JPINFV
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For the sake of people who haven't heard about Canadian EMS levels (I have on another board), how much class time do your PCPs have? B) EMT-Bs are more like your guy's EMRs.
What is considered a BLS call in your area
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ResTech
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The initial post in this thread is incorrect. Being a Pennsylvania EMS provider myself, I know what the state-wide protocols say and stabbings and chest pain are ALS in PA!
In most counties of PA and most EMS systems nation-wide, our dispatch center uses a tried and trusted system called Priority Medical Dispatch or EMD. Essentially its a system that interrogates callers and triages over the phone and assigns a response class of Class 1 (ALS/BLS emergency), Class 2 (BLS emergency only), and Class 3 response which is BLS non-emergency. This system is designed to add efficiency to an EMS system by greater resource allocation and to add an additional mechanism of safety for EMS responses. There is no need for a lights and sirens response or ALS unit for a finger fx, minor lac, etc.
This tried and trusted, national standard system of Priority Dispatch is what protects against litigation when not sending an ALS unit on every call. It is also an element of risk management by reducing the number of lights and siren responses.
So basicly, ALS IS NOT needed on every call. The Priority Dispatch system errs on the side of caution and I end up canceling ALS probably more times then not. In a perfect world every ambulance would be staffed by two paramedics... but thats not feasible in the majority of systems nor is it absolutely necessary.
Show me some data that says patients treated in an all ALS system have better clinical outcomes then two-tiered systems of primary BLS and ALS from a hospital. Show me data that says BLS cannot safely and effectively assess a patient and make a determination if ALS is indicated or not.
There are a 1,001 "what if's" we can play and if we want to play that game then why not have PA's and physicians staff an ambulance... then paramedics and nurses can just drive. We proceed pre-hospital with the information we get from the time the call comes in. If granny calls and says she has been having back pain for a week, should we all get excited and put the surgeon on stand-by cause it might be a AAA? That's crazy. You don't do that.
If BLS get's there and presentation dictates something more severe, call for ALS, expedite transport, and thats it. Besides whats ALS gonna do for a AAA anyway? Make them bleed out faster by over zealous fluid administration?
This post got a little long I know but some of this "para-God complex" stuff really annoys me at times. It's EMS! our job is to stabilize and deliver patients alive to definitive care in the hospital... not play doctors out in the field!
In most counties of PA and most EMS systems nation-wide, our dispatch center uses a tried and trusted system called Priority Medical Dispatch or EMD. Essentially its a system that interrogates callers and triages over the phone and assigns a response class of Class 1 (ALS/BLS emergency), Class 2 (BLS emergency only), and Class 3 response which is BLS non-emergency. This system is designed to add efficiency to an EMS system by greater resource allocation and to add an additional mechanism of safety for EMS responses. There is no need for a lights and sirens response or ALS unit for a finger fx, minor lac, etc.
This tried and trusted, national standard system of Priority Dispatch is what protects against litigation when not sending an ALS unit on every call. It is also an element of risk management by reducing the number of lights and siren responses.
So basicly, ALS IS NOT needed on every call. The Priority Dispatch system errs on the side of caution and I end up canceling ALS probably more times then not. In a perfect world every ambulance would be staffed by two paramedics... but thats not feasible in the majority of systems nor is it absolutely necessary.
Show me some data that says patients treated in an all ALS system have better clinical outcomes then two-tiered systems of primary BLS and ALS from a hospital. Show me data that says BLS cannot safely and effectively assess a patient and make a determination if ALS is indicated or not.
There are a 1,001 "what if's" we can play and if we want to play that game then why not have PA's and physicians staff an ambulance... then paramedics and nurses can just drive. We proceed pre-hospital with the information we get from the time the call comes in. If granny calls and says she has been having back pain for a week, should we all get excited and put the surgeon on stand-by cause it might be a AAA? That's crazy. You don't do that.
If BLS get's there and presentation dictates something more severe, call for ALS, expedite transport, and thats it. Besides whats ALS gonna do for a AAA anyway? Make them bleed out faster by over zealous fluid administration?
