The Day EMS Died ..........................

[crotchitymedic1986]

I am not saying that it should be the only class. I would hope that all services have a very rigorous training program that ensures quality patient care, but we all know that is not the case. Many services have no training (pencil whipped, or classes where nothing is taught), little training, or easy training that does not challenge the personnel. It was sad, that the only mechanism you had to ensure some training was a mandatory ACLS class, but it is even worse now that you dont even have that safety net.

If you work at one of those services that has such a good training program, that ACLS is an easy cert to pass, then that is great. But how many services can truly say that ? If I walked into your service with a hard ECG test that had WPW and some 30 second strips of mixed 2nd and 3rd degree blocks, would your medics be able to make an easy 100, or would your service be the kind where most of the medics correctly identified 60-70% of the strips on the first test (all of your medics, not just you) ?

[tniuqs]

I don't blame the AHA. I blame the Paramedics who get such a "cert" mentality that they forgo true education. Once one is truly educated in what ACLS is all about, one should only need a periodic update or review. If one is not responsible enough to maintain the basic concepts through their own education, then they are doing the Paramedic patch a disservice.

Sorry to disagree, I do blame AHA the point is that the Cert at one time was something to be proud to recieve, it was a culmination of the Paramedic educational process and just why (in my hood) it became mandatory to practice yet today damn near anyone can be endorsed as a provider, I handed an EMR an old book and he could pass ... verbally at the present level of parroting the new guidelines. The paramedic Proffession has always been akin to a Para Military organization and that will never change, some badges and stripes are seriously well earned, well in past anyway. Just look to the abismal ETI rates comming out of some areas hence all the "inventions" to deal with this situation as opposed to addressing the real root cause.

i.e. The Guidelines 2000 for Cardiopulmonary Resus and Emergency Cardiovascular Care.(500 + pages)

ACLS: Princples and Practices, over 375 pages)

I read them cover to cover.

These books had some meat to them but today its honestly a freaken joke, I too handed my paint by number book back in without opening a page, in protest with the warm soft fuzzy crap, consider this consider that, how many pages it that new one ?

Confronted WITH a REAL LIFE/DEATH Senario ... What Exactly will one do ?

consider this, consider that ...... Show Me !

I my day you could not just "talk" through Mega Code, Real Time, and REAL Instructors threw everything they could throw at you .... trial by "Peer Fire" and one had to Intubate, one had to start a Line on a dummy, one had to actually make this or that drip, actually push the meds. Frankly, I am disgusted with this new world order to have every run of the mill RNs have their "ACLS CERT" to work in ICU or ER when they will NEVER be asked to actually run a code, why, because thats exactly why AHA has gone this route, Anyone tell me this is not the AHA goal and I will loose it.

Ventmedic, cant tell you how many RRTs dont even bother to take this course anymore "I am just the A and B part ... just saying thats the reality.

The "Why Johnnie Can't Fail" concept unfortunatly dominates the current politically correct Educational Programs. Failing is sometimes the BEST way to Learn, self esteem should have something to do with accomplishement.

cheers

[AnatomyChick]

I couldn't agree more wholeheartedly with you tnuiqs! I was an AHA instructor for YEARS.. and was fairly proud of what we were doing. The last rollout was the final straw for me. I've had enough of dumbing down our students! Case in point, all of my students sat through the most current AHA Healthcare Provider course at the beginning of class.... Yesterday I was working with them on practical skills, I pulled out the AED, and we started to run through a scenario, and they had NO CLUE how to integrate any of the information that they were taught to the scenario. I was frustrated to say the least. Not at them, but at the fact that the AHA has gone so far to ensure that all pass no matter what, that they are putting out hundreds of subpar (at best) providers. Just my 2 cents.

AC

[VentMedic]

Sorry to disagree, I do blame AHA the point is that the Cert at one time was something to be proud to recieve, it was a culmination of the Paramedic educational process and just why (in my hood) it became mandatory to practice yet today damn near anyone can be endorsed as a provider, I handed an EMR an old book and he could pass ... verbally at the present level of parroting the new guidelines. The paramedic Proffession has always been akin to a Para Military organization and that will never change, some badges and stripes are seriously well earned, well in past anyway. Just look to the abismal ETI rates comming out of some areas hence all the "inventions" to deal with this situation as opposed to addressing the real root cause.

++++++++++++++++++++++++++++++++++++++++++++

Ventmedic, cant tell you how many RRTs dont even bother to take this course anymore "I am just the A and B part ... just saying thats the reality.

RRTs in many places are still required to keep up ACLS, PALS and NRP but they also spend 2 - 4 years in college studying Critical Care Medical concepts. They damn well better know some of the principles of ACLS. Taking an ACLS class is a mere formality for some since their education and training come from other sources.

As other professions increased their own educational levels, ACLS while it may still be required, should not be the only source of training.

To say your whole Paramedic education comes down to a 2 day cert is a slap for those in EMS that do have an understanding of medicine and the purpose behind ACLS.

Why should the AHA be totally responsible for teaching ACLS concepts?

The AHA is right in the fact they realized how much material there was and now they have placed more responsibility on the individual and employers. Unfortunately, Paramedics still want to be spoon fed and take little initiative to do more than a 16 hour class.

The "Why Johnnie Can't Fail" concept unfortunatly dominates the current politically correct Educational Programs. Failing is sometimes the BEST way to Learn, self esteem should have something to do with accomplishement.

You also must remember that Paramedics are relying on their ACLS "certs" to work. It doesn't look to good for the FDs or any other service if they fail ACLS. If Paramedic schools can no longer prepare a student to fully understand the concepts of ACLS well enough where a review or update "cert" class will suffice, then EMS education is truly in a sorry shape.

Let go of the past, increase your education level to understand ACLS concepts and not rely on a 16 hour class to teach you every thing you should have learned in Paramedic school. Even back in the day, the AHA ACLS cert was not intended to replace a very important part of Paramedic school. Unfortunately, too many came to rely on it.

.e. The Guidelines 2000 for Cardiopulmonary Resus and Emergency Cardiovascular Care.(500 + pages)

ACLS: Princples and Practices, over 375 pages)

I read them cover to cover.

500 + pages are more than most Paramedic text books. Many complain they can't get through everything in the Paramedic text either. Some still only memorized what they needed for the mega code.

AnatomyChick

Yesterday I was working with them on practical skills, I pulled out the AED, and we started to run through a scenario, and they had NO CLUE how to integrate any of the information that they were taught to the scenario. I was frustrated to say the least. Not at them, but at the fact that the AHA has gone so far to ensure that all pass no matter what, that they are putting out hundreds of subpar (at best) providers. Just my 2 cents.

And you are blaming the AHA for their lack of education and preparation? Blame the employers who still accept ACLS cards instead of providing their own competency training programs.

[tniuqs]

It just blows me away that RN instructors can teach this program when very, very few have ever actually run a code nor ever intubated anyone ... sheesh.

Flash box ? Funny thing that's a BLS skill set ? I even had one bystander tell me we were not following 30:2 with an intubated patient ... hmmmm.

Last course I was on a senario was presented ... Pulmonary Emboli .. The RN instructor told the student that "Coarse Rhonchi" heard over the affected side .. I quietly protested to the MD oveseer and it was never corrected ..... OMG shock and awe.

Why should the AHA be totally responsible for teaching ACLS concepts?

Because they set the standards ?

cheers

[AnatomyChick]

How far up the AHA chain are you Vent?

Yes, I hold the AHA responsible for dumbing down the course to the point that you could literally teach a monkey the skills they want you to show for certification. I miss the days where competency was actually a part of the course... heaven forbid that students actually get what they pay for or what they invest their time in. Heaven forbid we hold these "certification" courses to the standard of actually teaching us something, instead of reminding us to be good providers.

I also feel like students these days (the generation going through the programs now) feel entitled. In my program we hold our students to a higher standard.. but sadly not every program holds their students to the same standards.

AC

[reaper]

It just blows me away that RN instructors can teach this program when very, very few have ever actually run a code nor ever intubated anyone ... sheesh.

Flash box ? Funny thing that's a BLS skill set ? I even had one bystander tell me we were not following 30:2 with an intubated patient ... hmmmm.

Last course I was on a senario was presented ... Pulmonary Emboli .. The RN instructor told the student that "Coarse Rhonchi" heard over the affected side .. I quietly protested to the MD oveseer and it was never corrected ..... OMG shock and awe.

Because they set the standards ?

cheers

We should be pushing for better standards in medicine. This is not just a Paramedic problem. I have been in ACLS and PALS classes with Rn's and Dr's that had no clue what was going on. This is something that should be pushed in all the fields.

[tniuqs]

RRTs in many places are still required to keep up ACLS, PALS and NRP but they also spend 2 - 4 years in college studying Critical Care Medical concepts. They damn well better know some of the principles of ACLS. Taking an ACLS class is a mere formality for some since their education and training come from other sources.

Firstly ... most RRTs are no where near your diligence level, that said the are educated in the principles of ACLS but are very limited as to input with so many MDs running around, they will keep up ACLS, or PALS or NRP only if it applies to their specific area ONLY.

When I first started in multisystem failure ICU, GCS and level of inotrope's was not even mentioned in report .... the entire focus is pulmonary, and the majority of "floors" RRTs (placed thier for good reason) were no where near current standards in modern evidence based medicine, yes really.

Frankly speaking a vast majority become very complacent and are no where near as progressive or assertive as the REMT-P ... Jung stated "one is a product of one's enviroment" something like that anyway

as in every "proffession" there are good ones and bad ones.

cheers

[VentMedic]

Because they set the standards ?

The ATS, CTS and ERS also set the GUIDELINES for Pulmonary medicine which comes down to RT eventually. However, you don't see Pulmonologists and RRTs bashing them because their schooling was too inadequate to get them through a weekend cert class.

[tniuqs]

I think in this thread that we should include ILCOR for completeness (sp)... as really this is REALLY where AHA recieves the majority of information to set standards in the US ... CHF Canadian Heart and Stroke Foundation in most cases just adopt AHA standards. .... pansies ! Can you believe that CHF new standards were held back over a year .... because of a printing delay, Europe was paracticing new Standards 2 years before North America ... wierd eh?

Sometimes I wonder why I keep paying more and more for this "cert" and recieve less and less, and it means less and less or is it that we are just paying for the research to dummy it down.

http://www.erc.edu/index.php/ilcor/en/

cheers