While engaged in the endless threads here about EMTBs expanded scopes, usefulness, demands, etc, and having more time on my hands lately, I was wondering...
Is the service provided by the EMTB level really useful? (not to be confused with service provided by people who are EMTBs as like all providers there are good ones and bad ones)
In standard dinosaur manner, when I became an EMT-B, it was likely that was all anyone who called 911 was getting. We were the primary responders as well as the only prehospital person anyone was likely to see. From Soup to nuts, we ran every aspect of the call.
It seemed to work really well. (For what we knew at the time)
As paramedics became more popular in the area, the EMT was largely relegated to carrying equipment, driving, and performing ordered tasks in the official role as "a borrowed servant."
In this role, all of the benefits of being an EMT before becomming a medic are largely lost.
As our knowledge and technology advanced, the "basic" levels of assessment and intervention have largely become obsolete.
Yet the curriculum still revolves around EMTs being the sole responder in charge. (No doubt in many places they are still)
But for all of the advancement in scope and education, the level of assessment is still woefully under what is required. Evidenced by the stressing of calling for ALS throughout the educational process.
It is generally accepted in medicine, including prehospital, patients should be treated for pain.
It is a medical error to over-treat patients. (though we must admit to accepting some level of over treatment in any acute environment.)
But what do basics bring to the table?
CPR and an AED?
We know that early CPR and defib are effective treatments. But we also know that it is the bystander who will be able to effect this in time. CPR and an AED are useless after 8 minutes of nothing.
Assisting with meds?
Anyone can assist with meds. It doesn't even take a responder.
A handful of meds already carried and utilized by more advanced providers?
A spint?
A backboard?
I think it is obvious that many basics realize or want more treatments to be more effective. From narcan to pain medication.
There are dozens of add on certs in various states to amplify the value of the Basic EMT.
Nothing taught in EMT class is really useful for IFT, where most EMT Basics work.
In an ALS system, the Basic is far more useful as the tech for the medic than an independant provider.
Perhaps we should just come to terms that with the levels of medical care and technology expected today, the solution is not to "upskill" or "up educate" the EMT Basic.
The solution may be to just get rid of it?
The recently revamped AEMT is basically the minimum skill set and knowledge base that incorperates all of the "upskills" and add on meds Basics seem to think they need.
Should AEMT be the minimum to work on a EMS transport unit?
With the Basic level being the minimum level of "first responder."
Even at 150 hours for EMT, it is reasonable to do away with the first responder level entirely.
Is the service provided by the EMTB level really useful? (not to be confused with service provided by people who are EMTBs as like all providers there are good ones and bad ones)
In standard dinosaur manner, when I became an EMT-B, it was likely that was all anyone who called 911 was getting. We were the primary responders as well as the only prehospital person anyone was likely to see. From Soup to nuts, we ran every aspect of the call.
It seemed to work really well. (For what we knew at the time)
As paramedics became more popular in the area, the EMT was largely relegated to carrying equipment, driving, and performing ordered tasks in the official role as "a borrowed servant."
In this role, all of the benefits of being an EMT before becomming a medic are largely lost.
As our knowledge and technology advanced, the "basic" levels of assessment and intervention have largely become obsolete.
Yet the curriculum still revolves around EMTs being the sole responder in charge. (No doubt in many places they are still)
But for all of the advancement in scope and education, the level of assessment is still woefully under what is required. Evidenced by the stressing of calling for ALS throughout the educational process.
It is generally accepted in medicine, including prehospital, patients should be treated for pain.
It is a medical error to over-treat patients. (though we must admit to accepting some level of over treatment in any acute environment.)
But what do basics bring to the table?
CPR and an AED?
We know that early CPR and defib are effective treatments. But we also know that it is the bystander who will be able to effect this in time. CPR and an AED are useless after 8 minutes of nothing.
Assisting with meds?
Anyone can assist with meds. It doesn't even take a responder.
A handful of meds already carried and utilized by more advanced providers?
A spint?
A backboard?
I think it is obvious that many basics realize or want more treatments to be more effective. From narcan to pain medication.
There are dozens of add on certs in various states to amplify the value of the Basic EMT.
Nothing taught in EMT class is really useful for IFT, where most EMT Basics work.
In an ALS system, the Basic is far more useful as the tech for the medic than an independant provider.
Perhaps we should just come to terms that with the levels of medical care and technology expected today, the solution is not to "upskill" or "up educate" the EMT Basic.
The solution may be to just get rid of it?
The recently revamped AEMT is basically the minimum skill set and knowledge base that incorperates all of the "upskills" and add on meds Basics seem to think they need.
Should AEMT be the minimum to work on a EMS transport unit?
With the Basic level being the minimum level of "first responder."
Even at 150 hours for EMT, it is reasonable to do away with the first responder level entirely.
