Paramedic Shortage

[Kavsuvb]

I saw this article today in JEMS and what do ya think. Are we headed for a Paramedic shortage in this country and do you think it's time the American EMS system gets an overhaul and be more like the UK and Australia.

Here's the Link to the Article;
The Paramedic Shortage — Opportunity or Crisis?

The Paramedic Shortage – Opportunity or Crisis? - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

The Paramedic Shortage – Opportunity or Crisis? - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News - Administration and Leadership Get the most up-to-date news from the Journal of Emergency Medical Services.

www.jems.com

 

[Tigger]

I am not sure the commonwealth countries are a great comparison to this article. Nearly all ambulances are staffed by paramedics and operate at what we might term Intermediate Life Support. They are backed up by critical care level practitioners that often have a grad degree equivalent. There are very few "EMTs" providing BLS level care in a 911 setting in commonwealth settings. The average ambulance crew can provide ACLS, supraglottic airways, pain/sick person symptom control, anaphylaxis/respiratory medications, CPAP, interpret 12 leads, seizure control, among other things. They don't carry tons of cardiac medications, they rely on electrical therapy for symptomatic patients.

There is not a chance that AEMTs will be able to do most of these things. That said, in an urban area you still have to wonder if all of the above still has a place for most providers? Or would some IV fluids and zofran be a sufficient upgrade? I have no idea.

I do know that that the commonwealth model makes much more sense to me but I don't see that ever happening in this country on any wide scale. The provider levels are just too rigid and frankly are antiquated. I think this line is the most poignant statement in the article:

We would abandon the current concept of basic life support and advanced life support and look specifically at the tasks needed for adequate care and then educate the EMT in those skills that may be beneficial, regardless of whether they were once considered BLS or ALS.

The care levels in this county (paramedic included) need a significant overhauling. We continue to teach providers of all levels useless skills and underpower them to actually take care of their most common patient types.

 

[CCCSD]

Since they are still pumping paramedics out daily, I don’t think there is a need to worry.

Some of those articles require a real close look and better research.

 

[Peak]

I don't think that there is a shortage of EMTs or Paramedics by any means. There is a shortage of EMTs and Paramrdics that are competent and professional who are willing to be paid peanuts while being worked to the bone.

 

[DesertMedic66]

I don't think that there is a shortage of EMTs or Paramedics by any means. There is a shortage of EMTs and Paramrdics that are competent and professional who are willing to be paid peanuts while being worked to the bone.

This. There are a lot of providers out there and every medic program is full in my area. The issue is that not a lot of people stay in the field. Many are just using it as a stepping stone.

 

[Peak]

Also keep in mind that if you want to transition the US EMS model to one more similar to western Europe then we will be sending our entry level providers to college for years rather than a single 150ish hour course. You then have to justify that with the larger proportion of rural providers who see a comparativley small number of calls a year.

 

[KingCountyMedic]

There's too many Paramedics in this country. South of my county you can't swing a dead cat without hitting 6 Paramedics that are all fighting to get 1-3 tubes a year.

 

[DrParasite]

Saw this on linked in, so I'll provide the same response here:

it's both... and neither.

There is no paramedic shortage; there is a shortage of paramedics who are willing to work for low wages in poor conditions. there is also a shortage of paramedics who want to stay in EMS, vs leaving for a different field that pays better or offers better conditions. Not every EMS call requires an ER, however many do require treatment that can only be provided by an MD.

And we need to get EMS away from the FD, and provide enough resources to EMS to bring it to the point where it doesn't rely on the FD to stop the clock on the majority of EMS calls. Flood the nation with BLS 911 ambulances, and provide regional ALS providers for those limited calls that require it. And train those EMTs with enough knowledge so they know what calls require ALS and what calls ALS can't do anything more than provide the stare of life (which EMTs can do just as well).