cdcmj

sportygirl::So are you all saying that if as EMT-B's and MEDIC's if we had better schooling and training/practice in more skills that it would make patient care allot better?" Better schooling/training/EDUCATION and continued education/CME has nothing to do with more skills. I never said that. All I mentioned was EDUCATION as it pertains to the scope we as Medic's have now, which as already mentioned, is being stripped away due to incompetency and lack of EDUCATION.

All I have to add is that it is absolutely ridiculous to consider not paying people just because they aren't on calls. If you expect one to be ready to respond, in a uniform, and prepared to do the job, they get paid. My other feeling is that if I can't drink alcohol, then I am at work-hence pay me. When you dictate where and when, and how somebody should act, you are employing them.

All of the "hot-topic" controversial issues in EMS right now come back to one thing, and thats education. Improve education and real CE and most of this stuff will go away. OOH anything can be done if it is approached in a responsible and effective way.

crotchity, though I agree leaving your pt. hypoxic is hurting your pt., the whole hold your breath during intubation attempts bears no weight. It is shown that with proper pre-oxygenation, which unfortunately rarely happens in EMS , a pt. can maintain spo2 in the high 90's for a few minutes if left apneic. This is not to say wait a few minutes between attempts, but nonetheless, it should at least alert us to the positives that come from proper pre-oxygenation prior to ETI (less likelihood of transient hypoxia).

external pressure essentially dislodges the CO off of hemoglobin, which in turn decreases the pt.'s CO levels.

Nursing at a professional level starts at RN, anyway you decide to look at it. And CRNA's and NP's are advanced level practitioner's. Hence a need for paramedic being the baseline (min. associates), and up and away we go.

PR and public programs are secondary. EMS needs to be responsible for EMS. We control our own destiny. Dust, I disagree that we should have 2, 4, or even more levels of provider. All they are are more levels for ceilings of education. A profession does not have 5 levels of provider. Hence, reshaping of how we do things needs to be employed. We do on average 5% real emergencies. The other 95% of the call load needs to be addressed not only for the patient and community sakes, but for the future survival of our industry as well.

Agreed once again Dust. I am actually working on getting aboard an initiative out here in Pittsburgh to propose an out of hospital practitioner professional title, educated to the level of a PA with emphasis on the out of hospital delivery of medical care. This also entails all facets of healthcare, not just the 5% true emergency calls that we all generally deal with.

Dust, glad to see somebody else agrees with the notion that when you fix education, you fix alot of other things as well. HIGH Educational standards= a profession= a lot of the issues being talked about in this thread being resolved as a consequence of the one change.

National Standard Educational Requirements. Federal mandates/leadership to take over, no longer let states pick what they want to do. If we had real requirements, possibly through licensure (more education) and not certification, I would say a large portion of our issues would resolve themselves (from pt. outcomes and skill proficiency to practitioner compensation).

amen crotchity, I never understand the life long EMT-B or career EMT-B, ie one of my partners who has been an EMT for 26 yrs and never attempted ALS education..

As somebody who is in their last semester for an Emergency Medicine BS degree at a four-year university, I can attest first hand that this should now be the new standard for out of hospital practitioner's.

I am glad to some attitudes shift towards a sheep/following someone over the bridge mentality to one of taking responsibility for one's self. The phrases 'usually' and 'for the most part' keep getting flung around when describing LEO's being your savior. For real!!? As emergency workers and public entities, we all should be even more aware of the limitations of our own services. I dont know where anyone else works, but here, theres never a guarantee your armed white horse will arrive right when you need them, and how about the one in a million chance factor...anyways, I could go on, but its atleast healthy as a group to hopefully recognize and be conscience of the real dangers we face as a profession, and the possibilities of leveling the playing field.

precisely, it is a tool in the tool box, one that could potentially save your life, not necessarily your patients

Most people stating that guns/protection have no place in EMS have clearly never worked in some areas of the country. I work in urban areas of pittsburgh and surrounding suburbs. The theory is that EMS should never be anywhere dangerous without police is all good and dandy till you get called for a sick person that turns in to a gun fueled domestic violence. Anyways, at the very least, i think it is ridiculous that I am denied by law to carry pepper spray on the job, whereas my grandma carries it 24/7.....