Jobs not "trusting" emt-b?

evantheEMT said:
OR medics that are threatened by bls care doing more.
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No, i dont care if basics do more, but give them an actual education about what they are doing and why. 120 hours is far less than an emergency care provider should have. If our 'bls' was educated like Canadian BLS then I'd say go for it. Theres a reason some states mandate AEMT/EMT-I as the lowest level allowed to work on an emergency ambulance.
Sometimes the best thing for your oatient is knowing how to do a skill, but having enough knowledge and education to know that you SHOULDNT do that.
 
Please try to use the multiquote feature.

We should feel threatened by EMTs doing more because they lack the education needed to do more.
 
TransportJockey said:
No, i dont care if basics do more, but give them an actual education about what they are doing and why. 120 hours is far less than an emergency care provider should have. If our 'bls' was educated like Canadian BLS then I'd say go for it. Theres a reason some states mandate AEMT/EMT-I as the lowest level allowed to work on an emergency ambulance.
Sometimes the best thing for your oatient is knowing how to do a skill, but having enough knowledge and education to know that you SHOULDNT do that.
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Can't put all bls providers in the same group.
cruiseforever said:
This guy has been having good luck trolling today.
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I'm trolling because you don't like my opinions.
 
evantheEMT said:
Can't put all bls providers in the same group.

I'm trolling because you don't like my opinions.
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Until they actually have a real education, yes I can put all US BLS providers in the same group, including from my two home states with some of the broadest SOPs of them all. They don't have the education to do anything further.
 
Some contracts require an ALS only response on anything that comes through the 911 system.
 
evantheEMT said:
OR medics that are threatened by bls care doing more.
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Not threatened by it. Scared of it because of the amount of training that is required at the BLS level. 120 hours of classroom/skills and maybe a handful of clinical shifts is no where near enough.

I'd be fine with BLS having a wider skill set as long as they get the hands on training and the educational component behind why we do these procedures and why we shouldn't do them.
 
evantheEMT said:
Why are you grouping all emts together? That's insane just like grouping all medics in the same group saying they're all amazing.
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Because I am speaking to about a BLS SYSTEM. I'm sure there's the occasional trauma nurse out there that volunteers as an EMT, but I am speaking about the entire system.

I'm simply addressing that there is a vast difference in assessment skills. One group goes to school for about 120 hours. The other group does the same thing, and then goes back for additional training for another 1,000-14,000 hours.

I don't really care about the statistical outliers.
 
evantheEMT said:
OR medics that are threatened by bls care doing more.
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How would you feel about lifeguards starting IVs or giving drugs?

You would probably feel like they should receive more than a Saturday "update" class.

Again: it's not the actual administration of the medication that is hard, it's the hundreds of hours and multiple textbooks of difference in education that explains how, when, why, what to do if it goes wrong, etc.

You don't know how much you don't know.
 
DesertMedic66 said:
Not threatened by it. Scared of it because of the amount of training that is required at the BLS level. 120 hours of classroom/skills and maybe a handful of clinical shifts is no where near enough.

I'd be fine with BLS having a wider skill set as long as they get the hands on training and the educational component behind why we do these procedures and why we shouldn't do them.
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Im going to regret "feeding the troll" but this. I'm the EMT with 120 hours of training and only 4 12 hour shifts to get the cert. Now Ive been a EMT for 3 years and I still learn new things to this day. If my EMS agency said "Ok EMT's can now do supraglottic airways" and gave a basic 4 hour (hypothetical, bear with me) class on how and when to use supraglottic airways I still wouldn't feel comfortable with the skill. No. Wanna know why? You know how many times I've seen one used in 6 years involved in emergency services (3 as a fire explorer and 3 as a EMT)? 0 times. Wanna know how many time I've discussed them? 0 times. I have taken all of 4 hours in CE's on advanced airways and I always have a desire to know and do more (thats why I want to be a medic). I like to stay educated on things out of my scope of practice because I want to know more. So going back to my hypothetical situation, no I would not feel comfortable with this skill. I sure as hell wouldn't feel comfortable with some of the EMT's I've seen over the years with this.

For what us EMT's (basics) are allowed to do with ONLY 120 hours of training and 48 hours of field time is pretty damn good. I don't complain with what I can and can't do. I feel that my scope fits with what the local EMT classes are taught and trained on. Although blood glucose would be nice to do by ourselves, but thats a different topic for a different day. If we (EMT's) were to have a wider skill set, I would like to see it taught in EMT classes. I would also like to see a requirement determining you're proficient in said skills before being signed off for a county/state card and retested before recerting your county/state card. Im all for doing more, as long as you have beyond proficient training and understanding when and when not to do something any why.
 
CALEMT said:
Im going to regret "feeding the troll" but this. I'm the EMT with 120 hours of training and only 4 12 hour shifts to get the cert. Now Ive been a EMT for 3 years and I still learn new things to this day. If my EMS agency said "Ok EMT's can now do supraglottic airways" and gave a basic 4 hour (hypothetical, bear with me) class on how and when to use supraglottic airways I still wouldn't feel comfortable with the skill. No. Wanna know why? You know how many times I've seen one used in 6 years involved in emergency services (3 as a fire explorer and 3 as a EMT)? 0 times. Wanna know how many time I've discussed them? 0 times. I have taken all of 4 hours in CE's on advanced airways and I always have a desire to know and do more (thats why I want to be a medic). I like to stay educated on things out of my scope of practice because I want to know more. So going back to my hypothetical situation, no I would not feel comfortable with this skill. I sure as hell wouldn't feel comfortable with some of the EMT's I've seen over the years with this.

