EMT-ENHANCED - will be taking this test soon.....any advice?

[Dustdevil]

There's a reason why paramedic schools are as long as they are.

Yep. It's because the fire chiefs won't let us make it any longer.

[Scaramedic]

Yep. It's because the fire chiefs won't let us make it any longer.

I for once strongly agree with you on that one Dust. :thumbright:

I would say more but it might be considered a hijack.

Peace,

Marty

:thumbleft:

[Just Plain Ruff]

7Fissy There is a lot of good advice here. Dust gives his point of view and He's a good guy (really dust you are). There is differing point of view. You ask for advice and you get it. YOu get good advice and you get bad. Some people (recently) have not liked the advice and have come back with insults. You get what you ask for. A lot of us here have more experience out there in the field than some people posting here have been alive. I for one have almost 20 years of ems and ER experience so a lof of us have seen everything before and some of us have seen even more than that. Take whatever advice you want to take and leave the other advice to the side.

If you spend more time here you will see that most advice given here is spot on and excellent advice. Some have different ways of putting things, some are more abrasive than others, some sugar coat it more, it just depends on that person.

If you get offended or angry at this stuff then I'd hate to see how you react out in the field. Not saying anything disparaging but you seemed a little upset by Dust's post.

I don't agree with the insanity out there of multiple certifications but my opinion is that if you dumb down programs enough you get a bunch of dumb people

2 maybe 3 certifications or levels is enough but to have more than 5 in some states or so that is getting out of hand.

[rescue1531]

:? I think that saying EMT-E is a short cut is aweful. I mean think about it, there have been many calls in which I went on as a basic when I knew the patient just needed an IV to get a blood pressure up or could have used a breathing treatment because of asthma or some other problem. Isn't airway one of the MOST important parts of EMS? As an EMT-E that is one of the things I can do and that is protect an aiway. Also not all patients need a cardiac monitor placed on them. I am not saying that there are not times that I do not go on calls and need some more ALS backup but with what I can do it does help. Just think! In today's society many people do not feel the need to go to school as long as others but want to help the community. I do plan on going up another level but some people do not want to. The fact is nothing is really better than the basics...and that is something I have learned that a lot of ALS providers like to skip. I took the enhanced class in 5 months and I know some of you refer to it as being easy well things have changed and that state test is hard! We had 5 out of 10 pass and had a great instructor who had a 97% pass rate the past times. I believe that there will always be that middle section between EMT-B and Paramedic and I believe it is a good thing. Of course, that is just my opinion. I do agree somewhat with you all that there should not be so many levels I think there should be EMT-B, I and P. :? sorry just the way I feel.

EMT-EN

[scope2776]

I agree with most of what has been said here.

Plain and simple, there should only be two levels of prehospital providers. EMT-Basic and Paramedic. I think it's best not only from an education and patient advocacy perspective, but from a public perception angle. I already have to correct enough people calling me an "Ambulance Driver", I don't want to have to deal with people mistaking me for an Intermediate or whatever. Hell, not only does the general public have a hard time understanding what we do and the medical interventions we provide, most of our colleagues in the medical services have no idea either. I think it's just ridiculous that there are such things as EMT-Epi and EMT-Defib. I think as members of professional agencies such as the NREMT or NAEMT - or whatever state EMS agencies we belong to - we need to advocate the removal of recognition for these "Intermediate" levels.

I've heard the argument that not recognizing Intermediate levels will hurt rural areas. This is simply not true. If you want an expanded scope as an EMT for your special circumstance, then have a conversation with your medical director. And if the state doesn't allow some expanded practices, then have a conversation with your congressman. That's how it's supposed to work. Maybe your medical director could actually train and sign off your EMTs on the special skills. Or hire a Paramedic!

As a Paramedic student just finishing up school I feel like I have such a basic and entry-level knowledge of advanced care and cardiology/pharmacology. It's hard to describe, but it's like i'm on the cusp of ALS, and I think any education level below Paramedic, such as Intermediate, that picks and chooses ALS skills - not focusing ALS education or mindset, just skills - is below that entry-level understanding. And this cheats patients.

Whereas there is increasing pressure for Paramedics to justify practices such as intubation or the administration of cardiac drugs. And whereas many other ALS providers are continually challenging the Paramedic's ability to provide certain interventions based on lack of education. Then there is little if any justification for Intermediates to provide the same advanced skills.

Furthermore, I think it would be a great idea to increase the EMT-Basic curriculum to absorb some of the Intermediate stuff and requiring Paramedics to have degrees. But hey, that's a whole other conversation.

whew... my 50 cents.... lol

[dahlio]

Study the Skill Sheets. I never had a problem doing the sit down tests, but when it comes to the actually skills, I tense up. See if you can stay after with an instructor, or can study with other classmates. Good luck on your test!

I agree with most of what has been said here.

Plain and simple, there should only be two levels of prehospital providers. EMT-Basic and Paramedic. I think it's best not only from an education and patient advocacy perspective, but from a public perception angle. I already have to correct enough people calling me an "Ambulance Driver", I don't want to have to deal with people mistaking me for an Intermediate or whatever. Hell, not only does the general public have a hard time understanding what we do and the medical interventions we provide, most of our colleagues in the medical services have no idea either. I think it's just ridiculous that there are such things as EMT-Epi and EMT-Defib. I think as members of professional agencies such as the NREMT or NAEMT - or whatever state EMS agencies we belong to - we need to advocate the removal of recognition for these "Intermediate" levels.

As messed up as New Jersey EMS is as a whole, I think that's one thing that they got right. Two basic levels of training. This provides for good reciprocity to other states, as well as clear cut scopes of practice. This way you can't say, oh he's an EMT- Intermediate, and say, well, he's got IV training, why not just let him push medic drugs too. There is too close of a relationship between each specific certification. If you want that, why not have EMT 1, through EMT 10. 10 being the best :roll: . I like the idea of the two, clear cut.

Also, I like Emoticons

:wav:

[EMS49393]

:? I think that saying EMT-E is a short cut is aweful. I mean think about it, there have been many calls in which I went on as a basic when I knew the patient just needed an IV to get a blood pressure up or could have used a breathing treatment because of asthma or some other problem. Isn't airway one of the MOST important parts of EMS? As an EMT-E that is one of the things I can do and that is protect an aiway. Also not all patients need a cardiac monitor placed on them. I am not saying that there are not times that I do not go on calls and need some more ALS backup but with what I can do it does help. Just think! In today's society many people do not feel the need to go to school as long as others but want to help the community. I do plan on going up another level but some people do not want to. The fact is nothing is really better than the basics...and that is something I have learned that a lot of ALS providers like to skip. I took the enhanced class in 5 months and I know some of you refer to it as being easy well things have changed and that state test is hard! We had 5 out of 10 pass and had a great instructor who had a 97% pass rate the past times. I believe that there will always be that middle section between EMT-B and Paramedic and I believe it is a good thing. Of course, that is just my opinion. I do agree somewhat with you all that there should not be so many levels I think there should be EMT-B, I and P. :? sorry just the way I feel.

EMT-EN

Oh, Lord. There are so many things here that disturb me aside from the fact that they added yet another level to EMS.

First - EMT-EN is a shortcut. Period. You weren't in school long enough to become a paramedic, therefore, you took a shortcut. Everyone has heard all the excuses for not becoming a paramedic.

Second - How do you know that sometimes the only thing a patient needs to raise their BP is an IV? What are all the processes that can cause a drop in blood pressure? We'll just pick one. How about cardiac failure? Did you learn 12 and 15 lead interpretation? Can you assess a patient well enough to bet the bank they're not experiencing pump failure before you dump a ton of fluid on them? The alternative to drowning a patient is an inotrope. Bonus points if you learned what an inotrope was in school. Double points if you can name two inotropes.

Third - Is a "breathing treatment" really all some people need, or is it all you are able to provide at your advanced level? What exactly is your "breathing treatment?" Are you using Albuterol, or the Albuterol/Ipratropium combination? So you can fix a garden variety asthmatic, brilliant. Now fix the "some other problem" crashing CHF'er or the exacerbation COPD patient.

