Stethoscopes....

[CAOX3]

All those classes mean nothing when you cannot practice at an advanced level. (Not to devalue education, but simply having taken classes with big names does not make you a better provider, and does not make you understand the roles of a paramedic).

Classes with big names Oh so if the education lies outside the grasp of the paramedic student its a class with a big name?

I usually am a strong advocate for advanced education, but taking a handful of upper division science classes does not give you the right to chop down paramedicine (which you are not a part of)..

If you think I'm chopping down the importance of EMS, your dead wrong. I am just not confused about my role.

I will repeat myself, the certification you carry does not require A&P and the like, so it is moot point. Until you go to paramedic school, you cannot really comment on the education or abilities they have. I have a year of gross anatomy and human physiology. Far from entry level.

Stop repeating, your wrong, my EMT class required both anatomy and physiology as pre-requisites. I can comment on anything I choose. Any undergraduate education in the states is basically entry-level.

When EMS requires education we can discuss it, until then lets not run around blasting people who hold the certifications necessary to operate in it because you took a few college classes you feel you have the right. Respect your coworkers what ever the level while working TOGETHER to change the profession.

When you become one of my medical directors you can pick and choose who operates in your system, unfortunately you would have to take a few of those classes with the big names.

You certainly have the attitude part of your profession down, for the sake of your community lets hope you spent as much time mastering the other aspects of your duties.

 

[CAOX3]

It doesn't matter if you have a doctorate in rocket surgery, man. That's yesterday. Today you are in EMS, and you are back at square 1. You now have to work your way back up another totem pole. If you don't like that prospect, you should have stayed in whatever field you were doing so wonderful in before.

Do you get respect for your educational achievements? Absolutely. Certainly from me, at least. But you seem to think that makes you more of an EMT than the next guy, and I'm sorry, but it does not. And no amount of flexing and feeling sorry for yourself is going to change that.

I have not worked in any other field besides EMS, by choice.

It does not make me more of anything, besides a well rounded individual, its unrelated.

EMS does not require education. It requires training.

Who feels sorry for themselves? Again I work in EMS by choice.

 

[Ridryder911]

I have not worked in any other field besides EMS, by choice.

It does not make me more of anything, besides a well rounded individual, its unrelated.

EMS does not require education. It requires training.

Who feels sorry for themselves? Again I work in EMS by choice.

Unfortunately, you are correct ... it requires training and EMT's are trained and not educated within the curriculum taught (no matter where you have taken it in the U.S.). To be in medicine though, one should have an education within the science to provide care. Alike you said, many of those who take first aid training. If one does not understand the difference between education and training; chances are they do not have an education.

If your program required an collegiate level anatomy and physiology level for an EMT program it is a rarity and definitely not the norm. EMT alike MFR is the entry level for EMS, as the curriculum is developed for that purpose.

R/r 911

 

[CAOX3]

Unfortunately, you are correct ... it requires training and EMT's are trained and not educated within the curriculum taught (no matter where you have taken it in the U.S.). To be in medicine though, one should have an education within the science to provide care. Alike you said, many of those who take first aid training. If one does not understand the difference between education and training; chances are they do not have an education.

If your program required an collegiate level anatomy and physiology level for an EMT program it is a rarity and definitely not the norm. EMT alike MFR is the entry level for EMS, as the curriculum is developed for that purpose.

R/r 911

I apologise to Omak for hyjacking his thread.

Actually all EMS, EMT or medic requires training. Education is a personal choice.

I agree with your statements Rid. It was along time ago, unfortunatley they dont anymore.

Either way I am no different for better or worse then any other EMT. I have never claimed to be. Being a professional is a personal choice, there are doctors, nurses, professors, from A to Z who never reach professionalism. It isnt defined by education or training its defined by attitude and behavior. I agree we all need more education we also need more professionalism.

 

[emtjack02]

I fear I am in a EMS that is stuck way back..I didn't think I was. The really only difference in my system between medic and emti is the I's must call in for a few meds and I believe they maynot be able to do crics. With what seems to be a shortage of medics, at least in this area, I am impressed that there are places that don't have basics. For much of the country I doubt that is true. A basic that may have a few more education classes that allows them to see things more indepth most likely is more help than a basic that has only the basic "training." A good basic will my my job easier therefore providing better pt care.

