Basics Doing Advanced Patient Care - Good Or Bad?

[RatPack]

Wether they do or should is a moot point the fact of the matter is they are.

If they are not getting the education in school they need to get it somewhere. Why not here? Politics if you havent noticed moves slowly, when you have to dish out cash it moves even slower, and couple that with a recession, like a dead turtle.

Having degreed paramedics with four year educations is a great idea, we probably wont see it nationwide in the states at least required, in our life time.

So what do we do in the meantime?

Cute sayings like ill take my chances in a taxi wont change the fact that everyday EMTs transport sick patients all over this country and as far as I know not one of them is sitting on a protocol board. They dont come up with the advanced scopes, intubating practises or administration of medications orders, medical directors do. So although I agree with the argument the EMT is ultimatley not the party responsible.

Five or so pages of discussion here and I havent heard one feesible solution to the problem.

[itku2er]

No that is why we go further with the education. Allowing people to do the procedures without the proper education isnt a good ideal. I know they can be trained on the techniques but what are techniques without the knowledge behind them? I feel the same way about allowing EMT B to do 12 leads in the feild, what is the practical purpose of that other than giving the ER a look at what happened when they did it. They cant fix it so why do it?

[Just Plain Ruff]

One solution to ponder is a single certification. Paramedic

Allow 2 years of grace period for all emt's, emt-i's emt-j's and emt others (you get my meaning). Surely if there is money to be had in the stimulus or Porkulus bill to fund some the following pork projects then the money to get all of the EMTs in the USA through medic should be easy to find.

1,791,000 for swine odor and manure management research in Ames Iowa

2,192,000 for the center for Grape Genetics in Geneva NY

1,762,000 for a honeybee lab in Weslaco, tX

469,000 for a fruit fly facility in Hawaii

3 million to help make data received from Nasa(bloated entity) Satellite images more accessible to the public

500,000 for the manned Space flight education foundation in Houston to create a virtual space community for students

200K for the providence holy cross foundation tattoo removal violence prevention program (seriously theres violence in tattoo removal??? surely you jest)

39,700,000 for Robert Byrds advanced Training Center whatever the hell that is.

so if those are added up - it comes to nearly 50million dollars of Pork that could be culled into training all the emt's out there in the USA to become medics.

So let's not say there's not enough money out there to do this. I have more examples of Pork that could be chopped.

One more ok, 2,400,000 for the Air Warrior-Joint Service Vacuum Packed Life Raft pork proposed by Rep. Bill Young (R-fla) Just what the hell is a Air Warrior joint service vacuum packed life raft???

Edited May 28, 2009 by Ruffems

[Dustdevil]

Five or so pages of discussion here and I havent heard one feesible solution to the problem.

Then you obviously didn't read the entire thread.

Fail.

[FireMedic65]

What's next? Letting the medics to surgery? If you want to do the skills for sake of doing the skills, find a new career. Generally speaking, most of the skills that are done by paramedics, and even doctors are relatively simple. That is not the issue though. The issue is knowing why you have to do the procedure, and being properly trained AND EDUCATED to do so. Not to mention, if something goes sour, then what? Stick your thumb up your ass? No, get the education and training to handle it properly. Letting someone do a skill they can't properly manage if something goes wrong is just plain retarded. To get to the point of where you can handle it, you are wasting your time and just should have gotten the right education in the first place.

So no, definitely not!

What should we do? Smack the idiots who want to play 'captain save the day'. Chances are, they won't understand the importance it being educated though.

[RatPack]

Im sure the money could be located its the fact no one places any importance on it.

[Kiwiology]

No, no, and hmm oh yeah .... no!

It seems to me EMS always caters for the lowest common denominator. All these upskilling packages, advanced classes, accelerated programs and minimal education are simply holding us back.

EMS will never advance as a health care profession until we do away with these skill hungry, title seeking piecemail type dealies where you can get certs for this and that and that too without any real education.

I can see it now .... oh guess what y'all says so and so I am a Basic but I have these add on certs so I can do glucose (I have no idea about glycogenogenesis and the Krebs cycle), I can give you GTN (but I don't understand much beyond "it makes pain go away") and if I do a 16 hour course I can start IVs just don't ask me about osmosis, tonicity, diffusion and filtration because I'm not required to know it!

And .... if I go to 624 hour Houston Fire Department cookbook firemedic tech school I can get a bright red patch and begin shocking people in five months!

Strikes me that many in EMS are about minimal education to get out onto the street and start using thier skills. Seems too much emphasis is placed upon "skills" and not enough emphasis on a robust education focusing around A&P, pharmacology and pathophysiology because thats too hard and/or boring.

Edited May 29, 2009 by kiwimedic

[Happiness]

Okay Im saying no on the spreading of the ribs, I know some ambulances are clean but are they that clean and just plain yuck. I am considered a basic but I have done some ALS activities under their license and have enjoyed doing so but I have to say they have done the schooling and paid the big bucks for the schooling so I have to vote No.

