True national standard for EMS?

[DwayneEMTP]

I have a feeling this is one of these things that's going to generate a million "That's been talked about for generations, it's bullshit." type responses, but it's the first time I'm seeing it, so I'll throw it out there and see what happens.

Increased training requirements coming for EMS providers

By BUTCH HEMAN

Staff Writer

Carroll County's approximately 100 professional and volunteer Emergency Medical Services providers face additional training time for new national standards and certification levels that will take effect in 2010.

The National Highway Traffic Safety Administration, which sets national standards for EMS care, in 2000 identified a singular scope of practice as a goal toward having a quality and consistent national emergency medical system. The first draft of a national model was released in 2004 and the final version was approved last year and has been passed by every state.

"There always have been national standards," said Bill Fish, director of the Carroll County Ambulance Service. "But every state has been allowed to pick and choose what part of the standards they want to develop. Now they're trying to get every state on board with one set of standards."

Under current standards, there are 11 levels of first responders, emergency medical technicians and paramedics. The new standards will narrow the certification levels to just four: emergency medical responder, emergency medical technician, advanced emergency medical responder and paramedic.

- Community first responders will be required to take a few hours of continuing education to become emergency medical responders.

- An EMT at basic level can take continuing education to become certified as an EMT under the new system.

- An EMT at intermediate level can automatically become an EMT or take continuing education to become an advanced emergency medical responder.

- An EMT at paramedic level can automatically become an advanced emergency medical responder or take continuing education to become a paramedic.

- A paramedic specialist can take continuing education to become certified as a paramedic under the new system.

The Iowa Department of Public Health Bureau of EMS, which regulates EMS agencies and certifies the over 12,000 EMS providers in the state, adopted the new national scope of practice model in July.

Fish, who serves on the Iowa EMS Association Board of Directors and is a former longtime member of the Iowa Bureau of EMS Advisory Council, said having one set of national training and certifica-tion standards makes sense.

"Consider if you were driving from here to Colorado," he said. "If you'd have to call 911 for a car crash, you'd expect a certain level of EMS care, just like if you were robbed you'd expect a certain level of law enforcement no matter where you were. We're just trying to create a standard where it's quality care across the board and there aren't places that fall through the cracks."

Implementation of the new standards and certification levels is being held up.

"No one has given final approval to bridge the training," he said. "The standards for training to get from where an EMS provider is certified now to where they want to be certified under the new system have yet to be set."

Current training requirements range from 50 classroom hours for a first responder to 660 hours for a paramedic specialist. EMS providers are also required to take 12 to 60 hours of continuing education every two years to become recertified.

Fish said the IDPH will probably set the state's EMS education requirements through administrative rules in 2009.

The new training standards and certification levels will be implemented in 2010.

"I think everyone in Carroll County EMS is very receptive to the change," said Fish. "Our system has the training in place to bridge that gap without real concern. We have the instructors and equipment."

The Ambulance Service will provide training for all EMS members to meet the new guidelines.

"If you move laterally, you're not going to need a whole lot more, but if you want to move up, there's going to be quite a bit of training," said Fish.

"Yes, the volunteers are asked to do more and more, but as a consumer you expect to dial 911 and get a certain level of care. The volunteers have to understand they have to meet a certain level for being a provider."

Tests for becoming certified under the new guidelines will be administered online. Certification will still be done by the IDPH Bureau of EMS.

"The public in Carroll County won't notice a change. It'll be seamless here," Fish said. "If you call 911, you're going to see your local responders, and they're still going to be trained at the highest level possible."

Thoughts? Opinions? Debate?

Dwayne

[AZCEP]

The good doctor wants to be viewed as looking out for his community, but he is "training" his providers rather than providing the education they most definitely need.

As long as the "standards" are held to the lowest common denominator, there will never be any advancement of the craft.