 

[omak42]

I apologise to Omak for hyjacking his thread.

Actually all EMS, EMT or medic requires training. Education is a personal choice.

I agree with your statements Rid. It was along time ago, unfortunatley they dont anymore.

Either way I am no different for better or worse then any other EMT. I have never claimed to be. Being a professional is a personal choice, there are doctors, nurses, professors, from A to Z who never reach professionalism. It isnt defined by education or training its defined by attitude and behavior. I agree we all need more education we also need more professionalism.

Its ok CAOX3 everyone likes a good heated debate.....I agree with you though education is a personal choice....I made that choice as a basic because I was dedicated to the field of EMS and wanted to do my best. So I taught myself to look for underlying problems not just look at a patient and say they look like they are having problems breathing lets throw O2 on them. I sat there and based off of what I studyied myself asked questions that would get me answers way beyond what I needed to know....for me and for the medics that would eventually be taking care of this patient. Maybe I couldnt do anything to treat it but I still searched for the problem myself without following a flow chart. THAT is what I consider practicing medicine. Maybe I couldnt push the meds to help fix it but thats the easy part of practicing medicine. ANYONE can push a med that you give them, anyone can place an ET tube, etc.

As far as AJ....well congratulations on making GOD status....I bet your even one of those ****head medics that everyone is so thrilled to have on scene when you show up because you just think you know anything and everything about every situation. I know plenty of medics that have been in this career for 20+ years in this area and ARE grateful for the help of basics. And again I credit that to the system I work in. Im not saying anything like we are the most awesome EMT-Bs and Is in the country....what I AM saying is that we have great instructors that care about what they do and care about the success of their students as Basics. Not every system has that so you do have basics that just read how to do something in a book and repeat it on a patient. My instructors actually went into depth about processes going on in the body. And your right I may not have any experience as a medic, but I have been through the whole didactic portion, so I do have education. And because of my work ethic probably a lot more that needed and probably a lot more than what you had in your medic class. So say what you want about my education/training because you know nothing about it or me.

My suggestion for you AJ is to get off your freaking pedestal before you fall and the only thing that shows up to haul you off to the hospital are basics

 

[daedalus]

Classes with big names Oh so if the education lies outside the grasp of the paramedic student its a class with a big name?



If you think I'm chopping down the importance of EMS, your dead wrong. I am just not confused about my role.



Stop repeating, your wrong, my EMT class required both anatomy and physiology as pre-requisites. I can comment on anything I choose. Any undergraduate education in the states is basically entry-level.

When EMS requires education we can discuss it, until then lets not run around blasting people who hold the certifications necessary to operate in it because you took a few college classes you feel you have the right. Respect your coworkers what ever the level while working TOGETHER to change the profession.

When you become one of my medical directors you can pick and choose who operates in your system, unfortunately you would have to take a few of those classes with the big names.

You certainly have the attitude part of your profession down, for the sake of your community lets hope you spent as much time mastering the other aspects of your duties.

It is great to know your EMT class required A&P prior to starting, and like I have said before, a student with full college level A&P will find themselves wanting more in EMT class, and they will be less willing to accept the dumbed down explanations provided.

I am not knocking down EMTs. I am an EMT, as are most of my friends. What I am saying is I do not practice any sort of medicine as an EMT, and I will be as a paramedic (with an inadequate education to do so).

 

[emtjack02]

What I am saying is I do not practice any sort of medicine as an EMT, and I will be as a paramedic (with an inadequate education to do so).

Surprised to hear you say that the thing we more or less have been discussing is in adequate...I do have to wonder why you would want to "practice medicine" with an inadequate education. That just doesn't seem like you'd be a safe provider.
And are there different levels of practicing medicine because really it seems that people here are comparing themselves to physicians with education and (gasp) training that far goes beyond most everyone on this forum.

