5 things EMS must do in 2012

[Bieber]

1. Yes. YES! A million times over, YES! I would make EMT an associates and paramedic a four year degree if it were in my power to do so. We're taking care of people's lives and practicing medicine in a semi-autonomous manner... we need more than a high school diploma and a cert from a six month medic mill.

2. Education will change this, but only after the medicare schedule of billing changes too. I can guarantee that the wages we'll see after a medicare change will not be as high as they will if we improve our educational standards, though.

3. Our mission can no longer be to just "treat and take to the ER". Definitive care =/= the ER. Definitive care is whatever care is necessary to resolve the patient's condition, if any aided resolution is needed at all. Sometimes that's the ER, sometime's that's the patient's family doc, sometime's it's us. The idea that the ER is definitive care is nothing more than a treat for the lawyers combined with the cookbook medic's copout for true patient care. We have to think, we have to accept that the cookbook doesn't have all the answers in it, and we have to put on our big boy shorts and realize that if we want to play in the big leagues we're going to have to use our brains a little. What's right for 90 year old septic grandma is not what's right for the uncomplicated asthma attack resolved with x1 inhaler that was only dispatched because their friend didn't know what to do--let alone the high schooler who stubs their toe.

4. See number 3.

5. Patients are humans, and they deserve humane care. Pain should be treated, same with nausea. Emotional distress should be comforted, counsel given, and an extra minute taken to ask about and administer any non-medical palliative care that is warranted (extra blankets, a shoulder to cry on, calling the husband/wife, mother/father, etc). We're not just here to get you alive from point A to point B, we're here to TREAT suffering humans, and to improve our care continuously through constant reviews of the current practices and adjusting them in whatever way they need to be adjusted to make sure that our patients not only make it to the HOSPITAL alive, but OUT of the hospital alive and as much intact as we can make them.

I am not so sure, medics of the 80s had to pass real ACLS, and had less technology to make decisions. As far as ROSC and being released from the hospital in a productive state, I am not sure the numbers have changed a whole lot. To me its is kind of like the new whiz kid from college who got an agricultural degree, battling the farmer who has farmed for 50 years.

If that experienced farmer is one from the Medieval era who has never been exposed to the science of agriculture, and who lacks an understanding of plant biology, ecology, meteorology, advanced production techniques, prevention and correction of adverse conditions and agronomy, and whose entire practice is based principally on anecdotes of trial and error and their ensuing results, then your analogy works great!

There's something to be said about experience, but unless it's paired with formal education, what you're left with is largely anecdotal evidence--which is, at best, anecdotal evidence.