''SKIPPING LEVELS''

[JPINFV]

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.

I would consider splinting, bandaging, stabilizing (trauma-wise, since basics can't really stabilize medical patients, unless the only thing they need is oxygen) to be urgent care. While important, I wouldn't call an arm Fx emergent. Glucagon is a recently dead horse that doesn't need to be revived. When talking about epi, are you talking about epi pens (for anaphylaxis)? Also, are you talking about preprescribed ("assisting" the patient)? Also, remember, your protocols and my protocols (following from that, scope of practice) is not the same.

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.

Better and more important are two different things. Is a doctor better then a nurse? Sure, that is why the doctor is in charge. Does this make nurses unimportant? No. There are not enough doctors going around to provide the day to day care (assessments, medications, etc) or do everything that needs to be done medically speaking in health care for doctors to do everything. Is a doctor better then a NP or PA? Are NPs or PAs unimportant because of that? Is a family practice doctor more or less important then an emergency medical doctor?

I would say that there are a vast more bad basics then bad paramedics. The fact that a spectrum exists does not negate the fact that a paramedic can do a lot more for a patient then a basic alone could do. All the splinting in the world isn't going to help a patient with a MI (nitro, morphine, and aspirin will. Cath lab for the win, though). All of the levels have a niche to fill. It might be a small or less fun niche, but knowing your niche is half the battle.

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.

I guess you require all your doctors to have been a PA before being a MD/DO then? After all, if being half a professions is important, why isn't it seen more often?

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 guess you work for free then, or else you aren't that committed to the term "service." There are many more reasons to go into EMS then "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.

That's because you can't fix brain dead.

[stcommodore]

no doubt bls skills are critical and a good basic foundation is critical to being a medic but with a shortage of everything what do you expect schools, states, etc to do? They need medics out there and if they can pass the tests then medics they will be.

[JakeEMTP]

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 said that and stand by it. What you describe is First Aid, not medicine. Do a little searching at some previous threads and if you still feel a Basic is practicing some form of Pre-Hospital medicine, feel free to post again.

I am currently a Basic in Medic class, so don't think it is a slam on Basics. However, it is what it is. First Aid.