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

[ccmedoc]

You simply can't do it. It cannot be done. Without talking about how much cheaper they are, there simply is no rational justification for the existence of EMT-Bs as primary crewmembers on an emergency ambulance.

This is the hard truth and you cant get around it. Other than operating pure transfer cars, to and from dialysis appointments and the such, the only reason basics function as crew on emergency trucks, primary or otherwise, at all is fiscal. Throw the money card out, and you have drivers and inexpensive assists for paramedics. Truth hurts :-({|=

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?

Maybe a little of both. Given the difference in practices...apples/oranges in my book..Probably draw a fair amount of criticism for this, but so be it.

We are not, nor are we expected to be, physicians. Another time, another thread.. :roll:

Concerning the original post, Dustdevil is "right on the money". Excuse the pun :wink:

[Dustdevil]

PRPG, excellent points, as usual. Anybody who actually listens to me knows that I -- as does PRPG -- advocate the total renovation and elevation of educational standards at all levels, not just Basics. So I don't want to hear this selfish whining about Basics being singled out.

EMT-Basic level providers have an ABSOLUTE use in the field. They might be a useful level, when their level of education, professionalism, and scope are expanded as they need to be.

At that point, they would no longer be "basic," would they? Everything that is "basic" is already within their scope of practice. And a comprehensive, Ontario style entry level education certainly puts them out of the realm of "basic" regardless of scope of practice, doesn't it?

When I say that I have no use for a Basic, I am speaking of Basics as they currently exist in the U.S. And any meaningful change has to be comprehensive. You can't just give them more skills and say they aren't basics anymore. And you can't just change the labels either. Putting lipstick on a pig doesn't change that she is still a pig.

[brentoli]

See new thread

[Dustdevil]

OK, what would be the ideal scope for the "new EMT-B"

This topic is about the present. Discussions of the future would be appropriate for a NEW TOPIC.

This one is already being hijacked enough as it is.

[PRPGfirerescuetech]

PRPG, excellent points, as usual. .

Takes a bow.

Anybody who actually listens to me knows that I -- as does PRPG -- advocate the total renovation and elevation of educational standards at all levels, not just Basics. So I don't want to hear this selfish whining about Basics being singled out.

Agreed.

At that point, they would no longer be "basic," would they? Everything that is "basic" is already within their scope of practice. And a comprehensive, Ontario style entry level education certainly puts them out of the realm of "basic" regardless of scope of practice, doesn't it?.

As compared to a higher level of education, you could consider it the basic level, certainly. However, in the grand scheme of things, these would be titles really, and nothing more in the ideal world of EMS. Elevation and retitling of these lower level of providers, similar to the canadian system would be appropriate, but to suggest the complete removal of a lower certification would be no good in my thought. Our system works as it stands now, with the correctly educated professionals with the correct scope.

When I say that I have no use for a Basic, I am speaking of Basics as they currently exist in the U.S. And any meaningful change has to be comprehensive. You can't just give them more skills and say they aren't basics anymore. And you can't just change the labels either. Putting lipstick on a pig doesn't change that she is still a pig.

Correct. Then I stand by you in your opinion.

Something amusing of note however...I have been the attendant on 73 percent of my calls this year, since 1/1/07. Thats 426 of 601 patients being deemed BLS. Seems someones got a use for me.

PRPG

[lee357]

Are they relevant? DO they serve a purpose in the system? Most definitely they do. Why, the short and sweet answer is framed in a statement: go to school and spend 18 months and approx. $20,000 then go to a true rural setting and try to find a job that pays well enough (or at all) to pay off your college loans. Until a paragod can drug or assess an answer to that they need to shut up and realize that short of in the population centers (where it seems to be the only place that this is an issue) the rest of the country does just fine with bls transporting agencies backed up by als units. Now for the nuts and bolts (thats country talk for the proof) The main premise for the emt basic is to arrive on scene and provide basic life support. And for those who think they are educated that means Air goes in and out blood goes round and round. People, at this level of care it is not rocket science. So how does the basic achieve this simplest of goals? They do it by assessment of the PT. There are those of you that are going to get all riled up by this statement, but please read on before you reply (ya right, I to have read the post and replies in here). Is this the same assessment that the paramedics do? should it be? Obvious answer no, but is it? The purpose of the bls assessment is two fold, first determine if air is going in and out and if blood is going around and around, second to determine if this PT needs or, and more importantly, is going to need a higher level of care than the basic can provide. Oh my!! there is the value of the emt basic. Now back to is it the same assessment is the answer obviously no? Well yes and no. Answer this question and you will see what I mean: can a paramedic be a paramedic without being a basic? So how unimportant can the role of a basic be. Are the levels of als bls care different? apple and oranges. Some of the post I have read in this thread seem to be discussing bls as partners new people in the industry I hate to be the person who brings the bad news but it is only like that in the cities and suburbs. most of you don't seem to remember that basics are also stand alone care givers in the same chain as the paramedics. So if your reasoning about basics not being relevant or then every argument you use to justify that position can realistically be said by a doctor or PA about the position of paramedic. As I said it only serves to divide a profession. Now to tell you where my point of view comes from. I write this at 2:45 in the morning sitting in the front of my medic unit thinking back to my years as a lead EMT basic on a bls transporting ambulance in a location that the closest hospital was 45 min away code 3 and could be as much as 4 hrs away code 3 then as an intermediate for another Ils transporting agency and now in this dam paramedic unit in the big city. To conclude the basics role in the system is not the role of the paramedic so to try to compare them to justify why one should be considered irrelevant is ignorant.

[Dustdevil]

There are those of you that are going to get all riled up by this statement, but please read on before you reply....

That's a lot to ask from somebody who obviously didn't bother to read the posts before his own.

[PRPGfirerescuetech]

Are they relevant? DO they serve a purpose in the system? Most definitely they do. Why, the short and sweet answer is framed in a statement: go to school and spend 18 months and approx. $20,000 then go to a true rural setting and try to find a job that pays well enough (or at all) to pay off your college loans. Until a paragod can drug or assess an answer to that they need to shut up and realize that short of in the population centers (where it seems to be the only place that this is an issue) the rest of the country does just fine with bls transporting agencies backed up by als units. Now for the nuts and bolts (thats country talk for the proof) The main premise for the emt basic is to arrive on scene and provide basic life support. And for those who think they are educated that means Air goes in and out blood goes round and round. People, at this level of care it is not rocket science. So how does the basic achieve this simplest of goals? They do it by assessment of the PT. There are those of you that are going to get all riled up by this statement, but please read on before you reply (ya right, I to have read the post and replies in here). Is this the same assessment that the paramedics do? should it be? Obvious answer no, but is it? The purpose of the bls assessment is two fold, first determine if air is going in and out and if blood is going around and around, second to determine if this PT needs or, and more importantly, is going to need a higher level of care than the basic can provide. Oh my!! there is the value of the emt basic. Now back to is it the same assessment is the answer obviously no? Well yes and no. Answer this question and you will see what I mean: can a paramedic be a paramedic without being a basic? So how unimportant can the role of a basic be. Are the levels of als bls care different? apple and oranges. Some of the post I have read in this thread seem to be discussing bls as partners new people in the industry I hate to be the person who brings the bad news but it is only like that in the cities and suburbs. most of you don't seem to remember that basics are also stand alone care givers in the same chain as the paramedics. So if your reasoning about basics not being relevant or then every argument you use to justify that position can realistically be said by a doctor or PA about the position of paramedic. As I said it only serves to divide a profession. Now to tell you where my point of view comes from. I write this at 2:45 in the morning sitting in the front of my medic unit thinking back to my years as a lead EMT basic on a bls transporting ambulance in a location that the closest hospital was 45 min away code 3 and could be as much as 4 hrs away code 3 then as an intermediate for another Ils transporting agency and now in this dam paramedic unit in the big city. To conclude the basics role in the system is not the role of the paramedic so to try to compare them to justify why one should be considered irrelevant is ignorant.

What the f*ck are you talking about? Read the thread friend, all I ask.

Side note: The good qualities of the EMT basic that you describe can be provided by EMT's on a First responder unit, not on an ambulance.

[akflightmedic]

the rest of the country does just fine with bls transporting agencies backed up by als units.

Well, I appreciate the long response and do understand it was 0245 and you were tired, but my gosh, there was a ton of double speak, run ons and spelling/grammatical errors that made it very hard to follow. I am only commenting on this, because I am sure you had a point somewhere but it got lost in the shuffle. I would like to hear a more concise point of view from you when better rested and please break up paragraphs so we can follow along and respond appropriately. Not saying this stuff to slam you, only so I can appreciate and respond better to your point of view in the future.

As for the above statement which I quoted, can you quantify this please? What does "just fine" mean, and by operating status quo or "just fine" does that mean we should not improve or strive to do better?

Just because it is the only way we have always done it and it has worked "just fine", does that mean that we have achieved perfection and should not change?

How do you know everything has been just fine? How do you know someone has not suffered as a result of the "just fine" system?

[Janmarie3]

In all seriousness every level plays an important role in the system. How important is really up to the individual. I have seen so many basics, especially in a BLS service become to complacent and think they know it all already. This in my opinion is when they become useless to the patient and society and basically useless to the medic.

I have to get to work, but basically I would encourage that your education not stop at the basic level. Learn more!