 

[daedalus]

Surprised to hear you say that the thing we more or less have been discussing is in adequate...I do have to wonder why you would want to "practice medicine" with an inadequate education. That just doesn't seem like you'd be a safe provider.
And are there different levels of practicing medicine because really it seems that people here are comparing themselves to physicians with education and (gasp) training that far goes beyond most everyone on this forum.

It is not safe. Head desk.

I have been here for a year discussing why it is not safe for paramedics to practice without more comprehensive education.

 

[emtjack02]

OP hope you got the answers you were looking for. Sorry we hijacked you.

It is not safe. Head desk.

I have been here for a year discussing why it is not safe for paramedics to practice without more comprehensive education.

Seriously not to be argumentative but is there some source of medics being unsafe out there or do you just feel, like apparently many others, that medics could be better educated.

 

[VentMedic]

OP hope you got the answers you were looking for. Sorry we hijacked you.

Seriously not to be argumentative but is there some source of medics being unsafe out there or do you just feel, like apparently many others, that medics could be better educated.

Well, we do have the many headline grabbing incidents where Paramedics can not pass simple competency tests or even EMT-B exams with cheating. We now have much data about the competency rates of ETI which has also led to reluctance to expand protocols for DAI or RSI. We have areas where, if 12-lead ECG is even done, the machine will do the interpretation. You can find the results of one example pertaining to Los Angeles for that which is embarrassing to say the least.

Much of it depends on the medical oversight. Many medical directors dumb down the protocols to get pass the inadequacy in education and set up the recipes to where the least harm can be done.

 

[Ridryder911]

OP hope you got the answers you were looking for. Sorry we hijacked you.

Seriously not to be argumentative but is there some source of medics being unsafe out there or do you just feel, like apparently many others, that medics could be better educated.

Not just medics, but I am sure you would also agree nurses, respiratory therapists, and so on....

I as you might have also, have seen once the "goal" of reaching the license level many health care providers become complacent. Titles or being specialized from a professional board such as CEN, CCRN and so on does not mean one has accomplished anymore than another nurse but it does represent that person took upon themselves to have recognized the need of continuing onward within their education and profession. That at the least they have met having knowledge, experience, and standards developed by their professional peers within that specific area.

One of the reasons I continue my specialized certifications. Personally, I never study for the exams and take them "cold turkey". I use the exams as my guide of my "baseline" knowledge; as I feel it is a lifelong obligation I made to my profession(s) to study continuously and not just be prepared for an examination.

R/r 911

 

[VentMedic]

Not just medics, but I am sure you would also agree nurses, respiratory therapists, and so on....

I as you might have also, have seen once the "goal" of reaching the license level many health care providers become complacent. Titles or being specialized from a professional board such as CEN, CCRN and so on does not mean one has accomplished anymore than another nurse but it does represent that person took upon themselves to have recognized the need of continuing onward within their education and profession. That at the least they have met having knowledge, experience, and standards developed by their professional peers within that specific area.

One of the reasons I continue my specialized certifications. Personally, I never study for the exams and take them "cold turkey". I use the exams as my guide of my "baseline" knowledge; as I feel it is a lifelong obligation I made to my profession(s) obligation to study continuously and not just for an examination.
R/r 911

CCRN is not a good comparison since the RN had meet basic work requirements in an actual CCU/ICU before testing for that credential. After they receive their credential, the continuing education is a fair amount to maintain.

Critical care practice as a registered nurse is required for 1,750 hours in direct bedside care of (adult, neonatal or pediatric) acutely or critically ill patients during the 2-year period preceding date of application, with 875 of those hours accrued in the most recent year preceding application. All 1,750 hours must be in care of same patient population (for example, for the adult CCRN exam, all 1,750 hours must be caring for acutely/critically ill adult patients). Clinical practice hours accrued in an undergraduate student role are NOT acceptable. Nurses serving as manager, educator (in-service or academic), CNS or preceptor may now apply their hours spent supervising nursing students or nurses at the bedside. Nurses in these roles must be actively involved in caring for patients at the bedside; for example, demonstrating how to measure pulmonary artery pressures or supervising a new employee or student nurse performing a procedure.

http://www.aacn.org/WD/Certifications/Content/ccrn.pcms?menu=Certification#Initial

However, few states have standards for a Paramedic to call themselves CCEMT-P. Some employers will hand out the title after a 2 hour backroom inservice. Others who do take the CCEMTP course (80 -120 hours of basic overview) through UMBC do not know the letters stand for Critical Care Emergency Transport Program, not critical care Paramedic. They can also be used by anyone completing the course. Thus, there is no minimum standard that shows education or even CC experience when using the title CCEMT-P. They may not even need any experience as a working Paramedic to add these letters behind their name.

