"What every EMT should be required to experience before they graduate".

[firecoins]

No, I agree that EVOC should be taught. But I think that in order for EVOC to be taught, the amount of class time needs to be increased, instead of giving something less attention.

no one said anything about reducing class time.

 

[VentMedic]

Not many EMTs are going to be doing lead even when providing first aid to patients. But unfortunately for the patients, they are put alone in the back of a truck with those that need a medical assessment rather than first aid. Since EMTs do primarily IFT runs on medical patients where vital signs are important, the EMT should shadow CNAs and do no less than 100 sets of vitals on a variety of different patients. The EMTs should be trained by the CNAs to move the elderly, frail and patients with lots of attached accessories without causing pain and injury. They could also take a lesson on how to maneuver obese patients safely. EMTs are not adequately trained to be providing even "BLS" care to medical IFT patients such as those requiring dialysis.

 

[daedalus]

They should experience at least another 50 hours of education before they finish class.

I have never heard of graduating from a 3-5 credit hour class before...?? My Biology with lab class had the same amount of units as my EMT class and I did not graduate from Bio...

 

[Tincanfireman]

#1: For myself, done. We practiced extrication in an auditorium, and guess who got immobilized, on both a backboard and a KED? I have to say, though, that it's a good experience. It's not comfortable, and it's good to know what the patient has to go through.

+1 to this, and add a patient who weighs at least 250# and a flight of stairs to the mix. Given the ever-increasing weight of patients, a patient who only weighs 250 hardly counts as "big" anymore. Even using four people is acceptable, since the coordination of four rescuers can be a challenge.

 

[rescue99]

The EVOC is class time. EMT class does not teach driving but its part of the job.

EVOC and CEVO..would be nice. The problems that come up with is the cost of insurance liability and the cost of a course which requires a certified instructor, plus materials. Do students want to foot the bill for something employers have to make certain is done anyway? CA is one state where the employee foots the cost but I say, let employers foot the cost when ever possible. It's gotta be done their way eventually anyhow.

 

[medichopeful]

They should have CPR done to them

No, but seriously, they should be required to actually perform real-life CPR and actually use an AED.

 

[guardian528]

common sense. its not so common anymore.

 

[mycrofft]

I was thinnking more of getting the pt's experience, not more didactic or practicum.

Like, EVOC training while strapped onto the ambulance litter? Or duck-taped to the roof?

 

[ChicagolandIFT]

Not many EMTs are going to be doing lead even when providing first aid to patients. But unfortunately for the patients, they are put alone in the back of a truck with those that need a medical assessment rather than first aid. Since EMTs do primarily IFT runs on medical patients where vital signs are important, the EMT should shadow CNAs and do no less than 100 sets of vitals on a variety of different patients. The EMTs should be trained by the CNAs to move the elderly, frail and patients with lots of attached accessories without causing pain and injury. They could also take a lesson on how to maneuver obese patients safely. EMTs are not adequately trained to be providing even "BLS" care to medical IFT patients such as those requiring dialysis.

I am with you! GEMS would be a good part of a EMT-B class, and for Pete sake, some anatomy and physiology to include something more than the basics (or A&P I and II as pre-reqs). And while we talk about dialysis patients... why not teach why it is so dangerous to transport people with dramatic electrolyte shifts... I bet less than 1 in 10 of the basics I ask would be able to explain it better than "something about salt". Better yet... we really should have just paramedics! (though I work with a few medics that I am not sure know what the heck it going on either most of the time). We also need to drill the fact that just because class is over the leaning is NOT!

 

[firecoins]

EVOC and CEVO..would be nice. The problems that come up with is the cost of insurance liability and the cost of a course which requires a certified instructor, plus materials. Do students want to foot the bill for something employers have to make certain is done anyway? CA is one state where the employee foots the cost but I say, let employers foot the cost when ever possible. It's gotta be done their way eventually anyhow.

I footed the bill for my driver's license. I footed the bill for my car, my emt class, my medic program, college etc whats another 12 hours of education? With all the driving, why should I foot anything? Just drive over it.

 

[firecoins]

An internship portion of the class. I like Vents idea. More IFT exposure. So several IFT shifts and several 911 shifts. Isn't that the thrust of the class? Need to know how to be an EMT so 1 should not be on their 2nd shift when they start riding.

 

[atropine]

How about an exercise program, so we be rid of all fat medics.

 

[firecoins]

we need to always exercise

 

[medichopeful]

+1 to this, and add a patient who weighs at least 250# and a flight of stairs to the mix. Given the ever-increasing weight of patients, a patient who only weighs 250 hardly counts as "big" anymore. Even using four people is acceptable, since the coordination of four rescuers can be a challenge.

Yeah, we did it on stairs. I weigh like 120, and they needed like 5 people to carry me, which I found funny. But it made me feel more comfortable

 

[High Speed Chaser]

Not sure if any one wrote this or if it's possible to do, but maybe a mock mass casualty situation, especially for urban type areas, city departments. I know I'm just a newbie (training to be First Responder and hopefully next year, I can start going for the paramedic course) but triage is something that I feel I have trouble with and would like to practice extra in it. Then getting the class of EMTs/medics to work in a team to effectively triage, treat and transport.

I remember, an organisation in NSW held a mass casualty simulation bringing together the fire brigade and police to train and test the response.

[youtube]jDc9wMVJ-Ls[/youtube] and [youtube]g3M7dyEc2MM[/youtube] but those were only a once off. It shouldn't be that big that its stupid but a small team of people volunteering to act as casualties and assessing.

 

[Seaglass]

Not many EMTs are going to be doing lead even when providing first aid to patients.

It might be a good idea to teach them to take supporting roles on a team as well, rather than always being alone (like my class did) or leading. A lot of newbies don't really seem to know how to work with a medic, or anyone else in a position of authority.

Might also be a good idea to have local law enforcement and fire come and give a talk. Some medical personnel seem to have no idea what they're doing when they encounter them on-scene.

 

[RDUNNE]

do 10 rotations on the ambulance and 10 in the ER. Not the 1 and 1 we have now.

EVOC should be done as a part of the class.

I came close, I had 9 ambulance rotations and 1 er shift. and EVOC is a part of my class.

 

[mycrofft]

Getting off my own thread...work in a general clinic.

Orient to wellness and minor to major health issues, give the student a baseline, see people of differne ages and general health states.

 

[Shishkabob]

They should have CPR done to them

No, but seriously, they should be required to actually perform real-life CPR and actually use an AED.

No. I have over 250 hours of clinical time under my belt between EMT and medic(not even counting actual work time) and have yet to see a code, or anything worse than a respiratory arrest intubated... If CPR was required to get EMT I would have been screwed.

Medic is a different story as my school and the places we do our ambulance internship at expect us to be able to run a code as the lead medic.

 

[Tiberius]

+1 to this, and add a patient who weighs at least 250# and a flight of stairs to the mix. Given the ever-increasing weight of patients, a patient who only weighs 250 hardly counts as "big" anymore. Even using four people is acceptable, since the coordination of four rescuers can be a challenge.

true...Not enough time is spent on proper lifting/moving techniques. I don't mind showing ride students how to work the cot or transfer pts on/off the cot, since that's what we do constantly.

Also, as others mentioned, more A/P and a lot more practice with vital signs. Lately I've had a couple of ride students that did not know exactly where to find a radial pulse and could not take a B/P correctly. What is particularly disturbing about this is that these students are supposed to test out in just a few weeks; they should have been able to demonstrate a little more proficiency in this area.