Dustdevil Posted October 19, 2008 Posted October 19, 2008 I seem to remember discussion of some dispute regarding Seattle’s save data, but am unsure of the details. If you have access to the data, would you share a source so I may review it and more intelligently discuss the point? I'm afraid I do not. Just like I don't have my original EMT textbook anymore. Once I digest information, I generally don't keep the link on hand. And it would take too long to Google it. What they were doing was defining "cardiac arrest" in such a narrow way as to hype their save numbers. I believe they were only counting shockable rhythms, and possibly even only witnessed arrests, in their statistics. If we all did that, we would all have respectable numbers. But really, it's all a spurious point to even discuss. The measure of EMS success is in saving the living, not resurrecting the dead. And any system that insists on using those stats to justify themselves is simply operating on a dishonest agenda. I will be willing to discuss the “vitriol” in another thread, of your choosing, because I think that discussion would detract from the original topic. Before we “step-outside,” as it were, I should state that I am in no way naive enough to believe that peer bashing is unique to one particular group. With your experience, as evidenced by your Myspace link and your photo album, I presume you share that belief. I absolutely understand your concern, and I respect that. I would never attempt to deny that a bias exists here. And no, Fire-EMS is not the only recipient of that bias. Volunteers and educational minimalists catch it just as bad, if not worse. But really, I don't think we need to "step outside" to discuss it. We both understand that it is what it is. Again, I truly believe that both firefighters and vollies get a fair shot here -- and even earn respect and become popular contributors here -- when they demonstrate a professional commitment to EMS. I don't see anyone getting bashed simply for being one or the other. If they get bashed, it is because of their specific views on EMS. Those who leave their bunker gear at the door, and communicate on a professional level, without a lot of elitist attitude, do well here. But you don't have to be here very long to see how many come here with that attitude that somehow being a firefighter makes them better or more qualified than others. Similarly, one need only spend a short time at Firehouse.com or other fire-based sites to see non-fire EMS providers getting bashed, so this is not unique to this site. Our bias is only reversed from what you are used to, so it offends you. I also say thank you for your compliment (I think). I was absolutely being sincere, Bro. I honestly appreciate your contribution here. It is intelligent and well considered. I don't respect your opinion here any less than anyone else simply because you are a firefighter. As a former professional firefighter myself, I certainly don't dislike firefighters. I just dislike those who use that affiliation to cop an attitude, and those who would misuse EMS as a means to justify their own jobs and budgets in the fire service. But anyone who wants to come here and intelligently discuss EMS or medicine is more than welcome here, at least by me. I expect, from what you have said here, that you fall into that category, and that you have a lot to offer the forum. I hope you will recognise that you are absolutely welcome here. We may have disagreement on this one issue at hand, but I do not believe that negates all the common ground we share.
VentMedic Posted October 20, 2008 Author Posted October 20, 2008 Separately, could you provide a link to the information regarding accreditation? I am familiar with the existence of the education agenda of the National Highway Traffic Safety Administration, but not a deadline established by the National Registry. A deadline indicates a plan with specific requirements and I would love to read the plan. Here's the link: http://www.coaemsp.org/aboutaccreditation.htm http://www.coaemsp.org/ Link to a discussion on this forum: http://www.emtcity.com/phpBB2/viewtopic.php?p=140851 I know that 9 of your TN Paramedic programs offered at the colleges are accredited. There are a couple of members here that are intimately familiar with the NREMT exam and the stance the NREMT has taken. Ridryder911 is an excellent source of knowledge on the subject. The state of Florida still uses its own Paramedic exam and will probably continue to do so as not to upset our medic mills. Yes, Florida is the capitol of the medic mill kingdom and has one of the largest concentrations of Fire-ALS systems in the country. We also provide ALS services of some type to just about 100% of the state. However, I hope you take note of the mistakes we have made and are still making. Welcome to the forum!
Kiwiology Posted October 20, 2008 Posted October 20, 2008 Now nearly everyone has proven you are against the fire based EMS concept to begin with regardless of where training comes from. I cannot speak for everybody here but personally; but lets say that Big City A wants to intergrate fire and EMS, here are some of the flags that go off in my head .... - Does the fire department want EMS or will it become the neglected stepchild? - Do they understand EMS and what is involved in providing it or is it a way of getting more money? - Do they have the leadership and motivation to support these medical professionals? - Are the firefighters going to be cross trained, dual role firefigher/paramedics? - If they are, how much time do they get on the ambulance? - What clinical leadership, mentoring, skill revalidation and continuing education resources will the FD have? - Are the firefighters required to become paramedics? (see above post) Paramedics are medical professionals; when the fire department wants to run EMS you come up against the issues of leadership and oversight. If the fire department doesn't understand them or even want them (I know some places where EMS has been thrust upon the fire department; I think the FDNY was one) then you can bet it won't have quality systems in place to motivate, guide and lead its paramedics. They will probably end up the neglected step child without the quality clinical support, mentoring and continuing education you need. I don't think anybody here is any more against the fire department running EMS as they are say .... the freaking phone company running EMS. If I knew the phone company paramedics were ... 1) were dedicated to the practice of paramedicine because they wanted to be there and not just killing time 2) had excellent leadership behind them which was motivated to further patient care/provider education, and 3) had a solid clinical skill revalidation process that ensurd excellence in practice ... then I wouldn't have a problem with them rocking up in thier Dodge utility with the Telecom logo on it and treating my cardiac arrest and DSL upgrade at the same time. If I knew the Fire Department was the same and that the Paramedics were not either ... 1) just firefighters who had to be there until they could out onto an engine or 2) Paramedics who were not supported by the department in terms of leadership, clinical revalidation and continuing education ... then I wouldn't have a problem with it either.
VentMedic Posted October 20, 2008 Author Posted October 20, 2008 Paramedics are medical professionals; when the fire department wants to run EMS you come up against the issues of leadership and oversight. If the fire department doesn't understand them or even want them (I know some places where EMS has been thrust upon the fire department; I think the FDNY was one) then you can bet it won't have quality systems in place to motivate, guide and lead its paramedics. They will probably end up the neglected step child without the quality clinical support, mentoring and continuing education you need. Since the FDs are not structured according to medical credentials, you will have FFs with or without an EMT cert to supervise the Paramedics. In a non-FD setting that would definitely create problems and that type of situation would be avoided. Lt. Robert Kramer aka MemphisE34a has already shown his attitude toward Paramedics and it is stated he will be in charge of some. Not to just pick on him, this could be anybody in the FD who may have the rank but not the "patch" that can enjoy their position of supervision a little too much by knowing where their stance would be in a non-FD setting. Thus, even if the Paramedics are also considered FFs and hold the same Fire cert, they may not fit in or allowed to fit in. I think we've all read enough opinions on EMT vs Paramedic threads to get the jest of how things could be even without the FD issues.
MemphisE34a Posted October 20, 2008 Posted October 20, 2008 Since the FDs are not structured according to medical credentials, you will have FFs with or without an EMT cert to supervise the Paramedics. In a non-FD setting that would definitely create problems and that type of situation would be avoided. Lt. Robert Kramer aka MemphisE34a has already shown his attitude toward Paramedics and it is stated he will be in charge of some. Not to just pick on him, this could be anybody in the FD who may have the rank but not the "patch" that can enjoy their position of supervision a little too much by knowing where their stance would be in a non-FD setting. Thus, even if the Paramedics are also considered FFs and hold the same Fire cert, they may not fit in or allowed to fit in. I think we've all read enough opinions on EMT vs Paramedic threads to get the jest of how things could be even without the FD issues. As I have already stated, you know nothing of my city, my department, my company, or me. I do not paint everyone with a single brush. I judge people and treat them accordingly, not because they do or do not have any certification or qualification. Some of the most incompetent people I know are highly qualified on paper. You and many others in here are the ones displaying attitudes that the mighty paramedic is superior in mind, body, and spirit solely based on the status of being an "ems professional" having a "patch" and not a "fire monkey." I can assure you that both my firefighters and paramedics are happy, at least to the extent that our fine citizens allow, everyday they come to work because I go out of my way to take care of them. Our station houses both one of the busiest engines and ambulances in the city. There is not a month that goes by that people do not call and ask if we have any openings. I am sure people are not volunteering to get flogged on the engine and ambulance so they can also come put up with the inferior fire monkey Lieutenant who abuses paramedics. You are a paramedic. You ride in the back of an ambulance. I am sure you do the best you can for every patient you have. Your importance ends there. I highly recommend you enter some form of therapy.
VentMedic Posted October 20, 2008 Author Posted October 20, 2008 MemphisE34a, My post was merely stating that the FD is one of the very few work situations where an EMT would be giving orders to a Paramedic. Another exception might be the military. Do you ever read what you have written? All of your posts have been sooo predictable. Right now I am just toying with you because I can and you keep giving me more material that is of little relevance to EMS. But, it is useful for a deeper look into the mind of Lt. MemphisE34a. Some of the most incompetent people I know are highly qualified on paper. You and many others in here are the ones displaying attitudes that the mighty paramedic is superior in mind, body, and spirit solely based on the status of being an "ems professional" and not a "fire monkey." BTW: Has anyone ever seen the term "fire monkey" in any of my posts either on this thread or elsewhere? I can assure you that both my firefighters and paramedics are happy Same or separate? You are a paramedic. You ride in the back of an ambulance. I am sure you do the best you can for every patient you have. Your importance ends there. I highly recommend you enter some form of therapy. Yup, I bet you make your Paramedics feel good about their work. There is not a month that goes by that people do not call and ask if we have any openings. I am sure people are not volunteering to get flogged on the engine and ambulance so they can also come put up with the inferior fire monkey Lieutenant who abuses paramedics. quote from article: Faced with a shortage of paramedics in recent years, So what's all the stuff about not being able to find Paramedics? Just tell them to grab some paper with a patch attached from a medic mill and come back. Right now trading posts with you is only for amusement since you are so easy to mess with and you don't even realize it. I apologize to other forum members for derailing this thread slightly.
MemphisE34a Posted October 20, 2008 Posted October 20, 2008 MemphisE34a, My post was merely stating that the FD is one of the very few work situations where an EMT would be giving orders to a Paramedic. Another exception might be the military. And that is the what it is really all about. You and the others can't stand that an inferior "fire monkey" is in charge and the superior paramedic is not. This again goes back to the fact that you don't know what you are talking about as it pertains to the Memphis Fire Deparment. As a Lieutenant I am in charge of an ALS company, but even as inferior as I am, I have enough sense to know that my paramedics have charge of the patient while I have command of the scene. Hard for you to grasp I am sure, but there is a difference. Our SOP's mirror this concept and in the last 14 years I can only recall a handful of incidents where there have been problems between a paramedic and a non-paramedic officer. The only issue I have ever had is when paramedics get so busy and focused on doing doctor stuff that they forget that sometimes the best stuff is the basics and a rapid transport - especially with trauma patients. Of coarse I really don't know that because I am a fire monkey, but Barry told me that would be a good thing to say. In your part of the country, fire based EMS may be a spawn of the devil. Here, fire based EMS is the norm. It has the best pay and the best benefits and therefore draws the most paramedics. The ones that are working at non fire based systems here are the ones that get fired from us or can't make the cut to begin with. We do not train all of our own, in fact up to this point we haven't trained any of them. In the last year or two, there have been nearly 100 paramedics - Barry can probably better define an exact number - that have left the service they were at to come work here. I am sure that plenty of them were from non-fire based systems. If they had it so good, I wonder why they left? Maybe by the end of the thread you will have this retarded fire monkey hanging from the ceiling fans and playing with my own turds for your amusement, but I do not think you are as smart, clever, or important as you think you are. Because I am so retarded, what can you do as a paramedic that I cannot do as an EMT-IV?
