Difficulties with Paramedics as EMT's

[PRPGfirerescuetech]

I think dj is spot on here. If I'm working with a new basic or even a basic that I have never met before I NEED to be absolutely sure of where that person stands before we get put into a situation where a patients life could be effected by it. The highest level provider is responsible for AALL patient care regardless if they are in the front or back, attending or not. If something gets missed or a tx is not performed that its going to fall onto the ALS proveder and, "i thought my basic had it covered" is not going to be a good enough excuse.

I NEED to know if the person I am working with is actually someone who will be usefull and know a thing or two about patient care or if they are just a couple hundred pounds to fill a seat for twelve hours. While you are in the middle of a hairy call is not the time to find out that your BLS partner is not capable of performing their BLS skills and I owe it to my patients to make sure they are not put on the recieving end of that particular situation. There is nothing "god like" about any of this in my books.

This is not however a two way street. I have already prooved myself with years experience and my ACP certification and the suggestion of proving I know the adverse effects of every med I push is absurd. 90% or better of all the basics could probably not tell me what I can give for drugs let alone any of the indications, contraindication, adverse effects or dosages.

Any basic that says they can walk onto an ALS truck with a partner they have never met before and have nothing to prove is wrong, or their partner doesn't care enough to investigate. I however care about my livelyhood and my certification and I'm not going to let anybody else ruin that.

As a side note, I'm talking about basics that have completed a year long education with proper hospital and ambulance preceptorship, not the 140hr first aid course that is common in the states. So you can just imagine what I would think if in DJs shoes.

You havent proved a thing to any new partner. The point of the statement I made was simple.

If you screw up, we are BOTH liable in the eyes of the court system. Period. If I need to prove myself, my abilities and my competence, so do you.

I dont care if you have 30 years in. Let me do my job, and you do yours. Want me to show spineboarding, hare traction, and ALS assist skills? No problem. Tubes, lines, and med reactions please. thanks.

Its my job to find out how you work. A few questions on your style, and were set. You want to know how I work? Sure. Few questions, and were set.

I'd love to see a MD who asks the nurses to perform skills to "make sure they have their stuff down" on their first day working together. Bullshit.

[ncmedic309]

Plus 5 to both of the last two posts! :thumbright:

[Dustdevil]

Side note, is every medic here unintelligent because they didnt progress to nursing, PA, or MD school?

Invalid analogy. Separate fields. Separate professions. Apples to oranges.

Stagnating within your own field is not the same thing as progressing in your own field and not moving to another.

A more valid analogy would be to ask if every medic who doesn't progress to a college education and advanced certifications is an idiot. And my answer to that would be yes.

It is also invalid to hold yourself as a common example, because clearly you are not common. Just like one bad EMT doesn't make them all bad, one exceptional EMT doesn't make them all good either.

[Scaramedic]

Did being an EMT help be a medic? From my experience as an EMT, I will never forget:

1. The siren has three modes. Slow, fast, and real fast.

2. You have to screw the regulator on real tight or else it goes PSSSSSHHHH very loud.

3. You have to push the button on the side of the radio mic or else no one can hear you.

4. People are heavier than they look.

5. BLEEDING is BAD. Put PRESSURE on the BLEEDING to make it stop.

6. When in doubt, call the medics.

7. BROKEN BONES are also BAD. Keep them from MOVING to prevent the person from being in PAIN.

8. The NRB goes on the FACE.

9. Push fifteen times on the chest, THEN put in two breaths. Repeat until the medics get there.

10. Put the AED pads on FIRST, then turn the machine ON.

This is just to respond to all of the "Medics were EMT's.... and BLS before ALS" stuff on here. I had to learn to tie my shoes at somepoint before I could even become and EMT, too, but no one seems to harp on that much. You know what's even more important to be a good medic than being a good EMT? Anatomy and Physiology, Pathophysiology, and Pharmacology. They are infinitely more important to the successful treatment of a patient than BLS skills. Yep, you heard me. Good CPR will keep a patient viable, and it is very important to do correctly, and if you can do it well, you will be the vital part of a chain that can save someone's life, but you know what? It won't stop an asthmatic from going into respiratory arrest. It won't reverse a narcotics overdose, it won't stop and anaphylactic reaction from progressing or keep a rapidly slowing down heart from coding.

To add a few from way back when....

1. MAST trousers are indicated for hypovolemic shock.

2. The purple box is what the Paramedic gives to make the pt's heart go real fast.

3. The Paramedic gives the shot with a really long needle that he sticks in the chest.

4. You must change the siren every 30 seconds or it will hypnotize you and you will die!!!

and my personal favorite, I swear I am not making this up......

