteer police do you see now days? And they do not have to have any education past High School. They go to a 6 month class and bam They can write tickets, and shoot you.

 

[Fedmedic]

I have a question, and unfortunately it will probably stir up a hornet's nest. What would happen if there were no more volunteer services? What if everything had to become paid/professional services? My reasoning is this... there are no volunteer nurses or doctors. Respiratory therapists and x-ray techs don't have volunteer services.

If we expect to be treated as healthcare professionals (that we are) then we must take our educational process seriously, that means college level education at a minimum, nothing less than an Associate's degree to start. This is the lowest acceptable degree for a RN. If it means cutting out the less intellectually inclined, so be it. And please no commentary on "The best paramedic I ever knew only got as far as third grade walking uphill both ways to school." We have enough rhetoric to go around.

Other aspects of healthcare are continuously raising the bar academically to meet the challenges of their field. On the other hand we (EMS) are willing to let our standards deteriorate to allow more people become certified, or because we are unwilling to hurt someone's feelings. This is the "meat in the seat" or "pulse and a patch" mentality we need to do away with. We as a profession need to stop being concerned with the alphabet courses which teach the "what", but not the "why" a procedure is performed. By raising the educational requirements we will eventually move past simply being technicians. With that being done, pay and respect will follow. No longer will you have to hear, "Hey, the ambulance guys are here..." Ok, maybe that last part is wishful thinking.

And please before anybody says anything I like EMTs, I like them enough that I married one. Even she agrees the educational requirements need to be raised.

I think if the rest of the country adopted a philosophy similar to NC's if would help provide a better service to the community. I not 100% sure, but I am going to research it and get back to post what I found. But this is the way I think it is. Sometime in the 1970's, the state passed a law stating the each county must provide an ambulance service, just as they must provide law enforcement. By doing this, I think the entire state of NC has paid EMS, no matter how rural you can get an ambulance there within a reasonble amount of time. And the majority of the state is at the paramedic level. The only downside to this is they opened upon the paramedic program to most of the community colleges. Which sounds good in theory, because you can get your paramedic almost anywhere. The problem is most of these community college paramedic programs, for a lack of better words, really suck. I have always said, if you could take the best of NC and VA and combine them then you would have a top notch EMS system. VA has mostly volunteer agencies and it may take an hour or more to get an ambulance to your house, but if it shows up with a paramedic, then you can rest assured you are in good hands. Up until about 3-4 years ago, there were only approximately 5 places in the state of VA to recieve your paramedic. And these the large teaching hospitals, such as MCV, UVA and College of Health Sciences. Now there are more paramedic programs, but even these are still regulated by the teaching hospitals with satellite programs. So you still have excellent paramedic programs.

 

[trauma1534]

I have a question, and unfortunately it will probably stir up a hornet's nest. What would happen if there were no more volunteer services? What if everything had to become paid/professional services? My reasoning is this... there are no volunteer nurses or doctors. Respiratory therapists and x-ray techs don't have volunteer services.

If we expect to be treated as healthcare professionals (that we are) then we must take our educational process seriously, that means college level education at a minimum, nothing less than an Associate's degree to start. This is the lowest acceptable degree for a RN. If it means cutting out the less intellectually inclined, so be it. And please no commentary on "The best paramedic I ever knew only got as far as third grade walking uphill both ways to school." We have enough rhetoric to go around.

Other aspects of healthcare are continuously raising the bar academically to meet the challenges of their field. On the other hand we (EMS) are willing to let our standards deteriorate to allow more people become certified, or because we are unwilling to hurt someone's feelings. This is the "meat in the seat" or "pulse and a patch" mentality we need to do away with. We as a profession need to stop being concerned with the alphabet courses which teach the "what", but not the "why" a procedure is performed. By raising the educational requirements we will eventually move past simply being technicians. With that being done, pay and respect will follow. No longer will you have to hear, "Hey, the ambulance guys are here..." Ok, maybe that last part is wishful thinking.

