Preventative Paramedicine

[Kim_Possible]

This is an area, I am very interested in being involved. Maine is beginning this concept in rural areas. One of the Maine Comm Colleges has started a program, you must have at least an associate's degree in order to participate in the program. Yet, I am a certified paramedic.

I find this to be great for EMS. It gives another area of advancement in EMS, and a great outlook to its future. The use of EMS, in some aspects, has worn down the financial aspect of healthcare. I am not saying at all, do away with what we do now, or is unimportant, or is the reason for the current financial difficulties in healthcare. Yet, anyone who is involved in EMS knows that quite a few in the system, are illiterate to using it properly or know they are taking advantage of it. How many times on responses have we wanted to say, you don't need to go to the hospital. As a paramedic, my protocols state, I cannot insinuate to a patient not to go to the hospital or else it will end up in the revocation of my license. It would be wonderful if the practice was expanded that this could happen. I am not saying take medics without the proper training to do this.

National Registry standards are looking to extend the scope of practice of paramedics in many areas. It just gives so many other options in EMS. I will be continuing into nursing, but I want to be able to pursue this initiative. The only reason I am continuing towards nursing is to give credibility in Community Paramedicine. Out of facility healthcare I believe is the future. It is not a replacement, just another tool that will help to educate and serve society.

[rock_shoes]

Herbie, I'm not saying paramedics shouldn't be able to. Like others have said, most of it is basic stuff. The thing that would make me concerned is giving out medical advice. As Dwayne said, there are so many differences in the training that paramedics receive from state to state, county to county. You guys are awesome at knowing everything there is to know about resuscitation drugs (hell, you guys could probably teach me a few things). Counseling people about medications can be on a slippery slope to practicing medicine. Do I think paramedics are capable of it? Absolutely. Do I think that with the huge variation in training it is a good idea? I'm not too sure about that.

Excellent point. The US is likely going to be one of the last countries to have such programs because the US has the greatest variation in education. Countries like Canada, Australia, New Zealand, South Africa can be expected to lead the way because with current educational standards providers in those countries are looking at a minimum of three years educational time to become ALS providers.

All that said, I still believe developing a practitioner role will require further education beyond that received to become an ALS provider even in the above mentioned countries. It's all about goals of care. Even a Canadian Critical Care Paramedic who essentially runs a mobile ICU has little to no training in chronic care for the elderly dementia patient. They know how to knock them down with benzos and haldol if they have an acute psychiatric episode, but that's about it.

[Bieber]

We should learn from the Fire Monkeys. Getting people to stop calling 911 is bad for our futures, just like fire education has basically made all Fire Departments an EMS Department, as true fires have almost been eliminated through education and better building codes. Be careful what you wish for on this one.

Preventing disease and unnecessary emergency medical care > our jobs.

If we want to assure our own job security, it can't be at the expense of patient care. It's about them, remember?

Also, assuring our own job security means embracing preventative care models and become proactive in this area of medicine. At the end of the day, we're already doing a lot of primary care and a little bit of emergency care on the side; what we need now is the training and education to give that primary care without unnecessary transport to the hospital being a necessary component.

I foresee the future of EMS as transitioning to Mobile Health Services, where more and more we give people the care they actually need and less "magical" care; i.e. transporting a patient to the hospital for a simple lac that needs sutures as if that's the only or correct option.

There you go, singling out the black people. You are such a racist cracker.

Seriously though, are paramedics, with the current state of education, er, training, really the best people to be doing this?

Currently? Maybe, maybe not. We talk a lot about how inadequate paramedics are at providing primary care, however primary care health issues are what make up the majority of our jobs. We've got the experience, now all we need is the education to pair that with; and there's no reason why a paramedic can't be adequately educated on the appropriate provision of primary medical care.

Herbie, I'm not saying paramedics shouldn't be able to. Like others have said, most of it is basic stuff. The thing that would make me concerned is giving out medical advice. As Dwayne said, there are so many differences in the training that paramedics receive from state to state, county to county. You guys are awesome at knowing everything there is to know about resuscitation drugs (hell, you guys could probably teach me a few things). Counseling people about medications can be on a slippery slope to practicing medicine. Do I think paramedics are capable of it? Absolutely. Do I think that with the huge variation in training it is a good idea? I'm not too sure about that.

In all fairness, I think many if not most paramedics already do give medical advice to their patients. I know I do.

[rock_shoes]

I foresee the future of EMS as transitioning to Mobile Health Services, where more and more we give people the care they actually need and less "magical" care; i.e. transporting a patient to the hospital for a simple lac that needs sutures as if that's the only or correct option.

In all honesty, this is where EMS is headed whether we like it or not. Rather than fight it we had best spend our time conducting educational gap analysis to determine how we can best educate providers to fill our new role.

[DwayneEMTP]

...We talk a lot about how inadequate paramedics are at providing primary care, however primary care health issues are what make up the majority of our jobs. We've got the experience, now all we need is the education to pair that with; and there's no reason why a paramedic can't be adequately educated on the appropriate provision of primary medical care...

+4

I was going to give you a +2, but then saw what appears to be a properly used semicolon and felt that that was worth at least two more....Just sayin'...

Excellent point above I think...