mediccjh Posted October 20, 2008 Posted October 20, 2008 OK, my turn to chime in, being the burnt-out ghettomedic I am working in the busiest per-capita system in the nation. To the Memphis guys, it does take a lot of guts to come in here and talk. We can be intimidating and such; that's because we don't tolerate unprofessionalism. oneilljb and the other Memphis gentleman who was first to respond: Thank you for the intelligent posts. You have helped start a PROFESSIONAL adult conversation/debate, which seems to be going well. MemphisE34a: You attitude is what got you the responses. Get off your high horse please, leave your gear at the door, and please act like an adult if you're going to continue. Now for my thoughts: I do not condone fire-based EMS. The best example has to be New York City. I have worked there, and it is horrendous. The FD treats EMS like shit, and most (not all) of the firefighters have the same attitude. This kills EMS Morale. As for ALS engines, they are bad. Oversaturating an area with paramedics increases mortality, not lowers it. This has to due with skill dilution. If an ALS unit has 100 intubations a year, it translates to about 25 per provider per year. Keep adding ALS units, and the numbers go down. This counts with IVs and other things. There is a study that was done in LA area that proved this. Forcing firefighters to become paramedics tends to equate to crappy patient care. Look at it from a human nature perspective: If you were forced to do something you don't like, are you going to do it well? Personally, I have no desire to be a firefigher; I'm happy being a paramedic and cutting cars. All my firefighter friends respect this, and I respect that fact that they are firefighters. If I were forced to become a fireman, I know I would not be a good one. My esteemed colleague from Boston (p3, how's it feel to be beaten by amateurs?!!) hit the IAFF issue on the head. The IAFF's own papers have stated that they intend to take over EMS wherever possible to save firefighter jobs (paraphrased). Personally, I'm in favor of the third-service. Boston probably has the best setup in the nation (Bet you thought you'd never hear me say that, p3). Let's go back to the education aspect for a minute. As you have seen from our boards, we all want to see EMS move towards a degree-based EDUCATION. As one who doesn't have one, I kick myself every day for not having one. Paramedics should be educated in college. That is one of the changes most of us on this board are pushing for. Gentlemen, like I said, I welcome your dialogue (as long as 34A cuts the attitude and Paramedic-bashing). Productive dialogue can be produced here. Respectfully submitted, The World Infamous Herbie of the World Famous Medic 9 Paramedic Service of Bangor, PA aka "Hot Job" Herbie of the Brick City First Aid and Rescue Squad, Newark, NJ DISCLAIMER: My thoughts and my thoughts only. Not my employers', just mine.
Kiwiology Posted October 20, 2008 Posted October 20, 2008 Herbie, those are exactly the issues I was talking about
sirduke Posted October 20, 2008 Posted October 20, 2008 I just had an epiphany!!! Here is the plan, let EMS take over Fire and then we could be in charge of the money. Because from all I've read, seen and heard, that is the real issue here. Lets face it, firefighting has evolved dramatically over the last 50, hell 25 years, building codes have changed, safety engineering has advanced, and the incident of fires isn't nearly what is was when we all lived in wooden houses, and the average Joe worked in a dusty fire trap factory. With these changes, there has been a decrease in the amounts of fire calls, and thus, you can drop by any fire station on any day, and see the firefighters polishing trucks, driving the Lazyboy, etc. To protect their jobs, fire must make themselves appear necessary, thus, take over EMS. Now you can throw a Star of Life on your engine, show up on scene and grab the glory. It reminds me for all the world of these families that keep granny in the back room and live off her social security check, they don't give a damn about her, except that money. I would be interested in seeing the amount these fire based services spend on firefighting equipment and training vs what they spend on the ambulances and EMS training. My question to all the firefighters is this, how do you think you would feel, and how loud would you bitch if the shoe was on the other foot and EMS was trying with all its' might to take over your profession? Another question just popped up, How many of your calls really require a fire engine as opposed to how many require an ambulance? I am not talking about calls where the fire engine shows up because "thats how we do it" but calls where it is a Necessity. Just one man's opinion
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