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If you only have two ALS units for 75 miles, there is a simple solution... MORE PARAMEDICS!! Usually the EMTs who complain about Paramedics not respecting them are the ones who are either too lazy or scared to go to Paramedic school, or have tried several times and failed. I'm sorry, 120 hours does NOT qualify you to perform invasive procedures. Sure, you can start that IV, but what do you do if you suspect you've caused an air embolism? For a CHFer, would you attach saline or just a lock? What happens if you give too much Narcan to an unconscious overdose patient? Your patient is having a Right Ventricular Infarction... would you give them nitro? Can you give Bicarb and Calcium through the same IV? How does Bicarb work? What does it do? How does Calcium work? I'm sorry, but 120 hours with a few 16 hour "extra cert" courses should not qualify you to administer ANY medication. You have less education than a hairdresser and you want to inject substances into somebody that will alter their body chemistry? Substances that alter how their body is working at the cellular level? Substances that could kill them? When I finished my EMT class, I had training. Now that I am finishing my Paramedic schooling, I have an education, and I am going to be continuing on to higher education. Yes, there is a difference between training and education... for example, would you want your daughter to get sex education or sex training? Think about it.

Timmy, where have you been for the last year? We've been dissecting that show in the City even before it came on the air, and then took the show apart, item by item, on medical treatments used and abused, the use and misuse of the HEMS aspects, mental health of the characters as they work, play, and have sex with each other. We'd even disuss plot devices, like the guy thrown out of a bar. Normally, we'd expect the guy to come back with a blazing gun, or start swinging a samurai sword, but instead, had an out of control car come flying in through the wall. We never saw the guy again. I used to think, to insult someone for a "Cowboy" attitude on this web site, we'd start to call them a "Rabbit".

What we need to do is forget this BLS/ALS Bullshit. It is all pt. care. If I was the pt., I would hate it that an ambulance shows up and can offer me O2 and a ride. I would deserve a educated assessment by a educated provider and if I needed further interventions, then I could get them then. Not wait for the ALS truck to show up. Aeromedic, I'm surprised you don't have more confidence in your pt. care abilities. From your post it sounds like your more concerned with making mistakes than treating the pt. I can get a 12-lead in less than a minute. I don't need someone to do it, although it is nice. We ride double medic here. Everyone gets a thorough assessment and immediate transport and interventions if required. Does every pt. require advanced interventions? Of course not. However, when they are, pt. care is not delayed because we're waiting for advanced providers to get there. Another thing, Basics are for the most part, unable to determine if an intercept is necessary due to their lack of education. Another reason to have all further educated providers. In most Countries, EMT-B's wouldn't be aloud on a ambulance due to their limited education in EMS. Why do we allow it here? Anyway, these are my thoughts. After being a member here for a considerable amount of time, and having taken part in many of the same debates as this, I think I'm done with this thread.

This post is EXACTLY why I had the gastric bypass.I can imagine how embarrassing having FD and EMS providers need help to lift me. how sad. I was 305 at my highest weight now I am not I am a LOT smaller 160ish, I feel better and dammit I look HOT now I have had some problems but nothing I would take back. Being a size 24 in womens (54 ish in mens) to a 8 in womens (34ish in mens) tends to make ya feel much better about things. Also helps me to have compassion for those who are heavy. Dosent mean that I dont look the same way most do. Just more compassionate. Carry on!

Welcome aboard, Anthony. A quick word here. We're international in scope. What might be standard practice for your home area might be against the rules and regs I'd be following, here in New York City and likewise were I to try yours. I emphasize MIGHT. Please don't use abbreviations. Not all of them are universal, kind of like Mel Brooks' line in "To Be or Not To Be", "He's world famous in Poland". We will nitpick you, and expect the same in return, just keep it civil. Other items will be brought out, should you step on anyone's toes, but we're a fun loving bunch, despite everything I've said here. Again, welcome aboard! (Just remember, I'm a legend in my own mind!)