And please before anybody says anything I like EMTs, I like them enough that I married one. Even she agrees the educational requirements need to be raised.

I must say that I (suprisingly enough) am dissappointed in the EMT curriculam today. I sat in on an EMT-B class about a year ago, assisting with it, and I was shocked! The instructor was just going through the book refuring to what they would need to know to pass thier state boards. I was even more upset when they started doing thier ride time and I was precepting them. They were not even 3 weeks from finnishing thier class and testing out and they were CLUELESS!!! I really had nothing to precept, and believe me, I documented those things on thier precepting form accordingly. Half of them didn't know how to take a simple blood pressure, they were unsure of how to detect lung sounds or what they were listening to. They didn't know what to ask the patients during the assessments. When it was time to load and lift the stretcher, they were clueless as to what the functions of the stretcher were. And, my pet pieve, documentation. They could not write a call report on thier patients. These people were in no way ready for EMT-B test. Well... they may have been ready to take the test, but they were not ready at all to become EMT-B's in the field. The test site? They were passing in and everything during the practicals. As long as they placed thier hands on the sturnal area during compressions, it didn't matter if it was correct placement or not, they passed. As long as they said I'm clear, you're clear, everybody clear, they passed. They didn't have to have correct placement of the pads or anything. That was just with the AED station.

I said all that to say this. I do think the EMT-B curriculam should be fine tuned. I think they need to spend time learning how to be a good EMT-B in order to finnish the class.

What ever it takes to make these EMT-B's ready for the field, that is what needs to happen. As far as doing away with volunteers and making it an all paid thing, I think that would be a good thing. However, like someone else said, if that happened here, we would have no one wanting to do it due to the pay.

It is a hard thing to sort out. But for now, we have to try to make the best of what we have. That means we as experienced and seasoned providers need to take every opportunity we have to teach the new providers to be good. I'm not saying that every EMT-B class is as much of a cluster as that particular one, there are some really good instructors out there who have passion for what they do and want thier students to come out as very good providers. We just need to do the best we can to help eachother learn what they can. I still am learning. I will never stop learning. I try to pick out something new from each call I run to learn and break down.

So the fix to our problem? It would be nice to snap our fingers and figure out the perfect fix.

 

[Ridryder911]

You hit the double edge sword.. must would not do it for the current pay... Without proper education, there is no justification of paying what most EMT's want and truly deserve as pay.

It is a shame that most EMT's have to work 2 -3 jobs just to feed their children, and pay the electric bill. All just because they chose to "help" others. At the same time, one has to recognize there are very few to no profession one can enter the marketplace within less than 16 weeks (2 weeks if you go to a shake and bake program).

Trauma you are right about current standards and students.. I renewed my EMS instructor last year after a hiatus of teaching flight nurses/medics. It was a shock to see, or rather not see what was taught or required. It probably was not the students was not ready for test, rather they were not taught at all. Not that the instructor was at fault the system has dropped down. For example, remember when AMI was an approved abbreviation, which is now recommended to use the word "heart attack" and those 6 types of fractures we all memorized are no longer even discussed. I guess my astonishment was the discussion of treating a "bee sting" as an impaled object ... What? Even in boy scouts they are taught to "scrape it off" to prevent further injections from occurring. Now, I ask how are you going to immobilize a stinger?.... We have lost reality in some of the way, and what we teach.

As many of you are with EMS students, ask initially what the treatment of any injury and you will automatically get a robot response .. "scene safe, BSI, oxygen NRBM".. no thought, no process. Yes, I am aware we teach for testing and to protect them ... but rarely I see an introduction made or even reasoning of placing a nasal cannula in lieu of NRBM on a patient with active vomiting. A lot of this is common sense, which many times is not encouraged or practiced.