The FP-C is also just a knowledge exam and many who can comprehend some good study material can pass without hands on experience.

 

[Ridryder911]

We have areas where, if 12-lead ECG is even done, the machine will do the interpretation. You can find the results of one example pertaining to Los Angeles for that which is embarrassing to say the least.

Ironically, when I was at the NREMT; I was fortunate to meet one of the educators from (Clinical Field Internship Coordinator, UCLA Daniel Freeman Paramedic Program) that teaches the 12 lead portion for LA County and discussed this with her. She was appalled of what had been discussed and printed in regards to the County and City FD. She went into great detail to ensure me that they do NOT rely upon the "idiot box" as has been described and that their 12 lead course was several weeks long and portions taught by several cardiologist.

I will attempt to contact her for possibly clarification on many things that has been previously reported that I have found to be error. I was happy to see that they had cadaver anatomy lab and the number of live intubations during intubation clinicals was much more than I had expected.

I agree there is problems, but the best method is not always discounting and removing rather address the source of the problems and correcting it.

R/r 911

 

[VentMedic]

Ironically, when I was at the NREMT; I was fortunate to meet one of the educators from (Clinical Field Internship Coordinator, UCLA Daniel Freeman Paramedic Program) that teaches the 12 lead portion for LA County and discussed this with her. She was appalled of what had been discussed and printed in regards to the County and City FD. She went into great detail to ensure me that they do NOT rely upon the "idiot box" as has been described and that their 12 lead course was several weeks long and portions taught by several cardiologist.

Maybe she should talk to this person:
http://www.jems.com/news_and_articles/articles/Paramedics_Activate_Cath_Lab_STEMI_Patients.html

"But we have 2,500 paramedics [and 27 provider agencies] in L.A. County," Rokos said, "And obviously we can't train everyone to read ECGs." So Los Angeles County has paramedics rely on an automated computer ECG interpretation. "All they have to do is read ***Acute MI, and that's their ticket to go," he said.

Or this where they decided to instruct the paramedics on how to recognize artifact better or just transmit the tracing and let the doctor decide.

Poor tracings are a major contributor to false positive activation: artifacts or wavy baseline. This can be reduced by ensuring good electrode placement, reducing patient movement and/or proper setting of ECG filters according to manufacturer instructions. When the paramedic has any suspicion of artifact or irregular baseline on an ECG reading STEMI, the ECG should be repeated prior to base contact and/or transport when time allows. Paramedics should notify the base or the SRC of a tachycardia or paced rhythm in patients with suspected STEMI.

http://ems.dhs.lacounty.gov/pdf/FallNewsletter1007.pdf

These are just two examples from their own publications which haven't left much to make up stories about.

 

[daedalus]

Ironically, when I was at the NREMT; I was fortunate to meet one of the educators from (Clinical Field Internship Coordinator, UCLA Daniel Freeman Paramedic Program) that teaches the 12 lead portion for LA County and discussed this with her. She was appalled of what had been discussed and printed in regards to the County and City FD. She went into great detail to ensure me that they do NOT rely upon the "idiot box" as has been described and that their 12 lead course was several weeks long and portions taught by several cardiologist.

I will attempt to contact her for possibly clarification on many things that has been previously reported that I have found to be error. I was happy to see that they had cadaver anatomy lab and the number of live intubations during intubation clinicals was much more than I had expected.

I agree there is problems, but the best method is not always discounting and removing rather address the source of the problems and correcting it.

R/r 911

Well than why is 12 lead interpretation out of LA county scope of practice? Trust me, LA county paramedics are idiots. Daniel Freeman is an idiot factory.

