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ALS or BLS? Help me decide...


benanzo

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What impresses me Dust about them is exactly what we have talked about many times. They are taking a step in the right direction with the EDUCATION...You can not just be a medic and get a job with them. They require you to go through a very rigorous and comprehensive paramedic program. One of the best in the nation ( in my opinion) because of the amount of hours and clinicals they require. If all the programs were similar to this one, we would not have "firemonkeys" blindly following protocols. The training is tough, it requires dedication and you do not skate by or get passed because they need medics. I myself was ignorant of this program until I moved to the northwest. I know a few of the guys and I am very impressed with their education requirements. Since this is all you harp about, you should look into their requirements because I think you will then be pleasantly surprised and you may even pass on YOUR approval..lol

As for the system flaws, every system will have them, but I see exactly what they were trying to do and it makes sense. Not having worked in the system, I can not comment on whether or not it is truly working, but I have heard no negativity from the guys. The employees that I know are very happy and like I said there is very little attrition.

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Not having worked in the system, I can not comment on whether or not it is truly working, but I have heard no negativity from the guys. The employees that I know are very happy and like I said there is very little attrition.

You're not going to ever hear any negativity from ANY medics where they are paid big money and never have to run BLS or non-emergency runs! Would you? :lol: They know they have a good thing going on for themselves, regardless of the negative effects it has on the citizens.

So does anybody know how long and comprehensive their school is? Simply making medics go through their own school does not in itself impress me. Dallas does that too, and they are one of the worst systems in the state.

SPELL CHECKED: No errors found 8)

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I think one would have to see this system in person to get the understanding of how it works totally. I cannot relate to a system like this one where so many agencies are involved.

I don't have a problem with Fire based EMS. What I do have a problem with ( and this is going to ruffle a few feathers here ) is Medics who think they should only attend on ALS level calls and never have to do any BLS. IMHO when you are a medic you now have the training to deal with any situation you come upon and should have the sound clinical assessment skills to treat and deal with such. Even if it is Grandpa with general malaise who needs a taxi transport to the ED.

Maybe it is just from ignorance on how the EMS system works in other areas but having so many agencies in one area ( BLS, ALS, Fire EMS.....and so on) to me just opens the door for pandamonium. Maybe things here are just too simple, ALS unit does all calls and if the medic decides it is BLS then the EMT on the car attends.

As for the Pt at the beginning of this post, I am leaning to the recurrance of pneumonia again due to the temp, tachypnea and presentation. I too would like to know what the lung sounds were and if he would have benefited from a neb Tx. Yes if it was only 10 min to the ED if I was on the BLS unit I would transport this Pt.

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As for not basing decisions solely on protocol, I loosely disagree. But you have to understand that I am evaluating from BLS perspective which means that I am not using all the tools that the medics would. I can only treat from their vitals and what I see. We don't use glucometers or oxymeters (I use the facility's when possible.) If I see someone who is barely responsive with huge resp effort, it doesn't matter what I think is going on, I'm using protocol to base my decision to call medics. Now, if I see someone who is overly altered with diabetic history, I'm also using protocol to call medics, even if they find his BS to be fine and send him along with me.

His lungs were probably clear except for all the gunk in his windpipe. I only used that example because I have seen it consistently as being an area where there are mult. ALS indicators but the patient wasn't necessarily critical. This can be a fairly complicated situation to evaluate from a BLS perspective. The fact that he is almost completely unresponsive with severely labored breathing should trigger some sort of ALS indication...right??? Another example is a CVA with decreased LOC. A CVA with a normal LOC is a BLS call here. A CVA with altered or decreased LOC is an ALS indicator here. BUT, the medics usually don't transport that. These are just examples of potentially unstable situations that should be referred to protocol given the inevitable liability if the pt were to crash, which has happened.

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King County Medic One only employs Paramedics. We do not train or hire individuals to work at the EMT level. If you wish to obtain a career at the EMT level, please contact a local Fire Department or private ambulance company.

King County Medic One does NOT operate a Paramedic Training Program. The University of Washington is the sole training provider for all Paramedics in King County.

After a competitive testing process, we contract with qualified individuals to attend the University of Washington Paramedic Training Program. If the candidate is successful in the educational endeavor, they are hired by King County to work as a Paramedic, sent to orientation and placed on a one-year probation under the direction of Field Training Officers.

Call the University of Washington's Paramedic Training Program at (206) 731-3489 or click here to visit their website.

To be qualified to test with King County Medic One you must hold a current EMT certification and have 3 years of field experience. Field experience must be in the pre-hospital EMS setting (paid or volunteer Fire Department or Ambulance Technician); 12 months of the 3 years must be consecutive with a single agency. Military medic or nurse / hospital type experience is not accepted. You must have a high school diploma and a valid driver's license. Competitive candidates will possess excellent reading, math and writing skills. You should be physically fit and able to pass a job-related assessment.