At the same time, review most EMT instructors qualifications. No other medical profession would allow anyone to teach without a minimal B.S. degree or some form of formal adult education criteria. In comparison respiratory therapist requires at least a person with a B.S., in nursing the minimum is a master degree or higher, and so on. Although my fellow classmates in my EMS Instructor had a big heart, and well intentioned many lack experience, medical knowledge or expertise, and definitely an understanding on how adults learn. A 40 clock hour class cannot even begin to teach objective base teaching, or how to write objectives, key stem test questions for preparedness of state and national board examinations.

These dilemmas are many of the tasks we as EMT's need to address and try to solve. Many of these again are related to poor participation in EMS organizations and basically apathy among most EMS workers. We all like to complain, but few what to change things.

R/r 911

 

[Stevo]

Surely you are not implicating we should not become more professional requiring at least above high school level equivalency for our profession. Again, medicine is changing and we have to keep up with it, there is no choice. As well responsibities of the EMT will be increasing as those with experience can attest to. These will only becoming more and more as the generation ages increase and hospitals become more taxed.

The ABC's of ems have not changed have they?

Sorry, voluteer or paid that is really irrevelant.. the system should be about the patients sake not the rescuers ability to go to school or not. One does not see other professions maintianing status quo or regressing because the inabilty to attend school, etc.

So in your opinion, patient care should NOT be based on acedemic ability?

The old "we won't have enough volunteers" should not even enter the subject, again if people are really interested then they will attend. This is why a competent, good qualified First Responders, and Basic levels are essential for those communities.

1/2 correct, if the system creates enough obstacles, acedemic or not, the volly's eventually loose intrest due to lack of available time to donate

Just because a physician, nurse, or any other health care provider decides to work in a rural or less populated area, does not excuse them from having to attend courses like the rest of their peers. One is expected to know, perform, and treat just like those that want to work in a high call volume, and in fact one has to be better prepared due to less exposure. There is not a difference in standards of one that gets a salary or volunteers, professionally and legally all are compared equally.

Did i bring up a difference in standards rural/metro here ?

People afford other healthcare, clinics, hospitilzation, even nursing homes so EMS should be able to maintain and have just as qualified individuals to provide for their care as well. All hospitals still require RN's, even nursing homes do, no matter where and how remote it is some how; they always find a way.. maybe we should look at see if there is a way for EMS to get substainal funding and support as well.

Other Health care? is this like the other white meat? yeah they always find a way when the rest of the world turns them away all right, they call 911. Are you suggesting Homeland Security foot their bill here?

Sorry, the only progression for EMS to become substainal to expect revenue and reimbursements for the betterment of the medical community is for the education level of the EMS personel to increase. We are one of the very few if not only healthcare profession that requires such a limited courses.

Substaintial equates to renumeration to you? That's it? Please excuse me if i find this a rather prostituted mindset here because it insinuates those with the $$$ get better care than the many have nots out there (which are our fellow citizens btw)

We can only better ourselves off with increasing education, and as well as patients can expect to recieve better care.

Doesn't seem to me we are in such serious dire straights, but i'll tell you this. I'd rather have a boy scout with a pen knife trying his best to extricate me instead of waiting for some sheepskin waving ems'er from afar, which would you prefer?

~S~

 

[Ridryder911]

I guess I rather have someone who has been educated, tested and performed clinically to perform any skill. I much rather have a "sheepskin" waiving person than a boy scout any day be my surgeon, physician, & EMS provider as well. (and yes, I am a triple silver palm Eagle Scout, so this is not derogatory remark)

Has the ABC's changed?... Uh, yes they have actually. But, if EMS was only ABC's that would be simple, but it is not. It much more than such.. for example differential diagnosis, Left AMI versus anterior wall (such as administering NTG to a Left AMI can actually cause more damage even death). So if you were having the heart attack, would you not rather have someone knowing that before they gave you that nitroglycerin?

Personally, I could care less if those vollies lost interest. If they were truly in it for the patient sake, they would go to school and continue education. I do understand the conflict in proportion of keeping vollies and interference with maintaining staff. If the citizens are concerned enough, something will be designed and funding will come from somewhere. I bet they still have parks, LEO, and other so called required services.