This is an issue that has always been near and dear to me. I have read a lot of "Monkey Skills" comments, and yea, starting an IV or Intubation aren't that hard to do. But the time spent in class learning When to do it, How to do it right and most importantly, How to fix it when something goes wrong. Do I think EMT-B's should be trained to set up 3/4/5/12/15 leads, Heck yes. Emphatically, yes, do, please, but not in a diagnostic capacity. If I intercept, have an initial strip to look at, great. If I can have a 12 lead set up for me while I'm getting a line, doing a history, etc... great. Worst case scenario with a bad 12 lead placement is I get a useless strip. If they weren't trained, I wouldn't get a strip at all. All this being said, ECG's are a different animal from Drugs and invasive procedures. Lives are saved with BLS. Maintain Airway, Assist Breathing, Start CPR, Control Bleeding. Drugs are nice, drugs are good, but they can't replace rock solid BLS skills. Everybody has a place in EMS, and if B's were useless, we wouldn't have them. A lot of it comes down to cost. Medics are expensive to train, to hire, to pay and most of all, to outfit with all the goodies that they need. A Basic car to rapid respond, rapid transport and run with an AED and be able to pre-place for 12/15 lead makes a HUGE difference in EMS. If I can get to an intercept with an initial strip, patient packaged and ABC's looked after, I've got it made. A lot of this debate comes down to one of my biggest pet peeves... Overuse of ALS Skills. Not everybody needs an IV, and sometimes Oral Glucose is just as good as D50. The only drugs that NEED to be carried all the time are Epi and Oxygen. Those two save lives hands down. Cardiac drugs are nice, but they don't always work. Pain control is nice, but it can create huge headaches if you aren't COMPLETELY sure of your assessment pre-administration. Any ALS drug kit can kill somebody in countless ways (and it does sometimes), and that is with trained paramedics. I personally think this debate is less about skills and saving lives and more about feeling important and "needed". ALS Guys/Gals need to give BLS Guys/Gals credit for their work more often and show more appreciation, and most importantly, keep in tune with their BLS roots. Those are just my thoughts on it though.

I do not want to start an argument with this discussion, so please do not hate me. I just want to clarify that without the BASICS, Paramedics can not do their jobs. It doesn't matter that you are a Paramedic if you if the basics skills are not performed. EMS is definitely a cluster f***. Each state with it's own protocols, FD, PD, and EMS can not get along, EMS can not receive respect, EMS providers are ambulance drivers, etc. When then, would we degrade each other? Yes, I am ONLY a Basic to you, but the knowledge and skills I have acquired are the most important at ANY level. Remember the ABC's? I volunteer with EMT-I's and they seem to forget the ABC's because the are I's and can start IV's. Umm.......dontcha wanna check their pulse first and maybe do some chest compressions before you start that IV there EMT-I? Ok, I bantered a little. My point is that we are all important, on all levels, because without the ABC's covered, you just might end up with a dead patient and your knowledge of D50, Narcan, and Morphine won't mean crap. I read a of these posts and I see a lot of degrading of Basics. I do not think you necessarily need the philosophy behind the techniques of some things. People are trainable. One thing that cracks me up is that I am also a Medical Assistant. I was trained on EKG interpretation. I do not know if it is at the same level of a Paramedic, but I am aware of some interpretation. As a Basic, I'm not even suppose to touch the monitor. I can also give injections, as a Medical Assistant, not as a Basic (except the epi pen). Diabetics give themselves injections, patients give them selves Lovenox injections, B-12 injections, do you think they had any kind of training? No, the nurse said, "Poke here." I was a Pathology Assistant, I performed autopsies and dissected surgical specimens. I did not always know what I was looking for, but I knew the technique. I was an on the job trained Perfusionist with the local Organ Procurement Organization. I was part of the surgical recovery team from organ donors to recipients. People can be trained. Now, I was interested and wanted to know why I was doing things the way I was doing them, so I asked questions, had a great mentor, and have gained a tremendous amount of knowledge. Now, my whole point to this is why hate on the Basics? With out the basic skills, you have a dead person, so why do you feel that you are so much better? I didn't become an EMT because I wanted to be a hero or degrade Emergency Medical Responders because I have more education than them. We are all here for the same thing and that is to help people. If we want respect from our peers and the public, we should also respect each other:-) P.S. Don't be hating on me because I can intubate as a Basic in Ohio! :-) Don't be hating on me now! I'm a newbie:-)