Oh, Oh here we go again, new NAEMSE draft to replace DOT

[Ridryder 911]

I was reading my monthly JEMSand came onto the article; "Re-Directing EMS Education" ..( http://www.jems.com/news_and_articles/arti..._EDUCATION.html ). This is something I have been monitoring, as an active member of National EMS Educators (NAEMSE) in which proposals and drafts have been made to replace the current antiquated DOT curriculum, in which is being used.

I will not go into great detail over the changes, for one really needs to examine it themselves and make an objective opinion ( www.nemses.org - "right click on related docs" to view ). What concerns me is much more than the proposed changes. For you see, we have seen attempts to be made in the past in regards to the National Scope of Practice revisions. Unfortunately, instead of moving forward and being pro patient care, there are many that rather protect their own special interest. I see that it is much more important to satisfy their feelings, secure their jobs, than to ever provide thorough patient care and improve our profession.

Sorry, I know I may offend many, but personally do not care. Apparently there are those that do not care how they offend me and others by their lobbying and special interest in restricting the growth of the EMS as a profession. You see, this is my career, my livelihood. I chose to obtain multiple degrees to have the knowledge, as well as chose to remain in this profession. It is not a hobby, side line job, part of another job that requires me to be an EMT. So yes, your "special interest" affects me and thousands of others

As usual any thoughts of increasing the knowledge requirements of EMT to the Paramedic level education is already being under scrutiny and fire. For example in the article Chief Gary Ludwig; who chairs the International Association of Fire Chiefs (IAFC) EMS Section describes .." We have concerns how this will affect volunteer and combination fire departments:..

So Here We Go Again! Let's protect the volunteers and the firefighters! To he*l with the patient and the profession! As long as we protect ourselves is what really matters!

They say history repeats itself. It must be true. Review why the curriculum was diluted in the 90's and why the National Scope was canned.

Sure, not all volunteers and firefighters have such opinions, unfortunately they are being represented by those that describe they speak for the masses. I would definitely let my voice be known, if it is not your opinion.

I highly encourage those that really care about EMS as a profession and want to see a more defined curriculum and increased level of education to speak out. If you don't other will speak for you!

R/r 911

[spenac]

So Rid how do you really feel? Please stop beating around the bush. :twisted:

We do need to get a national healthcare scope. Forget the feelings. It needs to be a minimum that is higher than most systems currently have, but still allow for each service to even allow a broader scope if they so choose. Education needs to improve, but for the protection of rural areas that have no colleges, distance learning, must be allowed.

Perhaps we can see something included that allows us to weed out those that are just looking for a free taxi ride. Because if all we are going to be is taxi drivers there is no point of more education, broader scope of practice, national standards, etc. If with education and all the other we are then allowed to stop the abuse, I'm all for it.

I have chosen this as my career. I was willing to close the doors on my company and pursue this profession full time. I want to see it progress and be recognized as a healthcare profession, not a taxi, not a branch of Fire or Law, but a specialty branch of HEALTHCARE.

[Richard B the EMT]

Ridryder 911 says

It is not a hobby, side line job, part of another job that requires me to be an EMT.

(Italicizing by Richard

Sounds like you don't like the concept of cross-trained Fire Fighters, LEOs, or specific type work construction workers. While I may say that it might generate more positions for employment, I am guessing that you are probably on a different angle, here.

Please explain it further.

Spenac says

Perhaps we can see something included that allows us to weed out those that are just looking for a free taxi ride.

The only way, at least that I see it, to get rid of the "Taxi Rides", is for the third party insurers, like Blue Cross, Medicare, Medicaid, Medical, and others that you know and I don't know, to crack down on what they will be responsible for, addressing medical needs and, or issues. If someone gets a bill for a trip that could have been acomplished by taking a taxi instead of an ambulance, and at much less cost, over all, they just might think twice about asking again.

However, I do realize the problem of someone NOT requesting ambulance transportation, on their theory that they cannot afford it, who really would benefit from such service. There must be some legislation, law, or company policy (policies) to address this additional issue, especially for those not medically insured, and financially "down on their luck".

[spenac]

The only way, at least that I see it, to get rid of the "Taxi Rides", is for the third party insurers, like Blue Cross, Medicare, Medicaid, Medical, and others that you know and I don't know, to crack down on what they will be responsible for, addressing medical needs and, or issues. If someone gets a bill for a trip that could have been acomplished by taking a taxi instead of an ambulance, and at much less cost, over all, they just might think twice about asking again.

