Alex Woo

The way my proposal is structured. The new EMT-B/I/P will be affected the most. It will be difficult for the EMT-I85 and the EMT-P but in time the pain they'll have gone thru will have passed. My idea is just to put it out there and to see my peers reactions. Its up to the authorities in EMS to really make this change. I have many ideas but its up to them to have this change take affect. If its about the providers and not the patients; then we're not doing what's right. Healthcare is suppose to advance; I'm just assisting in advancing EMS care on every level. I'm asking for standards to improve. EMS is not a hobby; I'm trying to propel this field into a profession...

My ñYS Senator W. Larkin Jr has wrote me a letter of support and wrote a letter to the NYS EMS Director, L Burns requesting him to review my proposal. I'm inching closer to the yard of a dilemna... My written proposal is coming along. I will hand it to the members of SEMAC.... Thx y'all....

I totally agree... The EMT-B must know how to assist the AEMTs... It is in the back of the EMT book... I really don't know why the minimum is 110hr and I don't know why many courses are sticking with it; why can't all just have their course 150+hrs? So much more the EMT-B can do now; what are we sacrificing to have the course go 110hrs? Some may argue the tuition reimbursement is slow and low. Some may argue that they don't have enough instructors. Some may argue many students can't commit to that long of a class session. Some may argue that the state requires a minumum and they'll stick with the state minimum. U feel we hinder care; when we decrease training. My goal is to make Prehospital care in NYS and throughout the US. Many are aguing my approach; what I'm lacking; where I need to go; how I can propose this; who am I; my idea is absurb. yes, my idea maybe far fetch but change is built on ideas. Hopefully an EMS Org will assist me with this. I know my idea, if accepted, won't be taken fully. I believe if you give a person a choice of least resistance; they'll take it. I'm tryong to eliminate the path of least resistance.... Remember being an EMT is a profession; by making it into a hobby and weakening the course; we weaken the provider. Thank you...

I appreciate all that info.... I am producing a spark... I've sent to other organizations to back my idea; so I can pursue it... I can't just attend any of the meetings at NYC REMSCO; I've ask but I must be invited... However, I've just started this proposal of change. I don't need to have data on an email to NYS DOH EMS... I'm just doing this step by step until I can walk with this; then run. This a delicate process and I need to tread lightly. My proposal is a big change for mant ppl and can affedt their lives; it can limit ppl becoming EMTs to AEMTs... Its like a nmew Pres given the previous administration problems; I'm dealing with those problems.... I know all that info you produced; I'm doing this as a Per-Diem; I work FT and PT; so baby steps.... I'm waiting for other to join; as EMS World has. JEMS just needs sa lil push into this direction.... As for references; how I know what other AEMTs are called in other states. I have an idea; its an idea; when I can piggyback off a well known EMS Org; then I can really kick it into high gear.... Thank you..

Thank you Jim. I'm glad you agree with a lot of my revised ideas. I wanted to hear from others in NYS; so I can get a better idea of what others are deal with. I hope to get NYS and others to get on board. I want to make a positive change in EMS in NYS. I hope they're hearing us.... I will definitely continue to update you. I'm glad I placed my idea in this forum. All the best, Jim.. Alex Woo Jim, I'm going to look into the Farm EMT at Cornell. Thanks... If this does go through; I will definitely want to thank you and others... All the best, Alex Woo

