Rescue0ne

So...he would no longer be able to work there, due to losing some certifications? Nevermind being found guilty of sexual "whatevers" with a minor. -5 points to the Assistant Chief. -1 to me for not keeping up with EMT City's forums. Sorry, I know this thread had dust gathering, but I just now ran across it, and was surprised that no one else picked up on it and called him out

The private service I work part-time for has an issue that's somewhat relevant to this thread. Our local Level 3 hospital often requests an ALS ambulance for a patient transfer that is going out with no more than an INT in place. No cardiac monitoring, no meds, fluids, etc. Nothing at all. This means you're taking an ALS truck out of service (basically) to do a BLS transfer, when your EMT's at the station could easliy handle it in their sleep. It would be one thing if there were mitigating circumstances, but there almost never is. Just an INT. They are currently trying to educate the nurses on this matter, but one must tread carefully in the world of Convalescent EMS. That's right, it's the nurses that are ordering the ALS, not the Docs.

Mobey: Holy Crap batman!! 15 weeks...no wonder they call it a Paramedic SPECIALIST...Special indeed! (the darn "quote" function didn't work properly) Additionally, remember how Iowa does EMS. Intermediate-99 equivalents are "Paramedics". Paramedics are "Paramedic Specialists". I really don't get that, but to each state their own.

15 week Paramedic Program?!?!?! Is that start to finish, or are you required to be an EMT-BAsic prior to enrollment? Just curious...

Good luck with this dillema. One thing you may want to take into serious consideration, is when choosing a Medic Program, try to find one at a learning institution that will honor as many of the classes you have already taken, as possible. When I went through the course, it was 5 semesters long, with a 2 full day final exam. As with most halfway decent Paramedic Programs, it is an Associates Degree progam, which meant I needed English, Math, Sciences, Humanities, Electives, etc. It would be beneficial, on your part, to make sure that as many of the classes you have already taken, as part of your BA, are acceptable for which ever college you attend for your Paramedic Program. Otherwise, you'll end up sitting through English 111 again, or Advanced Basket Weaving, etc. I had to take a PE class AGAIN, as well as a computer class...and I already had an AS in Computer Science. Be careful when choosing a Paramedic Program. There are many out there that only care about $$$, and tend to graduate half-a$$ed Paramedics.

Point! This is the only one that I've really had any interaction with, other than at the state level, so it was rather new to me, initially.

Same story, different state. There are people in my area of Virginia that try to justify a volunteer ambulance showing up with just a driver and EMT on board, (because of staffing issues)and transporting them to an ER. "At least they showed up, it's better than nothing", ie: nobody showing up at all. WRONG! It's that mentality that is killing our patients, as well as the profession. If you're satisfied with that kind of prehospital care, then move to NJ, or wherever the state considers that crap to be acceptable. Myself, personally, would rather wait a few more minutes for qualified EMS providers, than allowing "Granny the EMT" and "JoePlumber the Driver" to transport me ANYWHERE, let alone an ER. Too often have I heard, on my portable radio, the following ecerpt of a radio report; "...complaning of sever chest pain, rated a 9 on 1/10 scale. Patient is on 3 liters O2, by nasal cannula, resting comfortably. vitals are within normal limits. We're about 5 min from your facility". So...no ASA, no assisted NTG, not even High-Flow O2???? They didn't even request an ALS intercept from an agency with available ALS. How is a brand new EMT-Basic going to know what in blazes is considered normal vitals? SEVERE CHEST PAIN! No 12-lead...not even a 4-lead! ST elevation...what's that? Our county has a new Emergency Manager, and she is taking a very close look at the volunteer EMS folks. She has already placed one agency on "probation", just so happens that the agency in question is the one mentioned in the paragraph above. I'm looking forward to what will happen next.

As much as I feel the NREMT was established because someone wanted to create a job for him/herself, I do like the idea of national EMS standards. Maybe the NREMT isn't the agency to regulate them...that's for our elected officials to decide. I know I'll give my congressman an earful when it comes time. Here in Virginia, there are five (5) levels of certification in EMS. First Responder (changing to EMR soon, I think.) EMT-Basic EMT-Enhanced (Soon to be Advanced EMT, think NREMT-I/85) EMT-Intermediate (NREMT-I/99) Paramedic At the Intermediate & Paramedic levels, first time testing candidates must successfully pass the NREMT exams before Virginia will grant the candidate a certification card. Afterwards, it is the candidates choice to maintain their NR certification or not, however, Virginia does not require it of them. What I don't really understand, is...why not do it at the EMT-Basic level as well? I don't know, but it's a double standard to me.

I'll have to co-sign what some of the others said previously. It's best if your local departments agree to a plan beforehand. At present, an MVA/MVC in my area, it's broken down like this. Fire Department - Fire Suppression/Extrication/HazMat/Traffic/ALS First Response Volunteer EMS (Crew/Squad/Etc) - BLS Transport (ALS Transport w/ an FD ALS Provider on board) State/Town Police - Law Enforcement/Accident Investigation If County EMS is available, however, they become primary EMS. They have no other responsibility on the scene other than that. If the incident is a very prolonged one, Virginia DOT has a contractor that will arrive and take over traffic control, freeing up the FD for other activities. Hope this was at least a little bit useful. FYI: The "Code of Virginia" states that at the scene of an MVA/C, the senior Fire Officer on scene is in overall command, with EMS & Police doing their own thing, of course.

You are SO right. This is one of the issues my county is dealing with right now. We currently have an oversight commission in place to regulate the various agencies, which are all seperate entities. A plan is in motion to "strip" the FD & Rescue ambulances and unite them under an "EMS Authority". Like you said, part-time is not professional. What if I was a stripper part-time? That's certainly not my profession. Even if I was an MD or DO, and only worked in that capacity part-time. That still wouldn't be my profession. I'm a medic. That is my profession.

Thank you, Spenac. I usually do try to back up my opinions with factual information. As we all know, there are those out there that are bound and determined to hold on to their little fiefdoms of volunteerism, for whatever self-serving reason they may spout off about. There ARE those who believe that they're volunteering for the right reasons...and in the past, this may have held true. It's only now that alot of us have begun to realize that all of it has held back the profession for years, me being one of them. Additionally, I've been on the receiving end, lately, of several volunteer EMS agency leaders trying everything they can think of to keep their agency from being "shut down". In reality, they are so easily replaced. We have ALS trucks readily available, staffed by EDUCATED professional paramedics. Yet these BLS agencies feel that they should be allowed to remain operational. Why? I suppose because it will leave a gap in their lifestyle? Who knows. Additionally, who cares? I have hobbies that are non-EMS related. I'm sure they can find something to do with their sudden influx of spare time. Either that, or go to school, become a paramedic, and apply for a paid position. There's just too many people in Volunteer EMS that are in it for themselves, not their patients, nor their community. This is MY main reason for opposing Volly EMS. That, and the fact that, for some reason, my daughter is bound and determined to become a paramedic when she graduates from high school. I really would like for her to be able to earn a living wage in the field of EMS, if that's what she insists on doing with her life. Personally, I'd rather her get her BSN, or go Pre-Med, but she's hard-headed like her old man. :roll:

What exactly is rural EMS? I began my journey into EMS when I was a teenager. The county we lived in had 2 stop lights, no major supermarket chain, no fast food chains, and it was 45-60 minutes to the closest trauma center (which happened to be a level I). I consider that to be rural EMS. Additionally, that trauma center was also the closet facility that was worth a crap. Yes, there was a small community hospital 30 min away, but they killed more patients than they saved, due to lack of quality ER staff. At present, I'm now 30 min away from a level II trauma center. A level I is being built soon, 10-15 minutes away, on the very edge of our response area. I'm loving this fact, primarily for the patient's sake...but also because we'll save alot on fuel expenses. I no longer consider myself to be a rural medic, more like a suburban medic, I suppose. Heck, it'll cut down on the number of times I call for the helicopter, if nothing else...which isn't really that often to begin with. I've forgotten the point of this post. Anyway, in my opinion, anything more than an hour away from any type of trauma center should/would/could be considered "frontier EMS". I'd like others opinion on this matter.

The Rangers of Texas DPS wear regular cloths, with their small tiny little badge pinned to their shirt. How about a small little badge-type device with the caduceus on it? Worn with slacks and a solid colored shirt, with a tie, if necessary. Who knows. This is a topic that can & will drive us out of our minds, if/when the time comes to universalize our uniforms.

I realize I don't understand the way things are done in Canada...but for a provider to be a "Paramedic", and not be allowed to initiate IV therapy? Is PCP the same as an EMT-B? I realize this is sort of off-topic, but I'm really curious.

In reference to that video from PA...are they really that hard up for EMS providers that they had to resort to a crap video like that? As stated above, all that going to do is attract "wankers" who are mesmerized by the lights & sirens, and will treat EMS as if it's a video game. "Oh well, the patient died because I forgot my drug dosages & gave to much morphine. I'll just hit reset, and wait for the next set of tones, and do it all over again!" Chalk another one up for the Anti-Professional EMS Movement.