EMT/PCP/EMT-A/Paramedic/ACP whats in a name? [Small Rant]

[rock_shoes]

Well Tniuqs I'm going to have to bite on this one. A true PCP in the province of BC is in fact IV endorsed. Just for everyone wondering how we have people in the province of BC who hold EMA licenses that say PCP yet they cannot do IV's here is the story. At one point the BCAS in its wisdom decided that all of the EMA 1 attendants (equivalent to EMR using current terminology) needed be able to do more on car. To do this they put the majority of these people through a program called Paramedic 1. Unfortunately they essentially gave these EMR's a bunch of PCP protocols (minus the IV protocols) without the proper education to go with them. When the titles and occupational profiles where changed nationally these people where left in limbo. Not really PCP's but more than EMR's. Some of these P1 attendants have bridged into full PCP's (same idea as gap training in alberta) others have not at this time. Instead of calling them EMR's with specific license endorsements EMA licensing elected to call them IV restricted PCP's.

EMA 2's were people brought to the PCP level before the P1 program and before the PCP program. The remnants of the P1 program are one of the biggest things holding us back from working closer to the full national PCP profile. Any of us who have actually gone through a true PCP program have been instructed to the national profile.

As for the EMA FA remnants they are very soon to be gone. Nearly all of them are gone now and none of those who remain will have there licenses renewed. The only option for these people is to upgrade to EMR or relinquish their licenses all together.

On the note of a self governing body that too is coming. The legislation has already been passed. The body has not been formed yet. BC hands down is one of the provinces that needed the most change and finally it is starting to come. At one time you had to be employed by the BCAS to hold a license in BC. That is no longer the case. Just one of the many steps needed to improve things. The changes are happening everywhere in Canada and overall they are good. Educational standards are increasing and the days of slapping on the O2 and running for the hills are well on there way out. Just not soon enough for my taste.

[tniuqs]

rock_shoes"Well Tniuqs I'm going to have to bite on this one.

Good I like to bite but then I like to chew before I swallow.

A true PCP in the province of BC is in fact IV endorsed. Just for everyone wondering how we have people in the province of BC who hold EMA licenses that say PCP yet they cannot do IV's here is the story. At one point the BCAS in its wisdom decided that all of the EMA 1 attendants (equivalent to EMR using current terminology) needed be able to do more on car. To do this they put the majority of these people through a program called Paramedic 1. Unfortunately they essentially gave these EMR's a bunch of PCP protocols (minus the IV protocols) without the proper education to go with them. When the titles and occupational profiles where changed nationally these people where left in limbo. Not really PCP's but more than EMR's. Some of these P1 attendants have bridged into full PCP's (same idea as gap training in alberta) others have not at this time. Instead of calling them EMR's with specific license endorsements EMA licensing elected to call them IV restricted PCP's.

These are the additional competencies required to move from a level PCP paramedic in British Columbia to a level EMT paramedic in Alberta.

1. Professional Responsibilities

1.1 Function as a professional

1.1.I Participate in professional association

2. Communication

2.2 Practice effective written communication skills

2.2.B Prepare professional correspondence

3. Health And Safety

3.1 Maintain good physical and mental health

3.1.D Practice effective strategies to improve physical and mental health related to shift work

3.2 Practice safe lifting and moving techniques

3.2.C Transfer patient using emergency evacuation techniques

4. Assessment And Diagnostics

4.5 Utilize diagnostic tests

4.5.D Conduct peripheral venipuncture

4.5.L Conduct 3-lead electrocardiogram (ECG) and interpret findings

5. Therapeutics

5.5 Implement measures to maintain hemodynamic stabili

5.5.D Conduct peripheral IV cannulation

5.5.F Utilize direct pressure infusion devices with intravenous infusions

5.8 Administer medications

5.8.E Administer medication via intravenous route

Well the EMS Educators involved with PAC evaluations, it looks like they may disagree with you just a bit on that one.