First I want to thank all for your comments. I've changed my proposal and have sent to all parties I've sent to before with the old proposal. I will ask EMS Magazine to do the story on this new proposal which addresses all who've commented and relayed the problems with my agressive proposal for change to the NYS EMT Certification. Plz read the new proposal and fwd all concerns and questions.... Thx y'all.... ---------------------------- To Whom It May Concern, I writing for change and restructuring of the EMT Certification Curriculums. In the past I've sent emails asking for big changes and elimination of some EMT Certifications. I've received words from my peers and they have opened my eyes to the proposal I've made will hurt their services. So, I need to make it better without hindering care in rural areas in NYS. I am still pushing for change but less drastic. I want better care for our patients and my proposal is as follows. I feel we need to expand the EMT-B curriculum. There needs to be more hours in the EMT-B program: the course needs to be a minimun of 150+ hours not the minimum of 110 hours as it is now. Remember the EMT-B can administer Aspirin, Albuterol, & Epi Pen/Jr. In addition, EMT-B can also administer medications for WMD, from Atropine to 2-Pam. These skills need to be explained in more detail and practical days need to be slotted for practice. With all these changes and with the EMT-B class hours still at 110 hours; this is absurb. I had 160 hours in my EMT and I did not learn all these medication for administration. We only learn to assist the patient in NTG administration. However, I learned about many disease and traumatic processes in my original EMT-B program; which new EMTs out of class have no idea of what I'm talking about. So how can the new EMT-B student learn all this in 110 hours? What else are we going to cut out of the curriculum? Also, there needs to more rotations for the EMT-B student; 1 rotation with a choice of the ambulance or the ER is unacceptable. In my original EMT-B program; there was no choice of ambulance rotation; we only had to do 1 ER rotation. I felt that wasn't enough; so I asked my CIC if I could do more and choose a different hospital; he was fine with that. I chose a Trauma Center and I did 7 ER rotations. The ER Director there was so nice and he was a advocate for EMS. He invited me to help in the NYC Marathon at the First Aide Station. All the illnesses & trauma I saw at Harlem Hospital was a unique learning experience. There needs to be a minimum of 5 rotations on the ambulance and 5 rotations in the ER. I feel these changes are not drastic and can be implemented without any real issues. The EMT-I must be the EMT-I99 only. The EMT-I85 must be eliminated and EMT-I85 must upgrade to the EMT-I99. The EMT-I99 is a near equivalent to the EMT-CC and thus eliminating the EMT-CC. Since the EMT-CC is not a nationally recognize certification there's no need for this certification? Why are there so many AEMTs in NYS? Its so confusing. The EMT-I99 with additional didatic hours will be the medium between the EMT-I85 and the EMT-CC. The EMT-I99 has a strong knowledge of ALS care. My belief is if there's a need for the EMT-I85, then there's no need for EMT-B. If there's a need for the EMT-I99, then there's no need for the EMT-I85. If there's a need for the EMT-CC, then there's no need for the EMT-I99. Can you see the problem now? Too many AEMTs. I feel the remaining of the 3, should be the EMT-I99; the EMT-I85 isn't far from it and can upgrade to the EMT-I99 with a crossover program developed. The EMT-I99 has skillset that exceeds the EMT-I85 and comparable skills to the EMT-CC to have them eliminated. The EMT-CC is only recognize as an EMT-I99 by NREMT. These changes are not costly and will benefit communities in rural areas. I feel this is a change easy to implement and the care in rural areas with EMT-Is as the only ALS care; this will benefit the patients with the ALS Providers being EMT-I99. Areas who will have the EMT-CC eliminated; care will not be crippled, the EMT-CC will be known as an EMT-I99; the knowledge and skills will be almost the same. The EMT-P must be an AS Degree program only; with the elimination of private programs. The CCEMTP course must be part of the Paramedic Curriculum along with all the different Alphabet Courses. The CCEMTP is an intense program very similiar to the CCRN. These changes will propel the Paramedic as a true profession in the eyes of lay persons, like how the RN is looked at. This will allow the Paramedic to use their AS Degree to go further in healthcare if one chooses. In addition, college builds character and the pre-reqs will set them up for Nursing, PA, and MD degrees if one chooses to do so. If the BS in Paramedicine is available; this will bridge that gap closer. The new CCEMT-P will be able to work in any Prehospital setting. I feel that the reason the EMT certifications has not progressed is because there's so much emphasis to separate us from State to State. From NY with the EMT-CC to WI with the EMT-IV to VA with the EMT-Shock Trauma/Enhanced to VT with the EMT-I'03 to RI with the EMT-Cardiac to MI with the EMT-Specialist to AK with the EMT-II/EMT-III. So many variations. So how is one suppose to transfer one's certification if they choose to rellocate? Some may argue the needs are different. What needs? I am me, in another State. I will respond to medications the same way in AK to AL to AZ to AR. If I'm obsese in NY; I'm obese in MI and MS. If I having an AMI in CA; its an AMI in NM. If I'm SOB 2nd to APE in NH; its still APE in LA. ET Intubation is the same in NE; as it is in MA and NJ. IV Insertion is same in PA; as it is in TX and OR. Oxygen importance is the same from CO to DE to GA to FL to SD to NC to WV to WY to KS to HI to ID to KY to IL to MS to IN to MT. AHA CPR Guidelines are the same in SC to ND to TN to WA to WI to UT to NV to ME to IA to DC. So is there real difference? I don't understand why the EMT Certifications can't be the same or at least very similiar, country wide. The best EMT-B, EMT-I99, and EMT-P curriculum needs to be assimilated into all the 50 states. States can add more to meet their needs but can't decrease standards. This is a fight for NREMT, USDOT, and NHTSA but NYS DOH EMS can spark this change with my proposal to enhance the EMT-B, EMT-I99, and EMT-P. Its all about education for better care as the basis for the EMT-B, EMT-I99, and EMT-P. These changes will allow these EMT Certifications to be more competent and confident in respects to patient care. This can be the blueprint for change. My proposal will exceed other states and NYS can pioneer this change. It is not something difficult to do and it benefits all of the people we care for on a daily basis. Lastly, this will secure the EMT-B/I/P to be the only provider of Prehospital Care. I know many services uses the CCRNs to staff their CC-Ambulances. My proposal will be the norm for Paramedics to be CCEMT-Ps thus replacing CCRNs on ambulances; maybe even on helicopters and other mode of transportation of the sick and injured. I am available to assist in this change. Please forward to all applicable parties for review. Thank you for your attention in this sensitive matter. Regards, Alexander G. Woo NYS AEMT-P #214355 NYC REMAC WREMAC HVREMAC