Fourth - This notion that you're helping your community by letting them think you're a paramedic is mind-boggling to me. I often wonder what the public would think if they knew how completely jacked up the EMS system is. Do you think a patient would want to see a Physician-EN over a Physician - Physician? Being seduced by educational shortcuts is not helping our plight to be seen as professional clinicians.

Finally - I like my monitor. I use it often. It's not invasive, minus the sticky residue. It's saved my behind a few times during my assessment process. I run a lot of 12 and 15 lead EKGs. I like them. It rarely changes my treatment modalities. I also like capnography. I like the idea of being able to listen, touch, and see things on my patients when I assess them.

I realize I hijacked this thread, so I'll close with my advice on passing the test...

Go to a good paramedic school, study hard, listen, learn, then take the paramedic test. In this job, you are not the only person you are cheating when you do not obtain the full education.

[Asysin2leads]

:? I think that saying EMT-E is a short cut is aweful. I mean think about it, there have been many calls in which I went on as a basic when I knew the patient just needed an IV to get a blood pressure up or could have used a breathing treatment because of asthma or some other problem. Isn't airway one of the MOST important parts of EMS? As an EMT-E that is one of the things I can do and that is protect an aiway. Also not all patients need a cardiac monitor placed on them. I am not saying that there are not times that I do not go on calls and need some more ALS backup but with what I can do it does help. Just think! In today's society many people do not feel the need to go to school as long as others but want to help the community. I do plan on going up another level but some people do not want to. The fact is nothing is really better than the basics...and that is something I have learned that a lot of ALS providers like to skip. I took the enhanced class in 5 months and I know some of you refer to it as being easy well things have changed and that state test is hard! We had 5 out of 10 pass and had a great instructor who had a 97% pass rate the past times. I believe that there will always be that middle section between EMT-B and Paramedic and I believe it is a good thing. Of course, that is just my opinion. I do agree somewhat with you all that there should not be so many levels I think there should be EMT-B, I and P. :? sorry just the way I feel.

EMT-EN

EMS49 took care of most it for me, but I'll throw in my $1.96. First of all, those patients where you could "just tell" that they needed fluids? You couldn't. You can't "tell" if someone is simply hypotensive from dehydration until you rule out a cardiac cause. You rule out a cardiac cause by using an EKG. Same with asthma. Until you rule it out with an EKG, its never just asthma, particularly in anyone over the age of 40.

Secondly, if you want to help the community, but don't want to go to school to learn proper practice, feel free to collect donations for the needy, read to kids at the library, pick up garbage, help old ladies to cross the street. Playing with human lives is nothing to be taken lightly, even with the best of intentions.

Lastly, basics are just that, basics. I can't get to the call if I don't tie my shoes, but no one ever harps over how important it is to learn proper shoe tying. I mean, it is important, don't get me wrong, but we kind of just assume it.

You know something, there are people out there, really awful people, who create these levels knowing fully the risks involved and fully the consequences, and still dangle them out there for well meaning people to snap up so they save a few bucks. I can't imagine the horror and panic that goes through an inadequately prepared provider when the crap really hits the fan. Someone out there things its a good idea to have kids doing invasive procedures and surgical airway techniques on critical patients, because they know if things go bad, they aren't going to be the one losing everything when the tort lawyers come calling. Me, I think its just plain wrong.

[Ridryder 911]

Just amazing it is always the lesser trained poorly educated ones informing us what is needed for patients and desired levels. The same being of those that develop levels to dilute and make levels to excuse the needed education levels to perform adequate patient care. Another way to get cheap and poorly trained individuals...

Let's just call it like it is and really place a new level with the patches and card's etc.. Pseudo Paramedic or P P for short !

R/r 911

[JakeEMTP]

Let's just call it like it is and really place a new level with the patches and card's etc.. Pseudo Paramedic or P P for short !

R/r 911

:laughing3: :notworthy: