Boston EMS

[Ridryder 911]

Are you aware your Brady book is written at a 10th to 11'th grade reading level as well? Want to know why? It is assumed by studies that most Paramedic students cannot read above the Senior level. Makes one proud of a profession huh? Still want to debate the need for education?

Just because you have experience at various services does not make one an expert (might want to look up definition of such). Obvious it is clear you do not have a higher level of education, otherwise we would not be debating a proven thing. I will no longer will debate the values of education with you. It is apparent you do not understand educational concepts, theories and what truly mastery level of standards and skill performance really are. As well, have you not recognized we are the only health care provider that does not require a formal education. Does one not see why our profession is in the crapper? Want better pay, recognition by health care peers, one needs to do the minimum level as everyone did.

You allude to incompetence in the field. Are the current methods of training or educating working? Obviously not, again even you allude to that several times. You can not fix something unless you admit it is broken, and you are right it is broken! They way we train EMS personnel is horrible. That itself is the problem we train, not educate, which would mean one would have to think and rationalize, not just follow protocols mindlessly. Again, there is complete difference between the two. Remember providing health care is not black and white, it is not an exact science, it has an art as well. Making rationale decisions based upon education, and good clinical background experience is essential.

Far as making a statements of incompetence, one better have proof other than field experience. Acting like an idiot and being incompetent is totally two different things. Even saying such or implying such on one, can have grounds for slander.. you might want to look that one up as well.

R/r 911

[JPINFV]

JPINFY: First dont assume everyones EMT class was 120 hours, second I love being and EMT b, third Where I live we are allowed to give alot more then O2

1. Generally, basic classes are 120 hours plus change. Being the exception to the rule does not change the rule. The A/P in the average basic class is just enough so that you might be able to write a decent PCR, but not enough to actually understand what is going on.

2. Um, ok. I like ice cream (ones pleasure with a level doesn't make that level useful or properly education).

3. How often do you actually use those medications? Or is it like OB. sure I'm trained and equipped to deliver babies, but the chance that I might actually do it while in EMS is slim to none.

4. By your own standards, EMT's (remember, you might be the exception, not the rule. We have to talk about the average basic) are incompetent because their education level is "inadequate to or unsuitable for" delivering medical care. An EMT should be more then a gopher or organic blood pressure machine when a medic is present. That will never happen as long as the minimum level of training is 120 hours with no education.

[Ridryder 911]

3. How often do you actually use those medications? Or is it like OB. sure I'm trained and equipped to deliver babies, but the chance that I might actually do it while in EMS is slim to none.

You do realize you just jinxed yourself.... :shock:

R/rr 911

[Ace844]

RichmondMedik

EMT City Freshman

ACTUALLY if you do a little research on Boston H&H you will find they are run by Boston University and are no longer under the city -- so technically they are a private service with a real big ego

Paul

Contrary to your belief RichmondMedik, Boston EMS is not run by Boston University. Boston EMS is a third service agency. The EMTs and Paramedics are city employees that fall under the umbrella of the Boston Public Health Commission. This happened when Boston "Health an Hospitals" was disbanded when Boston City Hospital was privatized and became Boston Medical Center. The affiliation between Boston EMS and Boston University is this: our medical direction comes from Boston Medical Center, and there is a deep training affiliation with BU where there are certain fellowships where they become part of the Boston EMS training division. This meaning that they provide alot of the continuing education and many studies are done using the service. At no point and time is it a private service, or was it a private service. As far as the ego's go. They are the best EMS system on the east cost, possibly the nation. So I guess the ego is deserved.

"fenwayfrankee,"

First off, the only parts of the info. you posted above which are correct are, A.) That Boston EMS is a thrid service under the Boston Public Health Commission. PERIOD. Secondly, before you attack someone who is both a seasoned and highly experienced, medic, educator, and long time poster here it may behoove you to do some research first. "Paul, aka: Richmondmedik," has been doing this career longer than you've been alive. He is from this area of the country and is personal friends with Rich Serino. FYI: They used to be partners. So I am sure he knows as much or more about 'the workings of Boston EMS' as you do.

Next as far as their being 'the best service on the east coast.' That is a laughable assertion and far from fact. There are many reasons to the contrary for this. But just to show I am a fair guy I will apologize after you post independently verifiable facts and studies to back up your position. WHat's next are you going to try and say that 'A-16' is the 'Baddest truck' in the city. I think that the peeps on 'The Edge' would disagree with that..!!!

Lastly, B.) Boston EMS does have a medical control agreement and 'working educational arrangement with BU Med school (I.E.: City and University hospitals) because they HAVE TO. But, they regularly get med. control from ALL THE BOSTON HOSPITALS!! Ego isn't always justified, and we've yet to see that you deserve to have it. SO when you get your act together and man up enough to apologize to 'RichmondMedik' then I'll be waiting.

out here,

ACE844-

[Ace844]

Fenway on this board if EMT's are in anyway invovled in the system it must suck. This is a pro paramedic board where EMTs cant or shouldnt make any medical decision, they should be called paramedic helpers, and there paid way to much. Well they got one thing right most of the paramedics I meet defintley need help.

