BLS before ALS

[JPINFV]

A very big part of my post describes some things that EMT Basics can do. Some states do not recognize the EMT I and those skills are divided down and as EMT HP only. I feel that if you work in a system and are unhappy with the care of your partner or the area providers, then maybe you should have more input.

You have more input by becoming educated. With education comes the ability to think critically and present and support arguments professionally. If you think that level EMT-XYZ should be able to do something, then you should be able to support that showing the benefit to the system and what extra education and training would be required to implement it. This is how we avoid looking stupid by saying things like, "Basics should be able to use a pulse-ox because, after all, it's just putting a clip on a finger."

The posts that are written here represent some very educated people, some of these people cannot use spell check appropriately and some are EMT Basics and some are EMT Paramedics. This is a basic skill and it should be mastered otherwise don't work on any body

Grammar is important also. :wink:

[Dustdevil]

To suggest that one must actively want to take their education to the next tier to be "taken seriously" is a silly thought.

Which is another illustration of why the so-called "tiers" in EMS should be eliminated. :wink:

[cosgrojo]

What do EMT Basics do? Well that depend upon the system that employs them. If the system forces an EMT B to be a taxi driver and a gopher then that is what will be done. If the system allows the aforementioned provider to perform skills and interventions then that is what will be done. All systems have their fair share of idiocy and excellence. After a decade of seeing many different forms of service and how the levels interact, I feel that EMT B providers are being held back by the ego of the EMT Paramedic provider.

A request was made to have an explanation of what EMT Basics do, see if you can follow.

Airway

o OPA and NPA

o Combitube

o LMA

o King

o LMA

o ETT

o BVM

Of the above the most important is the use of a BVM to maintain PEEP and thus splint open the airway

Breathing

o Ventilation at the appropriate rate

o Proper BVM technique

Circulation

o CPR

o Bleeding Control

o Warming or cooling patients

This covers most of the stuff that we do. EMT Basics are also expert people movers and packaging is something else that is mastered.

In response to what makes them better than the high school kid with a first aid class, simple we come with the ambulance and we don’t really need you EMT Paramedics if you are going to be stupid and wast our time.

Maybe people with ADHD shouldn't be allowed to post on this forum.... :violent2:

Since you are new to these forums, I will not expect you to have read every other post on this site. This has been pretty thoroughly fleshed out, and I dare say we haven't gotten anywhere with it. If you would like to bash ALS (which is funny, because I think you are ALS), you may join spenac in one of his many bash the (fill in the blank) threads. If it is about education, than make it about that. If you want to be a part of these posts. Take your time and think out your ideas first... and don't bash people's spell-checking unless your s%#t is clean. :wink:

[Timmy]

I’m so over this debate between BLS and ALS! But I’ll add my 10 cents because I’m board.

I CAN NOT believe that EMT B work on Emergency Ambulances! I almost fell flat on my face when I found that I have a better scope of practice than an American EMT but yet I’m not allowed near an emergency ambulance which to me seems logical!

My correct title in Australia is Advanced First Aider which is a Cert 4 in Emergency Response. The course I have done covers everything from bandaid patrol to bumps and bruises, fractures and splinting to AED, medications administration, Pharmacology, Intravenous cannulation and fluid therapy and even wound closure.

I can only work with a private standby service or as an Industrial First Aider. If s#%t hits the fan or someone needs a ride to hospital then I call 000 and get the ALS guys to come help me out and take over care.

Now if I worked on an emergency ambulance with the training I have received I would crap my self. I mean if someone’s having a cardiac episode what more can I do than give them some GTN or aspirin, 02, get the defib ready and call 000. If I was having a heart attack I would be more freaked out that the people who rocked up could only put me on 02 and race me to hospital. At least when the ALS or even better MICA guys rock up they can pump me with drugs, do a 12 lead and hopefully get me pretty well stabilised before I’m even off the floor.

Personally I hate with a passion that I can’t do more for my patients but I’ll get there one day. I plan on continuing my education because I could think of nothing worse than being stuck doing BLS for the rest of my life. Frankly I don’t think I could handle this job much longer without knowing that I wouldn’t be able to do more or couldn’t continue to advance my education. It seriously scares me.

I totally understand why some people like BLS. I work with people who LOVE getting out there giving out bandaids and ice packs but when it comes to an emergency they can handle it but would rather be some place else. That’s cool, there only first aid that’s all people expect from them. They call for help and treat the patient to the best of there ability but ALS is only a phone call away. They know when to call for help and when to back off. Not everyone is cut out to be ALS but working on an emerg ambo is a bit far.

[cosgrojo]

I’m so over this debate between BLS and ALS! But I’ll add my 10 cents because I’m board.

