Is There a Need for the Advanced Practice Paramedic?

[UMSTUDENT]

That's very definitely where we differ. I think you can scrap it. I don't think we have to follow the same path we've always followed simply because we've always done it that way. Barbers used to practise dentistry in their chairs only a century ago. Was it wrong for the dentists to scrap that and establish a more focused professional specialty? Come on. What would be the upside of clinging to the failed policies of the past? Yes, you have to remember history in order to avoid repeating it, but that is the only useful purpose the last three decades of EMS have served: to show us how not to do it.

How is what you just said any different that what I said? Dentists/Surgeons made strides to separate themselves from centuries of failed practice such as blood letting, leaching, etc that seemed to "make sense" but really just did a great deal of harm. Oh, and killed our first president...

I'm saying that most of what we do is based on this same premise. Just because a certain intervention has a benefit in the hospital environment does not mean that those same skill sets, when implemented by the majority of providers in the field, will produce those same benefits. People realize this. Doctors...the people who control what we do are starting to catch on.

Inevitably what I'm saying is that there are thousands of paramedics in the United States. The majority, I would imagine, aren't you Dust. I've found that successfully determining when to use certain invasive skills or push certain medications often relies on a careful mix of education, observation, and talent. By the very nature of our profession we often only get one shot at doing it right and we have far fewer options to reverse course if our decisions are faulty.

When you're operating in a world like we are, under the conditions we are, with the workforce currently available, you're 'bound to get research results that point to reform. We don't disagree that the current problems need fixed. I just don't think you're going to achieve meaningful results by beating the same drum.

[Dustdevil]

How is what you just said any different that what I said?

On second glance, it doesn't. I thought you were being sarcastic in your previous post, and were saying that we can not scrap the current system and establish a new one. Sorry for the misunderstanding. I totally agree.

[PeachyMedic]

There are many good points made in the previous posts. I feel like there is a place for APP in EMS. Maybe not all of the practices of an APP described are best suited for every EMS service but for the area I work and live in we would greatly benefit from most of the practices. Alot of what was described in the articles on the medical side would work, but some things wouldn't due to not having the capabilities to support the proceeders. Lets face it EMS is not viewed as a professionals and until the mentality of the public, county officals, and medical directors change some services will continue to be held back. As far as the education goes I do feel like we (paramedics) should have an associates degree. What better way to give us some backing and to be taken more seriously as a profession. And for the EMS angecies that feel like their people aren't proficient in their skills due to lack of education that sounds like more of an internal problem to me and needs to be handled through QI and training. I work in a rural service and don't have the luxury of a hospital right around the corner. In most parts of the county I am at least 20 min from our local hospital which is limited in what they can handel and anywhere from 35-45 min away from a trauma center and thats just transport time. So think about how long a patient has to wait after they call 911 to get to an appropriate hospital. I feel like some of the things that paramedics would be able to do as an APP would greatly benefit the patient and isn't that what our goal is to provide the best care to our patients. I can say without hesitation that the paramedics that are at the service I work for are all proficient, we have to be. I may not work in a big city but I can bet you that most rural medics have the experience, if not more, in a shorter amount of time then a medic in a larger city. With all the changes in modern medicine why would you think EMS wouldn't be included in these changes and I am glad to see that there are people who realize it.

[Arizonaffcep]

How is what you just said any different that what I said? Dentists/Surgeons made strides to separate themselves from centuries of failed practice such as blood letting, leaching, etc that seemed to "make sense" but really just did a great deal of harm.

Leaching IS making a comeback!

[JPINFV]

So is maggots, but neither are being used for general care, but for special situations.

[Arizonaffcep]

Ya...I've got friends who have access to the med lab at the UofA...thought it'd be cool to have a leach as a pet...then I realized...I have a 19 month old.