BASIC TO MEDIC CLASS

[Asysin2leads]

Here's some BLS skills I've seen missed:

-Trying to start a line on a trauma instead of loading the patient & going (BLS skill)

Yeah, that's the one they always reiterate, isn't it? DAHHHHH THE MEDICS DON'T KNOW THE TRAUMA THEY JUST TRY AND START AN IV...DAHHHHHHH PLATINUM TEN GOLDEN HOUR BLS DAHHHH.

This is called being a dumbass. It has nothing to do with forgetting BLS skills, its called being a moron. But besides that, it takes me approximately 15 seconds to start an IV. Maybe you have a cramped Type II. Maybe I'm in a position to get to the AC that is going to change. If that's the case, give me 15 seconds to start the IV. I know the master skill sheets say otherwise, but sometimes things change.

-Not getting updated vitals...once again because trying to start a line

Okay, so the EMT's have their little freak out if OMG its been 5 minutes and you haven't done a blood pressure! OMG! OMG! OMG! So, you'd prefer that after someone is set up for the IV, they stop, take a blood pressure and monitor the respirations for 30 seconds, recheck the pupils, and do complete neurochecks, then start again? No. Were going to wait 6 minutes, then do it.

-Not doing pulse checks because caught up in watching heart rhythm (until EMT sitting around watching checks a pulse b/c it's one of the few things he can do...whoops PEA)

Again, this has nothing to with missing a BLS skill, it has everything to do with being a moron. These are poorly trained paramedics. Well trained paramedics monitor the electro/mechanical function of the heart and perfusion, not the EKG monitor. Besides, I'm sure for every time this has happened there have been ten Basics who started CPR because "I couldn't feel a pulse, really!"

-Not monitoring dressings to see if bleeding has continued/restarted

Is that because they had EMT's on scene and they apparently wrongly trusted them to do their jobs?

-Trying to get aspirin and intro aboard so fast, they forget O2

There has been no literature that documents someone's head exploding if aspirin and nitro are given prior to the O2 being started. Strange but true.

Realistically, BLS skills ARE forgotten. But like Dust said, they're forgotten by both EMTs and Paramedics. And they're not necessarily things that should get you thrown of the ambulance. It does make sense though that the larger number of things you have to consider and do, the more likely you'll miss one of them especially if equal emphasis was not spent on it in school. ONE reason I can think of for getting SOME BLS experience in first is that most medic programs aren't designed to guide you through BLS skills as well as ALS, both in didactic and internship.

You're right, they're not designed you to guide you through BLS. They're designed to incorporate BLS and ALS to the point that you don't think about things in terms of BLS or ALS but assessment and treatment. I find most complaints about "paramedics forgetting BLS" is simply because, either that the EMT can't grasp the concept of doing something out of order from what it says on a skill sheet, or because the paramedic believes, sometimes wrongly, that the EMT will do their job and perform the BLS skills without being prompted, rather than sitting back and critiquing the paramedic.

In any event, its BS. If I ever bring in a patient that some BLS skill isn't done, I should eat a damn bullet and/or go work at McDonald's.

[pmedicdude]

Not to brag but...... I decided after being away from the field for over 10 years to recert my medic (probably as the result of a head injury, but thats another story :shock: ). Granted I kept up my reading and stuff over those 10 years, but I also worked full time as a computer analyst. I studied like crazy for over a month before I took my NREMTP exam with a paramedic class. Half the class failed. I did really well on the exam.

Why :?:

I made up my mind to do it. Everything else got put on hold (recreation etc.). If you make up your mind to do it and put everything you got, emotionally and physically and give up Heroes, 24, ER and other favorite TV shows, you can do it too :!:

[mobey]

and give up Heroes, 24, ER and other favorite TV shows, you can do it too :!:

Alright but I'm not giving up House

[dahlio]

More complete nonsense with absolutely zero foundation in fact or educational theory. Going stright to medic school is doing it right. Do the math. Would you suggest that your children take a couple of years off in between middle school and high school? Of course not. Sound educational theory is constant, regardless of the course of study. That's why nurses don't spend a couple of years as a nurses aid before nursing school. That's why physicians don't wait a few years after graduation before continuing their education with an internship and residency.

