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EmilyKN

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Hello,
My name is Emily Nass. I am a college student majoring in Nursing at the University of Northern Colorado. I am writing my college research paper on the effect of First Responders in the medical community. My main argument is implementing a required first aid and CPR certification to legally hold a drivers license in the United States. I would like to interview a few EMTs to get feedback and some information concerning my topic. Any help would be much obliged. Thank you and have a nice day!

If you would like to help me feel free to email me at the address provided on my profile page. I am looking for someone that agrees with my argument, but if you disagree I would love to interview you as well. Thank you for your time and willingness to make our country a safer place to live!

Sincerely,
Emily Nass
 

Veneficus

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It is not that I agree or disagree, it is that I really don't think it will make people anymore likely to respond in anyway.

One of the biggest fears of laypersons rendering aid is worrying about properly performing such aid.

Anytype of medical skill or ability requires maintenence. Since it would be asking a lot to have people recertify every few years at their expense as well as possibly deprive them of the means to support themselves and family. If you are going to have somebody take a class when they are 15 or whatever and hope that they retain or are confident enough to render aid 2,5, or 10+ years in time I don't think it will have the desired effect.

It also creates major logistical hurdles. Where would these classes be offered? Taught by who? At what cost? Is the AHA card going to be equal to the Red cross or other card? Is anyone going to be able to teach this to any standards? What if one state requires such things and others don't? after all it is not a federal drivers license. In the countries it is required, it is a national drivers licence.

In theory it sounds like a good idea. I know of a handful of countries that do mandate it. I also know how it works out and several of the workarounds.

I would like to point out also in those countries, a fire extinguisher and first aid kit are required for annual vehicle inspections. You can know all the first aid in the world, but if you have nothing to perform it with, it is worth nothing more than the average bytander today anyway.

Like I said, it is not that I am for or against, I am just aware of the problems with doing such a thing.

Considering the implications, it might be better to require the classes be taught in highschools and states not complying would be denied federal education money. Of course I think there are bigger fish to fry in education, like how people get pregnant and the like.
 
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EmilyKN

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Thank you for your input. Both of you made valid points.

Because this is the beginning of my research, I am open to taking ideas. I think that your feedback will help greatly to shape my thesis.

Veneficus: I did not want to go into much detail when I first posted this, but I do have solutions to the points that you talked about. Yes, not all people would be willing to jump in and help, but if they knew they were certified it could make an impact. There would be no fines on people that did not help, it would just be a precautionary measure. The classes would be offered through the DMV and as well as with new drivers courses. The added classes at the DMV would add more government regulated laws. Because each state is different, it will be encouraged that all classes be the the same. The government will pay for the added classes to better the health of the nation. For the disabled, they will have to get a written excuse from a doctor.

Lampnyter: It is really not that expensive to get certified, and it may save lives. When I renewed my certifications it was about $35. It is quite affordable, and will cut down on lawsuits. We all know how much people love to sue these days!

I really value your feedback! Keep it coming!
 

Sassafras

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When you multiply that cost times the number of drivers out there it does get overwhelming. Where does the funding for this come from? More taxes? They can't even get people to agree to higher taxes for their own healthcare. I seriously suspect a coup would ensue if the powers that be demanded even more taxpayer dollars for such things.

I think a better approach would be insurance premium breaks. Hit it from the commercial stand point. Either auto or health insurance breaks for pursuing this type of training on your own. But there would still need to be a way to ensure it stayed up to date. I know nurses who don't stay up to date on BLS. I'm not sure how we could mandate the general public do so.
 
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EmilyKN

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Sassafras: I really like the idea that you had about giving the driver incentives. Lowering the premium would be a great idea. If this were mandatory it would add comfort in knowing that everyone knew BLS. Going through nursing school I don't understand how we could not stay up to date with BLS, but this would be added comfort. Thank you so much!
 

Veneficus

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The classes would be offered through the DMV and as well as with new drivers courses.

In order for the classes to be offered through the DMV, they will have to employ people who are credentialed in some way to teach CPR and first aid.

The other option is to outsource it to already existing instructors. (Which is a far more likely option) The average price for a HCP provider CPR class in my home state is $125 +book a person. Those same instructors are capable of teaching a lower level course, but why on earth would I or any other instructor spend time teaching a lower level class for less money which is not only required, but for the government, during the same time we could be teaching the higher level one for people who actually have to be certified or recertified to continue thier healthcare career?

On the flip side, what happens if the government pays more for teaching driving candidates than healthcare facilities to recert their employees or educational institutions their students?

That means you will need more instructors who will expect to be paid a competative market rate.

The other option is to create a curriculum which would have to be verified and that will come with a considerable up front cost.

Because each state is different, it will be encouraged that all classes be the the same.

Most states can't even agree on the types of drivers licences they offer. I have worked in states where you needed a commercial licence to drive an ambulance. The test had nothing to do with ambulances, but I could tell you when you were permitted to use an engine break (not found on ambulances) and how far behind your vehicle your load is permitted to protrude. There are also states which require a special ambulance licence. Many do not.

If you can't get them to agree on what licences are needed or issued, the only realistic way to get them to agree on a curriculum is to outsource an already established one. Which I must point out there is not one accepted standard for CPR or first aid in the country.

You must also take into account that some states like to disagree simply to demonstrate they have the right to or prove they can.

The government will pay for the added classes to better the health of the nation.

Government spending is not exactly very popular as of late.

As for bettering the health of the nation, I dispute such claim. First aid and CPR do not improve health. They are responsive measures to an emergency that has already occured.

They can lower morbidity and mortality, however, they are only the first step in one of the, if not the most expensive medical endevor in the world.

Lampnyter: It is really not that expensive to get certified,

That depends on where you live, who, and how many instructors are in your area.

and it may save lives.

The evidence does show this. But I think it may be cheaper to educate and encourage people to healthy lifestyles than to pay for and provide the care required to save a a life from acute presentations of disease processes that are often decades in the making. I also think it will save far more lives.

Another issue the US has to come to terms with is the cost vs benefit of some of the treatments available. The healthcare spending is already unsustainable.

When I renewed my certifications it was about $35.

You should send that instructor/agency a holiday greeting card. That buys about 1 hour of my time as a contract instructor where I supply only myself, certainly not what I expect for a full course, especially if I have to supply equipment.

It is quite affordable, and will cut down on lawsuits.

Not when the government gets involved. Then everything costs more for some reason. I have no idea how it would cut down on lawsuits. In just a simple way of looking at it, more people providing intervention increases the amount of people who will expose themselves to potential lawsuits. More people exposed means more lawsuits. Most Good Samaritan laws provide a limited affirmitive defense, they do not stop you from getting sued. They do not cover the cost of your legal representation, and they do not compensate you for the stress getting sued brings.

Tort reform is a fantasy and has some very wealthy and powerful advocates opposing it. The US cannot even pass medical malpractice reform, which is only a division of tort. What is the plan to make anyone who renders aid completely immune from a suit? There is already case precedent where lay rescuers have been held liable for injury to people in disaster conditions in the US.

At the scene of any emergency there are decisions that need to be made. In all aspects of life, when you make a decision, you are responsible for it. Rendering emergency aid is no different. when you are responsible, you can be sued.
 

lampnyter

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The class may cost $35 but do you think the people who are teaching will want any less than $25 an hour?
 

Tommerag

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and will cut down on lawsuits.

I can see that going the other way to. If someone stops to help, the person that is getting helped may feel that they were harmed by the the person helping and all of a sudden you have a lawsuit.
 

Tommerag

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In my opinion I think in theory it sounds great, but in reality I don't see something like this happening.
 

Handsome Robb

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Like lots of people said, it's good in theory, but impractical. Another point I'd like to add is that you create another hazard with civilians stopping at the scene of an accident to try and render aid. Also, I don't trust some EMTs/Medics to provide pt care, let alone a random layperson.
 

njemtbvol

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I think we all agree in idea, (the more people who know cpr the better) It's just that it doesn't work in practice.
I can say though that people who are improperly trained in CPR can do loads more harm than they can good.
 

usafmedic45

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Great in theory, but it falls apart in practice. Most people are selfish :censored::censored::censored::censored::censored::censored::censored:s who tend to not want to get involved and you can't easily legislate to change that. Not to mention the added costs (not only of training, but also tracking all this crap and dealing with those who are non-compliant)....it's just more of a headache than its worth.
 
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Veneficus

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So, it seems the general consensus here is that EMT/Medics are not in support of this?

I like the idea of everyone knowing first aid, cpr, and some basic care like nsaids for fevers etc.

But I have been at this game a while and I am an operations type person. I understand the difficulties of turning well meaning theories into reality.

I don't think mandating it as part of a drivers licence is a realistic possibility. I think it is much more realistically achievable to make it part of middle or highschool education.

I also have spent considerable time working with indigent populations. When you start talking about mandates that require individual spending, as healthcare providers we owe it to these people to see how it can affect their lives before we start lobbying for our good intentions.

The ability to drive a car directly relates to the ability to find and maintain employment.

That could directly affect the very tenuous balance these people have on life. Are they supposed to forgo a few meals in order to comply to obtain or maintain the ability to drive?

Should they be forced to not take their kid to the doctor or dentist in order to preserve family income?

Forgo clothing instead? Not pay the electric bill this month?

When you have a mandate, many of these people will be forced to make the choice to be compliant or noncompliant with the law based out of economic necessity. How devastating do you think it would be if these people get in trouble for driving without a licence because they cannot afford a CPR class but have to drive to survive?

The government isn't going to absorb the cost of this training. It is going to pass that cost on, whether they outsource or raise licensing fees.

Now consider the cost/benefit ratio. Is the cost of this program, its administration, and enforcement going to majorly impact and dramatically increase the amount of people who actually will respond in an emergency and therefore increase survival and decrease morbidity?

While I could see that some people who previously were not would be confident enough to make the decision to help, with the general every man for himself attitude of a vast majority the US populous, as well as the fear and real possibility of litigation, I don't see a major change in the amount of people stepping up. As such the benefit does not exceed cost.

Again, I am not opposed, but I don't think requiring first aid/CPR as a condition of obtaining or maintaining a licence to drive is a realistic possibility.
 

Asimurk

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I can see that going the other way to. If someone stops to help, the person that is getting helped may feel that they were harmed by the the person helping and all of a sudden you have a lawsuit.

Wouldn't a good Samaritan law protect a person from something like that?
 

emt seeking first job

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Not everyone is suited to render first aid.

Way back, schools had home economics for girls and shop for boys. In my generation, in the seventies, they split it up so each gender received a 1/2 year of both.

If schools still do that, incorporating it into that program seems more viable.

As far as adults. I see it more as a voluntary thing offered in adulting education programs.

As far as being sued, the laws just provide a viable defense, not immunity from a case ebing brought about.
 

emt seeking first job

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FOR THE OP:

I was thinking about your question, IMHO, the cost of individual training for CPR and First Aid ($50-$60) could likely fund more professional rescuers. And having a quicker response time to the scenes of crashes does nothing to reduce liability, it possibly reduces the damages.

The government could also reduce the approx 45k car crash deaths and hundreds of thousands of injuries by making more stringent licesning requirements, stricter enforcement, and getting people off the road in general in population dense areas by making safer and more reliable mass transit.

As I replied before, not everyone is suited to help a crash victim. The same way not everyone is suited to play sports or sing. The latter of which I hated being forced to do in school.
 

DesertMedic66

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my opinion is the same as everyone elses so far. its a really good idea. but in reality it wouldnt play out too well. if everyone knew CPR then there may actually be fights (as i have in fact seen) over who should be doing CPR. As for my High School we had to take a brief CPR/First Aid class to get our training for our drivers permit. Great idea truely but in reality it wouldnt play out for the best.
 

MedicOut

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Why not?

Cost practicality aside, I think it would be great if more people knew CPR.

Not only would it be beneficial to the patient as CPR was initiated prior to the average response time of an ambulance, it would give us (the professionals) more resources at the scene.

Having worked in a rural service, I know that sinking feeling when you look up while performing CPR and see a bunch of "deer in the headlights" looks on the faces of the bystanders. It is right about that time that the first volunteer firefighter comes over the radio and says "responding from home."

I, for one, am very appreciative when I respond to a call and see people at least attempting CPR.

Additionally, isn't this the direction the Red Cross and AHA is taking with the new "no ventilations" CPR? To get more people (namely the squeamish :p) involved?

My feeling is that what the interviewer is attempting with this proposal is not requiring people to act, but giving them a very basic knowledge so they are more likely to in that instance.

I know that if I know absolutely nothing about something, it is likely that I won't attempt to mess with it. But if I have a little knowledge, I might give it a shot.

It is easy to shoot an idea down on the argument that it is cost prohibitive or the money could be used elsewhere. But where would we be if we allowed this argument to deter new thoughts and ideas?
 
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