100 percent O2 not best treatment anymore....

[speedygodzilla]

I have never recommended that EMT-Bs be part of the team.

:roll: :shock: Please explain!!!

[JPINFV]

Education, or the lack thereof.

[Dustdevil]

Education, or the lack thereof.

That's it. However, perhaps I was too vague.

By "team," I am referring to two entities: the ambulance crew, as well as the greater picture of healthcare professionals involved in the patient's ultimate recovery (RNs, DOs, MDs, RRTs, LPTs, MTs, etc...). Neither of those two groups should include EMT-Bs. First Responders are a whole different story, and EMT-Bs are welcomed and encouraged there, but they are just First Responders, not medical professionals. And medical care does not begin until arrival of medics. Therefore, while they are a valuable part of the overall equation, they are not part of my "team."

[PRPGfirerescuetech]

That's it. However, perhaps I was too vague.

By "team," I am referring to two entities: the ambulance crew, as well as the greater picture of healthcare professionals involved in the patient's ultimate recovery (RNs, DOs, MDs, RRTs, LPTs, MTs, etc...). Neither of those two groups should include EMT-Bs. First Responders are a whole different story, and EMT-Bs are welcomed and encouraged there, but they are just First Responders, not medical professionals. And medical care does not begin until arrival of medics. Therefore, while they are a valuable part of the overall equation, they are not part of my "team."

Our opinions seperate here.

EMT-B's should be a welcome part of the team, as well as medics. This however is after both medics and EMT-B's education level is raised to the pointe that both provider levels can be truely referred to as medical professionals.

Until then...

WERE ALL JUST TRAINED MONKEYS!

[Dustdevil]

EMT-B's should be a welcome part of the team, as well as medics. This however is after both medics and EMT-B's education level is raised to the pointe that both provider levels can be truely referred to as medical professionals.

Until then... WERE ALL JUST TRAINED MONKEYS!

We're not far apart on this. Education is the key. But once entry level education is raised to the appropriate point, it will no longer be appropriate to call them "basics." This pretty well dooms the title of EMT-B. So our choice is to either change the semantics as we change the education, or to keep EMT-Bs as a non-professional, first responder level of first aid.

[PRPGfirerescuetech]

We're not far apart on this. Education is the key. But once entry level education is raised to the appropriate point, it will no longer be appropriate to call them "basics." This pretty well dooms the title of EMT-B. So our choice is to either change the semantics as we change the education, or to keep EMT-Bs as a non-professional, first responder.

Semantics, yes.

However we dont part far as long as your on board with a two tier ALS provider system, similar to the canucks...

[speedygodzilla]

And medical care does not begin until arrival of medics.

:roll: Please, that is just not even close to being right. ABCs is the main focus in EMS medical care. Key word medical care. Yes that may be what EMT-B focus on but that is also what I am am sure all medics must refer back to. What good are all the meds you give if the airway is never maintain. To define EMT-B care as not medical care is a disgrace to all EMT-B weather they are fresh out of school are been a basic for years.

We are part of the team. I know at where I work I am a vital part of the team. I am well known as an EMT-B and I don't know a single RN at the ER that does not appreciate my "basic" medical care.

We are all part of a team. Even the first responders, and trained public.

I do agree with you that EMT-B lacks education in many areas. That is why I try to learn more out on the field. I am sure even after paramedic class you lack education in many areas. Some things can really only be learn in the field.

[Dustdevil]

Semantics, yes.

And to further clarify on that point, when I speak of basics, I am speaking of a level of training and care, not a class of people. EMT-B is a level of training. It is not a statement on the intelligence, dedication, professionalism, or worth of specific human beings. One of the problems in EMS (and "public safety" in general) is that too many people get so immersed in the "lifestyle" that they are unable to separate their personal life and worth from the patch on their shoulder. It is unfortunate, but if somebody takes personal offence because I think the training they were given in their course was inadequate (through no fault of their own), then all I have to say is, 'get over it.'

...we dont part far as long as your on board with a two tier ALS provider system, similar to the canucks...

Hmmm... I suppose you are speaking specifically of Ontario, where the entry level is a two-year diploma, unlike the other provinces. I dunno. Here, we have a bunch of people who are overtrained and undereducated. There, we have people who are properly trained and educated at all levels, but underutilised. As well educated as they are, the PCPs in Ontario are, unfortunately, not deployed to their full potential. It's definitely a better option, without a doubt, but it still provides an inadequate level of care to too many patients.

I really can see no justification for tiers of care in EMS (ambulance EMS) other than bugeting concerns. Certainly no medical justification.

[Richard B the EMT]

Our opinions seperate here.

EMT-B's should be a welcome part of the team, as well as medics. This however is after both medics and EMT-B's education level is raised to the pointe that both provider levels can be truely referred to as medical professionals.

Until then...

WERE ALL JUST TRAINED MONKEYS!

This begins to fit the criteria of "Paramedic Shove", first exemplified when a Paramedic just shoved an EMT out of the way, disregarded all vital signs obtained by the EMT, and all previous treatment done by the EMT to the patient in question. The Paramedic didn't even apologize to the EMT, as the shove actually caused the EMT to fall over, and receive an injury.

I acknowledge that First Responders do it to "first aiders", EMTs do it to First Responders, Paramedics to EMTs, and the ER crews to Paramedics. Whatever your level, just be nasty to whoever is lower on the EMS "Food Chain".

'Tain't right, but it is done.

People, don't do it!

Remember the old story: A man is hit by a car, another man starts to help him, when a third man rushes up, pushes the second man away, saying, "Stand back, I am a trained first aider", and starts to assist the injured first man. The second man just stands there for a few moments, then tells the third man, "Per your protocols, you are supposed to call a doctor, when you get to that point, I'm a doctor, and I'll be right here!"

[katbemeEMT-B]

We're not far apart on this. Education is the key. But once entry level education is raised to the appropriate point, it will no longer be appropriate to call them "basics." This pretty well dooms the title of EMT-B. So our choice is to either change the semantics as we change the education, or to keep EMT-Bs as a non-professional, first responder level of first aid.

Well Dust, I do agree with you on the lack of education at all levels. There are things we are taught in class that could be taught much more in depth. Instead we get the abbreviated lecture and demonstration as our class time is very limited. My honest opinion is that the Basic class should be a two year class and Paramedic should be four year. Then you get down to the whole "label" thing. I would assume it's standard throughout the US that there are EMT-B, EMT-I, & EMT-Ps. What is up with the EMT-I? I can honestly say I have never met one. I do know that in my area our education and training is that almost equivalent to an EMT-I. The local college quit offering the EMT-I program. Maybe that's why I have never met one. So one answer to the labeling problem could be is have one classification of EMT and train them to that of a current paramedic level or above. Then you could have the Paramedic and make theirs a four year + degree. I also think that to maintain your certification you should be REQUIRED to attend bi-annual classes sponsored by a college. One of my biggest pet peeves is the EMT or medic who has been on the service for years that attends service sponsored training but no outside lecture or classes. But that's just my opinion.

As far as EMT's not being part of the team I feel is ridiculous. While maybe in other areas Basics aren't educated and trained to the same level as in my area they still provide an imperative service. Who else is going to fetch and drive. Medics aren't going to want to. They are going to want to do the patient care. Staffing rigs with two medics I see could cause some problems. Unless of course there is a strong manager in place to oversee things and keep them in line. I have already seen fights take place as to who is going to provide the care and who is going to drive between medics on the same rig. But again I would assume that if it were an all medic service and there was an equal rotation this would not be a problem.

In areas where the call volume is 300 calls per year or less, there is no ALS that is going to be willing to put a staffed rig there. It's not cost effective. The response time would be way beyond allowable standards if they were dispatched from their station. This is why there are still Basics out there. They are there providing services to the areas that no one else wants. When those areas generate enough revenue to benefit an ALS service, that service swoops in and takes over. I have seen it many times in my neck of the woods. It is sad that the lives of people comes down to the almighty dollar. I am by no means saying that these areas shouldn't have ALS services and be staffed by medics. I am just trying to give you a point of view from the little rural areas of the world that have nothing else. It's very frustrating. When we have a major trauma we have to depend on ALS Air support to transport the patient. So sometimes it goes beyond education. Sometimes it's a matter of economics. I would love to see our local service go ALS. I would be the first to apply for a job. Maybe by the time that happens I will have made it through medic school.

I'm just giving you my opinion based on what goes on in my neck of the woods. It is quite different than in a highly populated metro area. That's why a generalized opinion doesn't always work regardless of how good it may be.

Have a great Memorial Weekend! A :salute: to all servicemen.