EMA 2's were people brought to the PCP level before the P1 program and before the PCP program. The remnants of the P1 program are one of the biggest things holding us back from working closer to the full national PCP profile. Any of us who have actually gone through a true PCP program have been instructed to the national profile.

A True vs False PCP ? ... again my point ... legislation enacted with title protection, funny thing that BC jumped on the PCP title isn't it ? but BCAS left out the EMR level ?

Was that to quietly mislead the public .... IMHO YES.

Monty Pythons skit "Confuse a Cat" comes to mind.

IMHO: Whats holding you back is the all government minions in BCAS Licencing and the Justice Institute.

Its called application of the peter principal in political science, say hello to Lisettt Robinson whose latest comments were:

From a fly on the wall, there is aways some practicing good listening skills.

When I asked her what she thought on the inclusion of Alta's Paramedics here, her response was like a warning."They will have to pass our screening regardless of CMA" .

What does that mean?

Is that like to say -good luck - when there is two stikes already, and no balls here. Lizzette felt it was a great achievment - attracting the chinese to Canada's nummma one parimedic Academy-making BC's paramedical program - the best butt for a -buck. In tree months you gonna bee numma won in all the werld0-wong time!- eh!

Yikes....is this going to be your new Regstrar ? Lord help y'all, looks like the Lawyers will have to settle this one in a court room, tick tick tick ... AIT and labour mobility is comming right quick.

As for the EMA FA remnants they are very soon to be gone. Nearly all of them are gone now and none of those who remain will have there licenses renewed. The only option for these people is to upgrade to EMR or relinquish their licenses all together.

GOOD THING.... um so when is that deadline like we have in AB .... in a calender year? Or will EMP Canada pick up the torch and continue to blow smoke .... there is no national accepted EMR couse, they are lieing to their graduates.

On the note of a self governing body that too is coming. The legislation has already been passed. The body has not been formed yet. BC hands down is one of the provinces that needed the most change and finally it is starting to come. At one time you had to be employed by the BCAS to hold a license in BC. That is no longer the case.

Not from the information provided to me ... to work in BC I am forced to take a OFA "bridging course" to work in the bush WTF is that, I have flown out of your province, Intubated, Cardiac, Septic, neonates, and Poly traumas ... so suck my 3/4 of my brain out to lean how to secure a patient on a Stoke's litter that will not fit into a Jetbox OR an AStar .....Good Grief MAN .... Hey, I would rather have a bottle in front of me than a frontal lobectomy.

Just one of the many steps needed to improve things. The changes are happening everywhere in Canada and overall they are good. Educational standards are increasing and the days of slapping on the O2 and running for the hills are well on there way out. Just not soon enough for my taste.

Agreed but I would not hold my breath .. or you may encounter the same syndrome as mobey ...

I so enjoy teasing mobey it makes my life so worthwhile, just wait till I work with him on Car .... :shock:

cheers

ps no personal attack intended just friendly exhange of concepts, and data and most pleased you came back to attempt to justify the BCAS position rock_shoes btw who provided this EMT city link to you ?

are you still in the STOKE ? LOL.

[fortsmithman]

What does EMT mean to the public, I can tell you that to me it is someone who took a 2 week course slapping on O2 and "rushing" someone to the hospital. That is what the media has led them to believe.

That's the EMR course I thought EMT was around 6 months to complete.

[rock_shoes]

These are the additional competencies required to move from a level PCP paramedic in British Columbia to a level EMT paramedic in Alberta.