Richard B; I appreciate the history; I love to hear more of that. its awesome to see how EMS has changed from the 70s to 80s to 90s to x004 to 10s.... Jim; I know that there are AS degrees in Paramedics; I have one but I took my Paramedic Course at a hosp in Queens, NY. Then I took the pre-req's and rec'd my AS Degree at a CC. As a result of the pre-req's I'm able to just take RN courses for my RN (excelsior). That's what I'm saying; no more private programs; only AS and BS for EMT-Ps; like nursing.... To all; My real only concern are for the medics; there's too much resistance from EMTs. My quote; "if u ask 4 more, you get some. U ask 4 less, u get none." I'm asking for a lot of change so the org can change some. My goal is to really have the EMT-P to AS only and there be a BS in every state & the EMT-P will have CCEMTP training. Can we agree on that? This seems easier to do & ALS care will be better... Can we agree the EMT-B course needs to a bit longer & there needs to be more amb & ER rotations (8 total?). Can we agree on these changes? Can we? Thanks for all the comments...

Jim, I want thank you for your comments. I do agree that upstate NY is a lot different than NYC & the neighboring counties. I agree that the EMT-I is an important part of ALS care in real rural areas of NYS. I appreciate your words and I totally understand. The reason my stance is so strong for vast change; is for the sake of the patients. BLS is important but as a Paramedic; I can't just BLS all my patients; not only is it against protocol but I'll get sued & lose my certification. I feel with extra training the EMT can be a big part in early ALS care; it will be an EMT-I; like yourself. You're able to provide more care than an EMT-B; that's awesome for your patients. I know I will never be able to get this through but if all the organizations who have major influences in EMS would just take a few of my ideas & hear me out; EMS will be a better system with very good healthcare providers. My main concern is the Paramedic; I would like it to be an A.S. Degree program only. No more private programs & I would like the CCEMTP incorporated into the program. I want the EMT-B to have more rotation & didatic hours (re)added back on. That is the real basis on this most controversial movement. Remember this proverb:"When you ask for more; you get some. If you ask for less; you get none." Alexander Woo I wish you luck in your endeavors too. A. Woo

Of course not. I have a AS in Paramedics. I'm getting AS in Nursing. I'm not asking for candidates to get a BS; I'm asking for all candidates that want to be EMT-Ps; it will only be available as a AS degree; no more private programs. There must be a BS degree in Paramedics avaliable in all states. Not just in MA. MS can be developed. This is mirroring a RN's degrees; AS, BS, MS, PhD.... Minus the PhD..... Thx for your input ERdoc....