For what us EMT's (basics) are allowed to do with ONLY 120 hours of training and 48 hours of field time is pretty damn good. I don't complain with what I can and can't do. I feel that my scope fits with what the local EMT classes are taught and trained on. Although blood glucose would be nice to do by ourselves, but thats a different topic for a different day. If we (EMT's) were to have a wider skill set, I would like to see it taught in EMT classes. I would also like to see a requirement determining you're proficient in said skills before being signed off for a county/state card and retested before recerting your county/state card. Im all for doing more, as long as you have beyond proficient training and understanding when and when not to do something any why.
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I agree with the gist of your post. That said, four hours is about how long it takes to learn to insert SGAs and learn about their indications and contraindications. Pretty easy stuff, rest assured.

Meanwhile in Colorado we have a 24 hour class for IV access, fluids, D50, IV Narcan, Nebulized albuterol, and some other more AEMT type stuff. For me and other busy 911 providers, it's great. My partners taught me when IVs are and aren't indicated and helped me hone my technique. But I was lucky. I had partners that wanted to teach. Many EMTs don't, and they do a terrible job with these skills. Even worse is pure BLS services that cannot provide this sort of mentorship.
 
Tigger said:
I agree with the gist of your post. That said, four hours is about how long it takes to learn to insert SGAs and learn about their indications and contraindications. Pretty easy stuff, rest assured.

Meanwhile in Colorado we have a 24 hour class for IV access, fluids, D50, IV Narcan, Nebulized albuterol, and some other more AEMT type stuff. For me and other busy 911 providers, it's great. My partners taught me when IVs are and aren't indicated and helped me hone my technique. But I was lucky. I had partners that wanted to teach. Many EMTs don't, and they do a terrible job with these skills. Even worse is pure BLS services that cannot provide this sort of mentorship.
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The 4 hours was hypothetical. I honestly couldn't tell you how many hour(s) it would take to teach EMT's a new skill (SGAs as the ex).

For the IV access I'm totally for that. Is that at the EMT level or AEMT (here in CA theres not to many AEMT's so please mind my ignorance)?
 
CALEMT said:
The 4 hours was hypothetical. I honestly couldn't tell you how many hour(s) it would take to teach EMT's a new skill (SGAs as the ex).

For the IV access I'm totally for that. Is that at the EMT level or AEMT (here in CA theres not to many AEMT's so please mind my ignorance)?
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EMTs here in Colorado.
 
Tigger said:
Meh it's a mixed bag. I like being able to be helpful, but I wish we were just AEMTs instead.
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Yeah, makes sense if you're already giving IV fluids, IV Narcan, D50, and Nebulized albuterol. Is there much of a difference between the two now that you have "expanded" the basic scope?
 
CALEMT said:
Yeah, makes sense if you're already giving IV fluids, IV Narcan, D50, and Nebulized albuterol. Is there much of a difference between the two now that you have "expanded" the basic scope?
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A semester of education...

Scope wise there isn't much. This year EMTs will also have IV Zofran and IM Epi (ampules). We already do IOs. The only medication that EMTs won't have is IV Benadryl, though there is talk of that PO. Everything else is pretty much the same here. Not sure what AEMTs do in other states.
 
Tigger said:
A semester of education...

Scope wise there isn't much. This year EMTs will also have IV Zofran and IM Epi (ampules). We already do IOs. The only medication that EMTs won't have is IV Benadryl, though there is talk of that PO. Everything else is pretty much the same here. Not sure what AEMTs do in other states.
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Not that it matters much to me and I'm sure many people have thought this question. But why have basics in the first place then? If both scopes are so close together why not just do away with the basic and move up to AEMT? With the new scope and the new curriculum in EMT classes you might as well just say the hell with it and go for AEMT. What you described scope wise pretty much defines what a AEMT can do.

Edit: Unless of course if the AEMT scope gets expanded I don't see much reasoning to have the two since they're so similar.
 
CALEMT said:
Not that it matters much to me and I'm sure many people have thought this question. But why have basics in the first place then? If both scopes are so close together why not just do away with the basic and move up to AEMT? With the new scope and the new curriculum in EMT classes you might as well just say the hell with it and go for AEMT. What you described scope wise pretty much defines what a AEMT can do.

Edit: Unless of course if the AEMT scope gets expanded I don't see much reasoning to have the two since they're so similar.
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Like many things, "because this is how we have always done it." Remember that the AEMT level is fairly new. Until only a few years ago we had basics, intermediates, and paramedics. The intermediates were at the I-99 level--they had a paramedic scope of interventions (minus a few) that they had to call for and about half the education of a paramedic. There were not many paramedics or intermediates, so the EMT-IV was created as a temporizing measure for the lack of ALS care and it stuck around.

I asked the state EMS director your exact question last year, he said it makes no sense as the levels are practically the same anyway [sigh]. Also "it's not realistic to have make volunteers go through that sort of training, and most EMTs in this state are volunteers." He is right about that, however the bulk actual patient contacts are made by paid EMS professionals. We have a strong rural EMS volunteer tradition here, but even the most desolate areas are starting to see paid ALS crews. There might be only one for 100s of square miles, but it beats the alternative.

At the very least I'd like to see us do what Nevada and Tennessee do. You can still be an EMT, but you do not transport. To be on an ambulance, you must be an AEMT or better.
 
What system in CO, lets basics do IO's? I know AEMT's can. I know Denver Metro does not and no service in NoCo lets the basics do them.
 
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