should we do away with EMT certification

[cbcalk]

let your friend know that over 90% of all patient care happens in the rural setting and is performed by volunteers who, by the way, can't afford the time or the money to make EMT-I or Paramedic

[spenac]

let your friend know that over 90% of all patient care happens in the rural setting and is performed by volunteers who, by the way, can't afford the time or the money to make EMT-I or Paramedic

Sorry that answer will not fly. No excuse not to improve care. I live in a very rural area. 90 miles to hospital. 250 miles to nearest college.

Do some reading in the rural area of the city and you'll see how to make your service paid.

Welcome to the city.

[Just Plain Ruff]

let your friend know that over 90% of all patient care happens in the rural setting and is performed by volunteers who, by the way, can't afford the time or the money to make EMT-I or Paramedic

Care to back up that statement with facts and figures. If not then your statement is not valid.

[DirtyBlackSocks]

I think people thinking paramedics should require AS degree's are thinking a little too highly of the job position.

I hope I don't touch on too many nerves with this post, but having worked in a hospital setting with only EMT-B knowledge in the Army. I've had a unique perspective to see how small the scope of pre-hospital care is.

Paramedics are there to stabilize and transport. To open up the scope for an AS degree you'd basically be turning them into RN's/LPN's(LVN's). EMT-B's are there to assist Paramedics. Neither are trained with the expertise to perform grossly life saving techniques that Doctors are. None will be supervised by a Doctor like an RN would in performing certain techniques.

Giving some one a bit more General Education isn't going to help anything. Aside from Anatomy And Physiology I & II, Medical Terminology and possibly Interpersonal Communication or a Sociology/Psych course there isn't a whole lot that a Paramedic would benefit from.

I've already said this before, but we'll never get rid of EMT-B's because private company's can pay them minimum wage. An EMT-B and Paramedic responding to a call that isn't multiple patient is essentially doing the same thing an EMT-P/EMT-P team would. The only way you'd see EMT-B's getting eliminated is if EMT-P's took a pay cut.

A lot of people are going to disagree with the above and I had some trouble collecting my thoughts to shorten it up. But to sum it up I think the difference in scope between pre-hospital and in-hospital care is huge. Paramedics are well trained in doing what they do, but their primary goal is still to stabilize and transport. Not to find long term solutions to an issue. As a result I don't believe an AS degree or BS would make any sense.

[frontcrawl]

OK then. I don't have the time to respond to this at the moment, but I will make a few comments.

My comments look like this..

I think people thinking paramedics should require AS degree's are thinking a little too highly of the job position.

I hope I don't touch on too many nerves with this post, but having worked in a hospital setting with only EMT-B knowledge in the Army. I've had a unique perspective to see how small the scope of pre-hospital care is.

Now how exactly is that a unique perspective? Take note, if you will, of the RNs, RTs, EMTs working in hospitals and other medical folks on here. While I certainly can't speak for them, many of their posts would seem to suggest that these people do support higher standards.

Paramedics are there to stabilize and transport. To open up the scope for an AS degree you'd basically be turning them into RN's/LPN's(LVN's). EMT-B's are there to assist Paramedics. Neither are trained with the expertise to perform grossly life saving techniques that Doctors are. None will be supervised by a Doctor like an RN would in performing certain techniques.

What "grossly life saving techniques" are you talking about? You do know that there are paramedics running around inducing general anesthesia and pushing thrombolytics, right? What the hell is an associates degree for, cracking chests?

Giving some one a bit more General Education isn't going to help anything. Aside from Anatomy And Physiology I & II, Medical Terminology and possibly Interpersonal Communication or a Sociology/Psych course there isn't a whole lot that a Paramedic would benefit from.

Exactly what sort of general education do you think people are talking about? Art history?

I've already said this before, but we'll never get rid of EMT-B's because private company's can pay them minimum wage. An EMT-B and Paramedic responding to a call that isn't multiple patient is essentially doing the same thing an EMT-P/EMT-P team would. The only way you'd see EMT-B's getting eliminated is if EMT-P's took a pay cut.

A lot of people are going to disagree with the above and I had some trouble collecting my thoughts to shorten it up. But to sum it up I think the difference in scope between pre-hospital and in-hospital care is huge. Paramedics are well trained in doing what they do, but their primary goal is still to stabilize and transport. Not to find long term solutions to an issue. As a result I don't believe an AS degree or BS would make any sense.

Well trained?

Alright, that's as much as I can stand.

[DirtyBlackSocks]

OK then. I don't have the time to respond to this at the moment, but I will make a few comments.

My comments look like this..

Alright, that's as much as I can stand.

Frontcrawl, admittedly my experience in EMS outside of what I've done in the Army is very limited and I am only familiar with the limitations set upon Paramedics and EMT-B's in California as well as what my instructor's in the Army told us.

When I spoke of unique experience, I meant that as an Army Medic you essentially work as an LVN/LPN with only an EMT-B. We are cycled through everything from burn wards to OBGYN in the hospital and permitted to do things your average EMT-B/P will not be permitted to do. Such as trach's and chest tubes. So I would say, in terms of what I've done with only an EMT-B certification, that I've had a fairly unique experience.

When I spoke of getting an AS degree as a requirement of becoming a Paramedic I was more trying to make the point that some one might as well become an RN if they're going to go that route. I do realize there's an extra year of school required, but it just seems silly to me to REQUIRE Paramedics - whose training generally consists of 1 year - to obtain an AS. That doesn't mean I don't think everyone SHOULDN'T strive to be the best they can and take these extra courses. But the pay Paramedics receive does not warrant the requirement.

In a perfect world everyone would be held to extremely high standards and be paid accordingly, but we have to look at things somewhat realistically. Obviously most of us aren't in the EMS field for the pay, but how much of a decline do you think we'd see in EMT-P's if an AS Degree was part of the requirement?

Look at the lack of RN's in the field right now as a general comparison and while EMT-P's would require one less year of school then an RN for their AS, I'd say it's still a good impression of what would happen.

While we should in no way be settling for mediocrity, realistically there has to be a comprimise made. I'm not saying the EMS system is great by any stretch, but when you try and factor in additional things such as pay rate, job outlook ect. Some of the proposals made here just don't factor in.

I don't know how it is outside of California, but Paramedics here are generally hired the day they graduate because they're in such high demand.

I would also like to think that people take this field as seriously as myself and would strive to obtain further education on their own warrant for the sake of being better at their job. I'm not trying to downplay the role of a Paramedic at all, they're just as important as any other phase of EMS. I just don't think requiring AS degree's seems like a realistic possibility.

[frontcrawl]

DirtyBlackSocks,

First of all I'd like to apologize for being an ass, I'm having a bit of a weird day but that's no excuse.

Actually I agree with you that one might as well become an RN. That's probably what I'd do if I wanted to go deeper into the healthcare thing, but I've long since decided to go in a different direction.

Requiring paramedics to have AS degrees won't per se bring about some king of paradigm shift in EMS. Proof of this can, I guess, be found in Oregon and Kansas. Deeper systematic changes are necessary to bring about a truly significant shift. I suppose that in making a statement like that I should at least attempt to define exactly what the desirable destination of the shift might be, but I'm not 100% sure what it is.

All that said, from my perspective, and to be absolutely clear, I'm not a paramedic, the thought that there are paramedic programs out there that don't require so much as a single credit in anatomy and physiology is less than comforting.

[DirtyBlackSocks]

DirtyBlackSocks,

First of all I'd like to apologize for being an ass, I'm having a bit of a weird day but that's no excuse.

Actually I agree with you that one might as well become an RN. That's probably what I'd do if I wanted to go deeper into the healthcare thing, but I've long since decided to go in a different direction.

Requiring paramedics to have AS degrees won't per se bring about some king of paradigm shift in EMS. Proof of this can, I guess, be found in Oregon and Kansas. Deeper systematic changes are necessary to bring about a truly significant shift. I suppose that in making a statement like that I should at least attempt to define exactly what the desirable destination of the shift might be, but I'm not 100% sure what it is.

All that said, from my perspective, and to be absolutely clear, I'm not a paramedic, the thought that there are paramedic programs out there that don't require so much as a single credit in anatomy and physiology is less than comforting.

In my opinion, if people can certify without taking courses like Anatomy And Physiology. The NREMT-P test should be looked at to where curriculum like that is a requirement to be able to pass.

A lot of this can be solved in Continuing Education requirements ect, as well. One can't expect a Paramedic to come into the job knowing everything they're supposed to do. With anything dealing in medical care the best teacher is practice. But perhaps new requirements can be placed upon Paramedics as they progress in their career. I.E. for a second renewal require them to pass a new exam based around Anatomy And Physiology as well as the refresh course, if they didn't opt to take that exam the first time around.

[AZCEP]

let your friend know that over 90% of all patient care happens in the rural setting and is performed by volunteers who, by the way, can't afford the time or the money to make EMT-I or Paramedic

This is the single biggest obstacle to EMS being recognized as anything other than a refuge for those that can't find gainful employ in anything else. These rural areas need ALS significantly more than the urban centers do based on the proximity of the residents to a medical facility.

The volunteer argument has been well documented elsewhere, but it too needs done away with.

[Dustdevil]

Believe it or not...all of the ones in the immediate area (In Alabama of all places!)

are nationally accredited!!!

Sweet, but nobody here had any idea that you were in Alabama, thanks to the "Location" listed in your profile. But yeah, Alabama is indeed surprisingly heavy on accredited schools, unlike many other states. I'd be surprised if "all" of the schools in your area are accredited though. Hospital based and fly-by-nights are everywhere.