I can only speak for NYS... So you can see how bad the NYS EMT-B is. I want that changed; if the NYS sees my POV; then NYS EMS will be better. NY is not progressive. If your EMT-B was 240hrs then that state has higher minimum standards. My proposal is to make the EMT-B & P better; there's no need for EMT-Is; when the EMT can learn and become an EMT-I. That's my point; there's 4 levels; EMT-B, I (85/99), P; in NY there's CC's; thanks to Long Island. I don't know how ur state & other states are but NY does not have a good EMS learning system. My idea propels the EMT-B to be a prehospital practictioner not a advance first aide provider; in NY, EMTs are just that with asa, albuterol, & epi pen/jr; I am a mgr & supvr at a private ambulance; the EMTs I have didn't learn it in school; I had to in service them; NYS sent teaching/learning packets to all the agencies; this is not covered in refreshers neither. NY EMS is not good; the letter is directed to NYS DOH EMS; that's my forum & my bill. I want NY to be the best possible. I hope this explains why I'm doing this in NY. IDK how the other states are but in NY, outside NYC, the volunteer ambulances run 911. There's medic providers but they answer to the vollies of each town. The vollies w/ their stink attitude will question a paramedic on scene & if the EMT doesn't like what the medic did or didn't do; they'll have the medic fired. Many vollies in NY have a lot of poitical influence; vollies are members of the community providing free service; they help the community, which is a great thing but their career is not an EMT; to them its a hobby. I want EMTs to be a profession; not a hobby... The way the NYS allows its course programs to be so laid back; anyone can be an EMT; even ppl w/o HS/GED; some have criminal records. This is the NYS I fighting. I hope all the EMT City members see why I want change in NYS; my state... That's why I've said that the NYS Gov elect Andrew Cuomo wants to consolidate local govts; this may be a good thing for my idea of a better NYS EMS.... Thank you for ur input, Lone Star.... I'm cool with getting rid of the EMTs and EMT-Is (CC) and incorporate the BLS into the Paramedic Program; have only paramedics with AS, BS, & MS (maybe) degrees & disbanding the private programs. The medic program only available in colleges with CCEMTP training. I did say all this minus the EMT, getting rid of thing. So you agree with me; plz really read my comments & the email; I did say all that. My comments are for NYS DOH EMS; so you can't compare.... Thx...

Absolutely right. Its not the title but if EMTs rec'd more hours and were able to give life saving meds other than what than can now, advance airway not ET, IV with fluid resuscitation then maybe EMTs wouldn't be so lost in Medic school; maybe lives could have been saved. Instead of racing to the ER with the pt on O2 and supine/trenden because the BP is low and HR hi; skin cool, pale, diaph; AMS or wait for ALS; yes it will be bad. If my idea went thru and it became 8mon course with 170hrs of classtoom time & 8-10 rotations, instead of 110 and 1 rotation; this will be bad. If seasoned EMT-Bs were EMT-Is during their career; then they'll have more knowledge. Ask an EMT-B now who's in the EMT-P program; how much more didatic information there is, how there's so much reading, & so much more rotations; so why is that? My proposal will bridge the gap bet the 2; closer.... If its all about seasoned EMT-Bs; then why are there AEMT-Is (85/99), in NYS AEMT-CCs, & AEMT-Ps. We wouldn't need them. Plz really read the whole message; if you did, you wouldn't respond this way... If you've worked in EMS; you wouldve have met an idiot RN, PA, NP, & MD; you may have said, "how did this person pass school?" On paper the healthcare providers are for the better; it may not happen but on paper it is showing better care. Remember ppl are imperfect creatures who destroy a perfect plan... Hence, malpractice.... Thanks for your response... All MDs are not the same. Some good, some bad but on paper they're MDs... All DOs are not the same. Some good, some bad but on paper they're DOs... All PAs are not the same. Some good, some bad but on paper they're PAs... All NPs are not the same. Some good, some bad but on paper they're NPs... All RNs are not the same. Some good, some bad but on paper they're RNs... I'm trying to make it better on paper; its up to you, me, & others to make it good... Will you help me make it good? Its going to be tough; vollies will make it hard, with many who have political ties. But this proposal is like a lawsuit; you ask for more, so you get something. If I get something then it will be great. Can I get something? Thanks for your response, Lone Star....

Now JEMS contacted me about running something about this. This is an awesome end of year surprise; EMS Mag & JEMS looking to publish my proposal. I've read all your comments & thank you all for it. In addition, I've sent this idea to all of the NYS elected officials, the US DOT, NHTSA, NAEMT, NEMSMA, & NASEMSD. See the update letter sent: To Whom It May Concern, I'm asking for NYS EMT Certification Restructuring with elimination of some EMT certifications, with the advancement of the remaining certifications. I've sent letters and emails relating to this issues to the NYS Legislative Officials, NYS Governor, US DOT members, and various EMS publications & sites. ?My concern is for the patients receiving Prehospital Care. Are the EMTs & AEMTs coming out from school trained adequately to render lifesaving care? I believe the EMT & AEMT programs need to be more advance and more selective. Who am I? Do I have the background to spark this change? I'll let you decide. I've been a NYS EMT since 1996 and a NYS EMT-P since 1998. During my career I've worked in various Proprietary Services and volunteered as an EMT. I've worked in various NYC Hospital Based EMS and Surburban Solo & Dual Fly-Car EMS Systems. I served as a EMS Manager in a NYC Hospital Based EMS Ambulance Department but soon after the Berger Commission Report, I was eventually forced out of my position due to the closing of the hospital. I've been a Supervisor & Operations Manager at a Proprietary Service ever since. I've been in EMS and AHA Education since 2002. With all my experience in various EMS Regions & Services; I've seen positive and negative changes in EMS; which whether I agree with, is irrelevant. I've been in the field long enough to know that EMS care needs to progress faster. We all believe healthcare is for the good of the patient. I feel that the patient deserves the best care possible & currently the NYS EMTs & AEMTs do not do so. The NYS EMT curriculum provides very basic medical knowledge. Medicine is an iceberg; even the most seasoned EMT-P barely scratches the surface. I feel I have a proposal which will address these concerns. The EMT is the foundation of EMS care. However, the diseases have become even more complex and patients need more than BLS care. The prerequisite should entail the candidate to be over 18 years old and obtained a High School or a General Equivalency Diploma. There's some EMT Programs in NYC who do not require a HS Dipolma or a GED to enroll (That's another topic for another time). However, the EMT needs to have more didactic hours added, not taken away; skills can't just be added without formal training (Aspirin, Albuterol, and Epi-Pen/Jr). The rotation hours need to be increased; one rotation with a choice of ER or Ambulance is unacceptable. The EMT course needs to be an 8-9 months long course with Intermediate Training & more hours on rotation from the ER to Ambulance. This will eliminate the EMT-I certification. The EMT-B will replace the EMT-I. In addition, the EMT-CC will have to certify as an EMT-P; there can be a bridge program to accomplish this. However, the EMT-P will be an A.S. program with CCEMTP training. It will only be available in Universities or Colleges; a B.S. program must be available in several areas in every State. Even a M.S. program should be on the table. The EMT-CC will be eliminated. Current EMT-Ps must take the CCEMTP but the Degree can be waived for them; if they choose not pursue it. The NYS EMT or Nationally Registered Certifications will be only the EMT-B and EMT-P. Whether this is better care, is not the issue; on paper it will be. If the provider can't complete the upgrade they'll downgrade to the lowest level; so, the EMT who can't complete the EMT-I training will forfeit their certification. The EMT-I will be an EMT; there is no upgrade for the EMT-I (It depends on whether it will be the EMT-I 85/99). The EMT-CC who can't complete the new EMT-P program will become an EMT. The EMT-P who can't complete the CCEMTP course will downgrade to an EMT. There will be a specific time given to complete the upgrade and at no cost to the candidate. Let's look at how Nursing has progressed. In Nursing there's different licenses: CNA, LPN, RN, NP, & DNP with degrees ASN, BSN, MSN, & PhdN for the RN. The NP and DNP are healthcare practitioners who can prescribe medications and diagnosis conditions. Its amazing how nursing has really progress from the beginning of modern nursing during the Crimean War. EMS care in NYS can be the blueprint for this change and it should spread to all 50 states. The EMT program will be an intense 8-9 month long & it shall receive college equivalent of 6-8 credits if one chooses to go to College and pursue a degree in Paramedicine. The EMT-P will incorporate CCEMTP training, only available as an A.S. and B.S. degree program in Emergency Medical Paramedicine.?? My proposal with make the bridge from EMT to EMT-P closer. Currently many of the Paramedic Students, I've come across in my years of teaching, many are lost in the first half of the course. Whether because its too much information or their EMT course didn't provide the necessary information during the course; I do not know. The EMT will be more trained and if they decide to go further in healthcare; they'll have a strong education background. The CCEMT-P will be able to handle any setting; from emergencies to transfers. In addition, if the CCEMT-P decides to further themselves in healthcare; the new CCEMT-P's education will make it easier and with the degree, the prerequisite courses will have been mostly met. These changes for the current EMS Providers, shall be funded by NYS Education Fund by the NYS Government. This is an idea which can be modified but I hope I will see this kind of change in the near future. I'm going down the path, in which I would like to see happen. Its a long process but it can happen. I'm available to assist in any way I can.??? Regards, Alexander G. Woo, EMT-P NYS #214355

I thank you for the moral support... I know its going to be tough.... Many are resistant to change. Upstate will be the same fight... I want this fight; I'm prepared and we'll see where EMS Magazine will take this. I hope JEMS contact me soon. Thx & Happy Thanksgiving to you & yours....

Its just a proposal. It seems drastic but if the request for change is abundant; then more will be introduce into the system.... As for NYC; the private ambulance will follow NYS for the most part; FDNY EMS will be a tough one to change....

The Editorial Director from EMS Magazine emailed me; she wants to do a story on this.... Will keep all you EMT City peeps updated.... I know its going to be tough for things to change that drastically but I'm the guy to do it.... Now I'm waiting for JEMS, all the NYS Assembly and Senate Members; along with the NYS Governor, outgoing and incoming to respond to me and take this serious.... Gov Cuomo may see this as a good thing... On his debate he mentioned he wants to consolidate town and villange governments; to be run by the counties.... He makes sense; he may see my POV.... Thanks y'all.....

The degree is not for EMTs; who'll be EMT-Is & the EMT-I certification will be eliminated. The degrees will be for the EMT-P; it'll be available only as a degree no more certification programs. The EMT-CC will be eliminated; the EMT-P will also have the CCEMTP certification. The degrees available will be the AS; which is already available & BS; which in Mass its available. No more taking just the program. This will make the bridge closer from EMT to EMT-P; The EMT won't be so lost when they decide to take the medic degree program like many are now. The medic will have a science degree in which they can transfer the prerequisite credits to other allied health, nursing, or medical degrees. That is my proposal. This is a long journey but it can be made. My proposal is not unreasonable. Its for the good of the patients and the practitioners. Please read the topic and beginning comment; I'm staying still on my point. Remember if its an accredited college then its accepted nationwide. I'm taking & completing nursing from Excelsior College; an adult continuing edu. No classroom; just reading the sent material & taking exams at an outside testing center. There's are ASN, BSN, & MSN degrees available in this format. You can have a nursing degree but not be a RN; just don't take the NCLEX. The degree for Paramedics will be just that; if the person doesn't want to recertify; they still have the degree. Maybe the EMT/EMTP should be CME recertification based. Just like nursing: they don't retake the NCLEX; they attend the required CEs and pay a re-licensing fee. Not all nurses practice; many are educators, writers, administration. Just like many Medics are. I'm a manager and an educator. I haven't worked as a medic in a year. Since I'm in NYS; I have 80hrs of CME in 3 years but its not good to recertify because I don't have the core hours but my NYC REMAC has been satisfied. So I have to refresh; I would have to take the NYS exam anyway because I'm a CLI but no refresher would have been great. I would have taken just the NYS & NYC MAC exams. This NYS Pilot CME program started 6-7yrs ago. It was new and time consuming but its mainstream for many services in NYS. If my proposal is accept; I will work on changing the CME Based Refresher to lessen the core (because its not easily available & when it is, its an 8hr day; how much can retain from 8hrs of straight edu/cme?) and increase the hours of MD given CMEs. I hope this is clearer....

Changing the EMT & EMTP Programs is a start. Money issue is a problem for all & its a result of inappropriate spending but that's neither here nor there. That's something our elected officials: local, state, & federal need to do. As I said the 3 most important services in the country is: Healthcare, Education, & Defense; the govt on every level spends very little for healthcare & education compared to other services. Is this fair? I'm not here to figure out budgets; that's the elected officials responsibility; which they've done really poorly with. My idea has & will meet resistance but the idea is about improving heathcare. Everyone who has argued it, hasn't stated why a more trained EMT & EMT-P will be a bad thing for the patient. Opposition states it hurts the budgets & vollies. It nothing that can be done. Its too much to ask from the EMTs. How is the State going to afford this? This will cost too much. I know but its for the good of the patient & that's what healthcare is about. If the govt on all levels paid/gave more (they did for fanny mae, gm, aig, etc), it wouldn't be a problem; that's why I've sent it to many elected officials. The NYS Assembly & Senate Members, the outgoing & incoming Governors, both the US Senators from NY, the outgoing & incoming Representative for Congressional District 19, the House Chair for Heathcare Commitee, the outgoing & incoming House Speakers, the President & Vice President; all received a summary of my proposal. My proposal for change is for the good of the patient. Let's blame NYS EMS for not policing these courses. Let's blame the corrupt NYS Legislative Branch for the lack of monetary support. Let's blame NYS Medicaid & local wellfare services for allowing someone to collect both who has a Benz and a 52in Plasma. Let's blame the uninsured for crippling the healthcare system. Let's blame the NYS Education system for not putting Paramedics into a Degree program. We can blame everone and everything; my proposal for change isn't looking at that; it looks to advance someone's education thus advances healthcare. Anytime you try to advance it cost money. We'll always be in debt as long as the govt continues to spend without just cause. Also, we need to restructure the spending and taxes but that's not my topic. Someone plz let me know this will be a bad thing for the patient. I can't concern myself with $ because then my proposal will not be looked at. I will prove the need and the use it will to patients..... Thank y'all....

I can't speak for up-upstate but I worked NYC, Westchester, Rockland, & Orange Co as a paramedic. As the newly elected gov; he wants to consolidate govts. No more hamlets, towns, villages. What that means is decrease spending & proper spending. I believe that the 3 most important things we need in the US is edu, healthcare, & defense. I'm working on 2 of the 3... Wondering where this is going? Resistance means that someone is listening. We all want better healthcare; many of us..... I worked areas where there is only 1 nys trooper covering 50 square miles. No village pd afterhours; taxes are the highest in NYS. There is a commissioner for every service; they're highly paid. Yet the fd and ems services are unpaid; responding from home; some come onscene in pajamas. Save a live; they gotta do what they gotta do to save a live. Kudos but what does that say about our piorites? In rockland; clarkstown pd my almost $100K to start. Ramapo pd make $85K. Fd chiefs have suv's; newest fire apparatus; electric stretchers; ferno stair chair; supplies; etc. They're is money for the vollies but the towns really cared then vollies will receive $$ for services render. Portion of taxes or taxes increased by .5% in sales can pay for this. I'm asking for better care for ppl. I have to start somewhere; vollying is great but is it fair? I think all 911 services should be paid. This has nothing to do with volunteering. Yes some EMTs will not be able to complete the upgrade. If you know something wrong with your local EMT course; say something but nys doh ems isn't helpful. I know a course in Bx and Qns who accept you w/o HS dipolma. One allowed students to miss classes they were suppose to attend as a result of their challenge exam. One allowed students to continue even though they failed exams and practicals. The state has been silence on these issues; emails sent w/o response. This is messed up; restructuring is what we need. Many will lose their certs; if this plan was incorporated; but this job is not for everyone....

