Progression of EMS

[Ridryder911]

A couple of half-truths have been floated here that need to be addressed. First, not every fire department that runs an ambulance uses civillian employess like FDNY does; some of the larger ones do, but look at the country as a whole and it is absolutely false that medics working for a FD are "not really FF's" and are getting paid less. The majority of dept's crosstrain their personell, and often the medic get's EXTRA pay for being a paramedic, not less. Second, if the educational requirements are changed, if it is MANDATED AT THE NATIONAL LEVEL that a AAS degree is required, and that states may not go below this education and still certify paramedics, it won't matter if ANY service wants to train medic's faster...there won't be a way to do it. Of course this won't happen unless some group steps up to the plate, but hopefully that will happen. If EMS is to survive, it needs to.

Actually, if you were to read IAFC ten year plan you will see them endorsing Fire Departments to attempt to change systems internally. Emphasis in to be able to still meet the demand of FF and then to have EMS as a different department. This is not just large FD's but moderate size as well. There is a reason IAFC and other fire department organizations did not want EMS to go to Project Homeland.. less funding for FD's.

Just as part of the problem, we have too many FD/Paramedics in large metro areas, where skill attribution has been noted. Enough, that intubation has been questioned if it should be even part of the curriculum? I know of some Paramedics that get to intubate about once a year (even in a high call volume area) because there are 5 Paramedics on each call, that are eagerly awaiting to perform the skill. Overkill needs to be addressed.

I do agree some there are some departments that have financial pay raises for Paramedics, which is great! Then there are some that it has became a requirement to be even be employed, (although many describe you do not have to keep current after a period of time). I have yet seen very many aggressive F.D.'s in EMS, especially those of being cross trained. Fire Science within itself is a full time study and profession. Specialities such haz-mat, prevention, investigation, etc. makes it a continuous study and profession within itself. EMS is medical and needs to be addressed as such. I do agree having the F.D. act as a first response, but past that point EMS should be placed as a independent agency. Medical not rescue, nor public service.

You will never see IAFC, IAFF support the AAS as entry for Paramedics. Heck, they won't require an A.S. or such for their own profession, do you really think they would endorse for a side line? I know this at a personal level with a degree in Fire Science and Safety Engineering.

Again, until we are on our own, we will never be recognized for our own endeavours.

The main point is get at least the ground level of the need of education, and removal of training programs, at least at the Paramedic level. Just like the remainder of the medical community, and its peers.

R/r 911

 

[triemal04]

Actually, if you were to read IAFC ten year plan you will see them endorsing Fire Departments to attempt to change systems internally. Emphasis in to be able to still meet the demand of FF and then to have EMS as a different department. This is not just large FD's but moderate size as well. There is a reason IAFC and other fire department organizations did not want EMS to go to Project Homeland.. less funding for FD's.

Just as part of the problem, we have too many FD/Paramedics in large metro areas, where skill attribution has been noted. Enough, that intubation has been questioned if it should be even part of the curriculum? I know of some Paramedics that get to intubate about once a year (even in a high call volume area) because there are 5 Paramedics on each call, that are eagerly awaiting to perform the skill. Overkill needs to be addressed.

I do agree some there are some departments that have financial pay raises for Paramedics, which is great! Then there are some that it has became a requirement to be even be employed, (although many describe you do not have to keep current after a period of time). I have yet seen very many aggressive F.D.'s in EMS, especially those of being cross trained. Fire Science within itself is a full time study and profession. Specialities such haz-mat, prevention, investigation, etc. makes it a continuous study and profession within itself. EMS is medical and needs to be addressed as such. I do agree having the F.D. act as a first response, but past that point EMS should be placed as a independent agency. Medical not rescue, nor public service.

You will never see IAFC, IAFF support the AAS as entry for Paramedics. Heck, they won't require an A.S. or such for their own profession, do you really think they would endorse for a side line? I know this at a personal level with a degree in Fire Science and Safety Engineering.

Again, until we are on our own, we will never be recognized for our own endeavours.

The main point is get at least the ground level of the need of education, and removal of training programs, at least at the Paramedic level. Just like the remainder of the medical community, and its peers.

R/r 911

Yeah...the International Association of Fire Chief's is a funny bunch...luckily they don't set policy for everyone. That's left up to the local department. It doesn't change the fact that the majority of departments have cross-trained FF/paramedics in their department, not straight civillian medics. Granted, some do, and I think there are some with both.

To be honest, I agree with the over saturation of medic's. It is a problem, and it will admittedly happen more with some (not all by any means) fire departments because of the nature of the organization. But, if the problem is recognized, it can be keep in check somewhat, it just needs to be recognized. Unfortunately, this is a problem that goes beyond the fire vs private medic debate; there are too many medics out there in all different kinds of services period.

Never say never; look beyond the east coast when it comes to FD's and EMS systems. Seattle is the easiest to point out, but they aren't the only one.

Much as it means that I'm shooting myself in the foot, I would like to see more ambulance services being run as city/county/region/whatever third services with ALS first responce done by the local fire department. EMS can be done, and be done well by a fire department, and the two go together well, but a service that is only concerned with EMS would have a bit of an edge. And yeah, it would be opposed by IAFF. No brainer on that one. But, if EMS had it's own big voice....

The same goes for requiring a degree for a paramedic. If EMS get's enough people together, then it won't matter who opposes it. Getting the people together will be the hard part though.

And don't be so sure about FD's not requiring degress...for entry level sure, but look at the requirements for promotion to Lt, Capt, BC, DV, ***, etc etc.

 

[reaper]

Our service is a county third service, EMS only. City fire does run ALS first response. We have no problem with it.

I don't want to see the FD taking over transports. That is where the problems start. Right now the fire/medics are happy, they get to play medic until we show up and takeover care.

 

[chfite]

Contrast of Paramedic Preparation

I feel that I have gained a broader perspective, having read all these posts.

Looking at the education of a Paramedic in the state where I attended school wherein the program grants an AA degree as the base for Paramedics versus the educational requirements in this state left me incredulous.

The instructors of my school were required to have a Master's degree. Here the EMT-P and an instructor's course are all that are needed. The course here is a couple of days a week for a few months with some slapdash clinical and field time, then test. The only text for the course is the Paramedic text we all have seen. The Intermediate course for my school was longer and more intense than the entire Paramedic program here.

I have heard the administrative grumbling here about the time when the program was lengthened to its current state being that the increased time for the course would create a perpetual shortage of Paramedics. I had to ask the obvious rhetorical question, “You mean it used to be less?”

What I have seen in the past 7 years here is a lack of depth of knowledge in EMS at the Paramedic level coupled with a lack of perspicacity. I have met some broadly credentialed instructors here who lack understanding. They know the drill and the checklists, but don't understand why or why not.

Operationally, nothing is done to better this situation. When departmental training is conducted for re-certification, the same, old, tired boiler-plate is trotted out. Repetition of this over time numbs the mind, making training weak.

Consequently, the view of the Paramedic here is that of an automaton, something to be directed and controlled, not someone to be guided and encouraged. This is borne out most clearly in the state standing orders and protocols.

Hence, the notion of warm bodies on trucks prevails over quality.

 

[reaper]

What state are you in?

 

[chfite]

South Carolina