nsmedic393 - this one is for you

[hammerpcp]

You have to understand the history behind this whole thing.

The whole reason the "intermediate" and "special skills" courses were implemented was for trauma resuscitation. This was instituted back in the 1970's when we still thought that a couple litres of Ringers in the field was a prudent thing to do for the exsanguinating patient. Although that theory was absurd, it did at the time provide not only justification, but necessity for a great many more field personnel to be able to start IV's. After all, the military had been doing it for over a quarter of a century with no more training than a Paramedic.

Those days are long past gone. We haven't believed in isotonic fluid resuscitation for trauma victims since before I left the field. Consequently, both the justification and need for a quickie skills class for IV's is gone. Poof. Kaput. No more. Nil. Nada. Nicht. It died not long after Johnny and Roy left the airwaves. Yes, they still teach it. Old habits die hard. And apparently nobody wants to be the Grinch who breaks the bad news to all the kiddies out there that they can no longer have their toys. Therefore, we are stuck with this culture of entitlement among sub-paramedic providers who believe they should have this little bone of advanced practice, whether they really have any justifiable need for it or not. I want it. I earned it with my extra couple weeks of school. Give it to me.

Personally, I don't see how anybody -- especially a medical director -- is impressed by any such argument from people who can't even tell us why they need it. It always comes back to saying they "need" it so they can give this drug or that. And since giving drugs is really the only true justification for IV's in the field, it is an open and shut case. They don't belong in the hands of sub-paramedic providers.

Who are you calling a "sub-paramedic provider"?

[Dustdevil]

Who are you calling a "sub-paramedic provider"?

Well, there are dozens of acronyms for them. Too many to list here, and more being dreamed up everyday on the east coast. But for now I'll just say it means anybody whose title begins with EMT and ends with anything other than P.

[Scaramedic]

To continue in the vain of the great post by Asysin2leads..

EMT-Sub-P A Paramedic who works on a submarine.

Peace,

Marty

:thumbleft:

[hammerpcp]

Well, there are dozens of acronyms for them. Too many to list here, and more being dreamed up everyday on the east coast. But for now I'll just say it means anybody whose title begins with EMT and ends with anything other than P.

I thought we were talking Canada here. Ayway, I am obviously missing your point because from what I understand you to be saying is that IVs are pretty much useless except for drug administration . I mean, if a PCP is giving a drug that requires IV access what is the difference between that and an ACP?

[Nate]

As far as you Nate, I think I don't want to even waste my time (or my breath considering I only have the one left that is in my lungs at the moment.) to argue with you. I know what I am ...I know what I have been educated to do. I will continue to do this and know that I am making a difference in my patients outcome. If I don't know 110%, I don't do it!

:roll: <~~~Do you see the concern in my face? Dude I could really careless what you do or don't do, I just wanted to aggravate you because the enjoyment is so much more when I can irritate you and then watch Dustdevil pounce all over you.

[Dustdevil]

Ayway, I am obviously missing your point because from what I understand you to be saying is that IVs are pretty much useless except for drug administration . I mean, if a PCP is giving a drug that requires IV access what is the difference between that and an ACP?

None. I guess I am missing your point too. :?

[09E]

I don't really understand why some of us Canadians come on this site, post about what EMT's can or cannot do. I.V.'s etc. , whats the point? My education and skills may differ from yours, right or wrong, but why do the EMT's get all pissy when challenged to explain their rationale for there post.

[PRPGfirerescuetech]

I don't really understand why some of us Canadians come on this site, post about what EMT's can or cannot do. I.V.'s etc. , whats the point? My education and skills may differ from yours, right or wrong, but why do the EMT's get all pissy when challenged to explain their rationale for there post.

Because "because i wanna" and "cool toys fun *Grunt*" are unacceptable explainations, they know it, we know it, and thats all they got.

XOXO

PRPG (the EMT-

[Ridryder 911]

I wish we could clear the air for a while and stand back and look things objectively.

Ever observe grand rounds with residents?.. There really is a methodically to its madness. Just ordering a test is not good enough, why is the test ordered, the risks, the potential findings.. again the same is true when discussing medications the same should be going through every EMT and medics head for every procedure, tasks, and medications administered.

In my Paramedic school we were required to make grand rounds with internist, to start having the in-sight to ask ourselves each time, each patient, each procedure "Am what I doing beneficial, pertinent, and possibly change the outcome in positive side and do I know the risks and can I handle such risks, before doing anything? Yes, these become split second reflexes, but each procedure and action should have merit.

Just because one is "certified or authorized" does not qualify the patient the need to have it done. One should remember we should be "treating patients and their conditions meet our protocols, not have the protocols meet the patient". So many I have seen, establish IV's because "protocols".. and what are we going to do with this I.V. ? Most medics reply "I dunno know, it is in our protocols"...

Hmm...... here is your Milk-Bone, s-i-t-.........roll-over.....Good -Boy!

Ahhh....how well trained we are !

Procedures, even as simple as oxygen administration, should be known, how, why, and is it going to do good for my patient ?....

It is really a shame we are not allowed teach basic medicine to a profession that performs medical procedures.

R/r 911

[Nate]

In my Paramedic school we were required to make grand rounds with internist, to start having the in-sight to ask ourselves each time, each patient, each procedure "Am what I doing beneficial, pertinent, and possibly change the outcome in positive side and do I know the risks and can I handle such risks, before doing anything? Yes, these become split second reflexes, but each procedure and action should have merit.

We had a similar setup, and it showed many that being an EMT (of any level) is more then just dropping off a package. Many believe we are FedEx with human cargo, and that is one of the biggest problems with education in EMS. The colleges are restricted by number of semesters, the private schools are offering a faster turn out then the colleges, and some where between the two a good chunk of IMPORTANT information gets left out.

I'll be the first one to admit I don't know every single thing about medicine or pre-hospital care, but I do know that it is VERY important for everyone on that truck to understand why we do what we do, what the effects are, what the benefits are, and the risks. Even more important is knowing that even though we aren't seeing the effects of procedures or drugs like Lasix right then and there, we are setting the patient up for a faster discharge because we STARTED treatment.

I strongly suggest anyone who has never had to do a shift with a doctor to go and ask (most will let you) to hang out for a day and be quizzed, see what happens after we leave. The multiple blood draws, the effects of the medications, the stuff that often gets over looked during hospital clinicals because more and more EMT-Basic students (and other levels) are being used as "free labor" by ER staffs.