In the 60's there were no EMTs; ambulances had strong men who had the ability to lift & drive... They were phased out; when the EMTs emerged. In the early 70's paramedics were born and the BLS/ALS care were in the beginning stages. Look how 40years have changed EMS; EMTs are giving epi, albuterol, & asa. Medics are giving more drgs & some of the skills performed now were never even heard or thought of... If we make changes now in 10years; there will be EMTs who are Is & even a more trained paramedic.....thx for ur reply....

Thanks Dwayne, Its going to be tough but we can tell Fire to fight fires. At least in NYC; Fire is not EMS; even though it says FDNY EMS. They are seperate. Thanks to NYC Health and Hospitals for not managing their funds and in 1996, FDNY took over EMS.... In NYC its fine but its the upsate bureaucracies that makes it even more troublesome with the volunteer corps. Don't get me started with Long Island with the cop ambulances.... I mean no disrespect to services but I am for positive change and we all say its about the patient; so my goal is for better pateint care... Thanks EMT City Senior for the advise.... Remember this was an email and the content doesn't need to be fully explained because it was sent to the EMS governing body of NYS.... I have the proposal edited (by a professor), quoted, and cited.... Its going to happen; with the suipport of my peers or not. If I habve to go through this solo, then so be it... But thanks for the comments.... Thanbks awesome; I know NYS is very slow..... Then I be the one to jumpstart NYS to become more standardized.... So what can EMT-B do in the state you're from? In NYS EMT-Is can start IV, ET intubate, read basic ECG, and give some meds; thats the EMT-I 99... There's an EMT-I 85 and its garbage.... Its ET and IV; thats it.... I want NYS EMT-B to have EMT-I 99 training; will be know as the EMT-B.... I want the EMT-I and EMT-CC (which isn't a NREMT recognize certification) and have only EMT-Bs and EMT-Ps but the EMT-Bs will be able to really assist the EMT-P; EMTs in NYS don't and can't unless they were taught on the road by someone,,,, I still mean no disrespect; I am pushing for change will will benifit the patient anytime the ambulance transports them to the ER... Like nursing the LPN is 1 year shy of the RN.... The EMT-B is well behind in knowledge and skills than the EMT-P.... To compare to nursing; the EMT in NYS is like the CNA in nursing.... Again, no disrespect.... I want change.... Thank you for the comments....

IDK..... Its on the EMS Discussion forum; somehow it ended up here & I can't erase it; I've been trying for weeks now.... Plz to all; don't respond on this forum; plz respond to the forum n EMS discussion. I will continue to try to delete this. No disrespect to LODD; I'm sorry about this..... I want and will see change in this.....

There was a time when the ambulance personel was 2 men just physically strong. The EMT provided basic care if any. Ambulances had basic safety features. There were no Paramedics. No gloves were worn. Mouth to mouth was performed. There was no C-Spine precaution. Care would be sub-standard in today's time... When I became a NYS EMT in 95 we didn't have Epi-pens, Albuterol, & Aspirin. MAST pants were applied for anyone in shock. AED was just recently put into the curiculum.... When I became a Paramedic in 98; pacing was just incorporated. Things change over time. Its time for change....

All I want is for EMS to provider better care..... Thank you....

Remember that this a summary of change. A letter too long will not draw readers... Ex resumes are suppose to one page; not many pages... This is just an overview; there's so much you can put in a letter... Then additional letters can be sent; as time goes on.... My backgrd suggests my understandin of the field; this will let legislative officials know that the message is not from a common joe... This is the beginning phase; remember the message; it will progress in NY.... Thx... Remember my name: Alexander Woo... NYS DOH EMS will be getting a copy of my proposal; it has everything everyone suggests..... Data, %, sources, etc..... I'll scan in future and post it here....

The Regional Emergency Medical Services Council of ____________________. There's a region which governs EMS in specific counties.... http://www.health.state.ny.us/nysdoh/ems/emsrep.htm