This post got a little long I know but some of this "para-God complex" stuff really annoys me at times. It's EMS! our job is to stabilize and deliver patients alive to definitive care in the hospital... not play doctors out in the field!
reaper
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According to you, we should just drive yellow taxis!! I will stick to medicine.
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Reaper, if ur referring to my post I really don't see how you can derive that from anything I posted.
reaper
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This is why!
I do not play doctor, I treat my pt. Treatment in the field is Medicine. Stabilizing and transporting to the hospital is BLS care. ALS care is there to treat the pt's, then transport for evaluation.
Most hospitals today have a wait time, till the DR. can evaluate the pt. Does this mean that the pt should be in pain or distress the entire time? No. If I can treat the problem in the field, the pt is already getting the care they need.
Sorry, but a BLS unit cannot evaluate a cardiac pt or for that matter, a trauma pt and determine that ALS is not needed. Basics are just not taught how to do it. Yes, it would be nice if they were, but for right now they are not.
We don't have Paragod complexes, we have Paramedic complexes. The pt's best welfare is paramount in our decisions, not whether we hurts the basics feelings.
This thread was not a ALS vs BLS bashing post, but if you want to bring out the Paragod phrase, then it will turn into that.:unsure:
Ridryder911
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Wow! Thank you for proving my point of ignorance. If you cannot determine the difference of a AAA and general back pain after assessing, something is wrong. As well, dispatch is not the "end all" of medical clearance.
I guess regulating blood pressure to prevent AAA from rupturing, is something you would not understand? Who in the h*ell, pushes fluids on a AAA? Go back to school!
As well, there are many documented problems with the "old and tried" priority dispatch system. Would you like to review the litigation's of that system? Yes, there has to be a system in place, but it is NOT without flaws. Sure there are non emergency calls, alike there are non emergency injuries and illness that arrive to ED, but guess what each one has to be evaluated by a person that can provide advanced care and be assessed to determine that there is not a life threatening event.
Sorry, a person with 150 hour course is not qualified to make the determination and definitely not reading Clawson's dispatch program eleminates these errors.
I don't play doctor, but I suggest you awake to 2008 and look around and look at over crowded ER's, and no hospital rooms. If you do not think that our role is not about to change, then continue to keep your head in the sand.
Field termination of codes, treating and releasing, etc. is now becoming an everyday event. The Paramedic Practitioner is not a "dream" rather a needed reality not just because the system needs it rather it but also an economical outlet that insurance corporations sees as feasible too.
If you think this is B.S., then I refer you to the CEO of NREMT, Bill Brown and his statements at the Eagles Conference and articles in JEMS, EMS, etc.
R/r 911
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ResTech
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Certainly I am not against ALS... I wish all systems could be ALS but like I previously stated, that's not always feasible. I do believe my post was taken slightly out of context. ALS is medicine... but too many times ALS stay's and ****s around way to long to try and be impressive when if they would just transport the patient to the hospital the patient would be getting exactly what they need and want. Medic's are so afraid of walking into the ED and catching sh*t for not being able to get an IV so they will take 20mins and try 5 times when they could just transport and have the pt there in under 10mins.
May I point out the study done in Los Angeles some years ago that showed patients who arrived at the hospital POV had a clinically significant better outcome then those patients that arrived by a paramedic unit. This better outcome was attributed to patients transported POV were taken direct to the hospital and didn't experience the delay of 911, dispatch, response, scene assessment & tx, and then transport.
That's not all to negate the benefits of ALS... for example treating CHF, COPD, DM, MI, etc. that ALS can make a huge difference in during the tertiary phase of their care. ALS IS NEEDED MAKE NO MISTAKE. However, you guy's must have no clue what good BLS providers are. You state BLS cannot make a determination if ALS is needed or not.. thats just bullsh*it... I do it and my peers do it all the time.... under a state-wide protocol! The medics here are totally cool with it.. they know we are more then able to assess. You guys must have never had the privilege of working with great BLS people. EMS is an art... you guys think EMT's stop learning after a 150hr initial training course? The amount of hours spent in a classroom outside the initial course combined with many, many years of clinical experience adds up to a hell of a lot more then 150hrs!
