''SKIPPING LEVELS''

[Asysin2leads]

I'm not exactly sure how you gauge a person's skills in BLS procedures by examining what they write, you know, I usually take direct observation in the field as the best indicator, I mean, just for me...

Anyway, yes this, this horse has been, beaten, flogged, shot, then dug up and set on fire numerous times. BLS skills are important. They are. But they need to be placed in the overall continuum of prehospital care.

I'll let you in on a little secret. Come closer. The standards that are set for BLS procedures are guidelines. Therefore, if someone does, say, 29 compressions and then 2 breaths, it really doesn't matter. If I set the NRB on 10 LPM rather than 15 LPM, and the person is keeping the bag inflated, its ok. And if I clear someone's airway using a dustbuster, a pair of needlenose pliers, and a fishing lure, and they can breathe, that's okay too. Peace be with you on your quest, and BTW, its pretty much standard around the country to have at least 6 months - year experience prior to advancing to a higher level. Then again I made the leap from basic to medic and bypassed all between, and I seem to be doing just fine.

[Just Plain Ruff]

I concur with Asys

First off Welcome to the city.

Yes experience is golden at times but I know a heck of a lot of excellent paramedics who went from emt-b to emt-p immediately one after the other. I am one of those people who did that and I do consider myself quite competent as a medic.

But on the other hand, there are enough bad paramedics who had oodles of experience as a basic and suck badly as a medic.

It's all in how you apply yourself and learn the ropes.

I do agree that there should be some sort of experience buffer but hey, some people do not have a lot of time or money to spend going to school.

As for the City here, Clicking on search and entering a search phrase will get you anything you need referenced on this site.

Google works really well by typing in a question and many of the links returned will take you directly to where you need to go.

It's all good, no "ruff"led feathers on my end here.

We're glad you are here.

Good luck in the EMS life - it's a good one.

[Dustdevil]

You don't have to be computer literate to simply read the forum rules and FAQs, so that excuse doesn't exactly work.

No harm done, Bro. But this topic has indeed been beaten to death and the general consensus here -- including that of the most vastly experienced persons on the board (see Old Timer Introductions topic) -- is that your theory is great on paper, but holds no water in reality. So-called "experience" as a basic in most cases only contributes to poor habits and poor understanding that are both very hard to break at the next level and weaken the Paramedic educational process.

And, you would find VERY few people with real experience as a Medic or as an educator who would agree that the Intermediate class contributes anything positive to the Paramedic educational process. In fact, it too tends to retard it. Thats why most states, apart from those largely rural states, are doing away with it altogether.

Again, nice theory, but only on paper.

[streetsmart]

Most EMTs work for a service as a basic while going to medic school, that's a minimum of a year's experience.

[Ridryder 911]

First Welcome to the City......My feathers are not ruffled but disappointed. A Paramedic should also have basic knowledge of grammar, and English composition as well. As you described "jumping" levels, I too believe we have allowed too many to jump education levels. Let us require reading, writing, and basic mathematics before allowing entrance into a health care profession such as Paramedic. Obviously, too many have "jumped" that level as well.

Yes, it is scary sometimes, I concur with that. But, because someone has experience does not always mean that it is good experience. One can be an idiot for several years, and not know it. Get the required education and experience, you can always obtain the experience level with time.

Logistically, and very unrealistically to expect EMS students to have experience. The job market is not that favorable. In my state alone, (which is considered rural) there are over 5000 basic EMT's... now when comparing that there is only 198 EMS services and almost a 1/4 of those are filled with advanced to Paramedic, how many positions would be available for the basic?.... neal to none?.. Now, compare this on a Nationwide Scale.. again, basic mathematics will tell you the answer.

Again, wlecome to the city!

R/r 911

[Dustdevil]

Ha! Excellent point, Rid. Plus 5!

Yes, I have to agree. Anybody who enters EMS without first completing a basic educational foundation is indeed "skipping levels" and should back up.

[NREMT-IL]

Friends-

I have known many people who have gotten through Basic school and have no desire to go any further. Now I would agree that this generally limits one's upward mobility within the EMS system as it currently exists. However there is a point in one of the first posts that I disagree with vehemently and that is (to paraphrase): Basics do little in terms of emergency medicine. I think it is a logical fallacy to make such a comment. We (basics) are allowed to splint, bandage, stabalize and in generally provide a certain degree of emergent care. We are also allowed to push epinephrine and glucagon. I think the reason that I point this out is that Basics do much of the work that Paramedics dont WANT to do...that doesnt make it any less important.

It seems to me that rather than beating the horse of Paramedic vs. EMT that we should see there roles not as one being better than the other (an unfortunate attitude taken my many medics) that we should see that we work together as partners and as a team to provide the best possible pre-hospital emergency care within our scope of practice. As far as one being better than the other, I have seen basics that practically have the PDR and Merck Manual memorized and can put that information into practice as they assist in patient care and I have also known those who have gotten through Medic school that couldnt bandage or splint if their lives depended on it. There are good EMT-Bs and good medics, there are also bad in each of these groups.

As for the statement in another posting that many states are doing away with Intermediate level EMTs, this may true. But my research would indicate that many services are taking on just as many intermediates as Paramedics. As for me, I plan to advance to the Intermediate level before going to Medic school.

Lets drop all of this petty bickering and realize that we are all members of a wonderful and time honored service to the public. And that, my friends is what its all about, basic, intermediate or paramedic...Service.

I would like to finish up with this idea: the past president of the AMA has been quoted as saying that the fate of a patient, in a majority of calls, is based on the quality of the first rescuer to attend to that patient. Notice he makes no mention of level.

Just some food for thought.

[medic001918]

I would like to finish up with this idea: the past president of the AMA has been quoted as saying that the fate of a patient, in a majority of calls, is based on the quality of the first rescuer to attend to that patient. Notice he makes no mention of level.

Just some food for thought.

Quality is important, and based on that I would like to think that a paramedic is a higher level of care and with that comes a higher quality of service through increased training and standards. The paramedic vs. EMT horse has been beaten to death repeatedly. The search function will yield many results to this topic of education. Also, let's not forget that the general public doesn't know much of the difference between an EMT and a paramedic, but as professionals we are familiar with the intricate differences.

On top of that, I would reasonably expect that anyone coming to handle my emergency situation is going to be trained in the fundamentals of education, those include basic reading, writing and math disciplines. These are critical building blocks of a foundation for a long educational career. With those fundamentals in place, a more complex understanding of many issues can be achieved. And that is a higher standard that we should all adhere to.

Shane

NREMT-P

[paramedicmike]

As for the statement in another posting that many states are doing away with Intermediate level EMTs, this may true. But my research would indicate that many services are taking on just as many intermediates as Paramedics. As for me, I plan to advance to the Intermediate level before going to Medic school.

Simply because it's a way for employers to claim ALS level service while screwing their community out of real ALS service at the paramedic level. Plus, they don't have to pay these providers as much as they'd have to pay a paramedic so they're saving money in the long run.

Who loses? The community and the providers. Who wins? The owners of the ambulance companies. Shouldn't the community be the winner here?

The latest JEMS salary survey doesn't really show a salary benefit to becoming an Intermediate level provider. You, and your patients, would be better served to go straight to paramedic.

-be safe.

[Nate]

Ha! Excellent point, Rid. Plus 5!

Yes, I have to agree. Anybody who enters EMS without first completing a basic educational foundation is indeed "skipping levels" and should back up.

To be honest, a fair amount of people in this industry don't even need to be allowed near an ambulance. :? This is one of the few fields where a complete putz can stand next to a graduate level educated person who is actually a lower rank then them. :shock: