When?

Why would an ETM-B program require 36 hours of ED time when that is not what EMts do. It is like telling a chef that they would need to learn to be a waiter while going to culinary school.
 
Agreed. 36 hours of ED time seems rather excessive for a basic. When I took EMT again, after letting my certs lapse, the program I was in required no ambulance time, just ED. I always found that to be really odd.

However, the majority of the people in that class were only taking EMT to increase their potential score in the Fire hiring process and weren't going to ever ride on an ambulance.
 
When I took my EMT it was just 48 hours combined field experience. We would have done I think 24 hours in the ED, but if I remember correctly the hospitals were charging an excessive amount of money so the instructors said screw it and they've been doing 48 hours on a ambulance ever since. How it was before was 2 12 hour shifts in the ED and 2 12 hour shifts on a ambulance. Now its 48 total on a ambulance.
 
Ambulance companies aren't offering vehicular rotations to ent courses anymore for insurance purposes. We did combined when I went through so I was pretty surprised to hear times are changing
 
I only did ride time for my EMT class. For my AEMT we did a few rotations at the hospital to get some IVs under our belts. I feel like, at the EMT level, it should just be ride time. ER time doesn't make sense for new EMTs, as it's a totally different animal.
 
For us students have to do 48 hours and make at least 10 patient contacts. We let the students go to either an ED (trauma/burn center), on an ambulance, or on a fire engine. Students can select where they go and how many shifts at each one they want to do.
 
We have to do 10 Assessments in a 10-12 hour shift (if we get those in 10 hours we can go home). But they dont want us to do ambulance because we will probably only get 1-2 calls in a night.
 
Patient contact volume is the reason that the programs around here require 24 hours in the ED. "Assessments," vitals, generally talking to patients, splinting, etc, all happen in greater volume in the ED (duh). I didn't think the ED time was useless, though I can't imagine not sending students out on the ambulance, like what's done in Massachusetts.

Our IV class was only done in the hospital. While it was nice from a time point, it was not a realistic training experience either. The difference between starting an IV on the bench seat (while seatbelted) and squatting next to a hospital bed is rather different.
 
dank said:
Why would an ETM-B program require 36 hours of ED time when that is not what EMts do. It is like telling a chef that they would need to learn to be a waiter while going to culinary school.
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I went to a private school. That's just simply what they required. I'm glad because every hour is one more hour of experience. :)

And if you want to get a job in an ed, it is exactly what EMT'S do.
 
It's been a long time (18 years?) but my EMT program required us to do four 12 hour shifts. Two of those were in the ED, two were on an ambulance. You might think that doing that much time in the ED would be a waste of time, but it's entirely for getting guided practice in performing patient assessments on a LOT of different people in a relatively short period of time. The other thing that is nice about the ED environment is that it's generally quiet-ish and at least somewhat controlled. It's not noisy like the back of an ambulance or as chaotic as being on-scene somewhere. The ED is where I first started really learning the different lung sounds, for instance. It's just not the same when you listen to recorded sounds when compared to the real thing.

As far as what to buy for school, before things really get going, I would suggest only acquiring only a couple of things: a couple pair of shears, some good supportive black shoes, and a stethoscope that's in the price range of about $30-$70. Stethoscopes in that price range will all be much better than the cheap steths that sometimes will be included in school packages and you won't break the bank if you somehow accidentally leave your steth somewhere or it gets stolen. My personal steth has been with me for about 14-15 years now and it's a Littmann Cardiology III. I bought it around the time I started going to medic school. I used it through nursing school and trust me, it's still very good. I wouldn't go out and buy one of those just because I said it's a good stethoscope. Learn to hear what you need to and once you've gotten the hang of it, then go buy the stethoscope you want.

As to the rest of it, only buy those things that the school tells you to. You don't need tons of equipment on hand to do 80% of the job and you don't need to wear it all on your belt. Typically, upon my person, you'll find only these things all the time, on all calls: stethoscope, pens (ball point & sharpie), notepad, small wad of gloves, watch, and pen light. Everything else I need will usually be within reach. Somewhere nearby will be a radio and a cell phone.
 
I acquired supplies toward the beginning. However, I also started riding along as soon as I got voted into our squad by the Board of Commissioners.

I did a lot of research and decided to drop money on good steth, mainly because I wanted one for young children and adults. The one I got had very good reviews for both. I also put together my own bag for two reasons: 1-wanted a bag in my vehicle 2-I researched protocols and did rig checks and/or discovered items on ambulance that were not up to par. Our squad captain isn't a very good one and oftentimes the squad has a bunch of stuff we don't need and has to make due with substandard equipment....like a BP cuff in our first in bag that needs to be recalibrated. She doesn't even stock hemostatic dressings. But what I carry on my person in minimal. I have actually had to use items from my bag numerous times, for non-squad incidence and a couple squad runs too.

I would suggest buying pants and boots well before clinical so you have time to break them in, beforehand. I got my boots and wore them around the house before I wore them to scenes
..did the same thing with my turnout gear and fireboots. I wanted to get use to how I moved and worked with it all on before I needed to wear it to a fire.

Good luck!
 
I did not read all the threads but I also suggest dropping money on one or two anatomy books, a review book, and reviewing all the scenarios you can.
 
dank said:
Why would an ETM-B program require 36 hours of ED time when that is not what EMts do. It is like telling a chef that they would need to learn to be a waiter while going to culinary school.
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I disagree. Getting Vitals, EKG placement on different types of patients , using different equipment than the one at your training center are all reasons to go to the ED. As well as more patient contact to observe the non-medical things that need to be done with patients.

And some EMTs work in ED as ER Techs.
 
ego said:
I disagree. Getting Vitals, EKG placement on different types of patients , using different equipment than the one at your training center are all reasons to go to the ED. As well as more patient contact to observe the non-medical things that need to be done with patients.

And some EMTs work in ED as ER Techs.
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Then you should not be classified as an EMT, you are an ER Tech.
 
Akulahawk said:
It's been a long time (18 years?) but my EMT program required us to do four 12 hour shifts. Two of those were in the ED, two were on an ambulance. You might think that doing that much time in the ED would be a waste of time, but it's entirely for getting guided practice in performing patient assessments on a LOT of different people in a relatively short period of time. The other thing that is nice about the ED environment is that it's generally quiet-ish and at least somewhat controlled. It's not noisy like the back of an ambulance or as chaotic as being on-scene somewhere. The ED is where I first started really learning the different lung sounds, for instance. It's just not the same when you listen to recorded sounds when compared to the real thing.

As far as what to buy for school, before things really get going, I would suggest only acquiring only a couple of things: a couple pair of shears, some good supportive black shoes, and a stethoscope that's in the price range of about $30-$70. Stethoscopes in that price range will all be much better than the cheap steths that sometimes will be included in school packages and you won't break the bank if you somehow accidentally leave your steth somewhere or it gets stolen. My personal steth has been with me for about 14-15 years now and it's a Littmann Cardiology III. I bought it around the time I started going to medic school. I used it through nursing school and trust me, it's still very good. I wouldn't go out and buy one of those just because I said it's a good stethoscope. Learn to hear what you need to and once you've gotten the hang of it, then go buy the stethoscope you want.

As to the rest of it, only buy those things that the school tells you to. You don't need tons of equipment on hand to do 80% of the job and you don't need to wear it all on your belt. Typically, upon my person, you'll find only these things all the time, on all calls: stethoscope, pens (ball point & sharpie), notepad, small wad of gloves, watch, and pen light. Everything else I need will usually be within reach. Somewhere nearby will be a radio and a cell phone.
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An EMT should train in the type of enviroment they will be called to serve in, (the field or back of an ambulance). EMTs are there to fix a person up as best we can and get them to a hospital (pre-hospital care), we are not doctors and thus not trained to diagnosis partents. I got pretty dam good performing assessments on patients from doing them in the classroom and on calls in the back of an ambulance. The only time I stepped into the ED was when I was transporting a patient. Train as you do, because if you have only been performing assessments in a sterile enviroment, it will be a hugh shock when you actually have to perform in the real world.

