should we do away with EMT certification

[jsadin]

For the record, I am shocked knowing just how undereducated the EMT-P level is.

You ain't kidding. Had a medic once who didn't know what to call an ampule ("ya know, I used one of them little glass thingies.."). Another one recently called an orbital fracture and occipital fracture. Wrong side of the head dude.

[AnthonyM83]

And meter maids save cops too.

Naw, that's explorers who save cops! Come on now.

[EMS49393]

This is the most fun I've had reading anything in hours. What a hoot!

I vote to do away with the EMT. I don't need one, I just need someone that is a great driver with a spectacular sense of direction. I do all my own patient care, always have, always will. I don't need some little know it all smartass trying to tell me that his little first aid class is going to save me. They can go get bent. I want someone that will sit down, shut up, and drive the ambulance.

Yep, I'm arrogant. Nope, I don't care that people think I am arrogant. I'm staring down the butt-end of both a B. S. in nursing and biology. That little two week class you took in conjunction with your GED qualifies you to scrub toilets at the local ambulance base and little else.

I'd be on board with this double medic idea, but I've met very few medics worth a crap. Besides, I hate driving.

[toutdoors]

The service I work for part time is predominantly double medic. Hopefully after next week there will be three new medics working, myself being one of them. (Practical on Sat, written is done.) After Feb of 09, there will be another medic, leaving only one I-85 in our system. Before P class, I had 9 years as a BLS EMT, 1 as a basic, and 8 as an I-85. I have worked part time for the ALS service for three years now, and full time fire for 10. So I see both sides of the fence here.

I don't think that eliminating EMT is the answer. Although I know there are some here who will shoot me dead for saying it. EMT is part of prehospital care. Definately not at the same level as medic, but it is the initial stabilizing of the immediate life threats that the EMT is trained to do. We all know this. I do think that paramedic does need to become more of the norm rather than the exception, or privelege that it is in some places.

Some EMT's say that a good EMT will save a medic. Not true, sorry guys not bailing on you just pointing out the obvious. The only way that an EMT is worth a darn to a medic is if the medic took the time to teach the EMT a few things. I read an article from an old JEMS magazine lying around the office one day in regards to the EMT/medic vs medic/medic partnership. There were some really good viewpoints on this subject. Some of you may have been in the article because some of what is said here mirrors what was printed. Some medics hate basic partners, some will say they prefer a really good EMT over a lazy medic partner. Hey it is your rig and your choice, but some intersting points were made that I took to heart, and started to learn from. One medic said that it is not the basic's fault for not knowing the difference between sinus brady and vfib; it is the medic's fault. If a medic is to work with a basic, than the medic should teach the basic a few things. This medic went on to talk about the drug box, and how the medic should show the basic the difference in what the drugs look like, and when they are used. He also talked about teaching the basic how to read the 3 lead ECG. Now the medic obviously was not trying to say that he allowed the basic to determine a STEMI, or that he would allow the basic to determine if atropine vs epi was indicated, but rather give the basic a little bit more working knowledge. More so in terms of preparing the basic to be more of an asset to the medic, rather than just being a driver.

After reading this article, I started to ask a lot more questions, and seek more of an in depth answer rather than the "cause that is what ya do" response. Of course some medics were very eager to share information and teach me things while others just wanted to get back to their nap. I was given informal classes on reading rhythms, and when what drugs were indicated, how the drugs are supplied, and where they are located in the drug box. Obviously, it was not a replacement for the much more in depth study that occurred in medic class, but it really made me feel better that if the medic was performing one task and asked for the drug box to get opened up and get out a med, I at least knew where to look for it, and what to look for. I was also taught how to hook up the 12 lead. Not a huge skill by anymeans, but it freed up the medic to look for the IV if they choose to do the stick vs allowing me the stick. I humbly yet truly feel I was a pretty good asset to my medic partners, and hopefully will be even more so this time next week after I finally find out if I get to wear the P on my shoulder. Of course, I will be one of the junior medics, with more to learn with all the new skills available to me, but at least I have become a more educated provider, that can take some more of the workload.

I think that one of the things that hurts the EMT stigma is the fact that people want to try to push more skills onto the basic level, without furthering the education. I mean really, why can't basics needle a chest? What is so hard about shoving a needle the size of a pencil lead into a person's chest? Nothing really, but the general lack of knowledge in regards to A&P is what seperates the two "skill" levels. This is where the basic and medic differ, is in knowledge. Leave the basic where it is at. Let the skills that they possess remain, but give them more education, increase the class time, increase the number of patients they must see in clinicals. This might help, it might not. What I don't think will happen, as much as some would love to see, is full time paid paramedics on every ambulance. I won't argue it would then be a perfect world, well closer to it anyway, but I just don't think it will happen. Then again I could be wrong.

[defib_wizard]

Well said toutdoors!

EMTs are probably here to stay, I say this is a good thing! Every profession should have an entry level. EMTs are a needed part of the prehospital care team.

However; I believe that as a team we are only as strong as the weakest link. A new EMT should be taken aside and taught how to be an EMT. After all getting the certification is just showing you passed the minimum standards to be an EMT.

Years ago they taught you A & P ( not as in depth as a medic class ) and how to distinguish different types of medical emergencies. More importantly patient assessment was taught along with the treatments and why we do them.

Now the course is ( dare I say it ? ) dumbed down to a checklist type of assessment : You see this do that type of care.

Plus most services treat their EMTs as drivers and equipment fetchers! Then have the nerve to complain that the new Emts that are trying to upgrade can't pass a medic course. Unless the medic course is "adjusted" to the level of comprehension of its students. Then we can't understand why they don't pass national registry.

We need to improve the curriculum of the basic EMT class. We need to let them get some experience and guide them to be better prehospital providers. This will in turn make them better paramedics when they decide to upgrade.

I believe we let this happen and only we can fix it, Whining here will not fix it but makes fore some interesting reading.

[Ridryder 911]

I attended a meeting that Bill Brown, CEO of the NREMT spoke at. Discussion was made if patients cared what school or education their medics had or not. His response (my reference) was most patients do not go through the listing of physicians to find the "worst" or "most incompetent available, quite the opposite".YES! Patients do care who takes care of them. Yes, I have seen patients inquire the education level of providers as well make opinions based upon initial impression. Should we think that patients would not do the same when calling for an emergency response ? Why should we not be expected to provide the best.

R/r 911

[Dustdevil]

EMTs are probably here to stay, I say this is a good thing! Every profession should have an entry level. EMTs are a needed part of the prehospital care team.

How do you figure? It's been many, many years since I've "needed" an EMT. Not once in my thirty-six year career have I ever not been able to function because there was no EMT around. What makes you think they are so indispensable? If your system cannot get by without them, then you should seriously consider that your system sucks. That doesn't mean that we should dumb the entire profession down to the level of your system.

[tamaith]

isn't a paramedic an emt? i learned that there were three levels emt basic, emt intermediate, and emt paramedic.

[Ridryder 911]

isn't a paramedic an emt? i learned that there were three levels emt basic, emt intermediate, and emt paramedic.

Actually starting next year the National Scope and EMS Curriculum (as many texts now have adopted) has recognized the three levels as

EMT, Advanced EMT, Paramedic

Please note EMT has been REMOVED from the Paramedic title! As well as the Basic, Intermediate wording/title has as well. Of course some states may still use their numerous acronyms, but the National Titles are as stated.

* might want to hang onto that souvenir Basic, Intermediate, NREMT-P patch

R/r 911

[defib_wizard]

Well Dustdevil I'm impressed with your response. So in your perfect world we wouldn't have any EMTs. It just impresses the hell out of me that you went from civilian teenager to paramedic without any stops in between. I can understand that the view from "Up on the pedestal" your on can cloud your vision. I do not feel that saying that the system I choose to work in sucks is very appropriate when you do not know anything about it. Unlike the "Pleasantville " you live in, rural america needs EMTs and will continue to use them.

If you can't handle that, stay in the city !