Paramedicine as an AAS?

[AMF]

So we recently had our last day of basic class, and I've begun to understand the difference between technicians and medics. Basically, while EMTs consult with a physician pretty much every time they give medication, paramedics never do (except for... I want to say... Heparin?). So basically, they have to understand everything about the drugs they're using, the drugs the pt could be on, their interaction with the body, their interaction with each other, variations between individuals with differing hx, etc. But our instructor told us that p school is basically an associates degree... how is even that possible?? I know medics aren't quite physicians, but still, 2 - ( 4 undergrad + 4 very intense grad + 1 very very intense internship + 4 very intense residency + 4 fellowship ) is kind of a ridiculous difference. I know PAs and RNs are much further behind, but they're not independent practitioners (usually). A Paramedic is the only autonomous health care provider in the field and the foremost authority thereof; shouldn't they receive over twice the training that an RN receives?

Also, I wikipedia'ed RSI... probably the principal reason why I won't get my p. I want a BS, an MPH, an MD, and an IM internship behind me before I try that ludicrous procedure.

 

[medicRob]

A Paramedic is the only autonomous health care provider in the field and the foremost authority thereof

lol.

 

[Shishkabob]

Be careful with the generalities, as in my agency I have heparin, RSI, and many other things many agencies don't have, and I don't have to call in for a single one of them.


Also, PAs, NPs, and many RNs are autonomous as well (Just look at offices run by PAs/NPs, and look at flight or ICU RNs) Yes, a Paramedic in many places is pretty autonomous, making our own decisions most of the time... but then you look at archaic EMS states like California, and their medics have to ask nurses for orders... (That's f'd up)



Also keep in mind that RNs are more generalist, taught to operate in all parts of healthcare in school, and out of school they specialize. From the get go, Paramedics specialize in emergency medicine, and specifically cardiology, airway and trauma management. That doesn't mean one is more capable than the other... just the basic knowledge starts off differently.



Now, yes, RSI is a scary procedure, and yes, it's no fun to make the decision of "I'm going to paralyze you now and hope I get the tube", however, studies have shown fantastic success rates in agencies with RSI, with minimal adverse outcomes most of the time... roughly equal, if not parallel, to RSI being performed in the ED.

When taught correctly, and taken seriously by an EMS agency, RSI is very safe all things considered.

 

[AMF]

I understand what you're saying, but I don't see how that justifies a 2-year paramedic degree, especially if RNs have to specialize beyond their 2-year degree to work in the ER

 

[Shishkabob]

Meh, you're taking "specialize" too literally. They generally don't go to more school to work in different areas, they learn on the job. An OB nurse that wants to move to the ED doesn't have to go back to school.



Or do you simply think that someone with a 2 year degree (or less) is not capable of being a good provider?

 

[AMF]

It's possible, yes, but as far as standards go, I think requiring a BS would be a step in the right direction.

A lot of this stems from the fact that while I'm training to be a QRS Basic, which is sort of by definition an over-qualification, I'm also training to be a Basic/I99 in 911 (Even those of us with Organic/BioPhysical Chem don't really understand what paramedics have us do).

Also, I was in Boston where I saw some pretty sketchy paramedics working IFT. I know Boston EMS makes Paramedics work as QRS Basics first... it just seems like all signs point to longer education. Plus American Premed consists of a year of cell hell, genchem, orgo, english, physics, calculus, and a semester of biochem... that's over a year and a half already without actually studying medicine.

That being said, take everything I say with a grain of salt; I plan on pursuing a physics PhD, which frequently takes over ten years.

 

[medicRob]

It's possible, yes, but as far as standards go, I think requiring a BS would be a step in the right direction.

A lot of this stems from the fact that while I'm training to be a QRS Basic, which is sort of by definition an over-qualification, I'm also training to be a Basic/I99 in 911 (Even those of us with Organic/BioPhysical Chem don't really understand what paramedics have us do).

Also, I was in Boston where I saw some pretty sketchy paramedics working IFT. I know Boston EMS makes Paramedics work as QRS Basics first... it just seems like all signs point to longer education. Plus American Premed consists of a year of cell hell, genchem, orgo, english, physics, calculus, and a semester of biochem... that's over a year and a half already without actually studying medicine.

That being said, take everything I say with a grain of salt; I plan on pursuing a physics PhD, which frequently takes over ten years.

I have an AAS in Paramedicine, Masters of Nursing, Completed a BS Biochemistry as Pre-Med, and just took the MCAT. I like to think that I am quite qualified as a paramedic.

Also, there are several issues that must be addressed with EMS education (see my other posts on the topic, I rant about it regularly).

 

[medicstudent101]

I have an AAS in Paramedicine, Masters of Nursing, Completed a BS Biochemistry as Pre-Med, and just took the MCAT. I like to think that I am quite qualified as a paramedic.

Also, there are several issues that must be addressed with EMS education (see my other posts on the topic, I rant about it regularly).

How'd you do on your MCAT btw?

 

[medicRob]

How'd you do on your MCAT btw?

Takes 30 days before results will show up on THx, couldn't hurt to check though.

 

[medicstudent101]

Oh. Well belated good luck!! B)

 

[medicRob]

Oh. Well belated good luck!! B)

Thank you very much.

 

[AMF]

Yes, Rob, you are well qualified, but that level of education is not required of and in my limited experience is not common amongst paramedics, nor is it sufficiently rewarded.

I've read a few of your posts, but unfortunately I lack the vocational background to understand them.

 

[MrBrown]

Here in New Zealand a Paramedic (ILS) requires a Bachelors Degree while Intensive Care Paramedic (ALS) requires a Post Graduate Degree.

We have a 97% success rate with RSI and so far have managed all failed intubations without cricothyrotomy.

Brown does not really understand what this dude is on about

 

[AMF]

Here in New Zealand a Paramedic (ILS) requires a Bachelors Degree while Intensive Care Paramedic (ALS) requires a Post Graduate Degree.

We have a 97% success rate with RSI and so far have managed all failed intubations without cricothyrotomy.

Brown does not really understand what this dude is on about

I am asking why our government (the sentiments of whom I assume some on this forum understand) doesn't feel it is necessary to maintain and mandate a BS curriculum for paramedics. Even if someone wanted to, he or she couldn't necessarily pursue a more advanced degree in paramedicine... to my knowledge.

While someone who worked for SW AMR dispatch on this forum said they had a shortage of medics, I was under the impression that this was generally not the case.



For the record, in the US, Post Baccalaureate refers to classes taken after graduation from Bac, independent of a degree program. Post Grad refers to the same thing, except after graduation from High School. If you attend school for a Masters, a Doctor (Medicinae Doctor, Juris Doctor, etc) or a Doctorate (PhD, LLD, etc), you are referred to as attending graduate school. Which I'm sure you knew.

 

[MrBrown]

Why not? Here is why not

- Lack of a professional identity as a health profession vs public safety role

- Lack of unified national professional representation i.e. analogous to the AMA, ANA, FACEP etc

- Lack of national industrial representation i.e. analogous to the IAFF/PBA/Teamsters etc

- Industrial influence by the Fire Service unions to keep standards low

Until the US recognises that Paramedics are a health professional and not a public safety provider there will be little advancement. Until the Fire Service stops using EMS as a justification to keep the Fire Service funded (and therefore standards as low as possible to make it easy) there will be little advancement.

The new "EMS Education Agenda" is a joke, the Fire Service managed to get the College affiliation requirement for a Paramedic program to be accredited by CoAESMP dropped and even if it did not there is only minor improvements.

Basically its the age old notion that until the providers themselves want it there will be little to no advancement.

 

[VFlutter]

I have an AAS in Paramedicine, Masters of Nursing, Completed a BS Biochemistry as Pre-Med, and just took the MCAT. I like to think that I am quite qualified as a paramedic.

Also, there are several issues that must be addressed with EMS education (see my other posts on the topic, I rant about it regularly).

You are officially my hero lol hopefully I will be able to follow a similar path as you in the long future ahead of me

 

[usafmedic45]

A Paramedic is the only autonomous health care provider in the field and the foremost authority thereof

*falls out of chair laughing* Wow....someone's a bit full of themselves regarding their chosen career aren't you? LOL

 

[usalsfyre]

The longer your in EMS the more you'll realize few paramedics are able to put an autonomous medical thought together, much less carry out a treatment plan...

Given the choice between the few paramedics I trust to control an airway and Joe Schmoe interenist, I'll choose the medics every time (Jane Schmoe anesthesiologist may be a different story).

Yes EMS education is vastly under where it needs to be.

 

[Shishkabob]

Even if someone wanted to, he or she couldn't necessarily pursue a more advanced degree in paramedicine... to my knowledge.

There are a few BS/BA in EMS programs out there... just no real need to get them with the current pay most Paramedics get / would get with it.

 

[AMF]

*falls out of chair laughing* Wow....someone's a bit full of themselves regarding their chosen career aren't you? LOL

Unfortunately, I will never be a paramedic. With the new UTSW plan, I may never leave the MICU after I get my coat.

The longer your in EMS the more you'll realize few paramedics are able to put an autonomous medical thought together, much less carry out a treatment plan...

Given the choice between the few paramedics I trust to control an airway and Joe Schmoe interenist, I'll choose the medics every time (Jane Schmoe anesthesiologist may be a different story).

Yes EMS education is vastly under where it needs to be.

Agreed. Being good at your job>Experience/Education/"Skills"/Letters

There are a few BS/BA in EMS programs out there... just no real need to get them with the current pay most Paramedics get / would get with it.

Ah. That's what I was asking, I guess.