A call to arms! EMT-B's defend yourself!

[Just Plain Ruff]

Ok ok ok ok STOP THE MADNESS!!!!!!!!!!!!!!!!!!!!!!!!!! [/font:96585efcc6]

I've read enough. I will give a compromise that will even make Dust agree.

Have a 3 person truck. An EMT To drive and two medics to take care of the patient.

That way everyone is happy.

[vs-eh?]

Basics in their current state are useful on their own as they take the patients to the hospital in expedient manner while stabilizing them to the best of their training and education, as described by Medical Director.

I, however, advocate expanding the education and training of EMT-B's to make them better providers. I think that CE classes should be put in place (or the original course expanded) to allow Basics to perform limited ALS skills that would benefit trauma patients. Medical stuff will still be ALS's domain, as it requires a great amount of education and time. And understanding.

As far as hypoglycemia goes, I would hope that a EMT-B can recognize it and treat accordingly. And if the patient is unconscious, be able to intervene with glucagon or D50.

Listen man, I don't want to bash you, but you seem to be attempting to fight the good fight.

Here is a novel thought. Instead of adding procedures or drugs to a person with 200 hours of education, why not simply add education to make them better at (oh, I dunno) BLS? Why must adding to a very minimal amount of education = adding ALS scopes of practice?

How about making EMT-B programs 600 hours. Educate on core concepts of BLS - CABC and their associated patho/normal physio/anatomy/etc...Have 240 hours (minimum) ride out time and 36-60 hours in an ER? This that really that hard? It will probably take ~ 6 months, but be far and away better than what I read as the current state. Don't add chest needles, intubation, whatever...Add core skills and good BLS procedures, so that people aren't listing placing dots and setting up lines as what they look for in a good BLS partner! That is seriously an embarrassment folks.

Let me tell you something...When I did my ALS OR rotation with the anesthetist(s) one of the major things they look at is GOOD BLS AIRWAY MANAGEMENT. They often use flow-inflating bags (amoung other things) which simply do not inflate/give adequate tidal volume unless you have a good seal/aw adjuncts prior to intubation. The doctors praised those who could accomplish this, and these are the "airway masters". It gave me a sense of satisfaction knowing my BLS airway maneuver's had been solid all that time.

I honestly don't know what else to say. Stop adding procedures and add to your education that is adequately needed to do your job. It is grossly apparent that those who are arguing for adding procedures don't really know how day to day EMS works.

[brentoli]

Well, it would be even better if two doctors were manning the ambulance. But it's just no way in hell it's going to happen.

Most small-town EMS's are struggling to keep even BLS ambulances staffed. Let alone having medics around the clock. EMT-B's provide a level of care to people that otherwise would not get any care at all.

Dust, I have concceded the fight. There is no justification for basic's when the medics are available. Regarding the above statement, EMT-B's do not provide a level people would not get, services need to do what is best for the community and not just keep themselves afloat. I am a basic, I work with a BLS service. If tomorrow I got called and told they were selling out to make a regional ALS service, I would start looking into medic school more seriously. I wouldn't mope and whine about how "Medics need EMT's to save their ass." or how "unfair" it would be.

As a community we need to stand up and take charge! EMT's belong in pt care. Just not primary care. Realize what you can do and what your skills are. Why are medic's in flycar's and not EMT's? The first links in cardiac arrest survival are Early CPR and Early Defib. Two things EMT's *SHOULD* be very good at. Thats why EMT-B should be in the hands of people that will be on the scene first. Cop's beat us to unresponsives all the time, because they are already out roving around.

Dust, we are not letting you win, it was a one sided arguement already. I basic has a role in EMS, just not on the ambulance.

[Cookie]

7 pages and no body count! Amazing

[batjka104]

Hey,

I completely agree that if the medics are available EMT-B's are not needed. Because it's a higher certification level, and paramedics can do everything BLS can do and a LOT, a LOT more. That's totally understood and does not need to be explained.

The only reason BLS exists is because medics are not available in volume, especially in smaller communities. Basics are the cheap labor, the illegal immigrants of EMS system.

Does the patient care suffer a little? Perhaps. Does it have a profound effect on the patient outcomes? Probably not. Things are going to change with comprehensive health care system that will encompass all aspects of prehospital, as well as hospital, care. When people will be able to make a living (maybe even good living) being an EMT. Like nurses. But this dream reform is not happening any time soon.

So, I will continue to volunteer as Basic and provide the limited care that I can. And I will try to further my education in EMS field as time and family allows.

Once again, I would like to stress that not teaching Basics medical skills and limiting their scope to simple procedures should give way to expanded classes and expanded scope. Perhaps the intermediate level should be the "Basic". That's all, folks.

Yeah, and those sirens, they just make my heart sing! :-)

[JakeEMTP]

Once again, I would like to stress that not teaching Basics medical skills and limiting their scope to simple procedures should give way to expanded classes and expanded scope. Perhaps the intermediate level should be the "Basic". That's all, folks.

That would be an excellent beginning!

Yeah, and those sirens, they just make my heart sing! :-)

Nah, that's just wackerish :wink: .

[somedic]

"A call to Arms" EMT-Bs Defend yourself! So dramatic... Whay dont you lot go to PARAMEDIC school instead of trying to defend your minimal role in EMS.

Somedic Sends.

[Richard B the EMT]

JPINFV wrote

"Would you say that 2 doctors of the same specialty bouncing treatment plans off of each other also qualify as needing remediation or would you just chalk that up as a consult?"

Wouldn't that cause the plotlines on ER, and House, and who knows how many other TV medical programs, to collapse?

Ruffems wrote

"Have a 3 person truck. An EMT To drive and two medics to take care of the patient. That way everyone is happy."

I am not going to be happy, that is a taxi driver's job (playing devil's advocate, here).

I also mention, 30+ years ago, a lot of smaller ambulance operations fought NYS DoH on the requirement that at least one EMT be involved in patient care in the back of the ambulances. Their reasoning was, cost of the training, time commitment of the training, versus their call volume (figure the organizations that perhaps never got more than 2 or 3 calls A WEEK took this line). They just wanted to continue using American Red Cross First Aid, and ARC Advanced First Aid, trained personnel.

A Paramedic team, or even a "Mensa Medic" ambulance, may be a good idea, but even when they respond, their skills are not always utilized (I'm using the NYC "think" here, it might not apply in other areas of the world). Due to no penalties for callers who say the medical or trauma condition is worse than it is, will result in, shall we say, an "over-response"(yes, I just made that up!) which, once the crews arrive, can downgrade to a lower priority, some callers do simply want the "free" ambulance transportation to the ED.

Wait until the Medicaid/medicare/blue cross/blue shield and other 3rd party insurers start refusing to pay for "non-essential ambulance transportation and care", and the person gets the bill! They should have gone by an actual taxi!

[ladyemt51_2000]

Wow! Is anyone who is a basic starting to think this is more a site for Paramedics than for EMS as a whole? I come here to learn (I am in Paramedic class) but I get the feeling that basics are unwelcome here. I can't help but wonder if the new members who browse the forums see this thread and wonder the same. It would be great to get back to the sharing of knowledge this site was so well known for than the nastiness it has become. Sad.....

[whit72]

We are discussing a topic, nothing is personal, you shouldnt take it that way. There are many educational threads on this forum.

If we all shared the same views these forums wouldnt be very interesting.