How Does Increased Education Alter Treatments?

[Dustdevil]

Ummm...if we become more educated then maybe our protocols will change to guidelines.

Exactly. The people who don't understand the difference that education makes are thinking back-arsewards. Education is not to be tailored to match protocols, because protocols are tailored to match the education. The reason our scope of practice is a simple book of instructions today is because our educational preparation is insufficient to justify anything more. And the people who don't get that never will, until such time that they come to quit thinking of EMS as a skills-based labour job, and start to see it as a medical profession. As a medical profession, we become assessment based, not skills based. They simply cannot envision such a thing because up to this point, they have always lived and died by the cookbook. And they think "it works for us!", but they know nothing else. And they never will know anything else until they get an education.

When the field as a whole (not just one out of every thousand medics) has a significant educational preparation for the profession, the scope of practice will reflect that. Cookbooks will disappear and clinical judgement will be the order of the day. Then we will see what difference it makes in our treatment modalities.

My recommendation is to not waste your time banging your head against a brick wall trying to even discuss it with people who you are unable to convince that IT'S NOT ABOUT SKILLS! If they can't get past that one point, then there is no hope whatsoever of them ever understanding the rest of your argument.

[Doug]

Jsadin, here in Western Mass. they have told us that our protocols are now "guidelines" Come to Region 1 my friend!!LOL

[Medic65]

More education is always better for the simple reason you know WHY you are doing something, and not just because you are supposed to. More people need to stop treating patients by way of "because this is what I was taught". More times than not, your patient isn't going to be the one you read of in your text book.

[Mateo_1387]

More people need to stop treating patients by way of "because this is what I was taught". More times than not, your patient isn't going to be the one you read of in your text book.

Either you had some really bad classes/schools, or some horrible textbooks, and horrible instructors. My paramedic education has helped prepare me to identify what is going on with my patients. The blanket statement "more times than not, your patients isn't going to be the one you read of in your text book" needs to be backed up. My patients constantly present "textbook." Why do you have the perceptions that they mostly do not present "textbook?" Why have the education with the textbooks if they are not going to do us any good? It does not make too much sense to me.

I agree with the statement that education makes a more confident provider. As an educated provider, the paramedic has an understanding of what is physiologically going on with their patient. I believe that an education makes us better at assessing our patients also. I also think that a solid education, degree, and the whole DustDevil Curriculum will help any medic in the long run. If and when EMS advances, those medics are going to be the ones with the education and foundation to be advanced providers.

As far as how education affects treatment, I think education affects treatment in a positive way. I can give you two examples that come to mind.

A MVC. Low velocity, patient was restrained, sitting in car when you arrive. Its an accident, it does not look to bad. Now how many medics have you seen that go into CYA mode and immobilize a patient who has absolutely no physical injuries, complaints, or symptoms of injury? The care the paramedic would have provided in this instance would have been cookbook, CYA, and just plain stupid. The patient did not need to be placed on a backboard. An educated medic in this instance would be expected to understand the kinetics of the accident, the effect it would have on the body, the patient presentation, and make the right call that the patient did not need immobilized.

Second example. You go to a chest pain call. Patient has been having chest pain for a couple of hours. Maybe some cardiac history. The patient is obese and ate bojangles his whole life (for those who do not know, bojangles is a friend chicken restaurant chain in my area). So FD pops Aspirin and O2 on the patient before you get there. The uneducated medics asks a few questions that they will probably not take into consideration about the patient presentation and put on a monitor and go ahead with nitroglycerin and maybe morphine. I am sure all of us have seen this countless times. An educated paramedic would be expected to get a detailed patient history, do a detailed physical exam, which would include listening to heart tones, at which time he would not aortic stenosis. This would clue the paramedic into how to properly treat the patient, or better yet what is probably the cause of the patients chest pain/discomfort.

The list can go on and on.

These are just some examples that I came up with and have seen.

[Medic65]

I wasn't saying me. I was speaking in general.

[Mateo_1387]

I wasn't saying me. I was speaking in general.

About what? You are being very vague. I am curious how you came to your conclusions and why you see things as you do. I am talking about your view on patient presentation.

[Medic65]

My view on patient presentation comes from what I know and have learned. Learning doesn't stop in the classroom.

[mshow00]

No offense Mateo_1387 but your examples seem to be more about the laziness of the paramedic in question. I have seen both(degreed medics and "mill" medics) do both in your examples. Just because you are a "mill medic" does not mean that you incompetent and can not differeniate(sp?) between the proper and the necessary treatment, and the reverse is true as well. Example a co-worker of mine is a life long student. He has several degrees and is back in school to get yet another. This guy called off Arch(medical flight unit) and attempted to work a trauma code in which a biker left over 3/4 of his brain on a stop sign(80 mph no helmet), while is partner was working the rider(level 1 trauma).

I agree that education is very important (especially after coming here and talking with the people here), but it does not compensate for common sense(at least on a basic level)

[Mateo_1387]

No offense Mateo_1387 but your examples seem to be more about the laziness of the paramedic in question. I have seen both(degreed medics and "mill" medics) do both in your examples.

No offense taken.....yet......

There are always exceptions to every rule. Sure there are some degreed idiots out there, but there are a lot more medicmill idiots. To be fair, they are probably not all idiots, just uneducated.

The two examples I gave I see commonly. Believe me when I say this, in the two systems that I have worked in, I have not seen a single medic mill medic listen for heart tones, not a one ! The only other medic I have seen (besides myself) listen to heart tones is one other degreed paramedic. I have never seen a non degreed paramedic listen for them.

I do not think it was a deal of laziness. I think it was a combination of being uneducated, and scared. It is a whole lot easier to clear someones C-spine, let them walk out of the car and into your ambulance than it is to apply a KED, and you lift the person out of the car, onto a backboard, and then wheel a stretcher to your truck. In the chest pain case, it would have been easier to just say the patient had aortic stenosis, and not to give a drug like nitro, which may severely reduce his pressure for one, and is most likely not even indicated for this patient. That to me is easier than going through a chest pain protocol, checking blood pressure out the yinyang, and get the patient all worked up that I am only doing this because it might be a heart attack.

My main point is a degreed medic will have a full Anatomy and Physiology course, Psychology courses, English courses, and other courses such as what I listed, plus more time for more intense medical education making them a well rounded, more educated medic, that will be much more prepared to deal with patients then someone who goes through a medic mill and gets the bare minimum.

I agree that education is very important (especially after coming here and talking with the people here)....

Me too !

....but it does not compensate for common sense(at least on a basic level)

Medical knowledge is not common sense. If we want to be professionals we have to have the degreed education.

My view on patient presentation comes from what I know and have learned. Learning doesn't stop in the classroom.

:roll: Forget it

[mshow00]

I do apologize, I misinterpeted what you had written. We don't really have any medic mills around here, closest thing is a Community College (or hospital based) sponsered program that is a school year(fall and spring semesters), so I dont have any experience with these "medic mill" medics. I don't understand when you say they take short cuts, because it is "easier". Is that not the more dangerous route to take?