The successful candidate

King County Medic One strives to hire individuals that will perform well in the academic setting. Successful candidates must demonstrate spatial reasoning skills, critical thinking skills, and leadership ability. Candidates should be exemplary in teamwork and customer service skills as well. Qualified candidates are given a series of evaluations, which include:

General Knowledge Test

EMT Level Test

Physical Agility Test

Assessment Center

Physical Exam

Criminal Background Check

Two Oral Boards

Sorry to make it sound like an ad, but I am displaying information that I think justifies the debate

Paramedic Training

To become a Paramedic, department firefighters must apply for the position and if accepted, begin a year-long training programming under the close supervision of the Medical Director at Harborview Medical Center and veteran paramedics. Paramedic trainees must successfully complete this intensive 3,000 hours worth of instruction and hands-on training.

After completion of their training, Paramedics are required to complete 50 additional hours of medical education annually. They are also required to document performance of required skills in excess of State requirements in order to maintain certification as an Advanced Life Support Paramedic by the University of Washington School of Medicine. These hours are divided into a formal lecture series relating to paramedicine, other medicine-related lectures, alarm review with the Medical Director, and teaching EMS-related subjects.

This first link is the best one..explains and lays out the training schedule...now please debate this and tell me it is no good..

http://www.metrokc.gov/health/medicone/trainingschedule.htm

http://www.metrokc.gov/health/medicone/action.htm

http://www.cityofseattle.net/fire/medics/medicOne.htm

http://www.ncpa.org/newdpd/dpdarticle.php?article_id=1364

So, having said all of this, the only downside is it is not a degree program yet. I called the college and they are in the process of developing it, but they do give credit for the course so that you may apply it to another degree if you so desire.

The bottom line is the paramedic program is NOT open enrollment. You must be hired by one of the participating organizations and then you must attend this intensive program or you can not work as a medic..period.

7 days a week for 9 months, 600 pt contacts..read the list..it is amazing. I wish my program had been like that

So, to sum it up...in my opinion, this is what I think makes these medics so much better than medics from other areas..they put the empahasis on education, not just skills.

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Sorry, but blah, blah, blah!!!! I have seen time and again the "over-educated" non-street smart, just follow the protocol cook book medics that have come out of the "great" paramedic programs (around upstate ny). And, let me tell you, I AM NOT in ANY way wonder medic, in fact, I am a lowly AEMT-CCT!! HOwever, I can tell you that myself and several other of my CCT cohorts can dance around some of these "paragods" from the college.

We do have an agency around here that sounds an awful lot like this Medic One unit. We call them the "God squad" because that is what they think they are. Just recently given the powers for MFI (last year) they have had to had to cric 5 people in the past 7 months alone. Never mind that they should have done this, but SHOULD they have done this? Not being on the scend, I cannot clearly say. But seems to me that you should be able to ascertain if you are going to be able to get a tube before ya'll go and paralyze someone!!

OOOOO... sorry venting about that one!!!

Anyhow, just wanted to give a little input on the walk on water medics out there! :)

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Those paragods with their stupid college degrees are no better than me! I don't nead no stinkin book learnin! I know everything I need to know! Just because every other state in the country would laugh my night-school AEMTCCDEFGHIJK certificate out the door doesn't mean anything to me! I can start an IV and intubate as good as any doctor can, and that's all that really matters! And besides, I have a Littmann Cardiology III!!! Now, where's my MagLight? I have a gomer tote to make.
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Sorry, but blah, blah, blah!!!! I have seen time and again the "over-educated" non-street smart, just follow the protocol cook book medics that have come out of the "great" paramedic programs (around upstate ny). And, let me tell you, I AM NOT in ANY way wonder medic, in fact, I am a lowly AEMT-CCT!! HOwever, I can tell you that myself and several other of my CCT cohorts can dance around some of these "paragods" from the college.

We do have an agency around here that sounds an awful lot like this Medic One unit. We call them the "God squad" because that is what they think they are. Just recently given the powers for MFI (last year) they have had to had to cric 5 people in the past 7 months alone. Never mind that they should have done this, but SHOULD they have done this? Not being on the scend, I cannot clearly say. But seems to me that you should be able to ascertain if you are going to be able to get a tube before ya'll go and paralyze someone!!

OOOOO... sorry venting about that one!!!

Anyhow, just wanted to give a little input on the walk on water medics out there! :lol:

And you wonder why they still call us ambulance drivers ?.........Oh by the way spell check CAN be your friend.. It will help present your idea better.

A word of hint...it is better to be presumed ignorant than to remove all doubts.

Be safe,

R/R 911

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Sorry about the venting. Do not get me wrong, I am still learning. Will do so with every call taken. The day I stop learning, I stop riding/working. I am a big proponent of education, however, am also very turned off by those that think that they know it all. I do believe that there are some great medics practicing out there (both paramedics and in NYS critical care). Although my certification was done at night, I also have an associates degree so lets not assume that ALL was gained at "night school". In this area, there is quite a monopoly on the paramedic program and one has to travel 1 1/2 hours away for day classes at another college to "bridge" into the paramedic program. As for my "night school", I was trained by highly qualified paramedics who demanded nothing but the best out of everyone. And, not everyone passed.

I am not here to defend what "little" education many may think that critical care or even EMT's have, just point out that being "highly educated" does not make the person/medic.

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