Heard at a city fire station the other day "I need some help with this wax" say engineer. Probie fire/medic gets up to help because he feels it is his obligation. Engineer says "Sit back down mother F'er, I want a firefighter, not a paramedic".

 

[Ridryder911]

CCRN is not a good comparison since the RN had meet basic work requirements in an actual CCU/ICU before testing for that credential. After they receive their credential, the continuing education is a fair amount to maintain.

http://www.aacn.org/WD/Certifications/Content/ccrn.pcms?menu=Certification#Initial

Let's be realistic as well. I know of many of so called "patient contact" that occurs in the hospital environment. Many hospitals also use these certifications as part of their promotional grades, and will have associated CCRN preparatory courses.

True, what of what you reported ;but as well I know realistically that many educators, managers, directors of ICU's that have not been "bed side" for many years and still take and pass the CCRN. Yes, they keep up the knowledge and also all is needed is a signature from an immediate supervisor to take the examination. The term "... critical care"... is not well defined either to AACN. This could be from the cath lab, burn center, ICU, HEMS or even an EMS that provides IFT for patients needing such speciality. Fortunately, they did divide the age levels into specific areas.

I do agree with you, if one could pass such an examination I would doubt that they did not have the knowledge and some previous experience within that specific area. Again, the whole focus is ensuring that the professional meets the criteria within that specific scope.

Yes, I too agree that the CCEMT/P is too broad of a term. Unfortunately mainly due to the vagueness in the Medicare ruling for SCT. Yes, in comparison the two courses are definitely different and even now as I review to assist in teaching portions of the CCRN review course for a local ICU, it is contains a broader medical focus. The hand outs are remarkable and the power point for the instructor(s) are clean and well developed.

Fortunately or unfortunately (depending upon how one looks at it) I have been named to make a recommendation to our State licensing committee on what should be or not be required for the Critical Care Paramedic. I do feel IAFP appears to be one of the best ways to meet this requirement with their new CCP-C test. Although alike the CCRN there is no specific course to become one, the FP-C examination has demonstrated one has to have had some form of additional education and accompanying experience. This can be a requirement to become a CCP within our state. I will be closely monitoring the results as the test is released this fall.

One of the reasons I am recommending CCP-C test is because of the credibility the FP-C has obtained and not "restricting" one into a specific area. Courses can be developed for the CCP level and requirements of bed side experience can also be added.

I am however; very cautious that we do not want to limit or restrict one from being able to take the test that might meet the basic requirements. For example if Vent was to come to my state, I would want to ensure her to be able to use her knowledge, education and experience to be able to challenge the test and be able to provide that level of care. The reason I am against having one specific course.

R/r 911

 

[Ridryder911]

I will ask her to reply if not I will see her in Florida this late summer at the National EMS Educators conference (as she will be one of the speakers). All I can go upon is her statements as being associated with the program.

R/r 911

 

[emtjack02]

Well than why is 12 lead interpretation out of LA county scope of practice? Trust me, LA county paramedics are idiots. Daniel Freeman is an idiot factory.

Heard at a city fire station the other day "I need some help with this wax" say engineer. Probie fire/medic gets up to help because he feels it is his obligation. Engineer says "Sit back down mother F'er, I want a firefighter, not a paramedic".

I do not know any EMS from Cali let along LA county. But I do caution you with the over generalizations. I don't have much respect for the clinical knowledge of several people I work with but if some one said all blank county medics are idiots I'd have thing or two to say.

I suppose there are a lot of stories about medics doing stupid things. But as ryder pointed out Im sure there are similar things in different professions.
Be safe.

 

[Sapphyre]

I do not know any EMS from Cali let along LA county. But I do caution you with the over generalizations. I don't have much respect for the clinical knowledge of several people I work with but if some one said all blank county medics are idiots I'd have thing or two to say.

I suppose there are a lot of stories about medics doing stupid things. But as ryder pointed out Im sure there are similar things in different professions.
Be safe.

As someone who works in LA County, I can tell which medics went to the aforementioned school. They don't even TRY to look at the strip, they DO wait for the "idiot box" interpretation. And the ones that went elsewhere, yeah, it's just as obvious, and not just with 12-lead interpretation.