should we do away with EMT certification

[Arizonaffcep]

In most of Arizona (except for the most rural parts who are not dispatched by a fire/ems dispatch) they use the EMD system to determine if a call is ALS/BLS. If it comes in as a GT/or "non-emergency" response (we all know how how those go...) to a SNF, then the SNF requests the desired response level. As far as 911, specifically in the Tucson area, TFD will respond with an ALS unit for those that require an ALS unit (the city transports all ALS call, and turfs the BLS to Southwest Ambo). The ALS unit can be an engine/ladder/ambulance. Or, if the call dispatches as an "alpha" call (lowest priority, one resource BLS responding normal traffic) then they can do that as well. The unit on scene determines if the call is ALS/BLS, and if there is any question, they are supposed to contact UMC (their base hospital) for a consult. All I know about that system is, when I was a basic on the BLS contract for the city 8 yrs ago, I got more ALS calls off that than I did in my first 6 months as lone medic in my fire district. The only thing they really have on their side for this is typically, they are no more than 5 to 10 min away from any given hospital. Most of the other fire departments respond with only ALS equipment, and if the ALS unit (usually the transport unit) decides that it can go BLS (with hospital consult), then the EMT-B who is the one typically driving the unit (as well as performing BLS skills on calls) will take the patient, while the medic will drive in. The nice part about this is, if the patient tanks or what not, it's still an ALS unit, they pull over and switch places. Others, (Rural/Metro, Southwest Ambo) have a policy (their transport units are EMT/Medic) that the medic will always attend.

[paramistress]

To reply to Fifthkid - if you read read the regs on the NJ DHSS site, it refers to medics working as specialty care transport, air medical and mobile intensive care programs. Medics can transport under the first 2 conditions, but to work EMS must work through an MICU...which is strictly hospital based.

As far as volunteers, most squads do not charge the patients anything. Most of us are self supporting through fund-raising, and some of us receive a stipend or maybe a truck every now and again from our towns.

To reply to those of you that would like us to walk out....if you can get thousands of people to do that at one time...be my guest. But on the other hand...what happens to all the patients while the state is working out a new system??? Do you really think any government is going to solve that over night? We are all working to improve the system...patience is a virtue and if we are going to make changes, we want to make damn sure it is done right the first time!

[4kids]

Para, I think you may be incorrect in part of one of your posts when you stated that private ambulance companies, including AMR, where not allowed in NJ. It appears AMR is already in NJ and has been for awhile.

I just pulled this off from AMR's career posting board for NJ listing's.

http://www.amr.net/careers/search.asp

and

http://www.amr.net/careers/search.asp

[mobey]

Well I have posted it before... and I shall post it again!

The Rural service in Sask I left about 1 year ago.

Call volume - 80-90/year

Paid Employees - EMT 6, ALS 2, Manager 1

Volly Employees - 0

Units - 1 full time 24/7, 1 as needed (scramble unit when staff was available, never had a problem)

Number of vollys who quit when I was hired as the first paid full time employee - 4

Number of people who thought I was less dedicated than Joe volly - 0

Number of mouths fed because the volly's stepped back and allowed me to have a career - 4 (in my house alone)

Hmmm... food for thought.

Once again I say. We ran a full time ALS service from less than 100 calls/year, don't tell me it can't work in your area.

Realize you vollunteering is the only thing keeping it from becoming paid.

[Ridryder 911]

? We are all working to improve the system...patience is a virtue and if we are going to make changes, we want to make damn sure it is done right the first time!

Yes, I agree but you have had over 40 years of EMS availability. How long and more important how many have to die until you decide to change things?

Seriously, do you NOT see a problem? How does one state (the only state) out of 50 and out of countless number of countries (even third world countries) have a better system than NJ? Not to speak ill .. but.. hmm; one has to wonder what century you are awaiting on?

R/r 911

[bigj1130]

Cowboy,

Do you think that paramedics that want to further their profession are Paragods? Enlighten Me please why my belief of a paramedic at the side of EVERY patient makes me a paragod. Basics have their place in the health care system... It is not as the ultimate authority of patient care in a prehospital scene. That is a detriment to the patient first, our profession second. If your happy being a basic fine, but if you think you can be the ultimate authority over a patient and do it as well as a Paramedic and provide the best outcome for a patient that a Paramedic can with your scope of practice compared to a Paramedic scope of practice, you are sadly mistaken. you may think a diesel bolus and high flow oxygen will help an AMI patient. I think if that AMI patient was my mother or father or even my much despised in-laws, I would prefer ASA, NTG, IV, and ECG monitoring seems like a better choice.

I understand communities have to make do. But a smaller group of well trained, well educated Paramedics are a better option than a large group of lesser trained emt-b or emt-i. That is not to say emt-b or i trained personnel have their place.

And one more thing to say that you will be there when Paramedics fail very well could be one of the most ignorant things ever put in print. That kind of attitude is what destroys our profession. For you to say that will only kill patients because Whenever somebody fails the whole system fails. You might want to rethink that phrase just a little maybe to something like you will be there to provide assistance when help is needed to the utmost of your scope of practice and level of training. IF you want clarification or an explanation please feel free to ask but do it on the board. I have nothing to hide.

John Eeten

Paramedic ( or Paragod in the eyes of Cowboy)

Austin Travis County EMS

Austin Texas

[paramistress]

Reply to 4kids - to clarify - Paid services are certainly allowed in NJ, but they CANNOT have ALS EMS units. Their ALS units can only be Specialty Care Transport or Air Medical.

[Dustdevil]

Headed to a new forum..

Bye

Glad to hear it! =D>

There are plenty of whacker worshipping forums out there where you'll fit in just fine. It's just too bad that you happened to stumble into one of only two that are not.

[Don1977]

Well, I now have a headache after reading all the complaining about the JUST BASICS not playing the role of being useful in the EMS system. I'm too tired to argue, and It would be pointless. We (Non Paragods) know what you think of us, and I myself could care less. For those Teams out saving lives with us useless basics. We will be there to carry you when you start to fail. "And yes you will one day- Nobody is perfect.. Headed to a new forum..

Bye

...wow....

[Timmy]

12 Pages eh... Hmmm... I wonder if anything constructive has been made of it...