The final US NationalScope of Practice model/Draft..

[Ridryder 911]

I say let us start a petition to scrap the entire education and training programs ! Clean sweep, all of them ! Let's go like every other healthcare agency... 2 yr minimal college, then about 1 yr experience. Hey, it works for everybody else, and apparently what we have does not work.....

The guys giggle and laugh when they watch old Emergency episodes .. and how dated they are.. then you, think.. there are some communities that still can not offer what they did then... 32 years ago.. so how far have we really become ?.. the system to be point blank sucks! .if we analogized EMS as a patient we would had signed a DNR long time ago......

Be safe,

R/R 911

[PRPGfirerescuetech]

I say let us start a petition to scrap the entire education and training programs ! Clean sweep, all of them ! Let's go like every other healthcare agency... 2 yr minimal college, then about 1 yr experience. Hey, it works for everybody else, and apparently what we have does not work.....

The guys giggle and laugh when they watch old Emergency episodes .. and how dated they are.. then you, think.. there are some communities that still can not offer what they did then... 32 years ago.. so how far have we really become ?.. the system to be point blank sucks! .if we analogized EMS as a patient we would had signed a DNR long time ago......

Be safe,

R/R 911

nows that time to do that, where it would be the most understandable...

[EMT*Sweet]

Ok I"m behind.. Can someone send me the link to the EMS Scope of Practice? Thanks

[paramedicmike]

The link is in the first post to this thread.

[Nate]

Yeah, this whole thing sounds like yet another waste of money. I seriously hope they don't expect those of us that are "certified" paramedics to take a reduction in pay/promotions/and skills simply because we don't have some bull sh*t 2 year degree that is not worth jack sh*t.

Give me a degree plan that is worth somthing and I'll take the time to get it, but an AAS in EMS is worthless around here if you ask me. Heck there isn't even any chemistry, let alone organic or micro.

[Ace844]

Hi All,

I agree with the comments that "Rid, Dust, and PRPG," et.al. have posted and echo their setiment. I guess in addition to the concerns listed I have a few more.

"Statistical analysis and research on patient safety, scope of practice, and EMS personnel

competency must become a priority among the leadership of national associations,

Federal agencies, and research institutions. When EMS data collection, subsequent

analysis, and scientific conclusions are published and replicated, later versions of the

National EMS Scope of Practice Model should be driven by those findings."

HMMMM...I understand their desire to want to move more towards "evidence based" medical practice in EMS. Yet, it seems to me that to disregard "our current collective pracitice experiences" would be foolhearty at best. Based on this model, (if adopted) progressive EMS systems (Seattle, Richmond, and others) would actually be forced to take a few steps backwards. I had hoped that we as a profession had learned alittle something form the AHA blunder that occurred when it changed its guidelines in 2000 (i.e.:Amiodarone, hypothermic cardiac arrest management, etc..), and that we would not follow a similar path.

Now some of the contradictions that were mentioned.."Each State has the statutory authority and responsibility to regulate EMS within its borders, and to determine the scope of practice of State licensed EMS personnel. The National EMS Scope of Practice Model is a consensus-based document that was developed to improve the consistency of EMS personnel levels and nomenclature among States: it does not have any regulatory authority."

BUT later they say.. "The adoption of skills and roles beyond those proposed in this model will diminish national consistency, interstate mobility, and legal recognition for EMS personnel.

Additionally, content in future national EMS education standards, national certification

examinations, and curriculum-focused aspects of national accreditation standards will not

include those additional skills. States opting to exceed the skills identified in this model at any given level should do so with caution and purpose. Those States choosing to do so should only add skills from the next higher level (i.e., they should not “skip levelsâ€) and are discouraged from exceeding those skills identified in the National EMS Core Content. “Skipping levels†represents a large increase in cognitive complexity and patient risk and should therefore be avoided. Some States permit licensed EMS personnel to perform skills and roles beyond the

minimum skill set as they gain knowledge, additional education, experience, and

(possibly) additional certification. Care must be taken to consider the level of cognition

necessary to perform a skill safely. Particularly problematic skills are those that appear

simple to perform, but require considerable clinical judgment for an individual to know

when they should, and should not, be performed."

So if I am reading this correctly they are basically saying that this is the basis to bring states in line with our policy, and if you don't do so, we will eventually force you to comply. Next they say that in the implementation of additional skills the states shouldn't "skip levels", yet they themselves do do with the addition of some of their newly proposed "BLS" and "advanced EMT" skills.....such as: Manually Triggered Ventilator (MTV)<<seems to me they took "Demand valves off the trucks for a reason>>, Automatic Transport Ventilator (ATV)<<<What without being able to "Intubate, or even understand the phys and mechanisims behind the what/why/how of this>>Later they state that the "understanding of the 'basic-AEMT' should be "EMT and AEMT-Critical component areas i.e.:critical illness:understanding of principles and phys of these patients should only be::'Fundamental'. Then for 'Emergent Patients':'SIMPLE' ...:scratch:

The whole document goes on and on with such contradictions, etc... and in general a "decrease" in our professional abilities and standing....So the question is, WHAT ARE WE GOING TO DO ABOUT IT!?!??!?!?!?!

out here,

ACE844

[vs-eh?]

Yeah, this whole thing sounds like yet another waste of money. I seriously hope they don't expect those of us that are "certified" paramedics to take a reduction in pay/promotions/and skills simply because we don't have some bull sh*t 2 year degree that is not worth jack sh*t.

Give me a degree plan that is worth somthing and I'll take the time to get it, but an AAS in EMS is worthless around here if you ask me. Heck there isn't even any chemistry, let alone organic or micro.

It is a good thing you aren't in Ontario.

[Nate]

It is a good thing you aren't in Ontario.

When I looked into the degree and saw that it would set me back from getting my biology degree, that I would have to retake EMT-B (because I earned mine while in high school), that some of my classes would have to be taken over because they weren't for the allied health professional, I saw it was pointless.

The whole degree thing is great, I support it; but I think they need to require a degree that is worth something and requires you to take some actual science classes other then A&P and Biology and basic college math (for a degree here in Texas). I've always said it should be a four year degree similar to nursing in regards to chem, physics, micro, A&P, psych, soci, trig, and calc. Up until a year ago anyone with a college degree (60 hours or more) could get LP status here in Texas (licensed paramedic).

The thing is that there is no difference between what an LP is taught and what a certified paramedic is taught here in Texas. They still get the same paramedic course, still can do the same skills, etc. So why should there be a pay difference and a skills reduction for the certified paramedic when the one with a degree is no better off and in my case I hold more credit hours in advanced maths and sciences then what is required for the LP patch.

[Ace844]

Here's some cross posted links which have to do with this discussion....

Enjoy,

ACE844

http://www.jephc.com/full_article.cfm?content_id=337

http://www.jephc.com/full_article.cfm?content_id=356

http://www.findarticles.com/p/articles/mi_...i_90987569/pg_3