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Yes, I have a good idea. My point being, any educational threshold we currently mandate is rather arbitrary unless there is good literature out there. We need to convince a well established culture that a different approach is required. I will point to an extreme example of what a physician thinks. While it's old, I have not seen a statement of retraction on said website: http://www.fd-doc.com/2000Hours.htm How would you convince this person otherwise if he was your medical director? Anecdote and arbitrary position statements are not likely to work. Edit: "While"

Euglycaemia following cardiac surgery.

However, the occasional outlier does occur. Had one recently while precepting students. Patient experienced V-fib arrest in front of the EMS crew and was successfully defibrillated with ROSC. Patient coded in the ER and cath lab with successful defibrillation attempts and CPR. Ended up going to the theatre for a CABG. Post operatively the patient was moribund. A balloon pump was inserted, we had the patient on multiple pressors and dobutamine along with an antidysrhythmic infusion. Also ended up giving blouses of insulin and starting an insulin infusion and we had to administer bicarb for a profound metabolic acidosis. My students and I cared for the patient throughout the week. The patient went from being completely unresponsive to being successfully extubated and having us help the patient into a chair by the end of the week. The patient was neurologically intact and conversing with family. Interestingly enough, the patient's spouse was very happy to have us around and caring for the patient and even said that they hope the students were learning. Pretty gratifying all around and several of the students have come away with a very different appreciation of the ICU.

However, you've yet to produce any reliable evidence other than anecdote and opinion. You are free to argue, but bring something evidence based to the table. I've linked what little I can find and I understand another study has recently been published with similar results in BS educated nurses with specialty certification.

We could potentially look outside of the United States. For example, many countries have a six year medical school curriculum with no undergraduate requirements. How do these providers compare to physicians educated under a different model such as the one used in the United States? I am certainly not going to argue for less education, but I still believe we will need good evidence to convince people that these short courses are not necessarily the best route to take. Another thought is in regards to military trained medics. There are courses that are rough approximations of paramedic school that are intense and around six months in length. I wonder how certain core areas of knowledge that overlap compare to their civilian counterparts?

Okay, at this point this thread has probably run it's useful course. IHMO.

The ADN versus BSN outcome study that everybody loves to quote: http://jama.jamanetwork.com/article.aspx?volume=290&issue=12&page=1617 Unfortunately, it would be difficult to apply this to EMS and the limitations of the study mean that I'd be hesitant to generalise the conclusions many people draw from it. However, it is at least a nod toward increased education possibly leading to better outcomes.

Awesome, I'll look at posting the links I mentioned.

However, do you have anything else to bring to the discussion other than what you think or feel? My point being, do we have good literature that we can use to back up the notion of a minimum level of education? Remember, in this day and age, we need good evidence to convince people that a certain procedure or modality is helpful. Should we not expect the same of educational programmes?

Wait until the end of mass effect three...

Allow me to present somewhat of a challenge to stimulate continued and hopefully productive dialogue. How long should paramedic school be? Can those of you arguing for a minimum two year programme explain why two years is the threshold? Is there something special about two years and can we quantitatively say a two year threshold is the optimum curriculum? Why not four, six or eight years? Also, much of what we do is a behaviouralisic response to a certain stimulus. I would say knowing and learning when to perform the proper response is a difficult part of medicine and a lifelong process. However, what evidence do we have that one specific curriculum is better than another? Mind you I am not arguing against longer programmes, but rather I am struggling as an educator to find a way of equating education to outcomes. The evidence I've seen is not as clear as I'd like and not specific to EMS. There have been studies that suggest four year nurses are associated with better outcomes than two year nurses with many other variables that make conclusions murky. Additionally, there has been an aggressive campaign that includes literature suggesting providers with significantly less education have similar outcomes to physicians. Again, pretty murky.

Kiwi, unfortunately I do not see the AEMT changing much. It's the minimum level of education and scope of practice suggested. However, states and municipalities are free to "add" onto this as they see fit assuming they meet the national standards.

Bieber, many people fail to understand your point. Being a certain type of provider is about having a certain degree of education and competency validation in a specific area. You are absolutely correct that skills are not the bottom line, yet we seem to glorify skills and forget education quite often in EMS. Is a provider with a restricted scope of practice a "lesser" provider than one with a progressive scope of practice? However, what does concern me about the intermediate level providers is a tendency for skills creep to occur. This is not because my paramedic pride is hurt. I am not a paramedic. However, what does concern me, is having people with limited education performing high risk interventions. No disrespect to other providers as I hold this standard to all. I do not tolerate skills creep in other professions, but I will not start that conversation on this thread.

Scantly clad and doing pushups while soaked in cryosleep fluids.

Just saw it. Good movie with a few plot holes. Not for the squeamish, but I doubt that's a problem with many in this crowd.

Thanks all. I would love to see pictures of your collections/shadowboxes as well!

However, many of the newer transport ventilators are able to provide many of the same functions as a hospital ventilator. For example, the LTV-1200, CV4, Oxylog 2000 and EnVe are all transport ventilators that provide complex modalities and at least limited to full graphics capabilities.

Meh, at the end of the day it's just a patch, but the whole glitter thing is funny.

I have one of my polo shirts with the National Registry AEMT patch attached that I wear when I teach. It's more of a joke; however, because I can tell the paramedic students that their instructor isn't even a paramedic. On a side note: The NRAEMT patch is rather interesting. They brought back the rockers and did something interesting with the style. The NR Paramedic patch has always had glittery, gold material in it, hence the common term "disco patch."Tthe AEMT patch now has silver glitter in it. So, the registry has sort of an Olympic theme going on. The EMT patch is traditional red, white and blue, the AEMT silver and the PM gold. Rather amusing.

Sounds like you put some work into making it. Attached, is a picture of my shadow box. Used an old company shirt and attached name badges, patches and pins to it, then mounted it within the box.

I have a shadowbox that includes several patches, pins, photographs and a shirt to remind me of the good times my wife and I had back when we were flying.

A remarkably lucid post considering the intense nature of some of the dialogue here.

No worries, you could probably find out fairly easily.

Oh, by the way, I love fried rice.

Yeah, I've had to backtrack on the higher level degree issue somewhat after my degree experiences. Unfortunately, more is not always better. At this point, I'd rather focus on a quality associate degree for entry, then perhaps looking at good undergrad degrees. Unfortunately, nearly all of my core undergrad classes have been...well...worthless. I actually got more out of the humanities, public speaking and fine arts classes than the core classes. I'm actually quite disappointed by my experiences and IMHO, found the AAS that I completed in respiratory therapy last year significantly more scientifically rigorous, academically challenging and clinically relevant than the BS that I will have at the end of the summer.