[tracymae]

OK I saw in another forum a discussion of Basics doing "ALS" procedures. One post though seemed to indicate by sarcasm that it was a bad idea. Here is that qoute of Medic417

"Once when the hospital was in serious crisis I was asked to assist in surgery. Since I knew how to spread a chest I did to save time for the surgeon. Thinking about it I think we should start doing it in the ambulance to save time for the surgeon. I mean all we're gonna do is seperate the ribs,not actually touch the heart or anything like that. I mean its so simple a monkey can be trained to do it so why shouldn't we add this skill?"

So what are your opinions?

I do not want to start an argument with this discussion, so please do not hate me. I just want to clarify that without the BASICS, Paramedics can not do their jobs. It doesn't matter that you are a Paramedic if you if the basics skills are not performed. EMS is definitely a cluster f***. Each state with it's own protocols, FD, PD, and EMS can not get along, EMS can not receive respect, EMS providers are ambulance drivers, etc. When then, would we degrade each other?

Yes, I am ONLY a Basic to you, but the knowledge and skills I have acquired are the most important at ANY level. Remember the ABC's? I volunteer with EMT-I's and they seem to forget the ABC's because the are I's and can start IV's. Umm.......dontcha wanna check their pulse first and maybe do some chest compressions before you start that IV there EMT-I?

Ok, I bantered a little. My point is that we are all important, on all levels, because without the ABC's covered, you just might end up with a dead patient and your knowledge of D50, Narcan, and Morphine won't mean crap. I read a of these posts and I see a lot of degrading of Basics.

I do not think you necessarily need the philosophy behind the techniques of some things. People are trainable. One thing that cracks me up is that I am also a Medical Assistant. I was trained on EKG interpretation. I do not know if it is at the same level of a Paramedic, but I am aware of some interpretation. As a Basic, I'm not even suppose to touch the monitor. I can also give injections, as a Medical Assistant, not as a Basic (except the epi pen).

Diabetics give themselves injections, patients give them selves Lovenox injections, B-12 injections, do you think they had any kind of training? No, the nurse said, "Poke here."

I was a Pathology Assistant, I performed autopsies and dissected surgical specimens. I did not always know what I was looking for, but I knew the technique. I was an on the job trained Perfusionist with the local Organ Procurement Organization. I was part of the surgical recovery team from organ donors to recipients.

People can be trained. Now, I was interested and wanted to know why I was doing things the way I was doing them, so I asked questions, had a great mentor, and have gained a tremendous amount of knowledge.

Now, my whole point to this is why hate on the Basics? With out the basic skills, you have a dead person, so why do you feel that you are so much better? I didn't become an EMT because I wanted to be a hero or degrade Emergency Medical Responders because I have more education than them. We are all here for the same thing and that is to help people. If we want respect from our peers and the public, we should also respect each other:-)

P.S. Don't be hating on me because I can intubate as a Basic in Ohio! :-)

Don't be hating on me now! I'm a newbie:-)

[spenac]

I do not want to start an argument with this discussion, so please do not hate me. I just want to clarify that without the BASICS, Paramedics can not do their jobs. It doesn't matter that you are a Paramedic if you if the basics skills are not performed. EMS is definitely a cluster f***. Each state with it's own protocols, FD, PD, and EMS can not get along, EMS can not receive respect, EMS providers are ambulance drivers, etc. When then, would we degrade each other?

Yes, I am ONLY a Basic to you, but the knowledge and skills I have acquired are the most important at ANY level. Remember the ABC's? I volunteer with EMT-I's and they seem to forget the ABC's because the are I's and can start IV's. Umm.......dontcha wanna check their pulse first and maybe do some chest compressions before you start that IV there EMT-I?

Ok, I bantered a little. My point is that we are all important, on all levels, because without the ABC's covered, you just might end up with a dead patient and your knowledge of D50, Narcan, and Morphine won't mean crap. I read a of these posts and I see a lot of degrading of Basics.

I do not think you necessarily need the philosophy behind the techniques of some things. People are trainable. One thing that cracks me up is that I am also a Medical Assistant. I was trained on EKG interpretation. I do not know if it is at the same level of a Paramedic, but I am aware of some interpretation. As a Basic, I'm not even suppose to touch the monitor. I can also give injections, as a Medical Assistant, not as a Basic (except the epi pen).

Diabetics give themselves injections, patients give them selves Lovenox injections, B-12 injections, do you think they had any kind of training? No, the nurse said, "Poke here."

I was a Pathology Assistant, I performed autopsies and dissected surgical specimens. I did not always know what I was looking for, but I knew the technique. I was an on the job trained Perfusionist with the local Organ Procurement Organization. I was part of the surgical recovery team from organ donors to recipients.

People can be trained. Now, I was interested and wanted to know why I was doing things the way I was doing them, so I asked questions, had a great mentor, and have gained a tremendous amount of knowledge.

Now, my whole point to this is why hate on the Basics? With out the basic skills, you have a dead person, so why do you feel that you are so much better? I didn't become an EMT because I wanted to be a hero or degrade Emergency Medical Responders because I have more education than them. We are all here for the same thing and that is to help people. If we want respect from our peers and the public, we should also respect each other:-)

P.S. Don't be hating on me because I can intubate as a Basic in Ohio! :-)

Don't be hating on me now! I'm a newbie:-)

Why do basics always seem to claim that once someone gets a higher education they no longer can do the abc's? That is a bad arguement.