The EMT-Basic

[fma08]

I gotta disagree with that. Right now, a great many EMTs graduate completely incompetent in their skills. It's not that the skills are that difficult, or that the training is that inadequate. It's that the average person drawn to EMT school is an idiot in the first place. Improving competence would be more dependent upon improving the quality of students more than improving the quality of education.

As long as we are stuck with such a large percentage of nimrods, we really need to dumb it down more for them. Forget knowing why they are doing anything. They shouldn't be doing it for more than a few minutes anyhow. And learning about Battle Sign and Halo Sign contribute nothing to their ability to provide ABC care in the interim. They don't need to do a "thorough assessment". That's for the paramedic that should be arriving after them to do. There is nothing the EMT can do with the information acquired through such an assessment, so let's focus on providing what they are supposed to provide in the first place.

It's either a problem then of inadequate training or a lousy instructor. If the education base is upped, the "nimrods" will simply fail out then, as long as the instructor can realize that they aren't getting the material i.e. shouldn't be there. It's simple enough. If they can't learn the material in the first place. So why are there so many idiots and incompetent people passing? Because, they're either smart enough to get the curriculum in the first place, or it is tough enough, but the instructors are too lax in how they are judging the competency of skills during the testing. It's not that hard to memorize and say the few critical criteria on the test sheet and each box that has a point in it. They're incompetent because they don't know what it means. With enough training you could teach a monkey how to put on an NRB and crank the regulator to 15.

 

[Foxbat]

I didn't make a sweeping, across the board statement about eliminating all theory. I said eliminate that theory which does not contribute to technical competence.

So which theory would you teach them? What knowledge you consider necessary, say, to give O2 and do C-spine immobilization?

 

[daedalus]

Meh... I'd rather have a CNA on an IFT ambulance than an EMT. There's just not a lot of call for bandaging, splinting, and extrication while making the nursing home circuit all day long. I'd like to see the EMT requirement for non-emergency transfer ambulances eliminated altogether. It's just ridiculous.

I agree. It just makes the EMT resent their job because they were taught emergency first aid, where as a CNA knows what he/she is getting into, the long term care of incapacitated patients.

EMTs are way over-qualified to do the renal roundup or discharges.

 

[bstone]

I agree. It just makes the EMT resent their job because they were taught emergency first aid, where as a CNA knows what he/she is getting into, the long term care of incapacitated patients.

EMTs are way over-qualified to do the renal roundup or discharges.

I will admit I was completely blindsided in 2002 when I just graduated as a Basic and found myself attending to psych transports from halfway homes/NHs, renal roundup and other stupid calls.

 

[daedalus]

Its time to take the the lights, sirens, and EMTs off IFT rigs.

The exception should be for Critical Care Transport, which can remain an emergency vehicle staffed with EMTs, paramedics, and RNs / RRTs.

 

[AJ Hidell]

So which theory would you teach them? What knowledge you consider necessary, say, to give O2 and do C-spine immobilization?

Dude, if you want me to sit here and develop a comprehensive curriculum for you, you're going to have to pay my going rate for consultation. All I am willing to do for you here is suggest the concept. Suffice it to say that currently, most recent EMT graduates suck at the two skills you listed, so they need a LOT more practice at it, and a lot less lecture about Halo rings, GCS scores, and the anatomy of the heart.

 

[bstone]

Its time to take the the lights, sirens, and EMTs off IFT rigs.

The exception should be for Critical Care Transport, which can remain an emergency vehicle staffed with EMTs, paramedics, and RNs / RRTs.

Maybe put yellow caution lights on them.

 

[AJ Hidell]

Think of how much less ambulances would cost without them! Think of the improvement in the quality of people who would apply to work on them! Think of the improved retention rate of those people who came into the job knowing they weren't going to be a siren switching hero. Think of the improved image that EMS would enjoy by not being lumped into the same category with all the Medicare thieving private transfer companies by the general public.

This is a total win proposition with zero down side.

 

[emtguy]

I'm not quite sure which textbook the OP is referring to, but it is nothing like the one we used in our EMT-B class - the AAOS 9th edition. And from what I've seen, Brady's book is very similar. -ALL- of the items mentioned in the OP are covered and defined, and none of the deficiencies described are evident.

These items were also discussed in class, and I found no inaccuracies. Things like causes of Battle's signs, proper indications of high flow O2 are also covered and quite possibly tested in the NREMT exam - so lack of knowledge here will hurt the candidates chances of passing the exam.

Granted, not all schools use these books, nor are all schools taught by competent, experienced instructors. And we're all aware of the two week cram courses. Maybe I was just fortunate enough to have found a decent school.

I understand the point of the OP, but I just wanted to point out that not all EMT-B schools are bad, and some of us -do- receive the education and skills to provide a solid foundation for going out into the field.

Just my 2 cents.

 

[daedalus]

I'm not quite sure which textbook the OP is referring to, but it is nothing like the one we used in our EMT-B class - the AAOS 9th edition. And from what I've seen, Brady's book is very similar. -ALL- of the items mentioned in the OP are covered and defined, and none of the deficiencies described are evident.

These items were also discussed in class, and I found no inaccuracies. Things like causes of Battle's signs, proper indications of high flow O2 are also covered and quite possibly tested in the NREMT exam - so lack of knowledge here will hurt the candidates chances of passing the exam.

Granted, not all schools use these books, nor are all schools taught by competent, experienced instructors. And we're all aware of the two week cram courses. Maybe I was just fortunate enough to have found a decent school.

I understand the point of the OP, but I just wanted to point out that not all EMT-B schools are bad, and some of us -do- receive the education and skills to provide a solid foundation for going out into the field.

Just my 2 cents.

You have a lot to learn.

 

[daedalus]

Just because you define and describe something does not mean you have a background education in it. Can you tell me why pupils become non-reactive in brain trauma. Does this happen all the time? What is the sensitivity and specificity of a blown pupil in indicating brain trauma? Can you tell me how to diagnose a basilar skull fracture? What do raccoon eyes really mean and why are they there? Do you understand bruising, better yet, the inflammatory process? Why is CSF clear? What is its normal function in the body? Why is it a bad thing if its present anywhere but the spine and brain vault?

 

[rhan101277]

Its time to take the the lights, sirens, and EMTs off IFT rigs.

The exception should be for Critical Care Transport, which can remain an emergency vehicle staffed with EMTs, paramedics, and RNs / RRTs.

Our basic trucks run many IFT's, but it is possible to be sent on a 911 call if all of the ALS trucks are in use. Also a IFT can become an emergency.