I respect (however strongly disagree) your opinions and views from your own experience but from my experience (both ALS and BLS) hopefully you can learn from something that is done on an everyday basis in an EMS system outside of your own.
I'm all for the progressing of EMS... especially research based EMS where modalities are not done under the premise of "well, it appears to work" with no scientific data to support why we are doing it. I'm also in strong favor of the National EMS Scope of Practice and the EMS Education Agenda For The Future that advocates the need for an "Advanced EMT" that pushes meds such as NTG, albuterol, Narcan, D50, Epi, and ASA.
By the way, I have a subscription to JEMS and EMS Magazine and read the articles every month. Playboy is the only one where I only look at the pictures
And for the original topic of what constitutes ALS... here is the link to the Pennsylvania State-Wide BLS Protocols in PDF format... Protocol 210
http://www.dsf.health.state.pa.us/health/lib/health/ems/bls_protocols_2004.pdf
May I point out the study done in Los Angeles some years ago that showed patients who arrived at the hospital POV had a clinically significant better outcome then those patients that arrived by a paramedic unit. This better outcome was attributed to patients transported POV were taken direct to the hospital and didn't experience the delay of 911, dispatch, response, scene assessment & tx, and then transport.
That's not all to negate the benefits of ALS... for example treating CHF, COPD, DM, MI, etc. that ALS can make a huge difference in during the tertiary phase of their care. ALS IS NEEDED MAKE NO MISTAKE. However, you guy's must have no clue what good BLS providers are. You state BLS cannot make a determination if ALS is needed or not.. thats just bullsh*it... I do it and my peers do it all the time.... under a state-wide protocol! The medics here are totally cool with it.. they know we are more then able to assess. You guys must have never had the privilege of working with great BLS people. EMS is an art... you guys think EMT's stop learning after a 150hr initial training course? The amount of hours spent in a classroom outside the initial course combined with many, many years of clinical experience adds up to a hell of a lot more then 150hrs!
Why is this so hard? You mean a EMT can't assess if a chest pain is of a cardiac, pulmonary, or misc etiology based on exam and index of suspicion? An EMT can't assess a trauma patient and know if they will need ALS? This to me is elementary. Its not all that difficult to know if a trauma patient is effed up enough or suffered an event that warrants ALS. Your statement is quite the insult to every BLS provider on this forum.
No, I understand about regulating B/P... but when the patient has none to regulate that becomes kinda hard don't ya think? and medics are hard pressed to push fluids for hypotension when they aren't 100% sure of the cause.
I respect (however strongly disagree) your opinions and views from your own experience but from my experience (both ALS and BLS) hopefully you can learn from something that is done on an everyday basis in an EMS system outside of your own.
I'm all for the progressing of EMS... especially research based EMS where modalities are not done under the premise of "well, it appears to work" with no scientific data to support why we are doing it. I'm also in strong favor of the National EMS Scope of Practice and the EMS Education Agenda For The Future that advocates the need for an "Advanced EMT" that pushes meds such as NTG, albuterol, Narcan, D50, Epi, and ASA.
By the way, I have a subscription to JEMS and EMS Magazine and read the articles every month. Playboy is the only one where I only look at the pictures
And for the original topic of what constitutes ALS... here is the link to the Pennsylvania State-Wide BLS Protocols in PDF format... Protocol 210
http://www.dsf.health.state.pa.us/health/lib/health/ems/bls_protocols_2004.pdf
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I've got to side with Rid on the cardiac side... to rule out cardiac chest pain, you really need a 12 lead... and that isn't even always accurate. ANY chest pain patient is ALS until proven otherwise.
As for trauma... I often do make a decision to recall the medic. If the patient is CAOx4 with no loss of consciousness, dizziness or near-syncope, has a "decent" systolic blood pressure and pulse, along with clear lung sounds, equal chest expansion with no pain on inspiration, no resp. difficulty, no chest pain, no abdominal pain, and no severe bleeding or long-bone fractures... they are a candidate for BLS transport. If a patient has problems with any of these things... they are probably ALS.
