EMS Research

[AZCEP]

Can someone please explain to me what this rant has to do with the original topic?

...you can take a look at the profession you claim to take so seriously and realize that it is not perfect!

This is precisely what he is talking about. The system is a mess, and using "profession" to describe it is an insult to anyone that has taken the time to educate themselves beyond the first aid course that so many want to consider important.

I am very well educated and have professionally served several communities for nearly a decade.

Your "education" comes into question when you suggest that the current state of EMS is a "profession", or that the basic level should be "given" anything beyond what they already have.

At this time I will point out that other states have very sucessfull EMT-I programs in place. The (I) stands for Intermediate just in case you didn't know.

Allow me to point out that the intermediate level has outlived it's usefulness. It was, and still is, a stopgap measure to allow smaller communities to have ALS providers without the costs required of a full paramedic. In 1999, NHTSA expanded the scope to turn this level into what many areas are using as a replacement for the paramedic without the commiserate education. It is a level that needs to be done away with.

I know several MD's that ride BLS because they enjoy helping people

With the amount of education they have received they may well be the only providers that should be asking for more leeway in their BLS activities. This comparison has nothing to do with what you are trying to put forth.

Is that not why most of us are in the profession?

No, that is the textbook, feel-good answer when asked why we spend so much time involved in this bastardized system with little to no avenue for advancement. With few exceptions, people become involved with EMS to build a foundation for something else and become enamored with the environment that they land in. If they wanted to "help people" these same providers would be finding other ways to do it that don't involve flashing lights.

Thats right I'm a paid professional have been for a long time but you dont see me bashing volleys.

This again calls into question your education and dedication to the "profession". No one is asking you to "bash" anyone or anything, but you need to realize there is plenty that you have not decided to realize yet.

[JPINFV]

With the amount of education they have received they may well be the only providers that should be asking for more leeway in their BLS activities. This comparison has nothing to do with what you are trying to put forth.

Well, to be fair (assuming it's an emergency physician), what would be stopping them from operating under their medical license while using their EMT-B cert to fulfill staffing requirements? There's nothing, except insurance (Good Samaritan laws?), that would be stopping a physician from carrying around medical equipment and treating people on the street. This, of course, is a fundamental difference between EMS certification/licenses and medical licenses.

[BVESBC]

Lets talk about how the EMT-B treats a diabetic alone No Medics, our protocol says if PT known diabetic, responsive but altered you give oral glucose and transport. Our protocol also says not to delay transport. How do you feel that it would harm the PT to perform a blood glucose test (glucometer) to find a baseline prior to administration of a intervention? We take baseline vitals prior to any intervention, why should we not be able to use a minimally invasive diagnostic tool? It would appear that you are more concerned with provider autonomy than providing the pt with the best care in the least amount of time prior to arrival at a acute care facility.

[ERDoc]

Apparently you work within the perfect EMS system, So First Educate yourself on how to use spell check! After you complete the prior task, you can take a look at the profession you claim to take so seriously and realize that it is not perfect! I agree to some point that there are providers in the field that should not touch anything on or near a ambulance sharp or otherwise. I don't post my life on here, I am very well educated and have professionally served several communities for nearly a decade. At this time I will point out that other states have very sucessfull EMT-I programs in place. The (I) stands for Intermediate just in case you didn't know. don't be so quick to judge people I know several MD's that ride BLS because they enjoy helping people, Is that not why most of us are in the profession? Thats right I'm a paid professional have been for a long time but you dont see me bashing volleys.

Dude, you've got some cajones to come on to a site and, with only 7 posts, begin insulting veteran members and veteran providers. As I said in my previous post, search this site and you will find that this hass been discussed ad nauseum. As others have said, it is your unwillingness to see the flaws in the system that is holding back EMS. You can hardly call someone who has 110 hours of training, which required nothing more than a pulse to start, a professional. Having been an EMT for 10 years I can tell you that you don't know what you don't know. Let those that has the insight and vision make the changes to make this into a profession. True education comes from academia. It teaches you to think and not to follow a protocol designed for the weakest provider. Only when it takes a college education to become a provider will EMS even begin to be thought of as a profession. To think otherwise is ignorance and you are doing your pts a disservice.

