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Posted

Niftymedi911: Is 21.

To be honest, there are numerous instances where being as young as I am limited me from doing my job right and doing my job to the best of my ability. Dust hit the nail on the head with it all. It takes maturity. I'm pretty sure you all can agree with me that when I first started in EMS I was probably the worst wacker of them all. Now 3 years later I'm older, mature and understand what it takes to become not just a paramedic, but a professional paramedic.

Think of it this way, you start feeling 10 out of 10 chest pn radiates to the jaw and left arm, your very weak, can't think straight. Your spouse calls 9-1-1 and you witness a 18 y/o walk out of the truck and start asking you questions..... are you really going to want to go with them??? It is a hurdle we all at one point or another must overcome. To save yourself the agony of getting asked by your patient "do you know what your doing" or "kid, listen thank you for coming out but I didn't need a bandaid". Get educated, learn as many life experiences as you can, when you hit 21 I say, hit the pavement running.

I also firmly believe that a Paramedic degree should also be 4 years and an EMT cert should be 2 years.

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Posted
Interesting, and I agree with your point there Asys but let me look at this another way. I'm at the 14 St subway station at rush hour, my Metcard won't work and my train is leaving. I have a heart attack, er, myocardial infarction. The good people at the FDNY will dispatch an ambulance to me.

The closest BLS unit is 06 Adam (CSL: 14th & 2nd Ave) so they kick off the bums who are hassling them for medical care having been annexed from the firehouse and light up the LED and speed to my locale.

Wait a minute... Adam is a BLS unit, same as the 16 year old Superkids in CT. They can only pull out the AED and await an ALS unit. Closest FDNY ALS is 6 Xray at E 23rd & 2nd Ave by the FDR. Too bad 6X only works from 6am until 2pm. If I code at 3pm well ALS looks like it'll be 7 Robert from W 34th and Avenue of the Ameircas which is even further uptown.

vn

Kiwi, as a foreigner, I don't know how exactly how you know the absolute latest up to date suggested unit strings for the Borough of Manhattan, but I'm afraid I'm going to have now turn you into the Department of Homeland Security. Sorry, mate. :lol: You really almost nailed it except that no one except tourists and the KDT call it "Avenue of the Americas." It's Sixth Avenue. End of story.

I don't see how the 16 year olds being BLS and relying on Paramedics from county mutual aid is any different than your FDNY BLS unit being BLS are relying on FDNY EMS or perhaps somebody from Bellevue or one of the other providers I've seen around the city.

You're right, there is no difference. BLS care is BLS care. First of all, depending on gridlock, you would receive the care and more importantly the transport in a much more timely fashion. 06Adam, at least I hope, will be in their ambulance, awaiting a call, not coming from a classroom, getting changed, then coming. That is a major difference. My biggest point is from a risk of illness or injury versus benefit to patient and community standpoint, the risks involved with sending teenagers code three to a medical emergency in the general public far outweighs any potential benefit BLS care will provide.

I understand that and I can see where you are coming from. Something is wrong at City Hall if they think providing first running EMS to medical emergencies with teenagers is acceptable. Is it better than nothing? Yes, is it as good as a professionally run, career orentaited EMS service? No.

Sorry, I disagree with the "better than nothing" train of thought. Its worth than nothing because people have a false sense of security. One of the problems with EMS is that we are really not needed on 90% of the calls, if not more. People call EMS when they are scared, someone coughed on a chicken bone, they're ok, someone had chest pains, they're probably okay, baby had a febrile seizure, they're ok, all you really need is a trip to the hospital for a few tests to make sure nothing more serious is going on. You don't need oxygen and you don't need an IV, so, it is a very rare segment of the population who will see how really inadequate this type of response is. It will only be one or two families who really, truly, lose a loved one, who will go through life with the lonely knowledge of what these heros really are providing.

But, what differentiates them from the many other volunteer EMS (be they BLS or ALS) agencies around the world apart from thier age? Now I may be wrong, but, given that many small communities rely on the good nature of volunteer firefighters and EMTs to provide a "first running" response to fire and medical emergencies I just don't see the problem.

The vollies don't send children around town in response vehicles.

In leiu of a professionally run and funded EMS system which may not be financially viable or practical given a low workload what else can we offer? Nothing. That sounds good! Whoops too bad if you're dying, I mean really dying, from lets say massive hypovalemic shock while blood gushes from a severed artery.

Show me a 16 year old EMT who can identify and successfully tamponade a severed arterial vessel in a low volume system and I'll buy you a car. Oh, and BTW, this Darien, Connecticut. Lots of dough. They can afford a paramedic or two.

Well you can wait for county ALS or a fly car to turn up but hmm that might take a while, in the meantime we could have had some volunteer EMTs turn up and apply bleeding control, O2 and those blow up MAST pants I have noticed we don't carry anymore.

I know which I would rather have.

MAST pants have fallen out of favor. See my comment about bleeding control. O2, meh, sure, it helps. Look, if we want EMS to move forward, we have to look at things from both an individual patient perspective and a systemwide, public service perspective. In the former, sure, maybe, someday, somewhere, somehow, one life will be saved by a 16 year old volunteer EMT. It could happen. But if I had to put money down, I'd put it in the lives lost in auto accident on way to scene because of 16 year old volunteer based system.

Posted
Show me a 16 year old EMT who can identify and successfully tamponade a severed arterial vessel in a low volume system and I'll buy you a car. Oh, and BTW, this Darien, Connecticut. Lots of dough. They can afford a paramedic or two.
I don't get the point of that statement. Things like that are based on training and accompanying relevant education, not being 16 versus 18 or 20. Provided they had a good EMT class, I medically I'm sure they are either equal to or superior to first-year EMTs in their early 20s.

In the former, sure, maybe, someday, somewhere, somehow, one life will be saved by a 16 year old volunteer EMT. It could happen. But if I had to put money down, I'd put it in the lives lost in auto accident on way to scene because of 16 year old volunteer based system.
Probably as many lives saved by a 26 year old volunteer. You're not really supporting your statements on HOW age plays a role in their medical abilities. Also, I imagine if this system has been going on for decades, they must have a better driving record than most ambulance companies...

I'm not saying it's appropriate for 16 year olds to be the main crew of the ambulance (I posted earlier against that), but am asking you to explain your statements.

Posted

Because the difference between a 16 year old and a 20 year old is just as striking as the difference between a 12 year old and a 16 year old. And no, it doesn't depend on the person, that's why we have an entire chapter in the EMT book on human development.

Posted
Because the difference between a 16 year old and a 20 year old is just as striking as the difference between a 12 year old and a 16 year old. And no, it doesn't depend on the person, that's why we have an entire chapter in the EMT book on human development.
That's not really explaining much. Explain how that affects their ability to remember and then identify information when they see it in the field. This is EMT-Basic class, not rocket science. The 2nd and 3rd top students in my EMT class were in high school, both 17, I believe. An intelligent student given this opportunity (especially if pre-med) is realistically going to treat it seriously and will try to do their absolute best.

The problems I see are with aggressiveness and handling unstable mature situations/environments, but not with direct medical skills such as recognizing a life threatening injury.

BTW, which EMT do you guys use. If only ours had a chapter on human development. We had 40+ chapters, I think, but closest we got was a couple pediatric chapters.

Posted

Asys, I will agree with you that generally speaking, human development shows trends and that there are striking differences between 16 year olds and 20 year olds. Hell, there's a difference in a lot of cases between 18 year olds and 21 year olds. But you can't say that it doesn't depend on the person.

The level of maturity displayed, regardless of the physical developments in the brain that help lead to that maturity, is wholly dependent on the person's life history, experiences, personality, and cognitive tendencies. Human development and all of its associated theories, including Piaget et al, is absolutely fascinating. I absolutely loved my developmental psych class.

But you know what I learned more than anything? That the individual is more important than the theory, and there is *no* absolute that says you are going to behave with X amount of maturity at Y age because of Z physical reasons.

Just saying. You can't just throw out "human development" and a chapter from a book and assume that it explains maturity differences for individuals you've never met, or even those you have met...

Wendy

CO EMT-B

Posted
But you know what I learned more than anything? That the individual is more important than the theory, and there is *no* absolute that says you are going to behave with X amount of maturity at Y age because of Z physical reasons.

Just saying. You can't just throw out "human development" and a chapter from a book and assume that it explains maturity differences for individuals you've never met, or even those you have met...

Wendy

CO EMT-B

Sure there's no absolute. Hell, for most things, including medicine, there aren't that many absolutes. But your first paragraph was right; while not all 16 year olds may be immature and not emotionally/mentally developed, many, many are. It's like most things; we base what we do off the largest common denominator. And in this case, most 16 year olds aren't ready to be running EMS calls, especially as the primary. Is that unfair to some out there? Sure. Is that just a part of life though? Yep. And right or wrong, it is a lot easier to make a blanket rule like, "the minimum age to participate in EMS is 21" than to selectively weed out those rare individuals who are truly prepared at a young age.

Posted

I'm not even sure why we're getting that deeply into human development in this conversation.

Obviously, there are large differences between a 16-year-old and a 20-year-old, especially psychologically (and we discussed that relentlessly earlier in the thread), but honestly there's not THAT much difference when it comes to understanding and memorizing EMT-Basic curriculum, ESPECIALLY if you're picking the brighter more self-directed students from a good educational system (which I assume Darien has, if it has money).

Minus the psychological aspects and how that might affect interactions on-scene, I would probably place my money on a Darien youth EMT than with a 20-year-old volunteer with same field experience level.

Unless there's something I'm missing here....but it hasn't clearly been explained as it related to the academia of the job.

Posted

I'm training my 4 y/o to do BLS so if there's ever a problem in the neighborhood he can pedal his bigwheel over and preform care, maybe even be a first responder for the high schooler's. I did have to custom make him the cool white 1970's EMS getup with various large star of life patches so he wouldn't be different....623

Posted
Just to be clear:

The only con you see with this is that they are wasting time changing into uniform when the call comes in?

Yes. I think thats just stupid.

They are going to be in class for instance we'll use orchestra/band because that one girl was playing her instrument.

Tell me how long this would take:

1. Put the darned instrument up

2. Walk to get your stuff

3. Walk to the ambulance

4. Put your clothes..err...uniform on

5. Respond.

Too long to me. Maybe im use to a very short turnout time. here we strive for 30 seconds wheter its a EMS or a structure fire.

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