By the way, the above, as well as nausea/vomiting and headache are my list of pertinent negatives I document for most calls.
Rid... how many patients would pass those assessment criteria and still need urgent ALS intervention?
Nice. I'm even better... I've managed to get FREE subscriptions to both magazines... Unfortunately, I don't think Hugh Hefner gives out free copies to students/educatorsBy the way, I have a subscription to JEMS and EMS Magazine and read the articles every month. Playboy is the only one where I only look at the pictures
ResTech,
what to do? as Jon pointed out, it is fairly common knowledge (should be anyway) that a 12 lead is needed in suspected cardiac cases... BLS? can't do it, right?
i don't want to be accused of "bashing basics", because i am not.. in fact i am a basic... but these posts make me cringe, because they show a real lack of scope of knowledge, while at the same time belittling ALS treatments, and we all know where the post will go from there.
as someone who is trying to make more posts about A/P, so that basics may actually learn something, posts like these come along and start the whole ridiculous argument of BLS vs ALS...
costs, time, and other factors aside... from the view point of patient care, if every Basic was asked if they could have the ALS skills, would they want them... it would be 100% yes... so what's the debate?
yes, yes, i know it's not feasible in all areas... Bossy is rural, i am rural, i am well aware of these factors...
but the bottom line then, is that patients are not getting a "high" level of patient care with a BLS crew... if patients sometimes knew the level of care they were really getting BLS, they might be more afraid! We are providing a limited scope of care... do i think it is "first aid", personally no. Do i think it is anywhere near the stratosphere of ALS? also, no. Just pick up a Paramedic text and read for yourself...
as for just "scooping and running", which pops up all the time... many of us have long transport times, not 5 min to the hospital... i sure hope to he** emt's can do more than that...
again, i can't stress enough... i am not bashing basics... but the level is inadequate to properly assess and treat many, many ailments out there...
just because most of the patients won't code on the way to the hospital doesn't mean the Basic level is adequate.
what to do? as Jon pointed out, it is fairly common knowledge (should be anyway) that a 12 lead is needed in suspected cardiac cases... BLS? can't do it, right?
i don't want to be accused of "bashing basics", because i am not.. in fact i am a basic... but these posts make me cringe, because they show a real lack of scope of knowledge, while at the same time belittling ALS treatments, and we all know where the post will go from there.
as someone who is trying to make more posts about A/P, so that basics may actually learn something, posts like these come along and start the whole ridiculous argument of BLS vs ALS...
costs, time, and other factors aside... from the view point of patient care, if every Basic was asked if they could have the ALS skills, would they want them... it would be 100% yes... so what's the debate?
yes, yes, i know it's not feasible in all areas... Bossy is rural, i am rural, i am well aware of these factors...
but the bottom line then, is that patients are not getting a "high" level of patient care with a BLS crew... if patients sometimes knew the level of care they were really getting BLS, they might be more afraid! We are providing a limited scope of care... do i think it is "first aid", personally no. Do i think it is anywhere near the stratosphere of ALS? also, no. Just pick up a Paramedic text and read for yourself...
as for just "scooping and running", which pops up all the time... many of us have long transport times, not 5 min to the hospital... i sure hope to he** emt's can do more than that...
again, i can't stress enough... i am not bashing basics... but the level is inadequate to properly assess and treat many, many ailments out there...
just because most of the patients won't code on the way to the hospital doesn't mean the Basic level is adequate.
i guess, you can also look at it like this:
if you go down the list of Meds and skills that medics can administer and perform, you will clearly see the power to save lives...
however, nothing comes for free... with that power comes the risk of killing someone if skills and meds are not used correctly.
now, basics are not given the ability to take those risks... logical reason would say that it then becomes a stretch to say that they have the ability to "save" lives...
sorry, but it's pretty cut and dried for me...
ironically, the biggest risk to the patient from a basic, in my humble opinion, is indecision, inadequate knowledge, and poor assessment skills.
however, these are the skills that i see least improved by basics, citing things like "it doesn't really matter", "we just stabilize and transport", etc.
something is not equating for me here...
if you go down the list of Meds and skills that medics can administer and perform, you will clearly see the power to save lives...
however, nothing comes for free... with that power comes the risk of killing someone if skills and meds are not used correctly.
now, basics are not given the ability to take those risks... logical reason would say that it then becomes a stretch to say that they have the ability to "save" lives...
sorry, but it's pretty cut and dried for me...
ironically, the biggest risk to the patient from a basic, in my humble opinion, is indecision, inadequate knowledge, and poor assessment skills.
however, these are the skills that i see least improved by basics, citing things like "it doesn't really matter", "we just stabilize and transport", etc.
something is not equating for me here...
ResTech
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Who is saying cancel ALS on cardiac patients? Who said a 12-lead isn't needed for a suspected cardiac pt? I am saying that EMT's are able to make a patient determination of ALS or BLS. I've been doing it for the past 12yrs. And I am saying that EMT's are more then drivers and equipment gophers which is to the contrary of what Rid and Reaper like to think. That is all I am saying.
I have a perfect realization of scope for BLS and ALS. It is a large part of this as to why I am able to make an accurate patient determination of BLS or ALS. And no, I am not belittling ALS modalities. I am defending the BLS level of care from both a BLS and ALS perspective and am trying to give it the credit it is due. We all know the jokes of BLS and some of the loser EMT's in every organization. But that should not detract from the majority of well rounded BLS providers and what they are able to do. That is all I am saying. Its not about BLS vs ALS at all. Its about integration and realizing the potential of both and not dismissing one or the other. Some things I stated are simply to try and make a point and aren't literally what I believe.
I know I can assess a patient and know if they need ALS or not... a skill every BLS provider should possess.
I have a perfect realization of scope for BLS and ALS. It is a large part of this as to why I am able to make an accurate patient determination of BLS or ALS. And no, I am not belittling ALS modalities. I am defending the BLS level of care from both a BLS and ALS perspective and am trying to give it the credit it is due. We all know the jokes of BLS and some of the loser EMT's in every organization. But that should not detract from the majority of well rounded BLS providers and what they are able to do. That is all I am saying. Its not about BLS vs ALS at all. Its about integration and realizing the potential of both and not dismissing one or the other. Some things I stated are simply to try and make a point and aren't literally what I believe.
I know I can assess a patient and know if they need ALS or not... a skill every BLS provider should possess.
ResTech
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Kinda like what Peter Parker said, "With great power comes great responsibility." This is my gift, my curse. Who am I? I'm Spider-man (aka a Paramedic).
MEDIC213
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In my service, everything is ALS until proven otherwise.
so, in the world of atypical presentations, if you have a female patient who doesn't "feel well"... would that be ALS?
if it is, then aren't most of your calls ALS?
how do you rule out potential cardiac for ALS, when there are so many different presentations?
if you don't rule them out, you should be calling for ALS on most medical calls, no?
there is quite a bit of arrogance in your statement, but not much medicine. sorry.
if you have a list of 911 medical conditions that wouldn't prompt you to call ALS, it must be a very short list.
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3-Adam-28
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We are a smaller area so we have a county wide based ambulance service that has both BLS and ALS. We utilize volunteers in the cities for our BLS service and then we have ALS paramedics staffed in the middle of the county at our local hospital. If dispatch determines that it is an emergency call, we run a dual response. The nearest BLS service will get toned along with ALS. BLS is generally closer to the call so they can get there faster and get a patient report out before ALS arrives. If BLS determines that ALS isn't needed they call into medical control give the patient report and medical control decides if ALS is needed or not. If they get the ok then ALS reports back to base and BLS does the transfer. What's really nice about this is that we can get a BLS unit to the patient, have then packaged and loaded and then ALS jumps in the rig and away we go. For a smaller county, it works great and really cuts down on wasted time.
Outbac1
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JPINFV In answer to your post.
When I took my PCP in 2001 the National Occupational Competincy Profile (NOCP), had just come out, so my course was one of the first. I did about 850 hours of class and lab time followed by about 100 hrs of in hospital clinical time. This was followed by 260 hrs of preceptored time on an ambulance. I believe total time was 1200 hours. I know the field time has gone up to 504 hours(42 x 12hrs). The program takes about ten months to complete.
Many community colleges and dedicated schools across the country offer it. Of course every place has its own take on how to instruct it and there are variations in content and time. However all programs have to adhere to the "National Occupational Competency Profile" As put out by the Paramedic association of Canada. If a school wants Canadian Medical Association (CMA) approval they also have to meent stringent standards as to how they deliver the program. The NOCPs can be found at
http://www.paramedic.ca/Content.aspx?ContentID=4&ContentTypeID=2
At this site it lists the competencies for the different levels in Nova Scotia
http://www.gov.ns.ca/ehs/paramedics.htm
Each province and medical director can allow variations in the NOCP. Eg: PCPs in NS routinely do 12 lead ECGs but not Iv's. PCPs in BC do Iv's. ACPs in AB do RSI's but we don't do them here. There is always discussion as to what we want to do and in some cases are already trained to do, but the Drs won't let us. In that aspect it is no different than any where else.
The PCP level is a good first level, not perfect and there is room for improvment. But it is a good place to start.
In an ideal world I suppose we could have Dr's and Rn's on every unit able to do emergency surgery on the spot. But I don't think it would be very practical seeing as we don't have enough for the hospitals as it is. Until then we will have to make do with something else. We all need the best trained and educated people we can get for our prehospital care. We should not accept having our sights set too low. For that is all we will achieve. Your basic is not enough. If we can do better you certainly can. And for the record I don't think PCP is enough. I believe it needs more education and skills to properly handle the cases we get. That will mean better assessments and less duplication. The more correct Dx we do potentialy the less work for the Dr. and faster Tx for the Pt. the faster the Pt is out of there. There will be more Dx and Tx out of hospital.
I see the changes coming and I want to be part of it. We currently have nurse practioners that Dx and write prescriptions. There is a shortage of Drs for rural hospitals so they hire a paramedic to cover for emergencies. The day is not far away when they will have both a Rn praticioner and a Paramedic to run the small ERs. It will be business as usual with no Dr. The major emergencies will be shipped off to a larger Hosp. as they are now and the other stuff will be dealt with. The times as they say, are a changing. You can change and move with it or watch it go by.
Your basic level got your foot in the door of EMS. You've seen what it can be. If you want that for yourself you need to do it full time and make it your profession. If you educate the public to what they have and could have. They won't settle for basic service, they will demand better. With that you will have more pay, benefits, working conditions and respect. You will be a professional in a profession.
I've been watching the fireworks between the "Medics" and "Basics" and both sides have points to their arguments. I'm not knocking volunteers either. There is a place for them. I just don't think it should be the primary response unit for anyone.
My service is not perfect, we have our problems. However we moved on from where we were 10 - 12 years ago and we are still moving and improving.
There, I had to get my two cents in.
When I took my PCP in 2001 the National Occupational Competincy Profile (NOCP), had just come out, so my course was one of the first. I did about 850 hours of class and lab time followed by about 100 hrs of in hospital clinical time. This was followed by 260 hrs of preceptored time on an ambulance. I believe total time was 1200 hours. I know the field time has gone up to 504 hours(42 x 12hrs). The program takes about ten months to complete.
Many community colleges and dedicated schools across the country offer it. Of course every place has its own take on how to instruct it and there are variations in content and time. However all programs have to adhere to the "National Occupational Competency Profile" As put out by the Paramedic association of Canada. If a school wants Canadian Medical Association (CMA) approval they also have to meent stringent standards as to how they deliver the program. The NOCPs can be found at
http://www.paramedic.ca/Content.aspx?ContentID=4&ContentTypeID=2
At this site it lists the competencies for the different levels in Nova Scotia
http://www.gov.ns.ca/ehs/paramedics.htm
Each province and medical director can allow variations in the NOCP. Eg: PCPs in NS routinely do 12 lead ECGs but not Iv's. PCPs in BC do Iv's. ACPs in AB do RSI's but we don't do them here. There is always discussion as to what we want to do and in some cases are already trained to do, but the Drs won't let us. In that aspect it is no different than any where else.
The PCP level is a good first level, not perfect and there is room for improvment. But it is a good place to start.
In an ideal world I suppose we could have Dr's and Rn's on every unit able to do emergency surgery on the spot. But I don't think it would be very practical seeing as we don't have enough for the hospitals as it is. Until then we will have to make do with something else. We all need the best trained and educated people we can get for our prehospital care. We should not accept having our sights set too low. For that is all we will achieve. Your basic is not enough. If we can do better you certainly can. And for the record I don't think PCP is enough. I believe it needs more education and skills to properly handle the cases we get. That will mean better assessments and less duplication. The more correct Dx we do potentialy the less work for the Dr. and faster Tx for the Pt. the faster the Pt is out of there. There will be more Dx and Tx out of hospital.
I see the changes coming and I want to be part of it. We currently have nurse practioners that Dx and write prescriptions. There is a shortage of Drs for rural hospitals so they hire a paramedic to cover for emergencies. The day is not far away when they will have both a Rn praticioner and a Paramedic to run the small ERs. It will be business as usual with no Dr. The major emergencies will be shipped off to a larger Hosp. as they are now and the other stuff will be dealt with. The times as they say, are a changing. You can change and move with it or watch it go by.
Your basic level got your foot in the door of EMS. You've seen what it can be. If you want that for yourself you need to do it full time and make it your profession. If you educate the public to what they have and could have. They won't settle for basic service, they will demand better. With that you will have more pay, benefits, working conditions and respect. You will be a professional in a profession.
I've been watching the fireworks between the "Medics" and "Basics" and both sides have points to their arguments. I'm not knocking volunteers either. There is a place for them. I just don't think it should be the primary response unit for anyone.
My service is not perfect, we have our problems. However we moved on from where we were 10 - 12 years ago and we are still moving and improving.
There, I had to get my two cents in.
JPINFV
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I just wanted to make sure that you understand that you're comparing 1310 hours (class+lab+hospital+ambulance) to 110 hours (total) is kinda of bias. I'd like to hope that PCPs can do a fair amount more than a US EMT-B.
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Yea......thats definitely a huge difference.....
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Outbac1
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JPINFV
Yes I know. I didn't when I first started coming to this forum. I was quite surprised at some of the questions I was seeing until I figured out what a "Basic" was. It kinda puts me in the middle somewhere. At least until next year when I finish my ACP course. I was really quite surprised at the whole EMS setup the USA has. I thought it was much more advanced than it is and that we were the ones trying to catch up.
Having said that I know not all areas are the same. It is just a general impression that I get.
Yes I know. I didn't when I first started coming to this forum. I was quite surprised at some of the questions I was seeing until I figured out what a "Basic" was. It kinda puts me in the middle somewhere. At least until next year when I finish my ACP course. I was really quite surprised at the whole EMS setup the USA has. I thought it was much more advanced than it is and that we were the ones trying to catch up.
Having said that I know not all areas are the same. It is just a general impression that I get.
Ridryder911
EMS Guru
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Yes, we started a good start but dropped the ball back in the 70's & 80's and have not went any further. Unfortunately, we will not observe and attempt to even come up to standards of other countries.
Our system is so fragmented and poorly represented. As well, unfortunately many systems are represented by those that attended the first part of the EMS education portion (200 clock hours or less) then acclaim to be an "expert". Again in comparison a nurse aide or certified medication aide and acclaim to represent nursing, it would be considered ludicrous. Unfortunately our citizens are gullible and misinformed think that there is little difference or unaware there is so much difference between Basic EMT and a Paramedic, in reality there is very little in common if any at all.
I agree we need to proceed with more education and increase each of our levels. I agree as well, the Basic level should be a minumum of one year in length.
R/r 911