I CAN NOT believe that EMT B work on Emergency Ambulances! I almost fell flat on my face when I found that I have a better scope of practice than an American EMT but yet I’m not allowed near an emergency ambulance which to me seems logical!

My correct title in Australia is Advanced First Aider which is a Cert 4 in Emergency Response. The course I have done covers everything from bandaid patrol to bumps and bruises, fractures and splinting to AED, medications administration, Pharmacology, Intravenous cannulation and fluid therapy and even wound closure.

I can only work with a private standby service or as an Industrial First Aider. If s#%t hits the fan or someone needs a ride to hospital then I call 000 and get the ALS guys to come help me out and take over care.

Now if I worked on an emergency ambulance with the training I have received I would crap my self. I mean if someone’s having a cardiac episode what more can I do than give them some GTN or aspirin, 02, get the defib ready and call 000. If I was having a heart attack I would be more freaked out that the people who rocked up could only put me on 02 and race me to hospital. At least when the ALS or even better MICA guys rock up they can pump me with drugs, do a 12 lead and hopefully get me pretty well stabilized before I’m even off the floor.

Personally I hate with a passion that I can’t do more for my patients but I’ll get there one day. I plan on continuing my education because I could think of nothing worse than being stuck doing BLS for the rest of my life. Frankly I don’t think I could handle this job much longer without knowing that I wouldn’t be able to do more or couldn’t continue to advance my education. It seriously scares me.

I totally understand why some people like BLS. I work with people who LOVE getting out there giving out band aids and ice packs but when it comes to an emergency they can handle it but would rather be some place else. That’s cool, there only first aid that’s all people expect from them. They call for help and treat the patient to the best of there ability but ALS is only a phone call away. They know when to call for help and when to back off. Not everyone is cut out to be ALS but working on an emerg ambo is a bit far.

Timmy, in the U.S. you wouldn't be let near an ambulance because you are 17 y/o, not because of your training. I have garnered that there are systems of EMS in other parts of the world that are superior in many aspects over ours. But honestly... I think you are putting a little too much emphasis on 911 (or 000) calls. *about to break out a cliche here* Some of the worst calls I've done have been on transfer rigs. If you want to feel like you aren't ready because of your education.. fine.. congrats on trying to better yourself. But don't make the mistake of assuming that bad calls only happen when a response is requested.

My partner and I did a return trip for a guy that had a wheel-chair van ordered for him. Walky-talky and all that. My company didn't have any w/c's available so sent our ambulance to take them back. En route he goes gray and clutches his chest. Quick work-up, turns out he is throwing multi-focal PVC's. He has no cardiac hx, so by definition they are malignant. This was supposed to be a wheel chair call. You never know what is going to be thrown at you, be prepared ALL the time. If you are afraid of being on an ambulance... than you should probably be afraid of band-aid patrol as well, because it can happen to you there as well. At least if you are on the ambulance, you can get the pt towards definitive care.

EMS is not that complicated, you don't need to have the education of a thoracic surgeon. I would never sit here and say that a good medic is worse than an EMT I or B. That is hogswollop. But in my experiences there are just as many bad Paramedics out there as there are bad Basics. The difference is that medics have more things to hurt the pt with. Absolutely, you give me a choice between a good basic and a good medic, I take the medic. But I'll take the good basic over the bad medic any day of the week. This is not a ALS vs. BLS thing, I just want the guy/girl that is GOOD at their job, not bad at it.

So maybe that's the answer for me... If you are good at your job(whatever that level is), then let's rock and roll... if you stink at it, get the heck away from me, my ambulance, and my patient. 8)

[speedygodzilla]

Sdowler please take it from me a fresh EMT-B with little experience. I have been an EMT-B for about 4 months and a Boy Scout since I can remember. EMT-B scope of practice and education is not much more than my first aid merit badge in Boy Scouts. I thought when I got out of EMT school that I was really a big shot. What I am, is the short end of the totem pole in EMS. The EMS community doesn't need EMT-B it is just much cheaper.

Listen to the paramedics here, don't waste your time trying to stand up for a horrible scope of practice which a Boy Scout with an extra course on backboards, adjuncts, and such could be added to their first aid merit badge in less than a couple weeks.

When did someone ask what EMT-B do? Most of the paramedics were EMT-B for a time, so I am sure they don't need this explain to them.

I used spell check too and I think it could of summed up a much shorter posting:

Word correction

Sdowler

No Suggestions

[cosgrojo]

Sdowler please take it from me a fresh EMT-B with little experience. I have been an EMT-B for about 4 months and a Boy Scout since I can remember. EMT-B scope of practice and education is not much more than my first aid merit badge in Boy Scouts. I thought when I got out of EMT school that I was really a big shot. What I am, is the short end of the totem pole in EMS. The EMS community doesn't need EMT-B it is just much cheaper.

Listen to the paramedics here, don't waste your time trying to stand up for a horrible scope of practice which a Boy Scout with an extra course on backboards, adjuncts, and such could be added to their first aid merit badge in less than a couple weeks.

When did someone ask what EMT-B do? Most of the paramedics were EMT-B for a time, so I am sure they don't need this explain to them.

I used spell check too and I think it could of summed up a much shorter posting:

Word correction

Sdowler

No Suggestions

Hey now... let's not go overboard here... he's new to the site, and he has a ton of real world EMS experience and considerably more education than a BLS cert. Unfortunately.. Mr. Sdowler has the typing skills of a chicken trying to eat after being dosed up on Ritalin. Please don't make the mistake of thinking that these posts have anything to do with the person's intelligence or aptitude for EMS. It simply could be a lack of technological knowhow, or bad typing skills.

I'm trying not to speak for him too much, but I know him personally, and he has more experience and knowledge than I have (I just talk a better game). I'm not saying let him off on his comments, but let's not go nuts here... and speedy, no offense... but you are 21? How much experience CAN you have? 3 years max... and you already admitted you are a recent Basic certificate recipient. So don't be offended if we don't just "take it from you."

[Just Plain Ruff]

I think the attitude problem resides in Mr Sdowler. Check it at the door son.

But anywho, nice that he listed out all the things emt's can do.

I for one have no problem with an EMT partner as long as they are educated and able to assist me when I ask them to.

I don't really care if you are a bachelor of science or just have some college in ya!

If you can tell me why I need something or tell me why this patient is acting the way that they are, then I'll work with you. The more educated you are the better. You don't have to have a bachelor's degree but goodness, please don't come on to my ambulance with just your emt class under your belt and that having been taught only to the standard to pass the NR test and think you are going to save the world.

If you are teachable then I'll teach you. If you are not teachable then I won't work with you.

I've gone through many a partner who was unteachable, and I have no idea how half of them passed the class.

[whit72]

I have a few points to make:

Red cell wrote:

Well, the smart ones go on to bigger and better things...medic school, nursing school, RT school, or perhaps they get a teaching degree.

No, the smart ones get out of the medical field altoghether

Redcell wrote:

The drones do nothing. They go to work everyday and complain about how there's no chance for advancement and complain that the pay sucks. They hope that the State will create a new Advanced Scope EMT certification so they can do the same "neat" things medics do....but instead of a year and a half of night school/internship they'll expect to be able to knock it out in 4 weekend

Actually this drone you speak of works in a professional 911 system. Advancement in my place of employment has nothing to do with certification, it has to do with ability, as most promotions take you off the road. The pay does not suck, I make equal pay, if not more then many of the medics that work with me. Its called compensation for longevity.

My job isn't measured by amount of neat things I can do during the day. As my ALS counterparts would also echo those same sentiments. Only here would a person brag about a year of night tech school and consider that a an accomplishment. I have more then a year and a half of anatomy and physiology, so there goes your argument. As far as skills, I could teach my twelve year old nephew to perform both yours and mine in a weekend. Its the hows and whys, where education is crucial.

Sassy EMT wrote:

A word of advise....it's hard enough to be a basic in this field......don't make those of us who love what we do for a living and are trying to prove our worth to the medics look like a bunch of idiotic fools.

I guess it would be hard if I spent most of my day, trying to prove my worth, and craving acceptance. However I don't. You shouldn't either.

Mobey wrote:

First step towards being taken seriously as a BLS provider: DON'T PI$$ OFF ALS WITH UNNECESSARY INTERCEPTS

My job description dosent state to fulfill my duties without pissing anyone off. If its warranted ALS will be called. If that pisses you off, get a new job. If you have a shitty attitude with me when you arrive, get ready for a long night cause I will call you for everything, drunks, lonelys, and stubbed toes. You will be my ALS bitch

I would recommend you arrive in a timely fashion, with a smile on your face, and check your attitude at the door, assume I know the aspects of my job and be ready to complete the aspects of yours. Then we will both have a good night. I'm pretty sure my nights going to suck, how you treat me will determine if your is going to suck.

The medics I work with would never disrespect me or anyone in my position as I wouldn't disrespect them. Yes trust and confidence in a provider has to be earned its not assigned because you wear an EMT or medic patch on your arm. There are plenty knuckleheads that fill the ranks of both professions. Trust me. I have witnessed it first hand. There are also many that are more then capable to handle the demands of EMS. It isn't rocket science, so if the need to shit on a lower level of provider is how you justify your existence thats fine. Whatever makes you sleep at night.

[spenac]

There is nothing left to beat of this dead horse. He's decomposed and all the compost has blown away. ](*,) :pottytrain5: