Another Idiot Opposes Progress in NJ EMS Standards

[JTpaintball70]

Being a volunteer from NJ can I ask why all the hostility on the board twords us? I understand about the FAC and some squads not being the best caliber but why blanket wash all volies as a whole? I know some great EMTs that are volies, I also know folks on my squad that will call ALS in a heartbeat if they believe its above their expertise or the patient requires it.

As an example.... MVA w/ minor injuries but pt stated she was a diabetic and hadn't taken her meds today. ALS dispatched and checked pt.. released to BLS. Only reason for the ALS was the blood sugar, better have her checked then not.

The hostility isn't towards ya'll personally. It's just that most of us believe the system in NJ is one of the most retarded ones in the country. IMHO it's even worse than CAs incredibly fragmented system.

[uglyEMT]

Gotcha JT. I can understand that. I haven't seen alot of the problems first hand but have read about them. I guess I just took offense to some of the comments about getting what you pay for and vollies aren't good.

To me it depends on the person, when I went through EMT school I seen several students not give a rats behind about patient care and did just what was enough to pass (that lovely 70 average ) now are they going to become good or great EMTs? I dont think so but hopefully they get weeded out by where ever the go before the neglegence of a patient or worse.

I do think they need to up the qualifications without a doubt. I do think even for EMT-B school they should require more rotation time, be it ED or ride along. I think 10hrs just isn't enough for that hands on expierence everyone needs.

Hopefully one day the powers that be will get organized at figure out exactly what needs to be done and what level of training is necessary.

I will say this, I feel my instructor at school said it the best as far as the current level of EMT-B qualifications......

Just think you get 120hrs of class time and are expected to hold someones life in your hands. A hairdresser gets 400hrs of class time. I guess a persons hair is just that important.

[Dustdevil]

Only reason for the ALS was the blood sugar, better have her checked then not.

Better to just get her to the hospital than to delay definitive care for a so-called "intercept", when ALS should have responded in the first place.

Poor patient care and poor decision making. That's why we are anti NJ volly.

Edited April 19, 2010 by Dustdevil

[Kaisu]

To be fair, my understanding is that a nasal cannula is appropriate for patients suffering from chest pain absent shortness of breath. If the hospital they are transporting to has a cathlab and it's only a 5 minute transport, why waste time calling for paramedics?

and how is this judgement made that the patient just requires a nasal cannula and a ride? dispatch?

[JPINFV]

and how is this judgement made that the patient just requires a nasal cannula and a ride? dispatch?

...or maybe it was a response to...

not even High-Flow O2????

How about we not put words in my mouth when I'm replying to one specific part of a post? If someone is going to have a legitimate gripe, it helps if parts of that gripe show ignorance of proper patient care.

Edited April 19, 2010 by JPINFV

[uglyEMT]

Better to just get her to the hospital than to delay definitive care for a so-called "intercept", when ALS should have responded in the first place.

Poor patient care and poor decision making. That's why we are anti NJ volly.

Dust ED is 45 min ride away, ALS is responding from said ED, no waiting just intercept along the way. BTW ALS responds to most calls as per protocol, we are just far from the ED so usually BLS is onscene, packaged and in route before ALS gets half way. Dont knock the NJ vollies in their entirety, we do make good decisions, we just work with what we got.

[JakeEMTP]

Dust ED is 45 min ride away, ALS is responding from said ED, no waiting just intercept along the way.

Even more reason to have ALS on every ambulance.

BTW ALS responds to most calls as per protocol, we are just far from the ED so usually BLS is onscene, packaged and in route before ALS gets half way. Dont knock the NJ vollies in their entirety, we do make good decisions, we just work with what we got.

This is exactly what we're talking about. You shouldn't have to "work with what you have". Time to come into the '80's and have paramedics on all ambulances. It may hurt some people's feelings, but whatever. It is supposed to be about the patient. If a provider doesn't want to step up a few levels then step aside.

[Kiwiology]

Sadly this highlights how poorly setup the US system is in some areas. You require ALS to check a blood sugar, are you freaking kidding me .... actually it doesn't suprise me at all but it does sadden me deeply.

The original issue of not having two qualified EMTs on each ambulance is in itself just wrong. The fact that some would actually oppose such a measure is in itself even more wrong.

I am careful to be critial because our system is not perfect and we're probably five-to-ten years behind Australia thanks to the freaking Johnnos.

Oh and no Speanc aint drunk, he's probably had a stroke, at his age, it's a good probability!

[uglyEMT]

Yes I agree about the ALS. Unfortunatly all ALS in the state are hospital based. So volly or paid your still meeting ALS somewhere.

The whole blood sugar thing, yea REALLY anyoing. Starting in July BLS is supposed to be able to once the new round of Bs get out of school (being taught currently) Then the fun begins, your going to have Bs fresh out of school that can take BG levels yet folks with more time on squads will have to core 13 before they can. Stupid I know and I can see why NJ is a joke. Again paid or volley doesnt matter.

Most squads have 2 to 3 EMTs on board. Usually if you have just driver and 1 EMT aboard the driver is usually going through EMT school or is at least CPR / AED certified. Can help with pt care on scene but is not certified to ride in the back. At least in my area anyway.

I guess I am now seeing why you all look at us like jokes, sure sounds like we are. I guess my big problem is putting down vollies, dont understand why anyone would? We save tax payers money, are grounded in our communities, and are just as certified as any paid EMT.

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

[WolfmanHarris]

Most squads have 2 to 3 EMTs on board. Usually if you have just driver and 1 EMT aboard the driver is usually going through EMT school or is at least CPR / AED certified. Can help with pt care on scene but is not certified to ride in the back. At least in my area anyway.

This is the crux of my issue. Your driver has "at least" the same training as a Wal-Mart or McDonald's employee. They're essentially an untrained bystanders whose competence as an assistant is only gained by exposure and guidance by another provider whose training is inadequate for the job they have to do.