Collegiate EMS

[Dustdevil]

I think everyone will agree that there is a big difference between a green emt and a more experienced provider even if they are following the same protocols.

Absolutely. But what is "experience?"

Experience is not just a word. It is a qualifiable and quantifiable factor. What is the quality and quantity of experience you are giving your students? How do you measure them? Sometimes, no experience is better than bad experience or short experience. Medicine is much like the martial arts; there is a period early on where you know just enough to get yourself into trouble. Low-time volunteer agencies promote this problem.

[EMSGeek]

We give our new providers a safe way to learn EMS in the field. When someone gets their card they become "Attendants-in-Training" (attendant being the crew chief/lead medical provider) during which time they work with several different attendants but run the calls themselves. This acts as a safety net of sorts because if they need help they have it. I know that with my FD we are hurting for medical providers so bad that shortly after they get their card they are let loose into the field on their own.

We try to promote positive habits in the field including good scene control, good documentation, good leadership of a crew, and in general running smooth calls.

We acknowledge that we do not have a high call volume and encourage our members to work/volunteer at other agencies. The things we try and teach our providers should serve as a foundation.

[Dustdevil]

We give our new providers a safe way to learn EMS in the field.

Safe for whom? And in what way? I don't follow.

When someone gets their card they become "Attendants-in-Training" (attendant being the crew chief/lead medical provider) during which time they work with several different attendants but run the calls themselves. This acts as a safety net of sorts because if they need help they have it.

What are the qualifications for a crew chief and lead medical provider? Just another volunteer with more time on the squad? Doesn't sound that safe to me.

I know that with my FD we are hurting for medical providers so bad that shortly after they get their card they are let loose into the field on their own.

So it's okay if everybody else is doing it? Ever think that possibly they are doing it because of the example being set by the school?

The things we try and teach our providers should serve as a foundation.

Teach them in class, or teach them in the field? And again, who is teaching them, and what are their qualifications? I am picturing the blind leading the blind there. Are there any actual experienced and educated professional paramedic providers there to do any of this teaching and leadership?

[EMSGeek]

Safe:

As in the educational sense of safety that one has a safety net. Our new providers know that for the beginning of their time as an EMT with our agency they will have a more experienced provider backing them up. Little things such as tricks in dealing with an upset patient, the best way to document a call, etc. Dust, with all due respect I believe you may have forgotten what it is like to be a brand new EMT-B or if nothing else you may be unfamiliar with how little the current EMT-B curriculum teaches things like the finer points of documentation. As with any skill you may learn it but you still need to practice that skill and to practice it effectively you may need some guidance.

Crew Chief/Lead Medical Provider:

Our crew chiefs are in fact "just" more experienced providers, people who have more time with the squad. I don't even see why you raise this as an issue. Who would our crew chiefs be if not more experienced providers? Part of this is simply the fact that those individuals know the policies of our agency but more than that they have a greater base of experience to draw on and have shown leadership with in the agency. Coming from a paid agency all of the EMT-B and Paramedic supervisors I know are simply people who have put in the time with the agency. Why is this a problem? Bringing it back to the safety issue a provider who has run more calls than another newer provider may have incite into a given problem based on their experience. After getting punched in the face while treating a diabetic patient I have a different view of scene safety. At that call there were two LEOs, three ALS providers, and two EMT-Bs none of which could predict what the patient was going to do. I've learned from that experience and will treat altered patients with a greater degree of suspicion in the future. Experience does count for a lot but all of our providers will still be humble when dealing with a more experienced provider because we never forget we are new to this business.

New providers on their own:

You misunderstand me. I'm saying that the way my FD does it is not right. There is no reason a brand new EMT should be tossed into the back of an ambulance and have to work a traumatic arrest. In theory they are capable but in reality it takes a little time to develop one's own way of dealing with an emergency scene. I won't be bashful in saying that I think we have the right idea on campus regarding easing people into EMS. I'm glad that I was able to get some experience on campus in our system before I volunteered or worked elsewhere.

Teaching/Training:

We do drills twice a week on a variety of topics as well as the teaching/training that goes on in the field. I teach some of the classes but I'm not just spouting information. I come up with an objective for the lesson and write out a lesson plan. I use real resources such as EMT textbooks, the AMLS text, the PHTLS text, ACEP content, JEMS articles/references. I'm not an expert therefore I have no right to present this information on my own. I combine information from various resources and present that to our corp. Additionally we bring in guest lecturers such as paramedics, doctors, LEOs, pharmacists, etc to assist with training. Our consistent adviser is a Paramedic who has been in the field for 36 years. He is the individual who helps guide us and who I use as a resource as well.

My question to you, Dust, for a volunteer agency with a fairly small training budget (you'd laugh if I told you) who would you deem to be appropriate to be educating?

I hope that this cleared things up a little.

[spenac]

My question to you, Dust, for a volunteer agency with a fairly small training budget (you'd laugh if I told you) who would you deem to be appropriate to be educating?

I hope that this cleared things up a little.

Cleared it right up. Problem clearly is "volunteer agency". Get paid or get out, quit hurting our profession.

[EMSGeek]

Hey spenac great contribution to the discussion. You really nailed the topic on the head. /sarcasm. Did you even read the topic or do you just enjoy being an a##hole?

Spenac, you bring up another topic which is fair to discuss but this isn't the thread to do it.

[spenac]

Hey spenac great contribution to the discussion. You really nailed the topic on the head. /sarcasm. Did you even read the topic or do you just enjoy being an a##hole?

Spenac, you bring up another topic which is fair to discuss but this isn't the thread to do it.

Yup read it. Thanks for the compliment. (sarcasm)

Students doing ride alongs great but once certified need to be paid. I hope ya'll provide education rather than training. Big difference. Don't get your panties in a bunch over a forum, not worth the stress, bad for your heart.

[EMSGeek]

Anyone got anything on topic to continue with?

[Snafu3532]

I work for an entirely student run collegiate ambulance service, and although we are volunteer I more consider it an unpaid internship. We staff our trucks 24 hours a day 365 days a year. In addition to campus, we are primary 911 for 4 surrounding towns, including 12 miles of highway. All this adds up to between 2700 and 2900 calls a year, making us the second busiest ambulance service in the state. We are an ALS staffed and stocked unit 100% of the time. In addition, every member is pursuing higher education. My curriculum, heavily weighted in biology/chemistry classes, helps me better understand the pathophysiology of disease, illness and interventions, along with fostering the development of my critical thinking skills (unfortunately many of the surrounding Fire based EMS services do not hold these things in high enough esteem to mandate them). A student must run with our department for 2 years and show aptitude before being allowed to Crew Chief calls (direct medical care). We work very closely with our medical director and medical advisor to advance our capabilities for patient assessment. We are frequently the testing ground for medical studies, such as our most recent trial implementation of the Zoll AutoPulse. Subtracting as much bias as possible, I believe we are one of the best educated and most comprehensively trained services around, collegiate or not.

[EMSGeek]

Sanfu, it sounds like you guys have a hell of a service going. I'm impressed. I wish we could go ALS but unfortunately my school only has four year degrees and we can't keep people long enough to get them through basic and an ALS program. How many members do you have?