shake and bake courses

[46Young]

Name a health care profession that would allow you entry without a degree?

RN? RT? PT? OT? SLP? MD? PA? NP?

None of those will allow you to enter with just a few hours of training and a tech cert. Even to be an assistant to OT and PT you need a minimum of a two year degree.

I will ask again, do you think the Paramedic is a medical professional?

Sure, a paramedic is a medical professional. I've seen good medics and I've seen bad medics. I consider myself a good one, and I've worked with many as well. As far as training is concerned, you can't generalize tech schools. there are good ones and there are bad ones. Provided you take A&P and pharm prior to enrollment, the course content is pretty much the same. The degree is more desireable, but I've worked with proficient medics that graduated tech schools. You're lacking electives, but those aren't vital to be proficient as a medic. If you're going tech, you need to go to a quality school, not some fly by night program. Ask around to find opinions on programs in the area, and ask the good medics where they attended. In NY, the go-to school would be SUNY Stonybrook (tech), known for being rigorous and preparing their students well for the field. If you weren't sitting next to someone for the lectures, or have done clinicals at the same places, it's inaccurate to debunk anyone's paramedic training, unless you're specifically referring to local providers, who you've directly observed working.

What's the point of naming all those fields that require degrees? I'm asking what's wrong with PT enrollment?

 

[Melclin]

We don't enjoy the same subsidies and covered healthcare that your country has. Also, who's watching the children while that lady is going to class? Does the uni provide free healthcare? Over here, healthcare is the responsibility of the parent, and can be prohibitively expensive.

The children, as do many of the children of students, either stay with the parent as they go to class, are baby sat by class mates or spend time at the university day care, and some of the faculty members will baby sit depending on your relationship with them. As it happens the uni does have a doctors clinic on campus, but the source of funding is no different to any other in the country. However, students don't have to pay the co-payment which, small as it is, can be difficult for some students.

What's wrong with a PT option to make education more available to the masses? What negatives are assosciated with that? Why would that be a bad thing?

Just be a FF and let those who want to advance EMS to the level of medical professional with more education do the Paramedic stuff. It is unfortunate that the FDs will now applaud anyone for getting a degree in Fire Science but continue to view the Paramedic as just an "add on" like a CPR card. As long as the FDs are doing a "knee-jerk" get everyone trained as a Paramedic just to grab funding, EMS will continue to be held to by the standards of the lowest denominator.

I think its unfair (although I don't know anything about any history between you and 46, which often seems to be the case in these kinds of arguments) to be characterizing him/her as someone who doesn't care about EMS and pts, just because the system as a whole is broken and he or she needs to find a way to work within it.

That said, 46young mate, there's nothing wrong with doing the degree part time, but just like any other field, you just don't work until you finish the degree. You can take as long as you want to get you degree in education, but you don't teach until you do - simple as that - and if you need to support your family, then you work a job that isn't teaching until you can.

Here we have certain options. A paramedic undertaking a degree in their second year can be considered to have a a roughly equivalent qualification to the non-emergency pt transport officers (who do a six month course) and can sometimes find a job doing that. But that's a different story to what we're talking about. What we're talking about is like those pt transport officers expecting to become MICA paramedics (normally a minimum 11,000 hrs/ 7 years) after they do a six month course, with the proviso that they complete their degrees later. I'm not trying to be uncharitable here but you can see how its simply absurd from the point of view of other HCPs and indeed paramedics in most of developed nations, that you can even consider this kind of education as adequate.

 

[VentMedic]

I think its unfair (although I don't know anything about any history between you and 46, which often seems to be the case in these kinds of arguments) to be characterizing him/her as someone who doesn't care about EMS and pts, just because the system as a whole is broken and he or she needs to find a way to work within it.

He has just done too many threads on the forums trying to discourage the degree for the Paramedic. This includes the 2 year degree which even that is embarrassing for any medical profession. Thus, you see employers for RNs and RRTs now preferring the Bachelors degree and that may become their minimum entry very soon. The other professions have definitely passed them up in education and professional reimbursement recognition. The majority of his posts have also been about the perks of the FD and money with very little about patient care.

One can go to college part time at least to get the prequisites out of the way. However, EMS should follow the path to becoming a medical profession and have the entry raised to at least a 2 year degree. Unfortunately FDs and their unions will never allow that. However, that does not mean a FD will prevent those who are motivated to continue their education. One can be a FF and still promote quality patient care but to continue to state a tech cert is good enough fails as not all tech certs are equal and many of these medic mills need to vanish or stop feeding the FDs' desire for every FF to be a Paramedic just to get additional funding.

 

[alphatrauma]

46young... Not everyone can go to school full-time. Its just not feasible. The ones that are saying "just do it" or forget it are the ones who already have their degrees. So easy for them to say.

I would argue that "the ones who already have their degrees", did not simply have them bestowed upon them and there was some hard work and sacrifice involved at some point. Not everyone can go to school full time... that is a FACT! Yet one cannot ignore that THERE ARE options available, as it is not an all or nothing scenario.

I could regale (the collective) you with the trials and tribulations associated with my college/university endeavors... but I fear all that would do is provoke the gratuitous "good for you" or "want a cookie?" responses. I personally feel that those who are practicing, and do not feel the need for or recognize the importance of a sound educational foundation at the collegiate level, are doing themselves/the profession/their patients a grave injustice.

 

[VentMedic]

Sure, a paramedic is a medical professional. I've seen good medics and I've seen bad medics. I consider myself a good one, and I've worked with many as well.

Now imagine how good you could be if you actually had some education to support the skills and protocols you are allowed to do. Imagine what you could learn from a couple of real college level A&P classes instead of reading the adventures of Sidney Sinus and Abe AV nodes.

You are only as good as what you can compare yourself with but if all the Paramedics around you have the same training and the same protocols, what do you have to compare anybody with?

 

[MrBrown]

Best book I read all year, or all of last year

 

[TomTheDancingHobo]

Man, you guys take it out on this dude to the point of absurdity. He asked a simple, reasonable question, in a polite, deferential matter... and you guys basically told him he was a whiner idiot lazy moron who couldn't work as hard as the rest of you to go to school like everyone else even in washington which doesnt have real ALS certs and blah blah blah.
All of which is a huge bummer to anyone, like him or myself, who doesn't know much, knows they don't know much, but wants to know more. So much for helping people.
Jeez.

 

[EMTinNEPA]

do you think the Paramedic is a medical professional?

Yes, I do. Then again, I'll have a Bachelor's by the time I'm done with school.

 

[dave3189]

Washington State

BTW, what's with the shots on WA State? Seattle (King County) has the best stats on survival for witnessed pre-hosptial C.A. in the country if not the entire globe (around 45-46%). Some other jurisdictions might want to emulate WA state protocols?

 

[medic417]

BTW, what's with the shots on WA State? Seattle (King County) has the best stats on survival for witnessed pre-hosptial C.A. in the country if not the entire globe (around 45-46%). Some other jurisdictions might want to emulate WA state protocols?

Only way to accurately compare would be if all services used the same criteria. If all used the same criteria many services would be as high if not higher. Sorry as always statistics can be manipulated to say whatever we want them to by including or excluding.

 

[dave3189]

Just telling you what the AHA has documented. Even 60 Minutes said "If you have to have a heart attack, have it in Seattle".

 

[medic417]

Just telling you what the AHA has documented. Even 60 Minutes said "If you have to have a heart attack, have it in Seattle".

And 60 minutes means its a fact.

 

[dave3189]

The expression “If you have to have a heart attack, have it in Seattle,” was coined by 60 Minutes senior correspondent Morley Safer in a 1974 report that featured the fledgling Medic One program.

A USA Today series on the nation’s emergency medical systems studying 2001 data said, “Seattle sets the standard among the largest cities. Its 45 percent survival rate is [the] highest.”

A Seattle PI article from December 2006 reports that the most recent survival rate for sudden cardiac arrest in King County is 46 percent. Nationally, resuscitation rates for sudden cardiac arrest are between 6 and 10 percent, making King County the gold standard for emergency medical care.

According to the AHA, Medic One has achieved survival rates for cardiac arrest that are several times greater than the national average.

 

[JPINFV]

A Seattle PI article from December 2006 reports that the most recent survival rate for sudden cardiac arrest in King County is 46 percent. Nationally, resuscitation rates for sudden cardiac arrest are between 6 and 10 percent, making King County the gold standard for emergency medical care.

The problem with cardiac arrest data is that not everyone is using the same criteria. For example, if one city is counting all cardiac arrest calls while another is using Utsein criteria, then the numbers won't be compatible.

 

[dave3189]

The stats refer to out of hospital witnessed sudden cardiac arrest and have been published by the AHA. I love how people discount stats when they are not a benefit to them!

 

[JPINFV]

I love how people get snippity when a legitimate comment is made.

Out-of-Hospital Cardiac Arrest — Statistics​

There is a wide variation in the reported incidence of and outcome for out-of-hospital cardiac arrest. These differences are due in part to differences in definition and ascertainment of cardiac arrest data, as well as differences in treatment after the onset of cardiac arrest. Cardiac arrest is defined as cessation of cardiac mechanical activity and is confirmed by the absence of signs of circulation. Available epidemiological databases do not adequately characterize cardiac arrest or the subset of cases that occur with sudden onset. The following information summarizes representative data from several sources in an attempt to characterize the incidence and outcome of out-of-hospital cardiac arrest. (Circulation. 2004; 110: 3385–3397)

emphasis added.

http://www.americanheart.org/downloadable/heart/1236978541670OUT_OF_HOSP.pdf

 

[Veneficus]

The stats refer to out of hospital witnessed sudden cardiac arrest and have been published by the AHA. I love how people discount stats when they are not a benefit to them!

I don't think this is a case of discounting stats, but scrutinizing them.

As it was pointed out, If I am counting all cardiac arrests and basing my saves on survival to discharge neuro intact, my numbers will be worse than only counting witnessed arrests with immedate CPR and 7 day survival.

The AHA is not the final say, look at the European resuscitation guidlines, they do not always match up. Is that to say somebody is wrong?

The AHA also has had some past flubs, which is why they constantly disclaim certain treatments are not recognized over others.

 

[reaper]

Because stats can be manipulated to whatever you want them to say! If Medic one was really that much better then the rest of the world, don't you think there would be a push to do what they are doing?

They may only include shockable rhythms in their stats. So, for every 50 arrests that are run, you may have 5 that are in a shockable rhythm. If you have ROSC on 3 of those, then you percentage would be over 60%. So what about the other 45 people that were not included in it?

A lot of services include all pt in their percentages, so they have a lower overall rate.

Hell, I can put up stats that show 80% survival rates. Just depends on what I am counting!

 

[dave3189]

Not getting Snippity, just an observation. Your comments are valid about differences in reporting, however as I said... these stats refer to a particular segment of C.A. The below article about Utstein even mentions King County in relation to the 46% survival rate in comparison to other communities and stats relating to different criteria. The 46%, again, refers to out of hospital witnessed sudden C.A., even further with VT/VF. The stat is valid and is not in question. That being said, I wouldn't expect it to be compared blindly to all cardiac save rates regardless of criteria.


The effect of different definitions on survival rates is readily apparent from a 1991 King County study. The study reports rates of survival ranging from 16% to 49% depending on definitions of what patients comprise the denominator. (Eisenberg MS, Cummins RO, Larsen MP. Numerators, denominators, and survival rates: reporting survival from out-of-hospital cardiac arrest. Am J Emerg Med 1991;9:544-6.) For example, when all the cardiac arrests from all the causes are included the survival (hospital discharge) rate is 16%. But if only witnessed collapse cases due to underlying heart disease with an onset of CPR of 4 minutes or less and definitive care of less than 8 minutes are included then the survival jumps to 49%. Same community, different survival rates. It’s magic! Just change the definition and one triples the survival rate. This is why trying to draw cross-community comparisons when all parties do not agree on the definitions is like attempting to organize a tournament when each team plays by its own rules. A community, determined to be number one in cardiac arrest survival, could simply define its cases as patients with witnessed cardiac arrests in VF, who have bystander CPR, who respond to one shock with a perfusing rhythm (good blood pressure and pulse), and who wonder what’s for dinner upon arrival in the coronary care unit. Such a denominator might result in a survival rate close to 100% yet such a figure would be silly and meaningless.

 

[JPINFV]

Not getting Snippity, just an observation. Your comments are valid about differences in reporting, however as I said... these stats refer to a particular segment of C.A. The below article about Utstein even mentions King County in relation to the 46% survival rate in comparison to other communities and stats relating to different criteria. The 46%, again, refers to out of hospital witnessed sudden C.A., even further with VT/VF. The stat is valid and is not in question. That being said, I wouldn't expect it to be compared blindly to all cardiac save rates regardless of criteria.

Still doesn't resolve the problem that you don't know what criteria was used to generate the 6-10% stat that you're comparing it to. It's like saying one farmer is better than another because his watermelons are bigger than the other farmer's apples. So is the watermelon farmer the gold standard? I'm not saying that something like Utstein shouldn't be used, however if different criteria is used to generate numbers in two different locations, then you can't compare numbers and declare a winner.