Probably the best argument I've seen so far in this thread. You don't wait a year after Kindergarten to practice your ABC's. Why wait to practice putting a Non-Re breather on?

By the way....someone didn't use spell check 8)

[JPINFV]

Probably the best argument I've seen so far in this thread. You don't wait a year after Kindergarten to practice your ABC's. Why wait to practice putting a Non-Re breather on?

By the way....someone didn't use spell check 8)

While I'm not one to usually play grammar nazi (Godwin?), provided the post is at least readable and moderately coherent (i.e. shows some sort of sentence structure and isn't a wall of text (paragraphs)), this picture is for you.

[AnthonyM83]

Asys, chill out. No one said anyone was freaking out about anything. I was just posting what I said I was posting. Examples of BLS skills being missed/overlooked...and not ones where a more critical task was being performed or they expected EMT to take care of it (EMT was assigned another task). "Being a moron" happens a lot, just does. Like we said with ALS and BLS.

Besides, I'm sure for every time this has happened there have been ten Basics who started CPR because "I couldn't feel a pulse, really!"

Ah...I see what this is about. K, see ya.

Different topic:

You're right, they're not designed you to guide you through BLS. They're designed to incorporate BLS and ALS to the point that you don't think about things in terms of BLS or ALS but assessment and treatment.

So, how do you get your BLS skills down, then? Like you said they're not teaching them. They're expecting you to know them already, so they can incorporate it with ALS they're teaching you. There's a risk of falling behind, especially since it can take different personalities different amounts of time to become comfortable on scene and internship is short.

[Asysin2leads]

Look, I apologize if I'm a little grumpy. I just got switched to the 0600-1400 shift after working afternoons for the past 5 years. I'm all out of whack.

Anyway, I guess if you mean doing CPR or the Heimleich, or splinting or doing a backboard, there is some expectation that you are familar with it, but the point is, every basic skill in medic class is at least touched upon, and then usually augmented. In any event, far too many people make far to much of basic skills then necessary.

[Dustdevil]

So, how do you get your BLS skills down, then?

By continuing to work on them during paramedic school. By the time you finish paramedic school, you've had two years of labs, clinicals, and internship, not to mention all the personal time you should have spent on your own practising with your fellow students. Seriously, if you can't figure out BPs and CPR in that time, you are a loser.

Again, NO other medical profession finds it necessary to break their educational development into disjointed segments like this, so why do people continue to ASSume that it is something that is necessary, or even helpful to us? It's because -- unlike every other medical profession -- there are damn few educational professionals in EMS, that's why. Instead of running an educational programme, developed by educational professionals, we run an advanced first aid course, developed by the Department of Transportation. That really says it all.

Yet more proof positive that the system is a total loss, and should be completely scrapped and rebuilt from the ground up.

[frontcrawl]

But don't you know, if we don't have EMTs then there won't be ANY EMS!!!!!!

Al'so, I don't need to take tho'se 'stupid gen ed classe's like, they're all extraneou's! What do I need Anatomy and Phy'siology for? Engli'sh comp? Leave me alone!!!!!

EDIT: Also, the guy that showed up at my EMT practical wearing a "coed naked EMS" shirt. I think he was an evaluator.

Scrapped?

Nuke it from orbit. It's the only way to be sure.

[AZCEP]

But don't you know, if we don't have EMTs then there won't be ANY EMS!!!!!!

Al'so, I don't need to take tho'se 'stupid gen ed classe's like, they're all extraneou's! What do I need Anatomy and Phy'siology for? Engli'sh comp? Leave me alone!!!!!

EDIT: Also, the guy that showed up at my EMT practical wearing a "coed naked EMS" shirt. I think he was an evaluator.

Scrapped?

Nuke it from orbit. It's the only way to be sure.

I'm going to guess/hope that this is sarcasm. If not this post is a good example of much that is wrong with the current method of EMS education.