No MEDICS!

[aussiephil]

As far as medic skills go, how can you deny some one the skills of a medic, just think about a code worked at an ILS level, lets say by the time the patient goes down to the time that the ambulance is on scene its been at best 5 minutes AT BEST! lucky for the patient the department really goes out of their way to teach lay person CPR Now the two ILS crews of 2 people each, secure an airway and start CPR with AED start and IV all while trying to load the patient up in the unit and get in route to the hospital. by the time this is all done almost always 20 minutes has lapsed, or more. Now its time for the 5 minute drive to the hospital, two of your members have left one driving each ambulance, while the two riding are messing around with BVM,AED, EPI, Radio report.... am I forgetting something? ah darn!, I knew it! CPR! Something has got to give guys! are 8 minute chain of survival is long out the window.

Without readin too much, what is the priority whe a person suffers a cardiac arrest? Is it airway? No, Is it breathin them up? No. Is it defibrillation? No. Is it gaining IV access & dru administration? No.

Simply it is effective CPR.

Do I need to be a medic to perform CPR? I don't think so. Relity tells us survival rates are minimal, regardless of Basic. Intermediate, Medic, or doctor.

[spenac]

The big reason for Paramedics is to stop a code before it begins. WHAT YOU SCREAM? You get on scene and find the patient it name the arrhythmia and out of your magic box you inject them with you name the drug and arrhythmia improves and you now transport them for definitive care and they return home intact. WHY YOU SCREAM? Because you practiced preventive medicine. An EMT-I or just an emt has to wait until the patient dies. DIES YOU SCREAM? Yes dies because once pulse less they are dead, so you as an emt or EMT-I just sit there going wow this guy looks bad wish I could do something. BAM he's dead now I can do something so you start CPR hook up AED and in the end deliver a corpse to the hospital all the while claiming nobody dies in my ambulance. Everyone that claims that is a liar or just stupid? HOW DARE YOU YOU SCREAM!!!! Yes you are ignorant because if you are doing CPR they are dead and just because they are not legally pronounced means nothing they were dead in your ambulance and death was just confirmed in the ER.

SO PARAMEDICS ARE NEEDED SO PEOPLE DO NOT GET TO THE POINT OF BEING DEAD IN OUR AMBULANCE OR ELSEWHERE!!!!! No we are not going to stop every patient we treat for an arrhythmia from dieing but at least we are giving them a true chance. SO yes every ambulance should have a Paramedic.

[zippyRN]

<snip>

Speaking from an international perspective the "less levels with higher education and scope of practice" is certianly the trend; Canada and Australia have already done it (can't speak for the NT/WA systems at all there), New Zealand is moving towards such a system over the next little while and well I'm not sure what to make of what the UK has done with the "Emergency Care Assistant" thing.

Emergency Care Assistant roles, especially the band 3 roles were a management bloody nose to the 'uppity' Techs who thought they should get band 5 pay same as a paramedic, in a few services they did get band 5 e.g. the London EMT4 role and the Yorkshire AS 'TWAT' role ... it was done to prove a point and for a cash saving

Band 4 Assistant practitoners is another cash saving idea, they are what techs 'should' have banded at and what some services banded their techs at- their job evaluation score is kept down by removing the creep of extra decision making that got techs into band 5.

Overall the UK is now closer to a Paramedic on every Emergency Ambulance than it ever was before because of 2 main factors

1. more direct recruitment to planned out 'Student Paramedic' pathways i.e. where there is a 'course' in place from the beginning rather than sending people on a tech course + driving and then saying you have to keep applying for para courses as they come up ...

2. ECAs and APs to backfill techs being abstracted to attend Paramedic training ( whether that's 'quick and dirty' IHCD courses or seconded out to HE based Diploma/ foundation degree), as this was one of the issuesi nthe past with releasing people for Paramedic courses.

Edited February 4, 2011 by zippyRN

[EMS2712]

I can full understand the original poster's situation, as I have been in a similar situation when I was first going to Paramedic school. I worked part-time for a County EMS system in Ohio, who won't transition to have some true ALS Paramedic level service in the county. I have seen several EMT-Paramedics that worked their while going to school, only to be run off by the "old guard" of the department. Countywide if you are a Paramedic you have to function as an EMT-Intermediate level. The reason I have been given for not going to paramedic level include the following:

We have gone without Paramedics for 25 years why do we need them now?

We don't want to alienate the EMT-Intermediates who work here because of your skills.

What can Paramedics do that I can't, it won't make a difference.

I have learned to bite my tongue on many occasions. Has anybody else dealt with this?