[SANDMEDIC]

So back in 2004 when this was still under development, I read the proposal and from what me and others interpreted was this:

In 2010 when this in implemented "All" paramedics national or state certified will be classified as "Advanced Emergency Medical Responder" with a few skills taken away. With more education those designated as such can obtain their Paramedic certification and get the skills "BACK" we all have been practicing all these years, and no additional "new" or more advanced skills, just the same old skills.

Now PLEASE hear me out this was 4 years ago when this was all being drawn up and have yet to look over the NHTSA guidelines, so this may have all settled down a bit.

I just don't see how making people whom have been Paramedics for years be reclassified and taking skills away unless they get more education to get their "Paramedic" title back.

I can see a lot of Paramedics tapping out of the EMS business to do other things. Unless they are going to pay more for paramedics than the current pay rate.

Excelsior RN program is looking more interesting to me now.

Could someone who knows what is going on or someone who has the time to go read the 200 page guidelines from the NHTSA and let us all know WTF. :?:

Take care.

[SANDMEDIC]

Here's the link if anyone is curious. It should interesting to see what will happen, although I do not see anything about demotion of those that are current Nationally Registered Paramedics.

It does appear they have reduced the amount of pages to 42.

http://www.nhtsa.gov/staticfiles/DOT/NHTSA...es/EMSScope.pdf

I am anxious to see what others are feeling, thoughts etc.

[DwayneEMTP]

Actually, on the face of it, I have no problem with removing a large scope of practice from all and then allowing those competent to do so to return to their previous status, with those that aren't finally being relegated to the lower standards that they seem to find acceptable.

Here in Afghanistan, even more so in the States, I get very tired of standing next to the scared, ignorant, puffed up with importance poser that gets to share my title, thus convincing most that we are equals and peers.

Will such a plan be a pain in my ass? Sure, but I have no fear of proving that I'm able to perform at the level my patch claims I'm capable of. To those that are worried, I say, thank God you'll finally have to put up or shut up. You've gotten to ride the "competent professional" gravy train for generations now, I'll sing the praises the day you're finally forced to step up or get out.

Of course my comments are geared towards a system that will logically and thoroughly be applied across the board, county to county, state to state, nation wide, without wavers for Fire so they can avoid their terrible 'staffing' issues.

Dwayne

[CBEMT]

The good doctor wants to be viewed as looking out for his community, but he is "training" his providers rather than providing the education they most definitely need.

Dude, you're getting worked up over the semantics in a newspaper article. I know the distinction is important to us but to an English (or worse, Journalism) major they mean about the same.

[AZCEP]

The words are coming from a medical director that shoud be able to choose the correct terminology when he is discussing the issue with the media. We've managed to muddy everything else about EMS over the years and now our medical direction is further damaging the perception.

[Ridryder 911]

This has all to do with transitional classes for those that are under the level of Paramedic level. Also if you considering Excelsior RN program you may want to explorer as more and more states are not accepting or requiring additional education before allowing one to be an RN in that state.

FYI: the new curriculum was developed by NEMSE for NHTSA. Again a lot of poor communication has been brought on by EMS forums that does not have accurate information.

Here is an article in reference to the changes. http://www.jems.com/news_and_articles/arti...n_to_unity.html

R/r911

[xselerate]

I'd have to say that it's a good thing to hold every EMS professional to a single national standard. It will allow us, as a profession, to gain the respect we've been due for years. Every FF and cop is generally regarded the same as any other because they generally recieve the same training, where as a NY EMT can work in NJ but a NJ EMT can't work in NY due to hours of training.

And I'm fairly sure that anyone who has attended a reputable medic program will have more than enough hours to keep there medic certification, especially if National Registry is used as the model.

[spenac]

Actually, on the face of it, I have no problem with removing a large scope of practice from all and then allowing those competent to do so to return to their previous status, with those that aren't finally being relegated to the lower standards that they seem to find acceptable.

Dwayne

Not a bad idea.