BV, I think we'd all like to know you credentials. It has been recurring theme here that those that think the way you do are the ones with the least credentials and experience.

[EMT-B 55]

Getting back to the original post.

Some ideas for EMS research would include:

1. Means to better lift the severely obese patient.

2. Means to reduce injuries to EMS staff.

3. Means to be able to get military field procedures into practice on the civilan side.

[tniuqs]

SORRY! But I was never educated in that I was busy learning latin medical terms!

Here is a short latin phrase that could be applied, to this now tangented topic:

EGO mos non sto pro a oneratus ballista si EGO errant vas!

If this topic of EMS research was allowed to proceed in an intelligent fashion, then I submit one could prove or disprove some of these rather obtuse theory's. But handing over the toys to those without a serious medical background is folly, akin to putting the "cart before the horse" which has been very clearly identified in many replies in this thread.

First on the topic of IV D50W for the EMT B is .... hmm cough, splutter (It passing I can't tell you how many hyperchloremic metabolic acidosis I have found just with an IV getting away from those have passed the test in that 1 hour discussion on electrolye balance ... or even put granny INTO CHF... I digress. Go ahead and submit your proposal to your Medical Director and his malpractice insurance provider (and when the screaming stops) then you can go proceed from there ..... so good luck with that.

I thought this TOPIC was EMS RESEARCH ? guess I was wrong, yet thanks for the lead northmedic, and if one is interested B.Bledsoe's website it has a link to "How to do research in EMS"

cheers

[BVESBC]

Getting back to the original post.

Some ideas for EMS research would include:

1. Means to better lift the severely obese patient.

2. Means to reduce injuries to EMS staff.

3. Means to be able to get military field procedures into practice on the civilian side

I think that you will find that these issues have been researched to near exhaustion,

1. There are many products available to move and lift morbidly obese PT's several mfg's sell equipment for this, it is expensive and few services are willing to spend money on equipment that get little use, I know of at least two hospital based services in my area that have at least one truck dedicated to this. They are the people we call when the pt exceeds the limits of our equipment.

2. Limiting injuries to providers is has many facets, Look around and take a good look at your co-workers you and will probably notice that we are not the healthiest individuals. Many don't care for ourselves as well as we care for our PT's This by it's self has and will continue to be a factor among many others. The mfg's of the equipment we use has made great improvements, example do you remember two man cots, now we can push a button and achieve the same results. I am sure that equipment will continue to progress.

3. History repeats, many things have trickled down to the civilian world from the armed services I'm not a expert on this I will let some one who is more familiar with it comment on it.

I dont claim to know every thing but it is my willingness to see the flaws that allows me see forward, eventually there will be no EMT-B, everyone in the field will have more education, and do more, take a look at the EMS system in London England, they are at least 50-75 years ahead of us. It is our pride in the past that prevents us from moving forward.

[tniuqs]

Getting back to the original post.

Some ideas for EMS research would include:

1. Means to better lift the severely obese patient.

2. Means to reduce injuries to EMS staff.

3. Means to be able to get military field procedures into practice on the civilan side.

Zactly 55 ... get medical based evidence at the basic level first its always the place to start ! The EMS world always needs a better moose trap, te he, I like the way your thinking, and you left your coffee right in front of me ....CHEERS!

[BVESBC]

No one ever said anything about IV D50 it is clearly beyond even some veterans in this field, This post was about the EMT-B using a glucometer on a altered known diabetic prior to admin of oral glucose which we already do.

[mobey]

and if one is interested B.Bledsoe's website it has a link to "How to do research in EMS"

cheers

Are you meaning the Powerpoint presentation, that's all I can find. (Although I've only had one cup of coffee so far!!