With proper funding from grants, tax revenue, and yes even billing patients properly EMS systems can work...difficult yes. I worked at some very poor rural cities with a total population of 6,000 and performed some of the most aggressive care, so size in this case does not matter...LOL Yes, it can be difficult and yes there needs to be more investigation and answers to solve these problems, but ignoring and keeping the status quo is not the answer.. it is not working now.. Do we think it would be better by ignoring the problem?

Maybe, incorporating nearby professional services to assist and provide medical education to staff members would be helpful and more financially feasible. I am starting a program to do such, where once a month we have "Pizza and Education" night, for our local 1'st responders from neighboring communities. This gives them the needed education, and as well develops a better working relationship between everyone.

It is amazing many assume Homeland Security is the answer or lack of answer. In comparison EMS only received very few grants of Homeland Security monies, by far in comparison of fire services, and LEO. So no.. Homeland Security should not be involved, this is a health care, medical issue... remember we are Emergency MEDICAL Services, and as of such we should meet and supersede the rest of the medical criteria.

Yes, unfortunately money does sometimes mean better care than those without. Hopefully, not in EMS, but cities that do not have proper funding does not always have available the staff, the equipment required to always function. Not that is right or fair, but that is they way it is sometimes. If your community does have the monetary revenue, why would they have to rely upon volunteers?

No, I don't have the answers or even attempt to claim to, rather hopefully to spark interest in EMT's to become more interested in their profession and become active in change. No matter what your opinion, get involved.

Again, EMS is on life support in many areas, and it is not going to get better. In my state alone we have lost 3 EMS in the past 4 months, and personally just adopted another site. This is not because we really wanted to (since it is about 25 miles away), but someone has to be there. We are attempting to develop something for this small community, maybe a better first response unit, rendezvous Medic truck.. we will see by trial and error. Again, if it is really important to the community, something will be developed and funded.

When ER's do not have the beds needed to accommodate patients, EMS role will change (as it is currently being investigated) because the number of patients in comparison of beds is not there. Google how many people a day turn 60 and over... now compare this with the building and closing of hospitals. It is scary...

Nothing more, at least this might get you discussing the problems among fellow EMT's and maybe someone will get involved.

R/r 911

 

[jeepmedic]

Like I said before I did not get into EMS to go to school. I hated school and still do. But if I want to keep up with the times then I need to go to school as much as possable because as Ridryder has said things change all the time. Pre-Hospital care is still a new field compaired to other medical profesions so things are changing at a rapid pace.

Yes we are learning that things we did 10 years ago were not the right things to do. It may not have harmed the pt. right then but in the long run it did. Like Dopamine we used to just start it and when the BP came up we would titrate it to keep the BP above 100 systolic. We saved the pt. for now but blew out the Kidneys in the long run. We as ems providers did not know this because we had tunnel vision stayed in the box. All we cared about was "I got 'em to the ED alive." Today I have learned through education that I need to do the math and be more careful with the drugs I do have.

When I took my EMT-A the only drug we could give was O2. Now EMT-B's are giving more and more. Some places EMT-B's can intubate, start IV's and give so called 1st round drugs in a cardiac arrest. And the EMT-B class is in no way as strong as the old EMT-A class was. I hope that the new standards will be stronger toward the why's and how's instead of just do this for this next. I am teaching a First Responder class and last night we went over shock the only thing the book says teach is S&S of shock and how to treat it. Does not say teach why it is happening. I think this is very inportant. How can you treat something if you don't know what is happening?

Some of my EMT-B's at the Fire Dept. can't tell me what the NTG does or how it helps the pt. but they know if a pt. has CP and there own NTG and a BP above 100 systolic give it to 'em. Some don't even know why you don't give it if the BP is below 100 systolic. Not there fault just wasn't taught to them. Thats why my EMT class takes longer to teach I try to teach them the how and why to what they will be doing in the field.

 

[FFEMT1764]

I have to agree with Rid also. Every month we are getting a new item into our protocol's. This month's item was CPAP. Who knows what we get next month. We all need to continue our education in some way. If you feel like you know everything or can't learn something new it's time to get out of this field before you KILL someone with ignorance. I enjoy learning as much as I can, and even though I am not doing it in a traditional sense (college, etc.) I am always reading new things in the various medical publications as well as here on the internet.

 

[trauma1534]

Like I said before I did not get into EMS to go to school. I hated school and still do.

Shucks! I slept through most of it!!!

 

[Guardian]

I hate most of the classes I'm taking right now...hell, most of the people I go to school with dream of sitting on a beach and doing nothing (I love that song banana's and blow by ween). Not liking school is no excuse for not getting an education.

 

[trauma1534]

I hate most of the classes I'm taking right now...hell, most of the people I go to school with dream of sitting on a beach and doing nothing (I love that song banana's and blow by ween). Not liking school is no excuse for not getting an education.

Those on here who know me, know that I am only kidding about sleeping through school!

 

[jeepmedic]

Those on here who know me, know that I am only kidding about sleeping through school!

No you were not.

 

[trauma1534]

Don't tell all my secrets!!! SHHHHHHHH!

 

[Stevo]

I guess I rather have someone who has been educated, tested and performed clinically to perform any skill. I much rather have a "sheepskin" waiving person than a boy scout any day be my surgeon, physician, & EMS provider as well. (and yes, I am a triple silver palm Eagle Scout, so this is not derogatory remark)

no offense intended Ryder, we'd all like 5 star service, but the qaulity/quanity point still stands, in reality we're not going to achieve both. Perhaps googling up Starve the Beast would enlighten you as to why i've sided as i do.

Has the ABC's changed?... Uh, yes they have actually. But, if EMS was only ABC's that would be simple, but it is not. It much more than such.. for example differential diagnosis, Left AMI versus anterior wall (such as administering NTG to a Left AMI can actually cause more damage even death). So if you were having the heart attack, would you not rather have someone knowing that before they gave you that nitroglycerin?

I don't belive the ABC's change even if your the dean of a medical college, in fact the greater % of all ems calls are basic abc calls, ....that simple to mitigate, where do you think the term cabulance came from?

Introducing 'what if' scare tactics is loosing it's umph, don't you think? Focus on the greatest good ems can do, as we are taught to triage, and the greatest percenatge of our populance benifits

Personally, I could care less if those vollies lost interest. If they were truly in it for the patient sake, they would go to school and continue education. I do understand the conflict in proportion of keeping vollies and interference with maintaining staff. If the citizens are concerned enough, something will be designed and funding will come from somewhere. I bet they still have parks, LEO, and other so called required services.

It's a simple theory Ryder, there's safety in numbers. And we already have continuing educational requirements that seem to work just fine. Now i'm all for education, but let's keep the advancement comprable to those who wish to be involved here. In fact, let's allow those within the system to create a reasonable menu of advancement that is a personal elective , as opposed to another unfunded mandate.
You do realize here that we really have no viable 'from the streets' collective voice here right? Personally, i'm tired of being the subject of DOT bigwigs, ex-ems magazine publishers, as well as the pharmacabal in what WE do in the trenches they've either long forgotton, or sold out to lobbyists for.

If in fact there are so many instructors (been one btw) who feel the constant ciric changes have disenfranchised ems, where is their voice?

to add, i would not wish the one entity on this earth with more compassion in it's pinky , than what could be prositituted by $$$ in a carear mans whole body to vanish...do you?

With proper funding from grants, tax revenue, and yes even billing patients properly EMS systems can work...difficult yes. I worked at some very poor rural cities with a total population of 6,000 and performed some of the most aggressive care, so size in this case does not matter...LOL Yes, it can be difficult and yes there needs to be more investigation and answers to solve these problems, but ignoring and keeping the status quo is not the answer.. it is not working now.. Do we think it would be better by ignoring the problem?

I find no great wrong being done by the status quo in the field, in fact may i inquire who it is that feels it is so broken we require (constant) change? i do find that the oversight of the entire gambit wishes to evolve not for the sake of the patient, but for the sake of the creation of more self serving bueracracy. So i ask here in ernest, what stats are there to justify change? If we are in such need, there must be something relevant out there that would dictate such aside from trauma studies on pigs & our educational contingent fishing for further employment, yes?

Maybe, incorporating nearby professional services to assist and provide medical education to staff members would be helpful and more financially feasible. I am starting a program to do such, where once a month we have "Pizza and Education" night, for our local 1'st responders from neighboring communities. This gives them the needed education, and as well develops a better working relationship between everyone.

It is amazing many assume Homeland Security is the answer or lack of answer. In comparison EMS only received very few grants of Homeland Security monies, by far in comparison of fire services, and LEO. So no.. Homeland Security should not be involved, this is a health care, medical issue... remember we are Emergency MEDICAL Services, and as of such we should meet and supersede the rest of the medical criteria.

Well Rider, i posted Homeland Insecurity as a joke, because it basically is one. Yes i would like prioritization for the benifit of the populance, instead of for the benifit of the top 1% in this country. But as it stands now the priorities don't favor the people Cost of War alone has precluded any viable benifit(s) that could be there. So you see, EMS is left with the vistages of bugetary concerns, the triage of dollars squeezing the life out of vaible concerns.
Operating for the reduced benifit of the whole, imho, trumps the favored benifit of the few....

Yes, unfortunately money does sometimes mean better care than those without. Hopefully, not in EMS, but cities that do not have proper funding does not always have available the staff, the equipment required to always function. Not that is right or fair, but that is they way it is sometimes. If your community does have the monetary revenue, why would they have to rely upon volunteers?

Do you do have any idea how incredibly caustic this remark is? You obviously need an update on vollies here, The greater portion of any rural contingent are vollies,in fact most small municipalities rely on vollies for everything. And they are involved, and not the perephrial entity you allude to here. We're your roots for gawd sake....

No, I don't have the answers or even attempt to claim to, rather hopefully to spark interest in EMT's to become more interested in their profession and become active in change. No matter what your opinion, get involved.

Again, EMS is on life support in many areas, and it is not going to get better. In my state alone we have lost 3 EMS in the past 4 months, and personally just adopted another site. This is not because we really wanted to (since it is about 25 miles away), but someone has to be there. We are attempting to develop something for this small community, maybe a better first response unit, rendezvous Medic truck.. we will see by trial and error. Again, if it is really important to the community, something will be developed and funded.

When ER's do not have the beds needed to accommodate patients, EMS role will change (as it is currently being investigated) because the number of patients in comparison of beds is not there. Google how many people a day turn 60 and over... now compare this with the building and closing of hospitals. It is scary...

This is greatly due to our Lambourgini of a health care system, within which most people drive Chevy's....

Evolving, or insisting on greater acedemics means the cost of ems rises also. In essence this continues the cycle of alienation for the 45 million have nots (along with millions more that have little)

I'm not signing on to any more of the insanity that turns our backs to on it's own, sorry



~S~

 

[Fedmedic]

no offense intended Ryder, we'd all like 5 star service, but the qaulity/quanity point still stands, in reality we're not going to achieve both. Perhaps googling up Starve the Beast would enlighten you as to why i've sided as i do.



I don't belive the ABC's change even if your the dean of a medical college, in fact the greater % of all ems calls are basic abc calls, ....that simple to mitigate, where do you think the term cabulance came from?

Introducing 'what if' scare tactics is loosing it's umph, don't you think? Focus on the greatest good ems can do, as we are taught to triage, and the greatest percenatge of our populance benifits




It's a simple theory Ryder, there's safety in numbers. And we already have continuing educational requirements that seem to work just fine. Now i'm all for education, but let's keep the advancement comprable to those who wish to be involved here. In fact, let's allow those within the system to create a reasonable menu of advancement that is a personal elective , as opposed to another unfunded mandate.
You do realize here that we really have no viable 'from the streets' collective voice here right? Personally, i'm tired of being the subject of DOT bigwigs, ex-ems magazine publishers, as well as the pharmacabal in what WE do in the trenches they've either long forgotton, or sold out to lobbyists for.

If in fact there are so many instructors (been one btw) who feel the constant ciric changes have disenfranchised ems, where is their voice?

to add, i would not wish the one entity on this earth with more compassion in it's pinky , than what could be prositituted by $$$ in a carear mans whole body to vanish...do you?



I find no great wrong being done by the status quo in the field, in fact may i inquire who it is that feels it is so broken we require (constant) change? i do find that the oversight of the entire gambit wishes to evolve not for the sake of the patient, but for the sake of the creation of more self serving bueracracy. So i ask here in ernest, what stats are there to justify change? If we are in such need, there must be something relevant out there that would dictate such aside from trauma studies on pigs & our educational contingent fishing for further employment, yes?



Well Rider, i posted Homeland Insecurity as a joke, because it basically is one. Yes i would like prioritization for the benifit of the populance, instead of for the benifit of the top 1% in this country. But as it stands now the priorities don't favor the people Cost of War alone has precluded any viable benifit(s) that could be there. So you see, EMS is left with the vistages of bugetary concerns, the triage of dollars squeezing the life out of vaible concerns.
Operating for the reduced benifit of the whole, imho, trumps the favored benifit of the few....

Yes, unfortunately money does sometimes mean better care than those without. Hopefully, not in EMS, but cities that do not have proper funding does not always have available the staff, the equipment required to always function. Not that is right or fair, but that is they way it is sometimes. If your community does have the monetary revenue, why would they have to rely upon volunteers?

Do you do have any idea how incredibly caustic this remark is? You obviously need an update on vollies here, The greater portion of any rural contingent are vollies,in fact most small municipalities rely on vollies for everything. And they are involved, and not the perephrial entity you allude to here. We're your roots for gawd sake....



This is greatly due to our Lambourgini of a health care system, within which most people drive Chevy's....

Evolving, or insisting on greater acedemics means the cost of ems rises also. In essence this continues the cycle of alienation for the 45 million have nots (along with millions more that have little)

I'm not signing on to any more of the insanity that turns our backs to on it's own, sorry



~S~

Well said! Two thumbs up Stevo!!

 

[Ridryder911]

System not broke.. C'mon no ALS available in up to 30% of the time and it not broke?.. Sorry, even if ALS is only required 1% of the time it should be there. Just to think EMS has been popular for over 30 years and see still most areas without providing ALS, because there is always an excuse. This would be the same comparison of not having trauma centers due to less than 10% trauma patients do not require Level I Trauma Centers.. most patients do not really have poly-trauma or MOI that requires such.

EMS systems going broke, no patient care in some places..EMT's on food stamps and the system is okay? Again, the old saying.. "why buy the cow, when you get the milk free" comes in mind

Sorry, it appears to me many rather see EMS live in 60's with first-aid squads and maybe we can even go further go back to funeral homes. They even applied oxygen, splinting, and rapid transport and was a lot cheaper.

I will maintain my position that as EMS personnel we should be considered health care professionals, and should meet the minimal standards. This should mean the minimal standards of reading, mathematics, and English, science should be at least high school to 14'th grade level. When in court, one of the evaluations is based upon education level, no matter volunteer, or paid.

I agree we will have to agree to disagree and that's okay.. I do respect your opinion. Thanks for your responses.


p.s. there is a group of us field medics attempting to change things...
www.fieldmedics.com

R/r 911

 

[trauma1534]

ridryder, uhhh.... there is a such thing as a silver palm eagle scout, however there is no such thing as a tripple silver palm! And the palm does not change your rank! Do you have the God and Country award? Now that would change your rank. Are you in the order of the arrow? I'm married to an Eagle Scout, and my son is cub.

 

[Fedmedic]

Ah yes, the Order of the Arrow, I was just looking at my sash the other day. Oh the fun times.