EMT-Enhanced

[Dustdevil]

There is no National Registry to this level thats the only down fall that I have found.

If that is the only downfall you can think of, then you didn't think about it very seriously or very long. :?

There's not enough bandwidth here for me to list everything I find wrong with it.

But I disagree with my colleagues who call for only two levels of providers. There should be three.

AS Paramedic. BS Paramedic. MS Paramedic.

[PRPGfirerescuetech]

MS Paramedic.

A step too far with this level, but I get what your driving at.

Anything below the Paramedic level does not have adequate education to be properly equipped to treat any/all patients in the pre-hospital field. This statement is fact, and not negotiable. The fact that we have providers with less than this education is one of the primary reasons why we get laughed by EVERY other facet

of medicine.

These additional levels were created because the people above us believe were too stupid to complete proper education standards, thus they give us these BS education programs that includes the skills we need without the knowledge as to why we do them.

Demand more! Encourage others to strive higher!

Before were left behind by the progressions of our peers in every other facet of medicine.

*now return to your regularly scheduled debate*

[Dustdevil]

A step too far with this level, but I get what your driving at.

LOL! Well, I didn't really mean them as "levels" in the certification sense. More of an educational level to strive for. And eventually, an MS requirement for teaching.

But no... for now I can still support full practice privileges with only two years of FOCUSED AND QUALITY education.

Nothing less belongs on an emergency ambulance.

[PRPGfirerescuetech]

LOL! Well, I didn't really mean them as levels in the certification sense. More of an educational level to strive for. And eventually, an MS requirement for teaching.

But no... for now I can still support full practice privileges with only two years of FOCUSED AND QUALITY education.

Nothing less belongs on an emergency ambulance.

CANIGETA AMEN?[/font:a99bc6bc4a]

[Ridryder 911]

Congratulations on completing the EMT-E. You ARE looking into the EMT-I, riiiiight?

As far as the argument for doing away with the intermediary EMS levels goes, in a perfect world, we'd all be Paramedics, with BS degrees. Obviously, it's not a perfect world. I can't speak for other localities, but in rural Virginia, the EMT-Enhanced is a valuable asset where your agency may not have a full complement of I's & P's to cover every shift. (While this brings up the other argument of taking volunteers out of the equation, it's one that will not happen anytime soon, so we won't go there right now.) The fact of the matter is, Virginia needs volunteers right now. Virginia Department of Health, Office of EMS must have thought that the EMT-E is a necessary level of care, otherwise they would not have instituted it.

I'm not going to second guess them at this point. After I get my MD license, and they appoint me as Director of OEMS...maybe.

In the meantime, we're all in this together. Volunteer & Career, Basic & Paramedic. Until the legislators & EMS representatives get it right, and the ball is rolling toward the Professional EMS goal...I'm going to concentrate on Patient Care.

I understand your point, however; I believe you as many others may get confused on how the cart before the horse scenario.

Let us look at the whole picture. Not just bits and parts. In rural settings (where most the multiple levels are placed) why is there a shortage? Lack of funding, pay, uninterested participants, not enough resources (educational facilities, etc). Is the other health facilities lacking in providers as well? How involved is the current level of participants in legislation, researching for Federal & State funding for grant monies and educational scholarships?

I have seen states (including my own) develop multiple levels. This is not always for the "need" of patient care, the best for the public or any researched reasons rather for a "quick fix". If you place a band aid on a arterial bleed it won't last long. EMS has always used short cuts and half ass excuses for remedies. When in comparison, if you were to analyze the costs of developing multiple levels, the educational supplies, testing, over all would had probably been a nice amount to fund scholarships through the full Paramedic course. Many in EMS do NOT want full levels, for multiple reasons. Many would have to pay appropriately, and if they are billing there is no incentive for level difference (profit over salaries) as well with a limited certification that is not transferable; where else are you going to go?

It is not the.."legislatures to get the ball rolling"... and as far as MD's caring, most are ignorant and apathetic on what goes on prehospital, they have their education and career. Rather it is the job of the EMS to educate them the need for change. It appears, many are satisfied with the easy way out. Multiple levels and half training. Unfortunately, it is the patient that makes that ultimate sacrifice.

No, it is not an ideal world, not will it will never change unless someone gets the ball rolling....

R/r 911

[Rescue0ne]

I have seen states (including my own) develop multiple levels. This is not always for the "need" of patient care, the best for the public or any researched reasons rather for a "quick fix". If you place a band aid on a arterial bleed it won't last long. EMS has always used short cuts and half ass excuses for remedies.

R/r 911

That's exactly what it is, Rid...a "quick fix", which has actually been in place for years. Nothing QUICK about it. I mean, does anyone really wake up one morning and say, "I'm going to have a career as an 'EMT-Enhanced' "? Of course not...well, I really HOPE not. For many in my area, Enhanced and Intermediate are stepping stones to Paramedic. While no one is told, "move on to a higher level of cert, or you will be canned", advancing to Paramedic is HIGHLY encouraged. These levels are often achieved by some who work full time as a job outside of EMS, or even in EMS, on transport services, etc. Anyway, I digress.

I agree, it IS a quick fix. What can I, as a lone EMS Administrator, do about it? I've already submitted my application, btw, as seen on FieldMedics.com, as well as lengthy correspondence with my legislator(s), and the State Office of EMS as well. Other EMS entities nearby only care about the almighty $, (read ambulance transport services). They're not concerned about education, not the profession as a whole.

All I hear/see is a whole bunch of talk...people making appropriate noise(s) about issues that they could give a damn less about. No one outside of EMS cares about EMS, that I've seen. I've been dealing with this locally & statewide for the last 5 years...and frankly, am getting tired of the runaround.

Like I said...I'm going to focus on patient care, and keeping the local self-serving politicians out of the Station.

[Ridryder 911]

I do understand your frustation. Hang in there... I wish I could say it would get better.

R/r 911

[Dustdevil]

Unfortunately, these quick fixes are like bailing wire on the muffler.

Sure, it's not dragging the pavement and throwing sparks into the air anymore, and consequently, fewer people will notice the problem. But it is still creating one hell of an annoying racket. And it is still spewing nauseating exhaust fumes and deadly carbon monoxide into the passenger compartment of your car.

We can't leave it like that forever, no matter how much the manufacturers of bailing wire would like us to.

People are dying.

[EMS49393]

People are dying.

Amen. My father used to tell me "if you're going to do something, do it completely, do it well, and don't cheat." When are people going to stop doing it incompletely, poorly, and by cheating? The excuses are old and worn out. Everyone has a sob story about why they can't become an educated paramedic. I don't know any educated paramedic that didn't bust their behind trying to get through school, and become the best provider they can be. They work hard after they become paramedics to learn and keep up with changing trends as we now focus on evidence based medicine.

So you become some bargain basement ALS provider and you get a few drugs and skills. Congratulations on getting your certification to kill.

[brock8024]

i see this where I work now. I work for a rural service and it is fun, but most do not like paramedics. most are intermediates with special protocols. I had one tell me that she would much rather one of those intermediates work on her family before a paramedic. I think alot has to do with some of the paragods out there who put others down. I told most of my partners that I do not care if they are a basic or what I will listen to them and see what they have to say.

I will agree most of my co-workers have no intent on moving up to paramedic. It cost money and they have families and already get paid crap. I think we need to find a way to fix the problem but how will that happen when most of the higher ups could care less about us.