Ridryder 911

NO! I can't just get along nor do I want to anymore! That is one of our major problems! We have got along way to long! Over 40+ years now, and still trying to attempt to make excuses for our piss poor profession. We all whine and bitch about things then we coddle and make excuses for each other. Seriously, there is NO reason that the entry level is not required to be at the least an Associate Degree! Boo-hoo...sniff, sniff.. So sorry that we may enforce one to actually demonstrate that they have competency in English, Mathematics and basic Science.. and yes then attend a course taught by those with more than just ..."good ole boy" experience! Give me any other reason than laziness..not to complete an degree program! Money, sorry pawn those lights & scanners or do alike the other 80% of the population and get a student loan. Why do you think you are so special? Maybe owing a little money will make you want others to take and consider your profession more serious! Getting tired of reading 10'th grade level textbooks and magazines such as JEMS & EMS ? Containing articles that are so watered down one can expect to see a "seek & find" in the next issue? C'mon folks this is not in-depth conversation, rather again attempts for those to "water down" the profession instead of promoting it upwards. How asinine to even make an innuendo that an education would be harmful or not even be needed? Really? Obviously the current system we use SUCKS! Maybe a time for a change? It is ludicrous to even consider anything other than a higher education, in fact any thing else should be considered harmful to the profession and towards patient care. We are not talking 10 years out of someones life, just two years to start as a professional.. Much easier in comparison than other health care professions. Sorry, if the truth hurts! R/r 911

Maybe an alternative would be that the Basic Level would only be good for two years. After that it would expire or immediately be lowered to a MFR level; unless you were currently in a Paramedic program (good standing), This would allow one to "work" in the field while obtaining experience, yet not procrastinate doing so and then increase our first responder ratio as common laymen for those that do not succeed or progress in the system. The only exceptions allowed would be very remote areas and those associated with non-EMS as their primary functions. R/r 911

Let's turn the tables... You prove to me requiring an education is more harmful or has poor benefits. As well having ignorant & non-educated personal provides better care than those that do. Hmmm.. Well again let's review the medical hierarchy. As Vent described, even Physical Therapy now requires a Doctrate level. Anyone that announces that their class was in clock "hours" were trained not educated. Again, much difference in philosophy in teaching, and expectations of outcomes. Something we should address. Trade/vocation versus professional services. Trade/vocation (blue collar) are usually trained not educated, thus the reason not requiring additional courses such Psychology, Mathematics, etc. As well no real formal in-depth classes are performed such as requiring thesis, research, and presentations. Rather trade/vocation are usually based upon simplistic objectives that focus upon a skill rather than knowledge or exploration past that. If we are to get past the image of a trade, we must embrace the requirements and challenges of becoming a profession. It is only when we actually start completing those elements then we can expect the benefits such as a decent salary, better hours, working conditions, respect from professional peers and even the public. R/r 911

Although, I understand your emphasis that the degree should focus upon the major, I do not truly believe alike medicine one can succeed without having the building blocks. For example as you described Psychology, that I doubt there is a Pyschology course that Paramedic would not need. In fact Psychology (advanced) should be required. What patient does not have a psychological response to an emergency? In fact all patients do, even those that do not require EMS care, still one can ask why they called 911? Again, another pyschological dilemma. Part of the problem in EMS is that "specializing" has finally bitten us. Where others have always built upon the basics then specialize, we did the opposite. Where now others are focusing or specializing, we are now attempting to catch up on the simple building blocks of general knowledge of science, mathematics, psychology, etc... One could wonder how much difference there would be in educational programs if the Paramedic text books could be published above a 10'th grade level? What discussions could be made among peers in regarding care, professional standards and "gulp" administration. Can one imagine if Supervisors actually was required to have formal knowledge of human behavior and business ettiqutte and principles... Wow! R/r 911

Two major points have to be understood. Training does NOT = Education EMS= Emergency Medical Services= Please note we are medical, NOTHING else. Hence the part of the problem of EMS. Unfortunately, since we our one of the few medical profession that does not require higher education for an entry level. One reason is because we are closely associated with Fire Services. Unfortunately they too are feeling the wrath that they too are considered a trade instead of a profession. True most employees are hired from the neck down, and even their system enforces and encourage using a paramilitary authority type structure. This is not demeaning but rather the type of structure that works best for them. The command has the knowledge based upon training & experience and guides, commands & is responsible for others. As well most of those that work in EMS, do not understand the difference between training and education. Again, most Fire Services uses the "training" method. This is definitely different than the educational model that those in medicine use. Performing research, obtaining scientific hypothesis and then deducting from those studies what is the best intervention to perform. Most of the enforcement of education is not so much of what is just taught, rather on how and where to obtain more information about it. To make a sound judgement based upon multiple factors, some influences not even associated with the focus of the problem. Alike what others described a more rounder and yes educated person. Each step and course is a foundation to make the person more knowledgeable in more than just one area. We ask physicians to be educated. One would ask why would it be important? It would be very simplistic just to send them to medical school. Look at the advantage of only going four years to a medical school in comparison to eight years.. Then one could argue if one is to be a cardiologist, should they even study any orthopedics? Seriously, should a gynecologist have to understand liver functions?... Doubt, they ever palpate many livers after residency.. Yet, we don't only want them to be fully knowledgeable in their specialty but diverse as well... and even know advanced Mathematics, English, Psychology, History, and other subjects.. Why? Again, education builds a foundation to build upon. Something training does not. In the real world, one is judged by how much effort placed upon not just physical strength but mental capability. The old saying ... "My ditch digger can never be a Doctor, but my Dr. can dig a ditch"..can be thought of. Professional structure is based upon knowledge and mental capability, something medicine is based upon. Any other medical profession, this discussion would NOT even be made. It would naturally be understood that it is a natural obligation that one would want to excel in knowledge, mentality, and have at the least a basic education. R/r 911

They will have to pry my dead cold fingers from my steak knife.. :shock:

We access them as well. Be sure you have the proper equipment (Huber needle, waste residual)and do take the time to be a sterile as possible. R/r 911

I am a PHTLS instructor and have been for many years, the costs of the fee includes a year membership in NAEMT as well (sponsor of the course)... R/r 911

Hey Doc, although Valium may not be your first line, I have seen it as the prefferred choice with those of dx. of Meniere's Disease. R/r 911

Oh do believe it. I know at least three that are NOT. As well, there are still very few that are using the 12 lead around here, even some that can but will not... shameful! R/r 911

Very good topic but here is the irony. What other medical profession would even have to have such a discussion to be made? Really, what would one think in reading other so called medical professionals having such a discussion? Could I imagine seeing a Psychologist, Audiologist, Nursing, or even Dietitians debating if their medical profession should consider the values of being educated? One week ago, I had the honor to meet with some of the top EMS educators (not instructors) within my state. This of course was one of the main topics. Alike, the rest on this forum; they too are angered, confused, and tired of fighting for the truthfulness of the need of a general understanding that education is the key of solving multiple problems within our profession. That there is even such a debate, it should be an automatic understanding within. A statement that something as basic as education would even be questioned in regards to treatment modality, would be considered ludicrous to most other health professionals. Think about it.... Over the past three years, participating on this and many other forums, as well as being active within State and National EMS education committees, I have also felt the same frustrations. It is with this frustration, I believe we need to focus on the problem, not the question or even the by products that are being produced. Where and what is producing these misunderstandings and feelings that we in EMS do not need more in-depth education? What is causing the continuation of ignorance within our profession? Then why do we continue such ignorance to occur? Of course, I too have more questions than answers, but I have came with some hypothesis. 1) Lack of professionalism: From the start of enrolling to exiting an EMS program. From the new employee to the administrator. From the State Board of EMS to National Level Organizations. If there was true professionalism within, then from the top down would require and demand education and not allow any excuses. Period. Sorry, this means physician level to the local Field Preceptor of the EMT program. Exactly how much emphasis have we placed on education from the first day of EMT class? In fact, how much was required before you even entered into an EMT course? Now, compare that with almost any other health profession or even any professional programs. Do we reinforce the need of education from the beginning, or even the formality of what the demands are of being a health care professional? That one is to be expected to become educated and that it is demanded and nothing else will be allowed. 2) Continuation of the current status quo. Yes, I will say it again. Legislation is the only true way to change things. Until we have formal requirements either nationally or state by state, mandating education nothing will change. The second part of that solution is that WE are the only ones that can produce that change. Unfortunately, since majority of EMT's have been trained as the former example, most do not see the need or even understand the problems. They much rather whine and gripe about the outcome of problems such as pay, and poor benefits, than to ever attempt to really change things. Again, what is a shame is the stupidity of this profession. Yes, being stupid (refusing to further or increase awareness and education) that this should never have to be a debate or question. That this is a medical profession, that the medical profession requires one to be educated to perform safely and be proficient. Again, which should be emphasized on the first day and taught continuously through out the program and professional career. One should never have to even consider that it would be a dilemma. As I have said before, talk is cheap. Actions speak better than words, and postings. Nothing can be really accomplished by coffee house talk. How many have reviewed the new curriculum? How many have written suggestions? Now, how many are member of EMS organizations or participate in legislation in changing the problems? Again, if you are not part of the solution, you are just one large part of the problem. R/r 911

Never seen it work out very long. We have a married couple (work opposite shifts) & they were medics prior to marriage as well. It is all fine and dandy until someone breaks up or gets a divorce... & it will happen. Then the troubles come.. I wish you best of luck, & I believe like Dust, pass the B.S. levels if possible. R/r 911

Contact NR for offical statement. Period. It does vary from state to state, as in agreement with NREMT.

Ironically, I have those that have an MBA's that works under someone that does not. I agree, and have attempting to point out if properly educated one can administer EMS without being a Paramedic. That is as long as they have an good understanding and working relationship with a clinical operations manager, etc. to be able to understand the needs and emphasis of EMS. I do believe that the lack of education of administration is one of major downfalls as a profession. Again, as described either the "good ole boy" method or promoted within without proper education. The same principle as in education occurs. R/r 911

Two things: 1) How is an EMS discussion? 2) NO R/r 911

Personally, I start out with Toradol & Phenegran IV, then use Morphine. Most renal calculi have severe pain and associated nausea. My opinion is either Toradol will work or not, not an in between drug. R/r 911

Congrat's ! R/r 911

Nawww.. Just thought it was nice to still be paid on "administrative leave", when accused of a potential problem. The rest of us would had been canned immediately and if suspended it would be without pay... R/r 911

Geez, to think this was associated with a fire program?....What a surprise!..

First welcome to the site; but oh, please... Review Muskogee protocols, they are way ahead of anything Sacra has written and far more advanced than EMSA ten minute transports. I have to re-train EMSA medics all the time, part of the problem is they a-s-s-ume that they know it.. because of their academy, yet though hang a NTG drip or transport a patient with a pleurovac chest tube, or any true sick patient and most are lost. Yes, they make a lot of calls.. so? It is what you do and how much care is the determining factor. I have yet seen EMSA not hire anyone.. true they may not make through the academy, but as long as your background is okay, and you have a current license and pulse (optional), your hired. Another Jack Stouts's vision... No, I am not a burned out ex-EMSA employee, and yes I realize that there are some great medics there as well. It is a good place to get some field experience as long as you plan on leaving after one year.. and no longer. Turn around is definitely something to explore. R/r 911

Do a search, you will find that it is NOT recommended! Many states do not recognize your RN, (even if you are licensed from another state). Unlike EMS, it also depends upon where you obtained your education, as well many institutions do not honor it as a B.S. degree, and one has to take additional courses or may not be allowed for upper level advancement. I suggest the traditional route or bridge program. R/r 911

Not to be rude, but check the search, it has been discussed several, several times.

I am re-writing our protocol for cardiogenic shock. Our medical director wants me to include Dobutamine (preload), Dopamine (afterload) and Epi drip for use of an increased vasopressor, and for bradycardia. R/r 911

Yeah, I received about $6K afterwards. Most EMS have learned the rulings and how to go around or loopholes. R/r 911

Dubin's is one of the best Cardiology books around. Many physicians have learned the basics form his text... ironically he was not a Cardiologist (not to say anything of his past :shock: ). Nice to see that he finally focused upon EMS since we endorse his methods. For those that might review the text, don't be alarm by how simplistic it appears. It is actually written at a high degree, but the method used is unique. Like Dust described read a few times, let it cement itself in your cerebellum and then I suggest visiting an ICU/CCU and asking for any additional strips (tell them why you need them). Chances are that they will be able to provide you with hundreds of oddity strips..to review. It takes hundreds to thousands to master true ECG interpretation skills. Good luck! R/r 911