100 percent O2 not best treatment anymore....

[Ridryder 911]

I cast my vote to start reform from the top down. Want to change the system? Start working with medical directors and universities to offer/require education. Better yet, run that class or become that medical/EMS director. You can't require more education until the educational resources are available and you can't expect people to go for the higher/more expensive education as long as they'd be lucky to find a job for $10/hr.

Thus the problems of EMS. EMS is not considered a necessity rather a luxury. I know of many areas without EMS and then some only having a 1'st responder type system, but they will have LEO and F.D. again for safety and ISO ratings. Until we have an authoritative regulation requiring EMS and the components we will never progress, because there is no reason to do so. Without a regulatory watch dog such as JCAHO for hospitals, management will do what it can to get by and payers such as Medicare and Insurance Corporations will pay the nominal fee's understandably.

R/r 911

[katbemeEMT-B]

I cast my vote to start reform from the top down. Want to change the system? Start working with medical directors and universities to offer/require education. Better yet, run that class or become that medical/EMS director. You can't require more education until the educational resources are available and you can't expect people to go for the higher/more expensive education as long as they'd be lucky to find a job for $10/hr.

Personally, I think a good system would be an associate's degree for the BLS level and a bachelor'S degree for the ALS level. Granted, this might require the addition of 2 cert levels to set the groups apart in terms of scope and pay. The BLS level focuses more on broad theory and breath (courses: chem, physics, writing, intro to physical exam, intro bio, intro to psych, genetics, biochem, etc) with the ALS level being courses taught through university medical schools like the special masters programs (SMP programs are like "Med school light" where it is a 1 year masters program with most of the courses being 1st year medical school classes. The classes are handled anywhere from fully integrated classes, separate classes, same professor, or distance learning with taped lectures).

I think that one of the biggest crimes right now is the lack of practical experience prior to letting basics loose on the public. A physical exam is more than memorizing and regurgitating a sheet and being able to ask OPQRST/SAMPLE. You have to understand what your asking for, why your asking it, and what, if any, follow up questions you need to ask. Basics are neither expected or required to be able to do that. Too many of us are content to play with plastic O2 masks and cardboard arm splints to expect more.

I agree with so much of this. I feel as a whole we are all under educated and that truly is a shame. You would think that as those who have first contact with the patient we should have better education not so we can diagnose but so we can treat the patient properly. Everything we do pre-hospital impacts the patients outcome. While I am proud of who I am and the job I do, I also feel that my education did not prepare me for what I would be facing in the real world of EMS. I have learned more on the job and by educating my self else where to assist me in performing my duties. My initial education is actually above that of the National Standard from what I can tell by reading other posts but it still wasn't enough. I think in some cases it comes down to the instructors of these classes and what they are willing to put into it. An ex: When we took our practical exam we had separate testers for trauma we had two testers for assessment. One tester rushed you through the assessment telling you to skip this or that. The other tester let you run the assessment and gave you extra points for asking follow-up questions or for explaining to the patient why you asking a specific question (ie: why do we need to know if you use herbal remedies?). I fortunately got the second tester. During practice I had the first guy and it basically came down to he just wanted to get the hell out of there. The second tester would spend the time with us after we were done and talk to us about what we could improve on, how to accomplish that, and why we should improve it. I walked away from my practical exam knowing even more than I did from the class. It was great.

So I pose a new question. If Basics went to an Associates Degree and Medics went to a Bachelors (which I would love to see happen), do those that are already certified get grandfathered in or do they have to start all over? This would impact a large population of people in EMS. Also, would you have to receive you EMT-B certification first before moving on to the Medic program like you do now? I'm just curious what you all think as we would all be affected.

[AnthonyM83]

If Basics went to an Associates Degree and Medics went to a Bachelors (which I would love to see happen), do those that are already certified get grandfathered in or do they have to start all over? This would impact a large population of people in EMS. Also, would you have to receive you EMT-B certification first before moving on to the Medic program like you do now? I'm just curious what you all think as we would all be affected.

I don't know if I agree with Basics having an Associates. We need a basic first responder level that needs to be easy enough to fill in all the positions even in rural Anywhere, USA. Definitely harder than it is now, but don't think Associates is necessary if it's still going to be a position people might leave at high rate. I don't know.

Medics definitely Bachelor's, though, b/c these would be career medics and can invest the time and money into it.

[paramedicmike]

I don't know if I agree with Basics having an Associates. We need a basic first responder level that needs to be easy enough to fill in all the positions even in rural Anywhere, USA. Definitely harder than it is now, but don't think Associates is necessary if it's still going to be a position people might leave at high rate. I don't know.

Medics definitely Bachelor's, though, b/c these would be career medics and can invest the time and money into it.

If you change the educational requirements so that it's more difficult to get in and succeed, you'll get people there who want to be there and want to work to make it succeed.

Furthermore, if you get people who are willing to work harder to succeed, you'll get people who aren't going to be as ready to leave a job or the industry because they can't play whacker on Saturday night.

Increase the educational requirements and you'll get smarter, more dedicated people involved. Get smarter, more dedicated people involved and you'll see a change in the system make up even in rural areas. You'll also see an increase in pay and legitimacy in the industry as a whole.

How can this be bad in any way, shape or form?

-be safe

[katbemeEMT-B]

I don't know if I agree with Basics having an Associates. We need a basic first responder level that needs to be easy enough to fill in all the positions even in rural Anywhere, USA. Definitely harder than it is now, but don't think Associates is necessary if it's still going to be a position people might leave at high rate. I don't know.

Medics definitely Bachelor's, though, b/c these would be career medics and can invest the time and money into it.

I'm from one of those rural systems. Do you know what it is like to respond to a call with a guy who hasn't increased his education since 1979. It's pretty damn scary. He thinks he is SUPER EMT on top it. This would take those type of people out of the equation because they are only in it for the glory. Not that there is any of that anyway. Our local fire dept trains every fireman to first responder level. Some of the EMTs on our crew are trained no better and don't care enough to better themselves. The schooling has improved and the new EMT's are being trained at a higher level to accommodate the standards and protocols set by most of the rural services in our area. That is another reason I believe the schooling should increase to an associates. In all honesty, with all the extra classes I had to take to be certified for the meds and procedures we are allowed to perform I wasn't that far away. The only problem is that it went through the hospital and no college credit is given. The plus side is that when I do go to medic school I will have the edge over some of the other students who didn't get that same extended learning.

If we want to be seen as professionals we not only have to act as professionals we have to be educated as professionals. :study: :read2:

[AnthonyM83]

At first responder level, I can see us becoming severely understaffed. EMT companies here are already dying for EMTs and they get most of their EMTs from pool of people who want to go into Firefighting. If we lost out on that group, too, we'd be in some big trouble. I'm just trying to consider other not so obvious implications.

[katbemeEMT-B]

At first responder level, I can see us becoming severely understaffed. EMT companies here are already dying for EMTs and they get most of their EMTs from pool of people who want to go into Firefighting. If we lost out on that group, too, we'd be in some big trouble. I'm just trying to consider other not so obvious implications.

Maybe the answer there is to make it a requirement that to be a member of the fire dept you also have to be an EMT or Medic. That's what many of the Metro fire dept do in Minnesota. Most require you to be a medic though. They respond to calls before the ambulance gets there. They are like a rescue unit all though some of them will bring out the big ol ladder trucks to calls. :-k I still feel that the better we are educated the better we can care for patients and the better our communities will look at us as professionals.

[AZCEP]

A better suggestion would be to remove EMS from the fire service entirely, and have a separate EMS service being provided. Reduce the numbers of non-fire calls that the fire service responds to, increase the funding for EMS. Perhaps this would result in a recognition of the work that EMS does.

This topic has been discussed ad nauseum, but continues to be brought back up. Please do a search of the subject. You will gain much information much quicker than forcing us to redo the entire thing.

[spenac]

Definitly no need to rehash the fire dept only wanting to have EMS so it can get more shiny trucks, even if true. Definitly no need to rehash education fight as it was fought recently and obvious while education was agreed to be needed no agreement on the amount.

[spenac]

I thought this was about restricting O2 use but seems we've strayed. :oops: