I don't trust him

[DFW333]

Im kinda confused as how he can pull the rank card in a BLS only service. What good is paramedic training if you cant do ALS interventions? Tell him you're both Basics and he's driving.

Sounds like he's just an uneducated bully. Im kinda curious as to why this guy had to flee to another state and go vollie in order to stay in EMS....

 

[JPINFV]

Im kinda confused as how he can pull the rank card in a BLS only service. What good is paramedic training if you cant do ALS interventions? Tell him you're both Basics and he's driving.

There's an entire thing before treatment dealing with a history and physical exam and coming up with a working diagnosis.

 

[DFW333]

There's an entire thing before treatment dealing with a history and physical exam and coming up with a working diagnosis.

So your EMT-Bs are not able to listen to lung sounds, palpate for tenderness, obtain a pulse rate, or review history? When it comes to examining patients the EMT can do everything the medic can except interpret the EKG.

 

[JPINFV]

Are you arguing that the only difference between an EMT and a paramedic are assessment tools and treatment options? There's no difference in either foundational education (anatomy, physiology, etc) or applied science (pathology, pharmacology, etc)?

 

[MrBrown]

Oh dear Brown's Parathinktheyare detector is going off

 

[jjesusfreak01]

Oh dear Brown's Parathinktheyare detector is going off

In this case however, it seems the Parathinktheyare is the Paramedic.

 

[DFW333]

Are you arguing that the only difference between an EMT and a paramedic are assessment tools and treatment options? There's no difference in either foundational education (anatomy, physiology, etc) or applied science (pathology, pharmacology, etc)?

In a BLS only service like the one in question there are NO differences in treatment options and tools. BLS means EVERYONE is limited to BLS all the way around. What is the medic going to have on him that will enable him to assess the patient any better that he can use without exceeding protocol? His knowledge has already been brought into doubt by the original poster...doesnt leave much else.

And it is entirely possible that the EMT-B's knowledge, training and experience could vastly exceed the medic. I can name 20 people right off the top of my head who are medics with 0 experience cause they went straight to medic school from basic school. I can name just as many EMTs who have been EMTs for over 20 years, and it aint cause they failed medic school.

 

[usalsfyre]

In this case however, it seems the Parathinktheyare is the Paramedic.

If I understand Brown's thinking on this subject, most parathinktheyares have a valid EMT-P card in their pocket.

 

[usalsfyre]

In a BLS only service like the one in question there are NO differences in treatment options and tools. BLS means EVERYONE is limited to BLS all the way around. What is the medic going to have on him that will enable him to assess the patient any better that he can use without exceeding protocol? His knowledge has already been brought into doubt by the original poster...doesnt leave much else.

And it is entirely possible that the EMT-B's knowledge, training and experience could vastly exceed the medic. I can name 20 people right off the top of my head who are medics with 0 experience cause they went straight to medic school from basic school. I can name just as many EMTs who have been EMTs for over 20 years, and it aint cause they failed medic school.

Half the battle is getting the patient to the right facility and pointing the next set of providers down the right treatment path. So yes, a Basic can do just about any physical assessment I can. If they have no clue why the information means, it's an exercise in pointlessness. To put on my "arrogant @ss" hat for a second, I'm fairly certain I and most other halfway decent paramedics can run circles around even 20 year basics in this regard. Your right, someones not an EMT-Basic for 20 years without a reason.

It's not all about needles, tubes and drugs folks....

That is not to say with the stupidity that the OP says is on display I consider this clown to be a halfway decent paramedic.

 

[DFW333]

Half the battle is getting the patient to the right facility and pointing the next set of providers down the right treatment path. So yes, a Basic can do just about any physical assessment I can. If they have no clue why the information means, it's an exercise in pointlessness. To put on my "arrogant @ss" hat for a second, I'm fairly certain I and most other halfway decent paramedics can run circles around even 20 year basics in this regard. Your right, someones not an EMT-Basic for 20 years without a reason.

It's not all about needles, tubes and drugs folks....

That is not to say with the stupidity that the OP says is on display I consider this clown to be a halfway decent paramedic.

Again, in a BLS only service why does it matter if you know what the information means? Tell the hospital (Im assuming there's only one in the area in the case in question) what the patient has, what the patient's history is, and let them make the decision what's going on.

If you're going to be starting ALS interventions, giving cardiac drugs and all that other good stuff, then yeah you damn well better have that education and know what's going on.

Every service is different, some might have an ALS agreement with mutual aide, some might have 30 hospitals to choose from. I was drawing my conclusions based solely off what I saw from the circumstances outlined by the OP.

Now to jump to a far-fetched conclusion not based on anything, whatcha wanna bet the guy always insists on jumping in the back so he can sleep rather than drive?

 

[JPINFV]

In a BLS only service like the one in question there are NO differences in treatment options and tools.

Agreed, to an extent.

BLS means EVERYONE is limited to BLS all the way around. What is the medic going to have on him that will enable him to assess the patient any better that he can use without exceeding protocol? His knowledge has already been brought into doubt by the original poster...doesnt leave much else.

Knowledge is pretty darn important. Heck, if I was to go work on an ambulance tomorrow, I wouldn't be able to just turn off the assessment tools and medical knowledge I've learned so far in medical school. Just because a medical condition (more differential diagnoses to consider) or manual assessment technique (e.g. dermatomes, muscle strength beyond grips, cranial nerves, and many more) that wasn't taught to me in EMT school doesn't mean I could be expected to turn it off on the ambulance.

And it is entirely possible that the EMT-B's knowledge, training and experience could vastly exceed the medic. I can name 20 people right off the top of my head who are medics with 0 experience cause they went straight to medic school from basic school. I can name just as many EMTs who have been EMTs for over 20 years, and it aint cause they failed medic school.

Experience is only important if the knowledge and training is there. Additionally, I'm not impressed with "experience" as being some sort of equalizer. If the EMT had the drive to provide good prehospital emergency care, they would advance well before they hit 20 years. Additionally, all too often in EMS it's 1 year of experience repeated 20 times than 20 years of experience. Personally, I'd take the EMT with 6 months of experience and a college degree in a biological science than an EMT with 20 "years of experience" (or 1 year repeated 20 times).

 

[JPINFV]

Again, in a BLS only service why does it matter if you know what the information means? Tell the hospital (Im assuming there's only one in the area in the case in question) what the patient has, what the patient's history is, and let them make the decision what's going on.

Reasons knowing "why" is important to an EMT.

1. Do I need to reroute?
2. Do I need to call paramedics?
3. Do I need to call medical control and request a variation?
4. Do I need to turn on the flashy lights and woo woos and put everyone on board and around us at risk by engaging in one of the most risky interventions we have?


Yea, sure, if you're in BFE without paramedics, one hospital, and relatively no traffic, I guess it doesn't matter who's in the back. Heck, in that situation you don't even need an EMT. Anyone can throw a NRB on and drive with the woo woos to the hospital.

 

[DFW333]

Oh I see what you're doing. Taking it to the absolute extreme and saying basics have no knowledge whatsoever.

Here is the bottom line I was making with my original response because you clearly do not understand it:

IF YOU HAVE KNOWLEDGE USE IT. IF YOU HAVE A PARTNER WHO CLAIMS TO HAVE KNOWLEDGE BUT CLEARLY DOES NOT, THEN DO NOT LET HIM USE IT.

Are you really so dense as to think I was telling you to turn off your brain? :sad:

 

[JPINFV]

I'm not the one making the claim that there's zero difference between an EMT and a paramedic working as an EMT.

 

[DFW333]

I'm not the one making the claim that there's zero difference between an EMT and a paramedic working as an EMT.

In most instances there is a HUGE difference. Speaking strictly to the scenario at hand, it does not appear there is in this case.

 

[JPINFV]

In most instances there is a HUGE difference. Speaking strictly to the scenario at hand, it does not appear there is in this case.

Strictly speaking, the situation at hand appears to have an idiot who would ignore assessment tools and administer the wrong medications. However I think the issue of the functional difference of an EMT working as an EMT and a paramedic working as an EMT are separate from this case.

 

[MrBrown]

If there is only sometimes a difference then why is that outside the US a 120 hour EMT would not be qualified to even set foot on an ambulance and it takes three to six years of education to become the equivalent of an American Paramedic?

 

[FrostbiteMedic]

Now, to be fair, I am probably about to get yelled at for this, but please folks, hear me out. This guy might have a case of what my instructor, years ago, called the -P syndrome. The -P syndrome is where a Paramdic forgets that his licensure starts out with the letters EMT. I do not see it a lot in here, but I have seen it in the real world many times. He feels that since he is a -P, basic level interventions are completely below him. Just a thought.....

 

[usalsfyre]

The -P syndrome is where a Paramdic forgets that his licensure starts out with the letters EMT.

I really, really, REALLY wish andecotes such as this would disappear...:glare:

 

[emt seeking first job]

In this case however, it seems the Parathinktheyare is the Paramedic.

I am not expert in EMS, however, I can understand the issue in this thread.

Somebody could have an MD from John Hopkins and be a working brain surgeon at a hospital.

However, if he or she joins a BLS volunteer ambulance as an EMT, neither the MD, other knowledge, other job position affect his or her position.

It is the same as an out of work finance position with a Wharton MBA getting a job as a cashier at Applebees. The manager has an AA in liberal arts. Because the cashier has a higher level of buisness training does nothing to put them in automatic authority above anyone else in the organization.

My questions to the OP remained unanswered.

1) who was the crew chief on the bus ? what was their angle on this ?

2) what is your services VPO angle on this ?

As far as the medicine goes, dont quote me, but in my b class, I rmemver the instructor staing in NYS the protocol is glucose regardless if they are hyper or hypo since more sugar will not make a difference..not sure on the full explanation.

As far as the administrative authority goes, I know I am right. If this person was designated crew chief, do what they say. If you know they are wrong 100% then refuse and report to your VPO.

Once again, there is no automatice authority granted to anyone with more education, training or experience in a BLS ambulance service if their position is EMT.