5. If you feel the need to wear gloves there's a box under the bench somewhere.

Peace,

Marty

:thumbleft:

[Nate]

I think I'm going to need a rescue boat with all of the crying going on. Freaking flood waters are getting high.

[PRPGfirerescuetech]

Invalid analogy. Separate fields. Separate professions. Apples to oranges.

Stagnating within your own field is not the same thing as progressing in your own field and not moving to another.

A more valid analogy would be to ask if every medic who doesn't progress to a college education and advanced certifications is an idiot. And my answer to that would be yes.

I meant on a more broader scale, a overseeing medical provider, working over several others, accomplishing tasks. Medic works over EMT, with EMT working independantly.

Just the same.

Your analogy is also invalid. Every medic should get the advanced certifications in their field I agree. But are they an idiot if they dont move into higher practice? No.

Just like a basic isn't an idiot if they stay a basic.

*ding* Whos next?

[Dustdevil]

Your analogy is also invalid. Every medic should get the advanced certifications in their field I agree. But are they an idiot if they dont move into higher practice? No.

Just like a basic isn't an idiot if they stay a basic.

Still doesn't work out as an analogy. The issue is being the best you can be within your field. The issue is not moving into a completely different field. And the issue is not moving into supervision or management within your own field.

While "idiot" may well be an inappropriate term, if you do not strive to be the best you can be in your field, you are indeed less than desirable and have professional issues that need to be resolved ASAP.

Unless maybe what you are saying is that EMT and Paramedic are, or should be, completely different professions? If that is the case, then, in that context, your point may indeed be valid.

[nsmedic393]

You havent proved a thing to any new partner. The point of the statement I made was simple.

If you screw up, we are BOTH liable in the eyes of the court system. Period. If I need to prove myself, my abilities and my competence, so do you.

I dont care if you have 30 years in. Let me do my job, and you do yours. Want me to show spineboarding, hare traction, and ALS assist skills? No problem. Tubes, lines, and med reactions please. thanks.

Its my job to find out how you work. A few questions on your style, and were set. You want to know how I work? Sure. Few questions, and were set.

I'd love to see a MD who asks the nurses to perform skills to "make sure they have their stuff down" on their first day working together. Bullshit.

Perhaps the laws are different in Canada. I'll sum it up, here as far as patient care is concerned, the highlest level of certification is in charge of the call and the highest level of certification will swing from a branch before anybody else does if something goes wrong. Like I said, maybe its different where you are from but here the BLS providers, unless functioning with annother BLS provider bear almost no responsability for what happens on a call.

With that ebing said, since its my arse on the line I have nothing to prove to a BLS partner. Its not like I give each new partner a quiz before the shift, but if i suspect that they don't know whats going on I am going to probe deeper. How you go about completing a simple truck check can proove loads about what you know. ie, where the stock is, specific pieces of equipment, operation of the defib and so on...

You say to let them do their job and we should take care of ours? Thats a load of crap. Our job is patient care. Its not two seperate deals. However, as stated above, when it comes to patient care I AM THE BOSS, peried end of conversation.

[Nate]

Our job is patient care. Its not two seperate deals. However, as stated above, when it comes to patient care I AM THE BOSS, peried end of conversation.

Amen brother. =D>

[EmergencyMedicalTigger]

Just like a basic isn't an idiot if they stay a basic.

*ding* Whos next?

I don't think there is anything wrong with a basic who wants to stay a basic. Some are really good basics. They've mastered the skill and they want to stay at that cert level. Some choose to go on to the next level because they got tired of giving 02 and taking blood pressures. However, just because you become a basic does not mean you should be pressured into advancing your cert level since that's what other people do. Yeah, it's really neato to start intubating and sticking IVs at the Intermediate level, but you have to also be prepared to take on a leadership role. If you're on a truck without a paramedic - it's just you and the basic - guess what, you're the lead on the truck. There are basics who go through Intermediate who do well in the class, but don't test at that level because they're not ready for that leadership role. But if they're awesome basics, then what is that hurting? They're smart people who do their job well.

I do agree that no matter what cert level you are, but especially basics, should have additional training such as BTLS, PHTLS, etc. to expand their knowledge base and to be a better EMT.

I know a couple people who went on to paramedic for the money and the special letters at the end of their name, but they have no business being paramedics. They suck at basic patient care and they're afraid to push drugs when they should be.