I feel compelled to register my disagreement that paramedics whose education barely scratches the surface of the disease of trauma, can claim to "specialize" in it.
Paramedicine as an AAS?
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I feel compelled to register my disagreement that paramedics whose education barely scratches the surface of the disease of trauma, can claim to "specialize" in it.
Ditto - I know it's semantics, but...
An EM MD specializes in emergency medicine. A cardiologist specializes in cardiology. The anesthesia folks are the specialists for airway management.
Paramedics have technical and didactic training in a wide variety of areas, including physiology, pharmacology, etc., but as Veneficus noted, it's scratching the surface in many cases.
Specialization implies a certain subset of skills. So if a paramedic "specializes", what do they specialize in compared to a paramedic who doesn't "specialize" ?
Not an accurate statement. Depending on the state, you are working as a delegated agent of a physician medical director.
The physician medical director (or the Office of the Medical Director) determines the range of activity and the levels of reporting when a paramedic is delivering out of hospital care.
You cannot "practice" as a paramedic without the permission of the agency's physician.
Good question about the AAS versus a four year degree. There are about eight programs that provide paramedical certification training as a bachelor degree. The additional academic work is not consistent - some provide clinical others focus on education or management.
About 350 community and technical colleges provide paramedic training as a two year degree. The Scope of Practice (2013) model for paramedics will be very difficult to deliver as an applied science associate.
Bryan Bledsoe, DO, former Texas paramedic, covered this concept in a June 13. 2007 online item in JEMS titled "I Can Do That"
Within 30 years, becoming a registered nurse moved from training at mom-and-pop hospitals or vocational schools to preferring RNs have a bachelor degree.
There are masters and doctoral programs for nurse practicioners.
This change was generated by the profession.
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Bachelors Degree? Really?!
Okay... Number 1, In the United States paramedics don't make enough to justify requiring a bachelors degree. That said, in Texas Licensed Paramedics are required to have either a bachelors degree in anything or an Associates degree in something emergency services related. Either way, it's the quality of the education that I think is important not how long you go for. If you are taking an intensive program for just a few months (think military combat medic school) that is very good vs a random bachelors degree program that is not so good I think you are better off with a shorter program.
Okay... Number 1, In the United States paramedics don't make enough to justify requiring a bachelors degree. That said, in Texas Licensed Paramedics are required to have either a bachelors degree in anything or an Associates degree in something emergency services related. Either way, it's the quality of the education that I think is important not how long you go for. If you are taking an intensive program for just a few months (think military combat medic school) that is very good vs a random bachelors degree program that is not so good I think you are better off with a shorter program.
Or does the standard paramedic training curriculum not justify higher pay? If one wants to move the profession forward, they'll advocate for a college level education, no less. US EMS needs to go the way of Canada and Australia when it comes to education. In my opinion, EMT should have its training be 1000 hours (~ equiv to an associated degree with emphasis on managing low acuity complaints and providing relatively basic treatments for acute/emergenct illness) and the present paramedic should be at least double that. Oh, and in my opinion, the title "EMT" should be abolished. But, I'm not holding my breath. The general EMS populace is far too complacent for change to come anytime soon.
Like I said - semantics. I'm hunting for the word I want, but "specialization" isn't it.
You might want to check the research on that. The EMS systems that have come near ED in terms of success are ones where the intubators, so-to-speak, are limited (King County, Wa; Whatcom County, Wa; Boston, Ma; Melbourne, AU; French SAMUs; and some flight services). Though RSI has been shown to improve the overall success rate marginally, it doesn't translate in to success nearing ED success. Dr. Wang's latest publication demonstrates this pretty well (http://www.ncbi.nlm.nih.gov/pubmed/21288624).
We have had a near 100% success rate with RSI (~97%) since 2006
Is the skill of intubation or RSI limited to a relatively small group of paramedics? I believe this is the practice in Victoria, Australia, so I would assume it is not much different in NZ. Correct me if I am wrong.
You are correct sir, RSI is limited to a selected group of Intensive Care Paramedics, whereas in Melbourne (MAS) all MICA Paramedics have RSI as part of their scope.
Now, early on it was restricted to only a few people as this was a very controversial procedure to introduce and we wanted to ensure high quality. RSI is just now (five years later) being taken outside of Metropolitan Auckland and to the rest of the country, it is still however, select Officers only.
In time Brown expects it to become a procedure for all Intensive Care Paramedics however it will take a few years yet.