Another Idiot Opposes Progress in NJ EMS Standards

[uglyEMT]

Like Doc I am not in the US (New Zealand) and agree with him. A 120 hour course in advanced first aid or a 24 week part-time course in "Ambulance practice" (and I use the term liberally) is not adequate for the job of being a prehospital medical professional. Unfortunately New Zealand is unable to get its thumb out its ass and do away with "volunteers" and move towards a totally college-level education system unlike Australia, Canada and the UK (which we oddly have done for Paramedic and Intensive Care Paramedic).

I agree 100% that the level of training needs to be raised. But that is our standard currently, unfortunatly.

Define "quality care" for me please? Is it "quality" care if you have to wait 20 or 30 minutes for advanced pain relief because you don't even carry entonox? Is it "quality" care for somebody to wait with crushing chest pain because you cannot give GTN? How many times a minute would you ventilate an astmatic patient who is catatonic and respiratory arrested, 10, 12, 15? Is it "quality" care if you cause them to have a PEA arrest?

Touche'

Did I say that you personally were a disgrace? No, I did not so don't take it so personally.

Sorry about that. Im haveing "one of those days"

Define "great learning experience" for me?

While attending school, even before that, by being a driver I was exposed to the field of EMS, got a feel for the dynamic nature of it. I found out if I liked it before commiting to a squad. While in school as I progressed I was able to do more at the scene. As I got further along and began more patient interaction I began loveing the field even more and striving to learn as much as I could to help patients more (within scope of practice of course)

The driver only concept is a disgrace. It is disgraceful that system administrators, funders and operatives consider it appropriate in a first world nation, in the twenty first century, to staff a prehospital medical resource with somebody who has no independant clinical ability and is only there to drive.

Lets say there is you, the EMT, and Wheels the Driver. Can Wheels do CPR? Can he help you apply a traction splint? What about extricate somebody from a car using a KED? How about treat the other person in the car because there are only the two of you there?

Again I think driver only is good, does it have draw backs yes. What doesn't but I see advatages. I had to take a course for driving the rig. Learning how to drive properly, when to use L&S effectivly. Driving in winter conditions on less than ideal road surfaces. All the while keeping my crew and pt safe and comfortable in the back. It left the 2 EMTs in the back free to treat the patient and not worry about the driver. As far as doing CPR, yes at least in my area all are CPR/AED certified. Then can help with extrications yes, usually that is left to the FD in my area. EMT in the vehicle monitoring the patient but the actual extrication is FD.

This is simmilar to what the UK has done with its Emergency Care Assistant program in that it places a huge onus on the crew member who has some actual clinical ability because they must take charge of a scene almost solo and attempt to supervise or instruct Wheels the Driver in helping them while making decisions around patient assessment and treatment.

That is not safe clinical practice and is a huge risk for clinical error.

I can see your point there. It is a burden if the driver is just a driver and has no experience and the EMT has to tell him or her what to do while also tending to the patient.

kiwi you make all valid points and thank you for them.

Guess I am just overly sensitive today and spouted off. I appologize for that and too anyone I may have offended, POed, slaped in the face, or gave the finger too during my not so bright rants earlier

Edited April 19, 2010 by UGLyEMT

[Kiwiology]

Sorry about that. Im haveing "one of those days"

Apology accepted

While attending school, even before that, by being a driver I was exposed to the field of EMS, got a feel for the dynamic nature of it. I found out if I liked it before commiting to a squad.

True but you get the same thing here with 6-8 observer shifts.

My problem with the driver only or driver/minimally competent clinican concept is that it keeps standards down and prvents any real progression.

[zippyRN]

I also support your opinion, what do you think that minimum level of knowledge should be?

Several hundred hours ab-initio for Ambulance assistants who work with Paramedics (excluding driving)

Several hundred hours across a period of time with hundreds of documented patient interactions as first aider / first responder for volunteer staff (excluding driving again) and a requirement to undertake a preceptorship period with HCP crew before being let loose

[Kiwiology]

Several hundred hours ab-initio for Ambulance assistants who work with Paramedics (excluding driving)

Several hundred hours across a period of time with hundreds of documented patient interactions as first aider / first responder for volunteer staff (excluding driving again) and a requirement to undertake a preceptorship period with HCP crew before being let loose

Better not tell whoever came up with our 24 week part-time Technician course or the magic 9 week ECA course in the UK (five weeks of which is driving), no press please Malcom Wollard

[Chief1C]

Resuscitation, EVO and Defensive Driving, Emergency Responder, Rescue Practices, Driving x 2 years w/ no serious moving violations, Privacy and Bloodbourne Pathogens Courses and ICS.

[Dustdevil]

Yes NJ policies are screwed up but dont blame the EMT, blame administration. We just follow protocol.

That's what the Nazis said.

Nobody's blaming the EMT. They're blaming the volunteer EMTs, whose very existence is the reason that the administration is forty years behind most of the world.

You're not just working with what you have. You are perpetuating what you have, rather than progressing to something better.

[Chief1C]

You get what you pay for..... Stop (NJ) Volunteer Ambulances, like my bumper sticker says.

Perhaps, the SVA movement would be better suited, doing what people in, near or from NJ do best. Develop a consulting firm, to aid services, squads, et al, in forming a plan of action, in order to became paid services. Where possible that is, and where paid services wouldn't be economical, develop a plan to condolidate multiple services into one large service. That would seem like a better idea, than harassment, suggesting damage and assault upon, and terrorizing, the volunteers.

[Dustdevil]

Never work. The vollies are hometown heroes. Everybody loves them for their selfless service to the community. They get the automatic sympathy vote from the ignorant court of public opinion, just like the firemonkeys.

Of course, we all know it's a crock. Vollies don't want a paid service. They want their hobby. They don't volunteer to fill a need. They volunteer to feed their own egos, and fight any attempt to replace them with professional service. Ever seen a volly squad publicly campaign for professional service? Ain't gonna happen. And to make matters worse, the hospitals of NJ probably aren't anxious to give up any turf by allowing others to provide ALS in the state either. Everybody fights for turf while the landscape as a whole dies.