What if EMT/Paramedic was one program instead of 2?

[JakeEMTP]

art lines are commonly done by students while going through paramedic school, but not usually done in the field.

Which school is allowing Paramedic students do art line insertion in clinicals?

Why?

Wouldn't it be more beneficial to get practice at skills that would normally be done in the field? Very, very few Flight or CCT Paramedics will get to insert art lines. I believe the state of Mississippi was being challenged on that and may have been successful for the RNs but not yet for Paramedics. Monitoring A-lines of course are accepted.

Also, why would you want to take the time to set up for a central line if you have the IO in the field? Central lines bring controversy in the hospitals and with an acquired infection from it the hospital will be denied reimbursement for the costs of that infection which can include an extensive ICU stay.

 

[eprex]

In order to be a cardiologist, you need to be an MD first. in order to be a thoracic surgeon, you need to be an MD first.

Actually you need to be an MD or DO first. I don't really find this to be an apt counterargument. Doctors specializing in biological systems is markedly different from an EMT getting slightly more training to become a paramedic.

Either way, I think the OP has a good point. As long as the medic student gets plenty of clinical rotations (which they do I'm told) then that should provide the experience they need. Many people argue that becoming an EMT for a long period of time beforehand can encourage the forming of bad habits but of course this is an arguable point.

 

[Bieber]

Which school is allowing Paramedic students do art line insertion in clinicals?

Why?

Wouldn't it be more beneficial to get practice at skills that would normally be done in the field? Very, very few Flight or CCT Paramedics will get to insert art lines. I believe the state of Mississippi was being challenged on that and may have been successful for the RNs but not yet for Paramedics. Monitoring A-lines of course are accepted.

Also, why would you want to take the time to set up for a central line if you have the IO in the field? Central lines bring controversy in the hospitals and with an acquired infection from it the hospital will be denied reimbursement for the costs of that infection which can include an extensive ICU stay.

I don't disagree with you on central lines. With IO's there's no need for them in the field. As far as art lines, paramedic students in my area are allowed to practice to their full scope in clinicals insofar that a physician blesses their actions. As for the why: experience? Education? Would it be better to practice skills used in the field? Yes. Are there always such skills needing to be done? No. Clinicals also provides a rare opportunity for paramedic students to learn about in hospital treatments that they might otherwise not have the option to learn.

 

[EpiEMS]

A Paramedic in the US is not an independent practitioner. You can not prescribe or bill and you work under a medical director who writes your protocols and should be overseeing your competency to allow you to provide ALS or BLS care. A medical director can also pull the ALS scope of practice from a Paramedic and have them work only at the BLS level regardless of what state license they hold.

I understand that, I just don't think that it makes sense to have that level of dependency. If we were to increase the educational requirements for EMS practitioners, it would make no sense at all.

This is not a personal attack on you but it sounds like you would benefit from some more experience with various healthcare providers. I think you are putting paramedics on a pedestal, so to speak (as I probably do to some extent with RNs)

There may be some small comparssion in relation to trauma care. But how much of ED traffic is actually trauma? Most would be lost with the majority of general medical/surgical patents

I totally agree -- I would like to spend more time in the ED watching and learning from the RNs and other practitioners there. What you said about ED traffic jives with what I've seen, as well -- it isn't usually trauma, it's mostly exacerbation of chronic conditions, and other medical complaints. This might just be a problem with the whole system -- the ED shouldn't be used for primary care, as we all well know.

 

[JakeEMTP]

I understand that, I just don't think that it makes sense to have that level of dependency. If we were to increase the educational requirements for EMS practitioners, it would make no sense at all.

The physican extenders in the US are the NP and the PA.

Right now the NP is a Masters and will increase to a Doctorate as a requirement for entry.

The PA is in some places a Bachelors and in others a Masters which that profession is now striving to make the entry.

The Physical Therapsit who has free standing offices and work under broad guidelines are Masters and going to Doctors.

The same for OT and SLP.

The PA is probably the youngest of those professions.

The Paramedic has been around for almost 50 years and still the Associates degree is not required for all states with the exception of one state in the midwest and Oregon which sorta requires it.

If the Paramedic is now 50 years old and the Associates degree is still not a requirement, how long do you think it will be to climb up to Masters?

The other question is "why?"

The 2 Physician Extenders, NP and PA, but have trauma and ER specialties. The PA can extend their eduation another 18 months on top of the Masters to specialize in EM.

They both already have reimbursement and prescribing established. Why should the public have to wait another 50 years for the Paramedic to advance to that level?

Raising the education will not happen overnight. It took over 15 years for there to be an agreement on the new NREMT levels and basically all that did was do some renaming and EMS is still nowhere closer to an Associates. EMS sometimes gets sidetracked by coming up with new titles and levels rather than focusing on eduation.

 

[EpiEMS]

If the Paramedic is now 50 years old and the Associates degree is still not a requirement, how long do you think it will be to climb up to Masters?

Give it a couple years. Give the providers an incentive -- a carrot, not a stick.