Frustrated Vermont EMT

[danvtemt]

Hi all. Been sandbagging this forum for awhile but not posting. This is a great site.

I am an EMT-I in Vermont. I run with two squads, one in St. Albans and one in Enosburgh. Both of these are paid positions and I consider EMS to be my career. I've been reading the Rural EMS forum here and also other info I can gather on the web and at last I feel like I'm not completely isolated up here in the frozen north. My big frustration lies with the powers that be and the lack of interest from our MD, our district, and our state EMS office in making VT EMS more progressive. Seems to me that the more rural the service area, the more important it would be to have a higher level of ALS in pre-hospital care. Our district is allowed no higher than EMT-I, and it is a pretty low scope of practice compared to other Intermediate scopes around the country.

OK, enough griping. I want to invite you to check out my blog. I write it about whatever comes to mind, but it is about EMS, rural VT EMS in particular. Its at www.wayoutems.blogspot.com.

Thanks for being here, and have a safe day.

Dan[web]http://www.wayoutems.blogspot.com[/web]

[EMT4455]

Does Vermont reconize National Regisrty? I am orgianlly from there but am an EMT-B in Indiana. I have foten thought about going home but was unsure what there requirements are. I am from Brattleboro. Nice to see someone else from home out here.

[Chief1C]

http://www.wayoutems.blogspot.com/

[Dustdevil]

Our district is allowed no higher than EMT-I...

Not allowed by whom? :?

Some powers can be fought, and fought successfully. Others cannot, and must be tricked into destroying themselves. Know your enemy.

Once you have assessed the opposition, devise a plan of attack. Obviously, nobody else around you cares enough to do anything about it. That puts the ball in your court. Get your ducks in a row. Let the citizens know what they are getting, as compared to what is provided in comparable communities across the country. My bet is that they simply don't know that they are thirty years behind the times. As long as they see shiny new ambos screaming down the road, they figure they have what everybody else they see on TV has. Stir the pot. But do it as an educated and concerned citizen, not as a disgruntled EMT. Remember, you are a citizen of the community first, and an EMT last.

Of course, you'll get fired for all this, and then you can really be disgruntled. And you can thank me.

Best of luck!

[Snafu3532]

Dan what district are you in?

I'm new to the Vermont EMS scene (originally from Massachusetts); however I've learned a lot thus far. As far as my understanding goes, Vermont's EMT-I is actually right on par with what the national curriculum is headed for. The curriculum is specifically designed not to have the highest scope of practice. We don't have paramedics up here because many areas are so rural and the call volume is so low that maintaining skills would be very difficult. However, i do know that they are working on recognizing paramedics in my area (district 3). Although we're rural and not the most progressive, I think we have a quality medical director and will be making progress with help from people like you.

[Cowboy7427]

[/font:3239475911] I would have to agree with you.. I also live in a rural area (Central Ohio).. I'm a new EMT-B and just got hired at our local fire district as a volunteer.. We have a Medic at all three of our county stations at times a total of four. Our Fire and EMS is not joined, but most of our 6 county fire stations also have a medic on most of the time.. To not have anything higher than an EMT-I would be.. Well lets say NUTS!! I feel for you and your team.. Hopefully the powers that be will realize someday how much more could be done in the level of care and remedy the problem.. In the mean time drive on..

[medic_HNX]

I'm a VT EMT.

Its not just your district, but the entire state that is not all on the same page. the VTEMT-I'03 is indeed the same thing as the NREMT-I'85, however our scope is not only limited by the state, but then even further by the medical director if he/she so chooses. VT is indeed a national state, but since it is so rural the state EMS office believes that the national scope of practice does not apply as there is not enough volume to support several advanced interventions (as is my understanding). This is the reason many districts do not have paramedics at all (like district 2 -Newport area as well as the most populated part of the state-Burlington) and why paramedics are limited and few and far between in others (think protocols in district 5 vs 4 for medics)

Why VT is unusual is because the state is broken down into several "EMS districts". The state amends the national curriculum and then leaves each medical director of each district to determine what state protocols apply to EMTs in that given district. Some areas can do everything the state says is within an EMTs given scope of practice. Other areas are only able to do quite a bit less if the medical director so chooses. The problem therein with that is that prehospital care throughout the state and even neighboring towns and services is not standardized. Another part of the problem is that many services in VT are still completely volunteer, although that is becoming more rare. When many services still rely on members to get up and leave there dinner cold on the table or attend trainings twice a month for free just to keep up skills and requirements its hard to compete with national standards that reflect a more professional and organized system. This says it all; the VT recertification hours required for an EMT-B to maintain certification is on 24hrs of CE in two years. That is compared to 72 hours of CE for the NREMT-B.

The philosophy of creating flexible protocols in laid out demographic/geographic areas is good in nature, however it does create the problem of lack of encouragement for those in VT EMS to advance. When ALS is limited and Paramedicine is still a thing of the future many are disenfranchised with VT EMS and move else where. ...there is not one single paramedic school or program based in the state of VT.

[CANUSAJenn]

Although in a rural isolated setting in the frozen north as well, I consider our volunteer organization fortunate to have a paramedic, and numerous ALS providers to continue to provide our region with skilled care and educational opportunites for the EMT-B providers.

[Doug]

I'm in Massachusetts and I know that Southern Vt. routinely uses Massachusetts based Medic services for PRIMARY response. I think there is 1 Paramedic level ambulance in Bennington, and it is not uncommon for Southern Vt Hosp. to call my service (about an hour away) to arrange ALS transfers.

Vermont also allows for direct reciprocity for any equivalent level from Massachusetts.

[911lady]

I can certainly understand your frustration there. Although I am only a basic, I think our agency should be allowed more agressive actions in all our levels we have on the service. We too are a rural agency and self supported through grants and donations and fund raisers. Hope you guys get the backing you need to provide the best possible pre-hospital care.

Hi all. Been sandbagging this forum for awhile but not posting. This is a great site.

I am an EMT-I in Vermont. I run with two squads, one in St. Albans and one in Enosburgh. Both of these are paid positions and I consider EMS to be my career. I've been reading the Rural EMS forum here and also other info I can gather on the web and at last I feel like I'm not completely isolated up here in the frozen north. My big frustration lies with the powers that be and the lack of interest from our MD, our district, and our state EMS office in making VT EMS more progressive. Seems to me that the more rural the service area, the more important it would be to have a higher level of ALS in pre-hospital care. Our district is allowed no higher than EMT-I, and it is a pretty low scope of practice compared to other Intermediate scopes around the country.

OK, enough griping. I want to invite you to check out my blog. I write it about whatever comes to mind, but it is about EMS, rural VT EMS in particular. Its at www.wayoutems.blogspot.com.

Thanks for being here, and have a safe day.

Dan[web:089d39bbe1]http://www.wayoutems.blogspot.com[/web:089d39bbe1]