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

[whit72]

I wasn't commenting on my service. When the calls are split ALS to ALS providers and BLS to BLS providers. Nobody stays up all night for the most part. There are exceptions.

I agree with you, at the point of 120 hours of training no one is ready or competent to handle anything. Let alone decipher what a pt needs ALS or BLS. Anyone who has been doing this for any amount of time, has a lot more then that, continuing ed, seminars. I have taken so many classes both in the college setting and work related training. I couldn't tell you what I learned in my EMT class. All are helpful. OK except for NIMS

I cant speak to the level of all EMTs on this board. I can only speak to the level of myself and the ones I work with. I am required 28 hours of con-ed every two years, last year alone I had one-hundred and forty. So do the math. I wont even get into my whole college fiasco, however its safe to say I will be walking down an aisle sooner then later I hope.

Do I jump up and down here stating I have more formal education them most? No. Am I more capapble? No. Why because they have the same amount of training that the state mandates to become an EMT. Does that training suck? Sure in the hands of someone who believes their done learning. I have never argued that point. I cant stop them from being shitty EMTs I can only prevent myself from being one. So think next time you make a comment that stereotypes everyone involved because you have had the misfortune of working with a couple meatheads. If you think eliminating will solve all your problems, I am afraid you are mistaken.

The only point I am arguing is, I believe competent EMTs have a place in EMS. I believe that the tiered system is beneficial to all involved. You had a few medics here state they prefer that over the all ALS systems.

Do I think you should come out of EMT school and be thrown on an emergency vehicle? No. You should have to prove your competence. Your ability to handle what is asked of you.

When I run into an incompetent medic do I berate the whole field, throw generalizations around that medics suck, there education and training sucks? No. because every occupation has its idiots its incompetence, no matter the amount of training or education. You cant eliminate it its a trait in some people. So yes I believe education is important at all levels. If you replace the EMTs you are not going to remove the amount of incompetence you will just shine the light on a whole different set problem.

I am really impressed that this discussion stayed somewhat civil. It just goes to show you there is hope for EMS and society in general.

[Just Plain Ruff]

let's all remember "if you build something and you think it's idiot proof, just remember there are inventors out there ready to invent a better idiot"

"some people are promoted to their level of incompentence"

and my favorite "if you drop the baby, pick it up"

[Dustdevil]

So before you blame the Basics, consider yourself being on a 2 medic truck running the bullshit calls - put yourself in the tech's position that transports a "patient" who just wants a refill for his meds and calls you an ambulance driver -- because you can take out the Basics, but you cant take out those who call 911.

Sorry, but I don't get your point.

I've been on dual medic trucks for the great majority of my career, working the BS runs right along side the emergent ALS runs. That's part of the job, and I accept that. I'm not one of those paragods who wants Basics around just to stick with all the un-glamourous patients that they think are beneath them. Only an arsehole would do that. Consequently, the paragod arseholes are the only ones who have any use for an EMT-B.

[Dustdevil]

I wasn't commenting on my service. When the calls are split ALS to ALS providers and BLS to BLS providers. Nobody stays up all night for the most part. There are exceptions.

When all runs are ALS, nobody stays up all night either. And two trucks never get yanked out of bed for the same patient because one got there and figured out they needed the other. Clearly, tiered systems are the ones with the extra workload, without any benefit to the patient.

And, of course, it goes without saying that any high volume system that works 24 hour shifts sucks.

I agree with you, at the point of 120 hours of training no one is ready or competent to handle anything. Let alone decipher what a pt needs ALS or BLS. Anyone who has been doing this for any amount of time, has a lot more then that, continuing ed, seminars. I have taken so many classes both in the college setting and work related training. I couldn't tell you what I learned in my EMT class. All are helpful. OK except for NIMS

LMAO@NIMS A pox on the idiot that invented that nonsense.

But again, you have to compare apples to apples. That means comparing levels to levels, not individuals to levels. You have to talk about the level of training as it currently exists. Period. You can't talk this nonsense about the rare BS in Biology EMT with 5 years full-time EMS and 4 years military ER experience and compare him to a 90 day wonder medic fresh out of school. You only invalidate your argument with that.

So think next time you make a comment that stereotypes everyone involved because you have had the misfortune of working with a couple meatheads. If you think eliminating will solve all your problems, I am afraid you are mistaken.

I've worked with many EMTs who were great at what they did. I'm not saying they all suck. I am -- AGAIN -- saying that the level of training itself sucks, is inadequate, and is all but useless to an EMS agency, unless they are just trying to save money by gambling with people's lives. Doesn't matter how intelligent, experienced, or educated they are beyond EMT school. They still aren't a full partner with me, so I still would rather have a new-grad medic with me.

The only point I am arguing is, I believe competent EMTs have a place in EMS. I believe that the tiered system is beneficial to all involved. You had a few medics here state they prefer that over the all ALS systems.

Sure. A lot people like having illegal aliens around too. Plenty of medics love to have somebody that they can dump all their dirty work on. Somebody whose faces they can rub their disco ball patch into and feel superior a few times a day. Somebody that can take care of geriatric patients because they are beneath them. Yep, you'll find a lot of those medics in EMS, but it doesn't make EMTs useful to the system. It just gives medics an excuse to be lazy and uncaring. I fail to see how that is a benefit to a system or the citizens it serves.

Do I think you should come out of EMT school and be thrown on an emergency vehicle? No. You should have to prove your competence. Your ability to handle what is asked of you.

Prove it where? If they aren't thrown on an emergency vehicle, where are they supposed to prove their conpetence? On a horizontal taxi service, with another EMT who isn't qualified to train or evaluate their competence? Sounds to me like you're not really talking about proving competence. You're just talking about paying dues. That's just another elitist theory like dumping all the geriatrics on EMTs. I don't play that game.

But no, you're right. They shouldn't be thrown on emergency vehicle. Not at all. Not ever. Not until they have finished a paramedic education.

When I run into an incompetent medic do I berate the whole field, throw generalizations around that medics suck, there education and training sucks? No. because every occupation has its idiots its incompetence, no matter the amount of training or education. You cant eliminate it its a trait in some people.

Still stuck focusing on individuals, I see. I know you are too smart to have actually misunderstood the point. So it is obvious that you are just trying to cloud the issue. It's about an entire level of practice, not about individual providers. Again, I don't care how wonderful of an EMT you or anybody else is. It is irrelevant. You still are not a full partner to me. You're just a helper. I don't want a helper. I don't want a gofer. I don't want a driver. I want a partner. And until you are educated to, and practising at the same entry level as me, I don't want you as my partner. And I darn sure don't want you out there taking primary responsibility for emergency patients.

So yes I believe education is important at all levels. If you replace the EMTs you are not going to remove the amount of incompetence you will just shine the light on a whole different set problem.

Very true. But at least then it is only one set of problems instead of two separate ones. That's progress.

I am really impressed that this discussion stayed somewhat civil. It just goes to show you there is hope for EMS and society in general.

As long as people are intelligent enough to understand that this discussion is not about them personally, there is no reason it can't stay civil.

[cwilliams17]

I am all for a paramedic on every ambulance. Education and experience is important when you have someones life in your hands whether it's a critical call or a BS one. I trust my EMT-B's, they have the skills to do a good assesment on a patient and know when they need my help. Their BLS care is excellent and I praise them for that.

I agree with Dust on the level of training of EMT-B's sucks. I agree it's time for a change, thats one reason I continued with my education and will continue further.

But untill things change we need to work together. Get on the trucks and answer the calls that we are requested to respond to. Work side by side to help your patient.

[AnthonyM83]

OK, here's one I heard today. Do you think having an EMT partner could be beneficial BECAUSE OF their limited scope. Since they can only worry about BLS, they're more likely to remember their ABCs when medics are doing their advanced skills.

Of course, in theory the 2nd medic should be able to have their BLS down pat...but the question posed to us in this thread has to do with the current system...not in a perfect system where all medic schools are adequate ones.

My argument would be that the whole EMT concentrating on BLS would be overshadowed by the benefit of having the 2nd medic on the rig BECAUSE of the additional things he could assist with?

[Dustdevil]

I long considered that theory, but it just doesn't bear out.

Some n00b medics do indeed get too focused on the next drug they think they are supposed to push and forget about the basics. No doubt about it. But his medic partner is no less capable of being the one to remind him than an EMT is. As always, the EMT is not as prepared or capable of doing the job as a medic is. Consequently, the theory is just silly.

And, of course, with all this talk around here about how EMTs are "useful" if they can set up a line, hand me the right drug, and get my laryngoscope for me -- not to mention all the EMTs who think that they too should be doing ALS interventions -- who does that leave doing BLS? Nobody. They are just as likely -- if not moreso -- to forget the basics as a medic is. That's why I'd just as soon they stick with what they were meant to do, not what they want to do because BLS bores them.

You do, however, make an excellent case for further limiting the skillset and scope of practice for EMTs.

[PRPGfirerescuetech]

I long considered that theory, but it just doesn't bear out.

Some n00b medics do indeed get too focused on the next drug they think they are supposed to push and forget about the basics. No doubt about it. But his medic partner is no less capable of being the one to remind him than an EMT is. As always, the EMT is not as prepared or capable of doing the job as a medic is. Consequently, the theory is just silly.

And, of course, with all this talk around here about how EMTs are "useful" if they can set up a line, hand me the right drug, and get my laryngoscope for me -- not to mention all the EMTs who think that they too should be doing ALS interventions -- who does that leave doing BLS? Nobody. They are just as likely -- if not moreso -- to forget the basics as a medic is. That's why I'd just as soon they stick with what they were meant to do, not what they want to do because BLS bores them.

You do, however, make an excellent case for further limiting the skillset and scope of practice for EMTs.

I dont buy it. Both EMT's and Medics are equally at fault for forgetting basic skillsets, which concentrating on "getting that line", or some other silly crap like that.

LEts educate all levels of providers to the point that we can close this website down, due to no need to discuss crappy EMT's and medics who this they are gods but are just as undereducated.

XoXo

PRPG

[Dustdevil]

I dont buy it. Both EMT's and Medics are equally at fault for forgetting basic skillsets, which concentrating on "getting that line", or some other silly crap like that.

I assume you are saying you don't buy the original theory I was responding to, and not my response?

Because you're basically saying the same thing I meant to say.

[Richard B the EMT]

I'm just breezing through the last couple of pages, so if someone covered this, my apologies for repeating youse.

Until the Second World War, Intern Doctors rode the ambulances, as a part of their training. In the shortage of personnel after December 7th, 1941, as the doctors were either volunteering for military services, or being drafted, first aiders were put into service on ambulances.

First Aiders kind of ruled, until a "white paper study" showing soldiers wounded in combat in Vietnam had a better survival rate than a ghetto kid hit by a car in Chicago. This was possibly in 1965.

The titles of EMT and Paramedic started being used around 1970. This is why I, when comparing the EMS system to the collective Fire Services and Law Enforcement Departments, refer to us in EMS as "da new kids on da block!"