1. Professional Responsibilities

1.1 Function as a professional

1.1.I Participate in professional association

2. Communication

2.2 Practice effective written communication skills

2.2.B Prepare professional correspondence

3. Health And Safety

3.1 Maintain good physical and mental health

3.1.D Practice effective strategies to improve physical and mental health related to shift work

3.2 Practice safe lifting and moving techniques

3.2.C Transfer patient using emergency evacuation techniques

4. Assessment And Diagnostics

4.5 Utilize diagnostic tests

4.5.D Conduct peripheral venipuncture

4.5.L Conduct 3-lead electrocardiogram (ECG) and interpret findings

5. Therapeutics

5.5 Implement measures to maintain hemodynamic stabili

5.5.D Conduct peripheral IV cannulation

5.5.F Utilize direct pressure infusion devices with intravenous infusions

5.8 Administer medications

5.8.E Administer medication via intravenous route

People licensed as PCP do not meet these competencies you are quite correct. Anyone licensed as a PCP-IV meets these competencies except for conducting and interpreting 3-lead ECG’s. All of us who went through a PCP program (not a P1 or EMA2 program) know and can meet this competency without additional educational time. Licensing has failed to add it in spite of the fact that we are now taught this competency. This particular issue is a failure in licensing not in education (not that I don’t recognize the existence of far better schools than the JI). I don’t like it either and the sooner we can change it the better.

As for the elimination of the EMA FA level that will happen by attrition. Prior to fall 2006 the licensing branch ceased to license people at that level forever. Anyone licensed as an EMA FA can not renew their license and licenses expire every 5 years. Therefore the last EMA FA will be gone the way of the Dodo bird by fall 2011 at the absolute latest. As things currently stand an EMA FA can not attend on car and is relegated to driver only. Yes I know what you’re going to say about this. The existence of driver only people on car is a horrendous failing of the system. I agree completely on that point.

IMHO: Whats holding you back is the all government minions in BCAS Licencing and the Justice Institute.

Both the JI and EMA licensing are huge hold backs. Unfortunately the BCAS itself is an even bigger hold back. EMA licensing essentially uses what BCAS lays out as it’s requirements to set licensing standards. The more expansive the licenses become the more it’s going to cost to keep us around. Let’s just say BCAS brings new meaning to the word cheap. Our dismal ALS capture in BC is a prime example of that. The guys/gals we have doing ALS are great. We just don’t have anywhere near enough of them.

The JI is finally receiving some competition. The Academy of Emergency Training has been running EMR, and PCP programs for a while now with better success rates through licensing and the students preferred by the on car preceptors. AET is also in the process of developing an ACP program so the competition is finally starting to come forward. In the mean time I’ll be taking the JI’s new ACP pre-requisites because I believe they are actually sensible pre-reqs. Whether or not I will go to school at the JI remains to be seen. I fully intend to use the AIT to my advantage and shop around for the best school I can find no matter what province it happens to be in.

Not from the information provided to me ... to work in BC I am forced to take a OFA "bridging course" to work in the bush WTF is that, I have flown out of your province, Intubated, Cardiac, Septic, neonates, and Poly traumas ... so suck my 3/4 of my brain out to lean how to secure a patient on a Stoke's litter that will not fit into a Jetbox OR an AStar .....Good Grief MAN .... Hey, I would rather have a bottle in front of me than a frontal lobectomy.

This particular failing belongs to “Worksafe BC” not BCAS or EMA licensing. I have to do the same bridging course to work in industry myself in spite of being licensed in BC. It’s absolutely ludicrous. My EMR license was recognized as OFA 3 equivalent but my PCP-IV license will not be. The course is a one day, show up and pass, BS session that will cost you a couple hundred bucks. I’ll end up taking it so that I can work in industry but you can bet I’m far from happy about it. To work to full scope in BC industry you need, a BC EMA license (as an EMR, PCP, PCP-IV, ACP, or CCP), the OFA 3 bridge, and a medical director to sign off on your scope.

Agreed but I would not hold my breath .. or you may encounter the same syndrome as mobey ...

I so enjoy teasing mobey it makes my life so worthwhile, just wait till I work with him on Car ....

You must mean hopeless optimism? Yeah I’m probably guilty as charged there. I’m a stubborn bugger and if things are going to change that’s exactly what we need. I just hope it isn’t misplaced.

ps no personal attack intended just friendly exchange of concepts, and data and most pleased you came back to attempt to justify the BCAS position rock_shoes btw who provided this EMT city link to you ?

are you still in the STOKE ? LOL.

No harm no foul. I’m a little too thick skinned to take things that way. Both of us are looking to improve things nationally for everyone. We may not always agree on the best way to do that but we’re both after the same goal. The protection of title issue is a prime example. I wholeheartedly agree that we need protection of title. I just don’t agree with one province using different titles than every other province. In the end I don’t care all that much what the titles end up being. I just care that they are uniform across the nation and protected. Personally I like the old EMA titles we used here in BC. EMA I, EMA II, EMA III. They were simple and to the point with no mistaking which was the higher level of attendant. Also they where protected titles in the province of BC.

I actually found EMT city through a My Space link. Probably the last time I was ever on My Space as I quickly learned it was pretty lame.

At the moment I’m mainly working out of station 318 in Lillooet but I’ll soon be transferring over to station 324 in Merritt. My home town. Long term I’m destined to end up in either Kamloops or Kelowna with those being the 2 closest cities with ALS. That’s if I remain with BCAS of course. I’m not making any definite plans to do that at this point.

Ed

[tniuqs]

People licensed as PCP do not meet these competencies you are quite correct. Anyone licensed as a PCP-IV meets these competencies except for conducting and interpreting 3-lead ECG’s. All of us who went through a PCP program (not a P1 or EMA2 program) know and can meet this competency without additional educational time. Licensing has failed to add it in spite of the fact that we are now taught this competency. This particular issue is a failure in licensing not in education (not that I don’t recognize the existence of far better schools than the JI). I don’t like it either and the sooner we can change it the better.

So whats the next step to change things ?

to work in BC I am forced to take a OFA "bridging course" to work in the bush .

This particular failing belongs to “Worksafe BC” not BCAS or EMA licensing. I have to do the same bridging course to work in industry myself in spite of being licensed in BC. It’s absolutely ludicrous. My EMR license was recognized as OFA 3 equivalent but my PCP-IV license will not be.

Well I had an Industrial A ticket in 1979 ... yes really, the course has not changed ... IS there a statute of limitations act ? :twisted: Honestly WCB dictating levels in health care delivery in Industry was accptable but today its is just assine.

You must mean hopeless optimism? Yeah I’m probably guilty as charged there. I’m a stubborn bugger and if things are going to change that’s exactly what we need. I just hope it isn’t misplaced.

No man fight the good fight ... apathy is what slays us all.

No harm no foul. I’m a little too thick skinned to take things that way. Both of us are looking to improve things nationally for everyone. We may not always agree on the best way to do that but we’re both after the same goal. The protection of title issue is a prime example. I wholeheartedly agree that we need protection of title. I just don’t agree with one province using different titles than every other province. In the end I don’t care all that much what the titles end up being. I just care that they are uniform across the nation and protected. Personally I like the old EMA titles we used here in BC. EMA I, EMA II, EMA III. They were simple and to the point with no mistaking which was the higher level of attendant. Also they where protected titles in the province of BC.

As I have said over and over Title protection is the key .... define the terms ... yea Alberta's being the stick in the mud nationally agreed but there is good reason its not an ego thing honestly, but changing all the legislation for a little PCP title that will just amount to confusion with the public is not a smart thing to do ... we have way more important issues on the plate today like our Government finnall declaring us essential sevices ... and introducing more options in delivery than reasonable and using the divide and conquer technique to divide labour... at least BC has one collective Union ..it just the top that needs to be change out ... not through attrition but by "dismissing" a couple.

Long term I’m destined to end up in either Kamloops or Kelowna with those being the 2 closest cities with ALS. That’s if I remain with BCAS of course. I’m not making any definite plans to do that at this point.

Now thats just plain sad, like there is no auto wacks and MCIs on the Smashahalla that desparatly need ALS intervention ... Merrit is on one of the busiest Highways in BC .... and great fishing too, I love Merrit !

Does not your friends and your Family deserve ALS. Make definate plans ... get involved become a Paramedic Alderman ... one Paramedic Guy in BC did that, didn't he ?

cheers will look for you when I go fishing in the spring.

[rock_shoes]

So whats the next step to change things ?

Well that’s the big question of the decade don’t you think? I suspect the enactment of the AIT will force the issue whether BCAS or EMA licensing like it or not. EMA licensing will either enact the full scope of practice for the various levels or those of us who insist on working to the full scope of our education will license in other provinces. Then through the AIT we will be able to return to BC and work under that license.

We did away with the Ambulance Driver EVO thing many years ago, honestly I was disgusted by a Paramedic FA on a trip into George on a Polytrauma Medivac ... I was attempting to get as much information Re: the industrial accident scene .... this is when I learned that the Driver with Paramedic plastered all over ........ I don't know I'm just ambleance driver

It’s safe to say all of us are looking forward to the end of that era. I don’t think these people should be allowed to wear clothing that identifies them as “Paramedics” but BCAS has failed to come up with separate uniform issue for these people. The excuse typically used is that ambulances in some areas wouldn’t have enough people to staff the cars without the use of driver only’s. I say put some onus on the communities in these circumstances. If the ambulances go down someone will step forward.

The door that needs to be open is that in the socialist Government, your Target should be the Deputy Ministers LOBBY them for an inprovement in services and other options in delivery of care go to the media ... BUT First you need a collective voice and I bet my bottom dollar that there are lots of "Like minded" doods and doodettes that would support. I believe that you all are provided with a john.doe@bcas.net address so demand a listserver from your Union to discuss the issues with your counterparts ... communication is everything. Your Union is controlling you not the other way around .... just saying who pays there wages .... you are forced too!

I think the only lobbying anyone is going to be willing to do in BC in the immediate future is for wages and benefits. Our contract expires spring 2009 and we’ve slipped a long ways from where we once were relative to other emergency services in BC. Long term I think the licensing body that will eventually be formed needs to be completely separate from the union. I sometimes wonder if we are in an appropriate union as part of CUPE. It seems like we are an afterthought in the bigger picture of CUPE. They will have my support in seeking a better contract but I’m certainly willing to ask questions along the way. Blindly following never got anyone anywhere worthwhile.

Competition in EMS education=Advancement..... got a link to Academy of Emergency Training ?

www.firstaid.ca . The website is in dire need of an update. The demand for their programs has been high due to expected recoil from the JI. Now that there is finally another option in BC many are fleeing from the JI as fast as they can. Their website has fallen by the wayside in the mean time.

Well I had an Industrial A ticket in 1979 ... yes really, the course has not changed ... IS there a statute of limitations act ? Honestly WCB dictating levels in health care delivery in Industry was accptable but today its is just assine.

Yup. Asinine is definitely the right word.

As I have said over and over Title protection is the key .... define the terms ... yea Alberta's being the stick in the mud nationally agreed but there is good reason its not an ego thing honestly, but changing all the legislation for a little PCP title that will just amount to confusion with the public is not a smart thing to do ... we have way more important issues on the plate today like our Government finnall declaring us essential sevices ... and introducing more options in delivery than reasonable and using the divide and conquer technique to divide labour... at least BC has one collective Union ..it just the top that needs to be change out ... not through attrition but by "dismissing" a couple.

You guys in Alta. are in for just as much or more of a roller coaster ride as we are in BC. I hope for the people of Alta. that it doesn’t lead to a degradation of service in more rural areas. I wouldn’t be surprised if there is a bit of a row in store for CUPE 873 before the end of our next bargaining agreement. I expect to see the upper level union members see some turnover for better or worse in the not too distant future.

Now thats just plain sad, like there is no auto wacks and MCIs on the Smashahalla that desparatly need ALS intervention ... Merrit is on one of the busiest Highways in BC .... and great fishing too, I love Merrit !

Does not your friends and your Family deserve ALS. Make definate plans ... get involved become a Paramedic Alderman ... one Paramedic Guy in BC did that, didn't he ?

There most certainly are a number of incidents deserving of ALS attention. The best method I can think of to force the issue is for as many of us as possible to bring ourselves up to the ALS level. If enough of us are ACP providers to staff more ALS cars BCAS will be incapable of finding an excuse for the lack of ALS cars on the road. I say fight the system with education. I don’t know the process for becoming a paramedic alderman. Sounds like a good way to work for progress to me. My focus at the moment is educating myself to what I feel should be the standard available to citizens.

cheers will look for you when I go fishing in the spring.

I’d be more than happy to drop a line in the water with you when you make it out this direction.

Ed

[tniuqs]

Well that’s the big question of the decade don’t you think? I suspect the enactment of the AIT will force the issue whether BCAS or EMA licensing like it or not. EMA licensing will either enact the full scope of practice for the various levels or those of us who insist on working to the full scope of our education will license in other provinces. Then through the AIT we will be able to return to BC and work under that license.

I am thinking more like Pandoras box, I am wondering myself just how much teeth the AIT agreement will have, "the labour Mobility part" but Yes prostituting oneself is something I just don't do, working in Industry if they don't have all the goodies/ drugs/ tools .. I go home PERIOD, I spit on ACPs that do not do the same thing.

The excuse typically used is that ambulances in some areas wouldn’t have enough people to staff the cars without the use of driver only’s.

Yes quite an obstacle to overcome, maybe govenment grants and mobile training busses? Hey if STARS can do it with their simulator RV.... just saying offer improvement in education not a "change of shirts" and an effective and tangible means to deliver it to the rural areas.

If the ambulances go down someone will step forward.

Yea if you look to NS right now with a threatened strike.

Government there is looking to retired RCMP cause THEY know how to drive L+S ?

And use tazers too..... :oops:

You have to wonder what goverments think or really know about what we actually do in the back of the gut wagons ... I find it disgusting their lack of comprehension ... there is another group that SHOULD recieve an Education, if just more of us would get off the couch and run for office ... just saying.

I think the only lobbying anyone is going to be willing to do in BC in the immediate future is for wages and benefits. Our contract expires spring 2009 and we’ve slipped a long ways from where we once were relative to other emergency services in BC. Long term I think the licensing body that will eventually be formed needs to be completely separate from the union. I sometimes wonder if we are in an appropriate union as part of CUPE. It seems like we are an afterthought in the bigger picture of CUPE. They will have my support in seeking a better contract but I’m certainly willing to ask questions along the way. Blindly following never got anyone anywhere worthwhile

Yes and No, You have some very strong members of PAC in the lower mainland, the stats in back injury in BC were instrumental in having us declared part of PSO legislation allowing you to pull retirement CPP benefits @ 55 y/o .... Another way that has been successful is starting an Association under the "societies acts" non profit and here one only needs 5 members to get a grass roots organization to get it up and running, this in fact was the way the ACoP got its start in the door ... way back. It is a repeatable model, but personally go with PAC a unified National voice !

The demand for their programs has been high due to expected recoil from the JI. Now that there is finally another option in BC many are fleeing from the JI as fast as they can.

GOOD ! If reciprocity is a go then use the Institutions that have good reputations as your next door neighbours ... we have a plethora of Great Schools to choose from .... that tool is "in situ" already, why reinvent the wheel?

Yup. Asinine is definitely the right word.

I never could speel Thanks for the correction :twisted: WCB setting standards in Health care delivery .... go away take it out of their mandate.

You guys in Alta. are in for just as much or more of a roller coaster ride as we are in BC. I hope for the people of Alta. that it doesn’t lead to a degradation of service in more rural areas.

