Dustdevil

Any ALS provider with half a brain and a decent education (yes, I know that excludes about half of them), would do a thorough assessment to determine that this is indeed an isolated dental event before ASSuming it is just a toothache. An EMT-B lacks the educational foundation or equipment to do that exam, therefore useless. No wonder so many people die of MIs. Not only are they in denial, so are their EMT-B rescuers. Actually, no. We're not talking about zebras here. We're talking about the number one killer of adults. Thousands a day. And anybody who keeps up with the current literature knows what a large percentage of MIs present atypically. They also know how often these people are undertreated because of their atypical presentation. If you routinely blow these people off because you don't want to admit that they need more than an EMT-B can provide them, then you are the problem. I've been involved with a lot of EMT-B courses over the last thirty years. I have yet to see one that gave its students the education needed to perform a thorough assessment. EMT-B courses simply do not give you the theoretical foundation necessary to translate your silly little "SAMPLE DCAP BTLS" history and exam into an intelligent medical assessment. Consequently, your beliefs about whether it is cardiac related or not are worthless. Just like EMT-Bs in general.

I agree. Financial concerns are indeed valid justification. However, that is not really relevant to the original question which was asked. That's why I excluded it from consideration in this instance.

That's not an oversaturation thing. That is simply an urban thing. Dual medics actually help lessen burnout because no one medic is stuck with all the patients or all the responsibility. What if the toothache or arm pain turns out to be an AMI? You are correct in theory. Those simple ailments do not require a paramedic. The problem is, you don't know that ailment is until you make the scene and evaluate the patient. Consequently, they do all need a Paramedic. Exactly. Hospital discharges are not an EMS function. That is horizontal taxi service. And yes, that is where the EMT-B comes in. Agreed. The problem is, most people only want to increase EMT-B skills without the requisite education. I maintain that the overwhelming outcry for more "skills" for the EMT-B is in and of itself proof that the EMT-B is currently inadequate for EMS practice.

LOL@Florida You can tell that was written by a real Canadian!

:shock:

Not by my scale! You're an automatic 25 percent just for having "fire" in your screen name.

Does Calgary hire EMT-As? If so, are they members of the same union?

I'm curious as to how (and why) you got an oral temp on an unconscious, unresponsive 92 year old. :? Are you confident in that temp? And would you consider that a fever?

I don't have any experience with EMT supervisors in an EMS situation. However, I have been with an agency that had both EMT and Paramedic FTOs. And part of the FTOs job was to QA all of the charts that were turned in. But only Paramedic FTOs reviewed Paramedic charts. I really can't imagine it any other way. :?

What was your first clue? Because whackerism is a multi-million dollar industry. Ask Gall's. I don't usually keep the prize at the bottom of the Cracker Jacks box either. But that doesn't mean I don't respect Cracker Jacks. And, of course, minus 15 for spelling and grammar.

Inspiration comes from the strangest places. Do you want to know what the proverbial apple on the head was that brought me to realise that volunteers were harmful to the (or any) profession? It came to me during a comedy routine by Gallagher in 1980. Gallagher, famous for his Sledge-O-Matic routine, also did a routine about all the things that were wrong with the way the government runs the country. He talked all the jobs we pay people to do that could or should be done for free by somebody else. He pointed out... It was hilarious! And you know why it was hilarious? Because it was absurd. And right then and there it hit me. It is absurd to let amateurs, who have neither the time nor desire to devote full-time professionalism, perform a vital service to the community just so we can blow that money on something frivolous. And the reason that we pay postmen and dam inspectors is two-fold: because it is important enough to pay for, and because nobody is willing to do it for free. EMS is important enough to pay for. Your community doesn't think so? They would if you weren't giving it away for free. Guaranteed.

Is there anybody even left in Sudan? From where I sit, it looks like they all up and moved to Iraq. Sudanese are the Mexicans of Iraq.

How about the rest of her vital signs? You're in a nursing home. Even if your agency sucks and doesn't carry thermometers, I bet you can find one there. Pulse Ox? And don't get tunnel vision on this hypoglycaemia thing until you've done a thorough examination for other conditions.

Exactly. Go big or go home. That's why I RSI all of my psych patients. You never know when they're going to go nutzoid on you. Prevention is the best medicine.

And this is exactly why you are respected by the medics here, while others are not. You have the intelligence and vision to see the big picture, and you have the self-confidence to progress and excel. I knew it! A volunteer! Hey... you wanna know why you can't make a living as an EMT? Because of people like YOU! If it weren't for you, there would be a paying EMT job available (don't bother to argue the point, unless you just enjoy looking silly). As if we didn't already know this, YOU are your own worst enema. Unfortunately, you are hurting the profession more than you are hurting yourself. And this is why you are not respected by the medics here. Despite a few really intelligent comments here -- you're obviously not a stupid man -- you just don't seem to get the big picture. Plus 10 for the most original and relevant point of this entire thread! :thumbright: Tis true, folks. This is not a new argument designed to run off EMTs. It is an argument older than modern EMS itself, and it is designed to progressively improve the profession as a whole. Those who stand selfishly territorial over their "right" to stay a Basic are standing dead in the way of progress at the most crucial time in EMS evolution. Congratulations! You're ruining the very profession you claim to want to be a part of. You wouldn't even think of arguing that Red Cross first aid is good enough for EMS, but you don't have any problem arguing that an EMT-B with not much more education is just fine. You wouldn't even think of arguing that Red Cross first aiders could take your job, yet you don't have a problem arguing that you should take a paramedic's job. And I am absolutely sure that, if you ever become a paramedic, you'll be whining about how you ought to be able to be an RN without "all that book learnin" too. The cycle never ends. There is no cure for retardism. You can't educate them. You can barely train them. They simply have to be weeded out.

Whackerism. Unoriginality. Those would be my top two guesses. You could possibly say "tradition," but that pretty much goes back to whackerism and unoriginality too. Personally, I like "Big Cheese," "Big Kahuna," and "Grande Poobah."

Uhhh... you kinda just answered your own question. BECAUSE THEY ARE ALS AND A BASIC IS NOT! Why is this such a difficult concept for somebody who thinks he understands pharmacology and emergency surgery? You're kidding, right? Obviously you've never done it. And having it "explained in detail" isn't exactly real education or experience. You're living in the theoretical dream world. Even CLS out here don't do that but once in a very blue moon. Show me a system in the U.S. that needs basics decompressing chests, and I'll show you a system that needs paramedics. Again, it is very obvious that you've never done any of this. If fact, it is painfully obvious that you've never even been competently educated or trained on any of this, or you'd know how silly you sound right now. How convenient for you to finally admit that -- after being told several posts ago -- when you hit the bottom of the hole you have dug here. You just killed your own argument. Again! You just said what we have been saying all along. EMT-Bs as they CURRENTLY EXIST (as opposed to how wonderful they are in your crack induced pipe dream), are not useful as a crewmember of an emergency ambulance. To be useful, they would require a great deal more education and training. You just said so yourself. What is with you people anyhow? You're certainly not helping the cause of "defending" EMT-Bs with this idiocy. Isn't anybody here going to say something that actually makes a valid case for their usefulness? Are you going to let me win this easily? I mean, be my guest if you want to just keep taking the discussion off topic in an effort to obfuscate the issue in hopes that we won't notice. Everybody has a right to make an arse of themselves if they so desire. But again, this nonsense isn't helping basics. It's just making them look worse.

Exactly. I have worked with excellent EMT-Bs. They are out there. But they are damn few and far between. I bet you probably are one of the better ones, Whit. I think I was one of them. But that is the problem. They all think they are among the best, usually about three months into their first transfer jockey job, after finally passing NR by one question on the third try. You have to judge the usefulness of the genre (which is again the point of this topic) by the norm, not by the anomaly. Therefore, EMT-Bs don't all totally suck. And neither are they all useful or even competent. And I am pretty sure that if you averaged the two, the useless ones would come out on top by a big percentage. Is that a reflection on you personally? Nope. And I don't mean it to be. This topic isn't about you. It's about the vast majority of the hundreds of thousands of EMT-Bs in the U.S. And even considering the very best of them, there is nothing they have to offer me that a paramedic partner could not also offer me plus a lot more. And that is the bottom line. EMT-Bs bring nothing uniquely useful to the table, and they bring a lot less than another paramedic, causing me more work. Why would I want that? The only medic who wants that is a wanker paragod who wants to feel superior to his partner. Personally, I want somebody who is on equal footing with me so that power dynamic never comes into play.

Well, if they had asked about EMS hats, I would have been in trouble. But since all they asked about was EMS shirts, I got lucky!

I suppose it is possible that we are talking about the same thing, but with different terminology. If your extra education adds up to about two years of college, I'm all with you. That's about what it will take to adequately educate them regarding their new responsibilities. So, now what you have done is expand the curriculum and the scope of practice, right? Guess what. You just eliminated the EMT-B as we currently know it, which is exactly what I advocate. So yes, I suppose we are in agreement after all.

So what colour is your Littmann?

That's one of the biggest problems we face. A combination of ignorance. Ignorance to the fact that things really are bad, and apathy towards ever improving. Everything is "good enough" as it is. It's "working." Working "just fine," according to this guy. And heaven forbid that anybody ever have to change or improve themselves. We wouldn't want anybody to feel bad about themselves, or have to go back to school. Let's just let everybody think they are an irreplaceably crucial element of the EMS system, even if they're not. In fact, let's just let anybody with a CPR card call themselves a Paramedic, so they all know that they are equally important to the overall system. More "I'm okay, you're okay" psychobabble crap. Sounds to me like he's worked one place his whole career, because he obviously doesn't have a clue what is going on in the "rest of the country" he presumes to speak for. I hope he is more lucid on a good night's sleep. Otherwise, I am glad I don't live in his district.

9% 1 scanner, but not in a vehicle 1 ambulance model gift from a friend ... and a tactical black Littmann scope, but not electronic! :oops:

That's a lot to ask from somebody who obviously didn't bother to read the posts before his own.