timdog88

Nurses follow protocols that their attendings create, and follow orders, much the same as paramedics. Here are 2 studies I found that show that higher educated nurses(following the same protocols and orders as their less-educated coworkers) have a positive impact on patient outcomes. And this is only after a 3 minute google search. So you can't blame medical directors and their unwillingness to change protocols, we have to look in the mirror and ask why paramedics as a group are not demanding higher minimun education standards. Until we do, we will always be looked upon as uneducated ambulance drivers. It's my assertion that, even when given exactly the same protocols to follow, more highly educated medics will have more critical thinking ability, and make better decisions, than their less educated counterparts. That's what the evidence says about nurses, why would it be any different for medics? http://jama.ama-assn.org/cgi/content/abstract/290/12/1617 http://news.bio-medicine.org/medicine-news...y-shows-8610-1/

To me, ALS is not exactly equal to "more education". You can have an ALS medic that went through a 6 month medic mill, or you could have an EMT that also has a masters degree. That's what I mean by more education. I am familiar with the OPALS study, and none of it's conclusions should really come as a suprse to anyone. Trauma is not really an area where ALS can make alot of difference, at least not right now. I was looking for a study that compared medics with degrees with medics that don't have degrees, and if there were any differences in patient outcomes. I got some good suggestions here, and I will follow up on them.

I'm not sure you need "more advanced" protocols to have an improvement in Pt. outcomes. I think better education would lead to better understanding of, and better adherence to, whatever protocols you already had. It would also allow the medic to think outside the box, and to know when there aren't any protocols that cover your given situation. I think a couple of posters have basically been saying that there would not be a big enough sample size to make a significant study possible, but when you think of how many medics there are in just 1 or 2 states( I'm going to look into this soon) that mandate degreed medics, I think you have a pretty large amount of patients. Or am I wrong about this?

I thought that there were 2 states that required a degree to be a paramedic, one of them was midwestern, if I remember correctly. I would think that one or 2 states full of paramedics, as well as countries such as canada and austrailia, would provide enough cases to compare against non-degreed paramedics, and comparing apples to apples, e.g., same city size, same number of trauma centers, same types of patients, figure out if more education equals better outcomes. It seems to me that it would, but some hard evidence sure would go a long way to convincing state agencies to mandate higher education, and if no study like this has been done, how would someone go about getting the ball rolling?

has there ever been a study that correlated patient outcome with the education level of paramedics? I have tried searching for one, but so far no luck. If there has not been one done, then doing one and showing better outcomes with higher paramedic education could be a great first step in raising the bar for minimun education standards.

I have lived and worked in Atlanta for about a year now, and from what I've seen, Grady EMS provides about the best experience you can get in EMS, especially if you don't want to go the fire route. The pay is good, you will work 40 hour weeks consisting of either 8, 10, or 13.2 hour shifts, the protocols are good, the medical director and education department are very active and hands-on, and the benefits are great for a non-fire based organization. Other good options in the area would be Dekalb fire, Gwinnett fire, rural metro, and metro atlanta, but I cant speak to any of those as I have no experience with them. Feel free to PM me if you have any questions.

well, i pay 750 a month now for a room in a friends house, so it would only be about 250 a month more (would be sharing the 2 bedroom with a friend). I checked on state income taxes, and it would be about $80 every paycheck more than i play now. throw in higher gas, food, and whatnot and it seems like 10k extra a year would about even things out. at least i hope so, because i think im gonna do it. i really dont like where im living, and i see no reason to stay if im unhappy. anyway, we'll see what happens.

high cost of living is one of the big things that I am considering. I spoke to a guy from AMR in oakland and he said they are paying medics there about 50k to start. It seems to me from looking on craigslist and others that a 2 bedroom apt could be had for around 2k a month, so that doesnt sound too unreasonable. How high is the state income tax and union dues? is there something else I'm missing( I know gas is also very high). I make about 40k where i'm at, so it seems like the extra money would even it out when you consider cost of living, but I dont know for sure.

i guess i should update my profile..i got my NR paramedic this past december and have been working in a high-volume, all 911, hospital based system for the last 7 months. No FD involvement in ems except to help lift really heavy pt's, good pay, liberal protocols, (basically the only call-in orders we have are for pushing morphine). Its a great job, the only problem is I really dont like the city I am living in. I vsited san fran this past summer and loved it there, Im just not sure if I want to live somewhere I like and have a job that is less than stellar, or have a good job in a place that i dont like. Im not married and no kids, so I dont have anyone else to support, so the decision is up to me. anyway, thanks for the input, and if anyone lives in or has lived in san fran in the past, I'd love to hear from you.

hi, just wondering if anyone works in the san francisco area or knows anyone who does? I am thinking of moving out there and was just looking for some insight on the area and the ems system out there. thanks

I just moved to Atlanta about a month ago, and got a job with Grady, and I have to second what bassnmedic said. Good pay, good training, pretty good protocols, lots of different shifts, lots of OT opportunity, paid CME, and some very good medics and EMT's. So far I am very happy with the job here.

well, i guess what i want IS experience..but id also like a decent salary (i.e. overtime opportunity ), Iraq is an interesting option..would anyone over there hire someone with only 5-6 months of paramedic experience? Also, I'd like to not have my head sawed off if i can help it, how dangerous is it over there? does anyone know anything about grady in atlanta? how about ada in idaho? canada i dont think is an option due to reciprocity issues. anyone have know of a sweet place to work and live, id love to hear it! keep the suggestions coming!

Ok, i have a question for everone: if you were a new paramedic, with no attachments to a certain area of the country, and could choose almost anywhere in the U.S. to go and work, where would you go? I will be in this situation in approx 1 year, and I am looking to move away from Alabama. By the time I move, I will have about 6 months exp. as a paramedic, and about 3 years as a basic. Please keep in mind the livability factor of the city as well as the EMS service. Thanks for any input!!

Thats great work, where did you find it? thats about the only time ive seen a study or review that was positive toward ALS. The fact that it was commisioned by the AAA hopefully doesnt have any bearing on the results, because they really sound very positive for ems as a whole. The last line of the article says something that I have thought about before; the only measure I ever seem to see in these studies is survival to discharge, but so much of what we do, and medicine in general, does not deal with life or death but relieving suffering and improving quality of life. How do we measure that?

Hey, thbarnes, I know this is off topic, but do you work in Atlanta, and if so, who do you work for. There is a good chance that I will be moving there in the near future, and anything you could share about ems in atl would be appreciated. BTW..if anyone ever tells me that they called 911 so the "wouldnt have to wait"..i tell the ER and 99% of the time they go straight to triage..in a sick way..it makes me happy..am I bad?