I like the hot chicks screaming part on the Roller coaster ... oops outside voice agin my bad ? :oops:

OH YES now thats a huge worry right now, the concept is good, but the plan is not (i think its a secret) Good grief, Yes indeed there its going to be very rocky road ahead, new rumour is that some changes to the action plan, but honestly I remain very skeptical as without a proper Communications network "provincially" in place and implemtation of THAT expected to be in 2 years.

US marines say if you cant communicate you cant shoot (ps they own the sunni triangle of death now)

This IS the back bone of any first responder system, and absient as is unified standing orders, nor Provincial Medical Direction ... nor standardization on car, check out the AHC website on requirements for BLS and ALS under Ambulance Service Act.... its a joke !

My advice go carefully and Listen to the Grunts on the ground and in the air ... but absolutley no venue for that right now .... sheesh, just more Government minions introducing yet another layer of government, funny thing no means to discuss this, we are on a US sponsored EMT City website ... just goes to show you .... but sincere thanks to admin and Ak the ugly one hiding in the sand box .... come out and drink akflightmedic you coward afeard of GOOD beers eh! :twisted:

I don’t know the process for becoming a paramedic alderman. Sounds like a good way to work for progress to me. My focus at the moment is educating myself to what I feel should be the standard available to citizens.

Rock Shoes my friend: Its easy hey if Dion can do it ANYONE can .... LMFAO!

ps I know a great pot hole lake just up the road from Merrit off the Smashahalla ... bring worms or flys and a bottle ...... I have the boat.

cheers

Thing is it just the 2 of us yaking here trying to shed some light in the dark corners ... WHERE is the rest of the GANG ... sure would like to hear what they have to say about this thread ... YOU ?

[rock_shoes]

I agree. It would be good to get an outside perspective from a different system. Any Aussies, Kiwis, Americans etc. are welcome to comment.

[SA_Medic]

I have no idea how relevant this will be, I got lost somewhere between Alba and BC. We in South Africa seem to be heading the same way you guys are heading. They are currently reviewing the education standards and has comeup with the two tier / qualification systemand simply dropping the "short" course system like a hot potato. With the short course system we effectively had three qualification. Basic Ambulance Assistant (a 120 hours course) which was followed by Ambulance Emergency Assistant (Intermediate, a 470 hour course)and then finally Critical Care Assistant (Advanced, a 1200 hour course) however before you can challenge the courses after Basic, you had to proove 2000 experiential hours between Basic and Intermediate. Likewise for the move between Intermediate and Advanced, acceptance to the course was also subject to passing an "entrance exam". A few years ago, they also introduced a 3 year university National Diploma which basically qualified you as a Rescue Paramedic.

Now the powers that be has decided they want to move to said two tier system. This system will basically consist of the 2 year univeristy certificate called Emergency Care Technician (It fits in somewhere between the old AEA and CCA), which incidently is also provided over 2 years part time

The next step would then be a B-Tech in Emergency Medical Care which, is yet again a university degree done over a period of 4 years. The interesting thing about this course though, would be the fact that they are going to teach primary healthcare and diagnostics. Included in the diagnostics section is x-ray interpretation. The chatter in the woods at the moment says they want to use these B-Tech people to work and run rural clinics where the doctors are not willing to work. Leaving the future of EMS in the hands of the ECT and the few B-Tech's that will remain as management.

There is however a pending court case, since people like myself who followed the good old three tier system (6 if you include the rescue mudules) will have our qualifications dropped. Wether they will simply allow us to keep working as we are I don't know. What I do know is the fact that since the introduction of N-Dip the CCA's no longer get a promotion into a management position. These seem to be reserved for N-Dip and recently B-Tech's.

We used to have the whole title protection laws making it illegal for anyone but a CCA to call themselves a Paramedic. Since the introduction of the N-Dip and B-Tech though, the fight started with regards to who the "real paramedics" are and the fight is still ongoing.