Your Controversial EMS-Related Opinion

[jgmedic]

The current tiered system is totally backwards. Sending someone with apx 120 hours of training to see if someone needs an actual assessment from a provider with formal education is backwards. You don’t know what you don’t know.

This is the justification for the LA/OC model. ALS first response with BLS transport that a medic can jump on if necessary. So while I agree in principle with you, that has been completely *******ized into what we have in SoCal today.

 

[E tank]

Private EMS (including IFT) should not exist. Putting profit over people is wrong.

When you say 'people', is that patients or employees?

 

[Fezman92]

When you say 'people', is that patients or employees?

Both.

 

[MMiz]

Additional education (AEMT and Paramedic) should be required for all paid providers after a set period of time.

EMT-Basic > 1 year > EMT-Advanced > 1 year > Paramedic

 

[jgmedic]

FD's should only be ALS if they can transport. The squad/ALS engine thing with BLS private ambos breed laziness and subpar EMS.

 

[GMCmedic]

Fire departments only EMS involvement should be BLS non transport.

 

[E tank]

Both.

Well, don't tell the guy that treats your kidney stones not to make a profit.

 

[Fezman92]

When I mean employees, I mean the CEOs and those high level jobs, not the ones doing the real work.

 

[VentMonkey]

When I mean employees, I mean the CEOs and those high level jobs, not the ones doing the real work.

Would you know all of the logistics and logistical challenges that go into the specifics of even a mundane renal-rodeo IFT? I don’t, I just transport.

Why shouldn’t those jobs exist? Please expound and your somewhat shortsighted comment.

 

[Fezman92]

Putting profit over everything else is wrong, when you only care about the bottom line, you put everyone at risk.

 

[CCCSD]

AEMT should be the minimum to work on a 911 ambulance.

AEMT should have needle decomp.

Paramedic should be a 2 year degree and CCP or CP should each be another year.

Needle Decomp is a BLS skill.

 

[GMCmedic]

Putting profit over everything else is wrong, when you only care about the bottom line, you put everyone at risk.

Your first mistake is believing this is limited to private EMS. I assure you, nobody is in the business of EMS to lose money. Not privates, not third service, not municipal fire, nobody.

If there is profit to be made, everyone is trying. When you're older, you'll understand.

 

[EpiEMS]

Needle Decomp is a BLS skill.

This is interesting - do you think risk/reward makes it so? I guess the view I have been told is that it is infrequently used enough and too risky for an EMT to perform. That said, less trained folks (that is, in terms of hours of EMS-type training) do perform it in, say, the military, right?

 

[EpiEMS]

When I mean employees, I mean the CEOs and those high level jobs, not the ones doing the real work.

You don’t think administering a large business or organization is real work? Tell that to the chief of the police department or the head of an oil company or a hospital administrator. Somebody has to hire staff, make budgets, buy equipment…to do it right is hard and that means it is going to cost a bunch, likely more than the rank and file will be paid.

 

[CCCSD]

This is interesting - do you think risk/reward makes it so? I guess the view I have been told is that it is infrequently used enough and too risky for an EMT to perform. That said, less trained folks (that is, in terms of hours of EMS-type training) do perform it in, say, the military, right?

It’s a monkey skill. It’s part of CLS/TCCC taught to 18 year old troops. I teach it in TECC. The reward is well worth the (minimal) risk.

 

[EpiEMS]

It’s a monkey skill. It’s part of CLS/TCCC taught to 18 year old troops. I teach it in TECC. The reward is well worth the (minimal) risk.

Makes sense. It was covered in TECC when I took it, but I would not want to be doing the skill unless refreshed on it/skill validated biannually (like any other), particularly because it wasn’t taught in my initial training to the degree I feel fully competent.

 

[CCCSD]

Makes sense. It was covered in TECC when I took it, but I would not want to be doing the skill unless refreshed on it/skill validated biannually (like any other), particularly because it wasn’t taught in my initial training to the degree I feel fully competent.

Agreed. I ensure repeated skills testing for my students throughout the year as part of my training programs.

 

[VentMonkey]

Needle Decomp is a BLS skill.

A potentially lifesaving one at that.

 

[FiremanMike]

Fire based versus hospital based versus government third service based is the red herring and almost entirely irrelevant to the care delivered.

The only thing that actually matters is the value the agency places on initial/ongoing training, quality improvement, and ensuring competency of their providers.

 

[Summit]

Needle decomp is life saving when needed, but it is also invasive and not without serious complications, and the biggest single failure point is employing it when it is not indicated which automatically adds potential for complication. For that reason alone in a non-combat environment, I can see the argument for keeping it above the EMT level, even though the actual skill is less complex and less difficult than other things that EMTs do. But it should be in the hands of AEMT at least.