Actually if you are involved in billing you would know that they do not pay most 911 ambulance calls. The majority of 911 callers do not meet the guidelines to be eligible for the trip to be paid. The laws basically give you know way to make people pay for the taxi ride, and most do not pay it, at least in my area. The best way to eliminate it is to allow EMS professionals the right to examine a patient, then deny transport if not a real emergency. This would still allow people to call 911 but stop those that just call and use us a a way to get to another town in my case or another part of the city in other cases.

[Dustdevil]

Now we have to decide how we can make everyone happy.

I know and respect Debbie Cason. She's been running that programme for nearly thirty years now. But it should be noted that the programme is a ninety-day wonder school for urban firemonkeys, and a certain bias comes with that. It's probably one of the very best firemonkey programmes in the country, but it's still just a tech school that caters to the lowest common denominator. When that is your milestone, then making "everyone happy" is no problem. But this does nothing to advance the profession.

At least it doesn't appear that they are taking us backwards. But at the very best, they are only marching in place. This is certainly not forward progress. That's why Dr. Bledsoe bailed on this organisation and project.

Screw making everyone happy. You have to break a few eggs to make fruit salad.

[medic5740]

I want to be the first rural volunteer to post a reply here. I was upset that the new scope of practice for all levels including paramedic would deny those in my area from providing patient care that we have provided for several years now. That was why I lobbied against the Scope of Practice. I don't believe 110 hours is enough training and/or education to get anyone ready to provide Basic Life Support in any community. My Medical First Responder class is 90 hours. My basic EMT program is over 200 hours with clinical measured in successfully completed tasks and objectives and not in hours.

I have been a volunteer EMS provider for twenty years. I support all those who are fortunate enough to have a paying EMS career. My career in EMS and as an EMS instructor has been in a rural area that is lucky enough to have the money to replace the supplies and equipment on the rig. We worked for 14 years to get enough savings by fundraising to offer a paramedic class, so we could provide the advanced level assessments and treatments that our patients deserve. After twenty years of work to get our level of treatments at this high of level, I certainly don't want someone diluting the treatments that we are able to provide with a watered down Scope of Practice.

I have not read the new article you suggest, yet, but I can assure you that I will not support elimination of treatment modalities from any level of EMS care unless there is scientific evidence that these do not benefit the patient. Political motivations, such as the fire chief's comments are just not worthwhile reasons to make changes. Give me a patient care reason to change--something that will help my patient, and then I'll investigate the suggestion, and make the choice on my own.

I was studying EKGs when I was a basic EMT, drugs and 12-leads when I was an intermediate. Now that I can provide IV pump medications, induce hypothermia, and actually give my patients some comfort from pain, and a chance to survive, why would I want to go back to a watered down curriculum with lowered expectations.

Our basic EMTs can give nitro, aspirin, and albuterol neb treatments. Our Intermediates can push D50 for insulin shock. We got these treatments by earning the respect of our medical directors and ER physicians. Why should we give them up? Why doesn't the Scope of Practice embrace these levels of care? Right down the road, there are basic EMTs starting IV's. Is there a reason that they shouldn't be doing that if they are educated and trained to do the proper treatments?

I'm sorry if I am coming on strong, but this is one person who believes that education is power. I supported the level of care named Advanced Paramedic with the higher level of education that would accompany a higher level of provider. That one lasted a very short time in the discussion phase in Scope of Practice discussions. Let's move EMS up the ladder of professionalism by increasing education and knowledge instead of moving backwards. Let's set the bar higher so our profession can strive to improve the level of patient care for every person in every community.

[stcommodore]

Because the blurry line between EMT-B and Paramedic only causes confusion....Maybe its because I'm from a state that has no middle ground that gives me this view but I don't feel a need for the middle tier of care.

[Dustdevil]

Excellent comments, medic5740, but I believe you would benefit from actually reading the article you are commenting on. That way, you could make your comments more relevant to the situation at hand.

But yeah... I can think of several good reasons why your EMTs shouldn't be starting IVs. I bet you can too, if you're honest with yourself.

[BushyFromOz]

You have to break a few eggs to make fruit salad.

Dude..... thats a weird ass fruit salad :shock:

[brentoli]

Dude..... thats a weird ass fruit salad :shock: