Well, I just wished it was only three. The county next to mine has 5 EMS services within the rural small area. All have different levels and provide different type of care. There are large metro cities that have multiple providers delivering anything from BLS to in-depth ALS care. Yes... frightening! More so frightening that many communities, much rather keep tradition than to provide advance care to their citizens.
As I described it is usually all dependent upon the protocol and involvement of the local Medical Director (physician). It may include RSI, central lines to having to make contact before initiating an IV. Again, all dependent on what that physician and service feels comfortable with.
We attempted a "National Scope of Practice" and was basically beaten down by many states with a large percentage of volunteer services. They felt it would require them to change and upgrade so much they could compete and provide the care required. With requiring minimal education levels.
Unfortunately, instead of centralizing and condensing, we much rather have substitute levels instead of the real thing. As usual there is always an excuse of having the real thing albeit they spend as much money on developing criteria, testing and certifying instead of doing it right.
Last article I read described we had at least 146 acronym or accepted EMT levels. So many, even those like me that are actively involved cannot recognize all of them. Fortunately, many states are recognizing the need of true education and investigating the associate degree level (2-2 1/2 yr) level for Paramedic. Right now, many only require the National Curriculum that can be achieved in some academy style programs in less than a month and a half. Yes, scary.. but; unfortunately there are many out there that rather "get through a program" than really absorb and learn, including clinical exposures. Most as of yet, have not comprehended the need and difference between training and education. Alas, there are some of us that do .... and are attempting to change things.. slowly but with time will.
So it is easy to be confused with our multiple levels and as well fragmented educational values. That is why, I do not pa attention to what level they say they are. Paramedic may mean the very basic ALS to comprehensive care.
Not like our neighbors of the North (Canada) that appeared to understand the need and defined their scope as well.
Maybe, with the decreasing levels of volunteerism, increasing demand for ALS in communities, we will see an increase in our education level as well. Hopefully, this will increase the professional benefits for providers as well in pay and long term benefits.
I hope I do not come across disgruntled, that it is not the case. Rather, I am more disappointed that our own professionals do not seek to better the cause. As an old EMS veteran, I have fought and continue to increase better care to our citizens and patients.
Again, welcome and feel free to discuss and ask any questions. We have some outstanding members on this site, from multiple areas.
R/r 911
