paramedic students

[uselessmedic]

Students, just a word of advise, practice your bls skills before going to boards believe me, it will help in the long run! Today at boards 75% of the students failed their bls skill station which was KED. ALS skills are important, but the bls skills are important too!!!! Ok I've ranted enough.

 

[KEVD18]

see this is where it gets tough for me.i dont feel that paramedic students shuld be tested on bls skills. i've already taken the course, been examined by the school and deemed competant, then independantly examined by the state deemed competant and licend to perform said skill. not to mention, every two years during my refresher i have to proves once again that im still competent. its ridiculous.

then, i read articles like this and wonder.....

 

[Ridryder911]

then, i read articles like this and wonder.....

No, this type removes all doubt. In fact one wonders why we may not have to start retesting every quarterly a year.
R/r 911

 

[Sparky79]

see this is where it gets tough for me.i dont feel that paramedic students shuld be tested on bls skills. i've already taken the course, been examined by the school and deemed competant, then independantly examined by the state deemed competant and licend to perform said skill. not to mention, every two years during my refresher i have to proves once again that im still competent. its ridiculous.

then, i read articles like this and wonder.....

If the medic isn't competent to pass a basic test of BLS skills, how can they be expected to pass an advanced test on more advanced skills?

To me this is a no brain-er!

 

[Epi-do]

If the medic isn't competent to pass a basic test of BLS skills, how can they be expected to pass an advanced test on more advanced skills?

To me this is a no brain-er!

I think it goes back to the fact that while in class, along with filling our heads with additional information to make us better providers, you spend pretty much all of your time practicing your new skill set. I am getting ready to take the registry in a couple weeks, and we have already been told that most people that fail a station will fail the BLS one. Because of that, my class has made it a point to practice those stations a bit more than we probably would have.

Different programs vary in how they prepare their students for the practical exam. Add to that, the nerves that go along with taking the exam, I don't think that it is that they can't pass the BLS skills. I think it is more a case of being so focused on doing the ALS skills properly, that they are making "silly" mistakes when it comes the the BLS skill station.

My class just did a PHTS course yesterday and the day before. On the first day of class, while doing skill stations, we all took the opportunity to use the LSB station as another chance to practice for registry, and went through that station exactly as if we were doing it according to the registry's check-off sheet.

 

[FireResuce48]

No, this type removes all doubt. In fact one wonders why we may not have to start retesting every quarterly a year.
R/r 911

Test 4 times a year? No thanks.
I'll stick to working and volunteering with places that put an empathize on continuing education and mastering skills.

 

[firecoins]

Test 4 times a year? No thanks.
I'll stick to working and volunteering with places that put an empathize on continuing education and mastering skills.

testing 4 times a year is putting an emphasis on continuing education and mastering skills.

 

[firecoins]

If the medic isn't competent to pass a basic test of BLS skills, how can they be expected to pass an advanced test on more advanced skills?

To me this is a no brain-er!

clealy it isn't

As I finish medic school the same thing happaned. everyone did well on ALS skills but failed most people failed KED. It wasn't that everyone didn't know how to use a KED. It was nobody practised actually using it. Everyone put time into learning new skills. Most people failed for excess movement.

 

[Sparky79]

clealy it isn't

As I finish medic school the same thing happaned. everyone did well on ALS skills but failed most people failed KED. It wasn't that everyone didn't know how to use a KED. It was nobody practised actually using it. Everyone put time into learning new skills. Most people failed for excess movement.

This is just an observation, and I'm in no position to judge (I've only been an EMT-B for about 6 months, so my experiance is laughable), but it seems to me that the use of a KED should not need to be a skill that has to be practiced by a would be medic. That was my point. If you can't do Basic skills in your sleep, how can you expect to be able to do ALS skills. I am not trying to be a smart a$$, just an outsider making an observation.

 

[Ridryder911]

Here's the problem. I probably have the chance to place the Hare traction on a patient about once every three or four years. I know of medics that have never delivered a baby, or placed a tourniquet on someone. Why? Because call volume and types of calls to use those are unusual and if ever occur.

Now, you described yourself as competent.. by who's standard? Your school? Your State's certification? Again, remember the pass only means you meet the minimal standards. As well, the NREMT itself has no skill testing. Do you really trust the testing system? So let's say you decide to go back to Paramedic school, after five years of being an EMT. How well do you see all your basic skills? You haven't placed a Sager on since your EMT class. Beginning to see my point?

Now, answer quickly.. What is the lowest score on the APGAR score? Did you respond in < 5 seconds? See?... and you just got out of school. If you don't use it, you may loose it.

That is why I teach, and believe in reviewing and retesting all clinical skills at every level. It makes one study and review, keeps everyone on their toes and held accountable.

R/r 911

 

[fma08]

R/r you may be able to answer this... For becoming a PALS instructor, is it a standard to need X amount of field experience before going through the instructor class? The service I'm at requires 3 years of experience before becoming an instructor. (pretty random question yes, but your comment about teaching made it pop into my head)

 

[Ridryder911]

I don't believe there is a "set" standard on requirement of clinical experience. It is only recommended that the instructor have some experience in that area. I do know of ACLS/ BLS/ PALS instructors that have never worked in critical care or emergency settings. They of course are well known as textbook instructors and usually refer any questions in clinical practice to those that work in those areas.

It sounds like your area has set their own requirements to prevent such an occurrence. In a way, it is good to know that the instructor should have some minimal exposure. Yes, one can have the technical knowledge for the course and standards but having the clinical exposure adds to the credibility of the instructor.

R/r 911

 

[FireResuce48]

testing 4 times a year is putting an emphasis on continuing education and mastering skills.

So does drilling on a regular basis. Not only, but its allot more convenient and you can make a much more life like environment and scenario in my opinion.

People start studying just to pass a test not to gain more knowledge. That's where the problem lies.

If you are in the ems business or even in the fire service as it pretty much is the ems business these days and you don't put forth the effort to hone and learn new skills on a regular basis you are either in a not so great system or are not putting forth any effort and have no business in the field.

 

[firecoins]

So does drilling on a regular basis. Not only, but its allot more convenient and you can make a much more life like environment and scenario in my opinion.

So what is it you have against Rid's suggestion of continually drilling BLS skills?

People start studying just to pass a test not to gain more knowledge. That's where the problem lies.

you are going to have to pass a test some point.

If you are in the ems business or even in the fire service as it pretty much is the ems business these days and you don't put forth the effort to hone and learn new skills on a regular basis you are either in a not so great system or are not putting forth any effort and have no business in the field.

Okay so you have keep drilling the BLS skills while learning the ALS ones. Right.

 

[FireResuce48]

my response was mainly to the test 4 times a year comment.

I agree with ALS providers knowing their BLS skills and I don't see a problem with throwing in a bls station during an als test. What good are ALS interventions if you can't do the BLS interventions.

 

[Sasha]

see this is where it gets tough for me.i dont feel that paramedic students shuld be tested on bls skills. i've already taken the course, been examined by the school and deemed competant, then independantly examined by the state deemed competant and licend to perform said skill.

This kind of thought reminds me of a rescue of nothing but medics I saw roll into the hospital.

Pt is in cardiac arrest, they have him intubated, pushing drugs, bilateral large bore IVs started, can't figure out why he isn't coming around. Then the doctor asks why no one is doing compressions.

Never forget your BLS skills or take them for granted.

 

[firecoins]

my response was mainly to the test 4 times a year comment.

I agree with ALS providers knowing their BLS skills and I don't see a problem with throwing in a bls station during an als test. What good are ALS interventions if you can't do the BLS interventions.

Several points

We are EMT-Bs We all work as EMT-Bs while going through the paramedic programs None of "forgot" the BLS skills. None of can not do the BLS skills.
As you said this is a test. We focused on the new skill set. Are ability to conduct a KED on a test has no bearing on our ability to intubate, give medications or start IVs.

I can not see how anyone would forget compressions on CPR becuase they are medics. People who failed the KED didn't do so because they "forgot" how to use it. It was a lack of practising doing the station. This is in a testing situation where the helper and patient are not as copperative as they would be in real life. If we had been doing something along the lines of Rid's suggestion, no one would have "failed" that station.

 

[Sasha]

Several points

We are EMT-Bs We all work as EMT-Bs while going through the paramedic programs None of "forgot" the BLS skills. None of can not do the BLS skills.
As you said this is a test. We focused on the new skill set. Are ability to conduct a KED on a test has no bearing on our ability to intubate, give medications or start IVs.

I can not see how anyone would forget compressions on CPR becuase they are medics. People who failed the KED didn't do so because they "forgot" how to use it. It was a lack of practising doing the station. This is in a testing situation where the helper and patient are not as copperative as they would be in real life. If we had been doing something along the lines of Rid's suggestion, no one would have "failed" that station.

Sorry, should have clarified. The medics didn't do compression because they forgot how to do them, they were just so wrapped up in doing all their ALS skills, they forgot to initiate the very BLS skill of compressions. That's what they told the doc anyway. Never take BLS skills for granted, one can never be too proficient in them!

 

[reaper]

I don't buy that. They may have stopped because they had ROSC, or stopped while coming through the doorway. Never seen a medic forget to do CPR, because they were worried about ALS skills.

 

[Ridryder911]

Sorry, should have clarified. The medics didn't do compression because they forgot how to do them, they were just so wrapped up in doing all their ALS skills, they forgot to initiate the very BLS skill of compressions. That's what they told the doc anyway. Never take BLS skills for granted, one can never be too proficient in them!

In all seriousness, it probably would had not matter. Now, with that statement they probably should had not started resuscitation efforts to begin with. Yes, if one is going to really attempting to resuscitate a patient then be sure all treatment are being performed correctly.

A word of suggestion though.. until you have really ran a code by yourself or be in charge of one, it is very easy to armchair quarterback; anyone can do that. I say the same to the Doc, where the busiest part is crossing one's arms.

R/r 911