I'm not trying to knock anyone, I just do not see any benefit from spending any time in the ED during training. I can learn the exact same thing doing assessments in the classroom and in the field.
 
All the expensive toys I had were bought for me...Master Cardiology was a medic school graduation present from my momma and my Raptors were a birthday present from my girlfriend.

Y'all needed boots in EMT school? I just wore comfortable black tennis shoes.

dank said:
An EMT should train in the type of enviroment they will be called to serve in, (the field or back of an ambulance). EMTs are there to fix a person up as best we can and get them to a hospital (pre-hospital care), we are not doctors and thus not trained to diagnosis partents. I got pretty dam good performing assessments on patients from doing them in the classroom and on calls in the back of an ambulance. The only time I stepped into the ED was when I was transporting a patient. Train as you do, because if you have only been performing assessments in a sterile enviroment, it will be a hugh shock when you actually have to perform in the real world.

I'm not trying to knock anyone, I just do not see any benefit from spending any time in the ED during training. I can learn the exact same thing doing assessments in the classroom and in the field.
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While I agree with train where you'll work the fact that you didn't do any ED time clouds your opinion on it. I saw far more patients in the ED than I ever did in field time in B, I and P school. Granted I did my clinicals at the busiest LII Trauma Center in the nation. I started hundreds of IVs in the ED for I and P compared to maybe 75 during field time. Also did more skills like NG/OG placement, 12-lead placement and interpretation (again hundreds vs tens) than in the field. For a frame of reference I had a little over 200 patient contacts in my 480 hour Paramedic Internship.
 
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dank said:
An EMT should train in the type of enviroment they will be called to serve in, (the field or back of an ambulance). EMTs are there to fix a person up as best we can and get them to a hospital (pre-hospital care), we are not doctors and thus not trained to diagnosis partents. I got pretty dam good performing assessments on patients from doing them in the classroom and on calls in the back of an ambulance. The only time I stepped into the ED was when I was transporting a patient. Train as you do, because if you have only been performing assessments in a sterile enviroment, it will be a hugh shock when you actually have to perform in the real world.

I'm not trying to knock anyone, I just do not see any benefit from spending any time in the ED during training. I can learn the exact same thing doing assessments in the classroom and in the field.
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You should note that I stated that we did 2 shifts in the ED and 2 on ambulance, so we did get "real world" experience. You certainly learn how to do assessments in class and while on an ambulance. Here's the thing about ride time... you'll only usually see one patient at a time. In a typical ED, you'll have the opportunity to practice a given skill on several patients, so you'll get better at that skill faster that way. Then when you hop on the ambulance, you already know what you're looking for, you just have to learn to adapt to the new environment. The point is that you don't use the ED to learn how to do ED stuff... you use it to learn how to perform your assessment skills on "real" patients and see lots of patients with different problems. Then you hop on the ambulance to learn the ambulance stuff and refine your skills for that environment.

From my EMT training, I was on a 911 ambulance and saw a grand total of 8 patients. In the ED, I saw about 20. That's about 4 per day while on the ambulance and about 10 per day in the ED. I'm not saying that you can't learn the exact same things on an ambulance, just it'll take longer to do.
 
While my PM program didn't have ED time, I wish they would have. As Akulahawk said, you have more exposure due to greater numbers. Thus, you have more chances to practice skills, build muscle memory, learn how the "other side" does things, create relationships, etc. And learning/refining a skill in a controlled environment (as compared to the field), benefits you greatly down the road.
 
Heres the deal on the ED/ambulance experience. Most peoe would consider the town i live in as "small" atthough its 100x bitter than my hometown. I asked the director why the ED and not ambulance runs, and he said if we strictly went ambulance we would probably only get 2-3 calls in a night and we need 10 vutal assessments. The hospital is going to give us scrubs to wear and all we need is our stethoscope and tennis shoes. I am also going to ask, though, if I can do an ambulance run too- eventhough theyre changing ambulance companies soon. I dont think it will matter much.
 
And above is the perfect example of why one must finish that first cup of coffee before attempting to write one's name. Sorry for the typos.
 
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