"Whit,"

There are plenty of basics who post on this board that are treated with respect. More often than not here, like in our profession; one has to prove themselves before being 'taken seriously'. If you act like the medical version of a betty crocker cotjockey. Then you will be treated as such.

It's often how you approach things and what you post here. @ quick examples of this off the top of my head are 'Richard B,' and 'PRPG,'...Ask them and I'm sure you'll recieve a similar setiment.

Hope this helps,

ACE844

[Ace844]

Again, Boston highlights a big problem in EMS. Who is going to work for 4 years at a salary of $637.00 a week for the honor and privelege of maybe someday being a medic? Nursing school looks awfully attractive given those odds. Say what you will about the NYC EMS system, but at least anybody with the guts, brains, and drive to be a medic can get a spot without so much friggin' hassle.

'ASYS,'

Boston medics here have a long history of being lazy and not being willing to do calls. They also have a large reputation for 'triaging down' to BLS, patients that are anything but. Although I am sure this is not a strictly 'Boston,' phenemonon. I hear there is a fair amount of that in the REMAC as well. I agree with the crux of the rest of your post. Hope all is well in Gotham.

ACE

[tinman694]

You do realize you just jinxed yourself.... :shock:

R/rr 911

I don't know nuthin 'bout birthin no babies!

(But somehow I delivered 3 in the field last month--Normal Deliveries w/o complications)

Why is it that any of these discussions always degrades into some type of free for all about education. Although it was by no means scientific, I put forth a poll a while back and rec'd only a paltry response about education levels. Most of the respondants indicated less than an associates degree level of education--but some persist in saying that "more education is the key" (This includes some who cannot use good grammer.) And yes...my grammitaical skills are not perfect, but are better than average.

When you look at the requirements for Boston EMS, it looks like there are so many requirements to have a job there that almost no one would join up--but obviously they are not lacking qualified and motivated individuals to staff the trucks...just look at the hiring web site and see what you find.

When it comes to the rubber meeting the road...we are a specilaized transport service--read movers of valuable goods--we are not doctors--as many would like to think they are--we initiate care for people who are ill and take them to seek the care they need while performing skills taught during training.

That seems to be the intent of the system from the start--why it has become this quasi emergency department on wheels is why so many have problems coming to grips with reality I guess....

ok....enough of a rant....

[Ridryder 911]

Actually tinman, most of the educated and professional medics I know pay no attention to EMS forums. That is why there is the usual same posters. Most profesionals regard these sites as "wanna-bees" and volunteers. Mainly those that really do not represent the true EMS.

How many truly professional medics post here? < 50 .. <25 out of 5000+ members, and these are from hundreds of thousands of professional medics. Says something about the regards of what professional medics really consider in regards about EMS forums.

As far as playing Dr., never professed to be one nor do I have the desire to be one either. However; this does not excuse us from having the knowledge of emergency medical care and providing competent medical care, that education not training can provide. The intent was always to stabilize patient for transport, the definition of stabilization has broaden and will continue to even more. As well, as the "you call.. we haul attitudes" will soon be long gone. The day of the overrated taxi cab is over, insurance/ medicare is tired of feeding them. They expect something in return and the patient should receive it as well. Anyone can load a patient onto a stretcher and transport. Treating and preventing injuries /sudden illnesses is however is a different story.

R/r 911

[JPINFV]

You do realize you just jinxed yourself.... :shock:

R/rr 911

Does this mean I get to write up a case report when my 70 y/o dialysis patient gives birth?

[JPINFV]

Why is it that any of these discussions always degrades into some type of free for all about education. Although it was by no means scientific, I put forth a poll a while back and rec'd only a paltry response about education levels. Most of the respondants indicated less than an associates degree level of education--but some persist in saying that "more education is the key" (This includes some who cannot use good grammer.) And yes...my grammitaical skills are not perfect, but are better than average.

I, personally, have seen how education changed how I look at patients. Just a little background, I'm currently a college student working my way though a bio degree (Dust would call me a part time yahoo out for the adrenalin rush... ). I finally got around to being able to take a human physiology class this school year (first 2 years was genetics, biochem, etc. All those lovely classes where half the information is not clinical applicable). The difference between my understanding of what I was seeing before and after that class was amazing. Simply put, the physio taught to basics is not enough to make any judgment calls. A basic education can be generally summed up as "If the number is out of this range, call medics, if the patient has anything worse then a stubbed toe, call medics." There is not enough to even attempt to decide what level of care is needed. This is a problem for those borderline patients.

When it comes to the rubber meeting the road...we are a specialized transport service--read movers of valuable goods--we are not doctors--as many would like to think they are--we initiate care for people who are ill and take them to seek the care they need while performing skills taught during training.

That seems to be the intent of the system from the start--why it has become this quasi emergency department on wheels is why so many have problems coming to grips with reality I guess....

ok....enough of a rant....

Nurses are not doctors either, yet they have been able to put together a mid-level provider (NPs) and been able to implement different levels of education for RNs. Would you rather have a RN treating you with a MSN or a certificate in nursing? Would you rather have a paramedic with a degree (higher the better) or a certificate?