NREMT-Basic

If you look at most EMT Patient report notebooks (the little 3x5 jobbies likes I carry in my top pocket) it is usually spelled PERRL as in Pupils Equal Round (and)Reactive to Light. A sidenote: if you keep your notes in these, dont let the ER staff take that notebook from you. It will disappear into the bowels of medical record hell. Offer to make a copy. I need mine for my PCR.

Dwayne- I would never intentionally disrespect a MArine. That wasnt my point. What I was getting at was and is that groundpounders in all branches are being given 500cc bags and a start kit. If they can do it on there own,while getting shot at and do it with one hand, I dont think it takes a paramedic. Are there complications to be concerned with? Yes. Should a basic be starting the line in every case. Nope. Hydration lines only. There are lots of things that can go wrong. Its a 6 week course in my case being taught to me who has a year or A and P and a year of diagnostics. I appreciate you saying that I am the exception rather than the rule. Fact is, as far as things like emboli are concerned, I recently asked a ER Doc about this as I saw air in a patients line. He took out a sharpie, marked four inches from the bubble proximal to the patient and said "if that fills up with air, call me." We arent going to be running meds or pushing them and we shouldnt be. We arent going to be hotshotting epi, nor should we. They arent including atropine, nor should they. It is a simple skill, which when learned properly can be done without complication even by medically untrained persons (hence the marine comment...i have agreat affection for marines and meant no slam against them. Just that this is a skill that can be learned one handed. thats all. Its not in my protocol, but I am already certified to start an I/O line. The times they are a changin! As for you Brentoli....the phones ringing.

Oh youre right. Now that you put it like that, I see. Because of course none of these are a concern when a medic does it..... Septicemia...in a 10 minute ride to the ER? Hematoma? You mean they might get a bruise? Infiltrate....oh God...I went through the vein!!! Catheter dislodgement? For the love of God man...where were you when the Illinois College of EMergency Physicians and IDPH created this new protocol. You mean the needle might not stay in? Good God Jim!!! Infection? How common is infection from an EMS intiated IV? I do commend you for your use of Taber's through. NEXT!

Hydration IVs ONLY. (read NaCL only .9%) Everybody went berzerk which is what I said would happen. In order to get the cert in IL, its a 6 week course. The same one given to CNAs and Patient Care Techs here now. Try to understand: Im sticking a needle in a vein, asking the medic how many dpm, taping, tegaderming and getting in the front seat. I said nothing about medicated IVs, in fact I specified non-med IVs. If they were going to let us do chest decompressions, I would feel worried two, but they arent, so its not a big deal. Nothing that every Marine in Iraq hasnt been doing for more than a year. Lets just move one.

Well then thats a problem I would bring up with your EMT program director. Its not my fault that you went to an inferior program. Look...starting an IV is such a rudimentary skills that soldiers in combat are being given kits to do it for themselves without having to wait for a corpsman. Its not that big of a deal. We just have a bunch of medics here who are bent about the idea that there might be Basics who can and do do more than drive. Im not gonna argue with you about it. If your jealous or something, talk to your states EMS director. NREMT out.

If the standing order is for a fluid bolus via IV, its doesnt matter who starts it. Starting the IV line takes about as much skill as starting a 3.5 inch line on a fire hydrant. Its a technical skill that I have seen paragods botch time and time again. Why shouldnt we get the fun of screwing up the same things they screw up. I mean if I have seen a medic take five sticks, then there must not be much skill involved. Its must all be luck. Who's to say you are luckier than I am? Seriously, I have the basics of hemodynamics down, lets just move on. What i predicated would happen has happend which is medics whining about us taking away their toys.

Its no more trouble causing that medics constantly bashing Basics or FFs. If admin sees it as trolling and wants to ban me, more power to 'em. It must have upset your paragod sensibilities....just goes to prove a point. Its not really about us doing it that bothers medics, its the idea that we can do some of what you do, and since there is no legitimate complaint to be made against Basics starting non-med IVs, you "turn me in." Good for you. Basically what I was saying is that higher powers understand that there is no reason that Basics cannot be taught to cath a vein. You got bent about it, didnt want to admit that I said you would and you did, so you ran to teacher. You just proved my point.

You will get a lot of folks here who believe quite literally that a Basic should do nothing but do heavy lifting, clean things and drive the rig. I don't happen to be of that mindset, but there are plenty here who are. And just to make you feel better, here in IL, the ILDOPH-EMS division has added a new protocol that allows Basics to start hydration only IV lines after a course in IV access and hemodynamics. Its up to each EMS division in the state now as to whether they will allow its use. But there you have it. I cant wait to there to roars of the paragods over this one. I think it is a good idea and am already sitting back in delight in the full knowledge that medics all over will be jumping up and down in their seats screaming "that's ours, that's ours." All I can say is get over it. Here we are also trained to use glucometers and administer either glucose or glucagon if the situations warrants it. I know, a lot of medics are going to be screaming over that toy as well, but, tough rocks kids, the horse is out of the barn. I wont be posting any further on this, I just wanted to spread the love and see how many medics stroke out.

I seem to recall something about "Signal Zero" but havent heard anyone mention it. I think its a bit antiquated but isnt/wasnt it a distress transmission?

Officially for who? What State, country, city, agency? Hence the need for common language?

Ah, the Duke speaks! All Im saying is I heard what I heard which was yet more of the same old same old profession bashing bilge water and it lit the fuse on something that has been simmering for a very long time which is that if you think that Basics (and there are more of us than there are of so-called Medics, at least in my state) and volunteers are the downfall of the profession (which you also say isnt really a profession) and that the field is in a sorry state, then either do something to fix it or dont let the door hit you in the arse on the way out. I mean after saving us all from ourselves for 35 years, you must be tired by now.

OK. I'll bite, but then I will also tell you at least one place where you reasoning is flawed, since you have been more than willing to do that for me. You asks what drugs I can administer in a cardiac "situation" besides O2: Nitroglycerin - standing order for 3 doses of .4mg Q5M on scene or en route the ER ASA - standing order for 4 tabs@81mg/tab for a total administration of 324 mgs And of course like the Basics in your area, we can place the patient in a position of comfort which may be lateral recumbent or semi-fowlers, but of course that is not the drug intervention you asked about. No. EMT-Bs in my area (IL region 1) cannot start IVs, though there is discussion at the state level of uptraining Basics to place I/O caths and including it in their protocol (EMS personnel do not have scopes of practice. There is a difference) While I am not allowed currently under my protocol to establish an I/O line, it is an intervention that I am trained to perform and feel competent in my skill to do so. Since we are on the subject of IV access, why do medics always use this as the gold standard. The attitude seems to be "if you cant start an IV, then you are useless" when in fact in non-cardiac or extreme blood loss, most IVs are started because the receiving facility will have a fit if it is not. Ive seen more Medics than I can count establish an IV cath and not hook it up to anything simply so the hospital is happy. Ive also seen an alarming number of medics who are so vastly incompetent at IV access that they should never be allowed to pop and IV start pack, let alone actually start one. We have a medic in my area who is nick-named Bloody Mary because her IV starts are so bad there we end up with blood all over the patient, the floor of the rig and the cot. But yeah....not being able to perform basic skills consistently is a problem specific to Basics. As far as shortness of breath, i have a standing order in my region for an albuterol neb treatment. ET intubation: I would be interested to see how many patients that call EMS and get an ALS response require intubation. There is also a new study in Japan that says that Combi placement should be the first line of airway protection (after re-adjusting the airway, etc) because it is faster and generally does not require multiple tries. Also, the "combi" technology has increased to the point where it is no longer simply a cram and slam procedure. But by all means, if I have a patient who cannot maintain a patent airway, I will call for an ALS intercept and wait for the paragods. Here is where you reasoning starts to run afoul of logic. You say that Basics are under-trained, under-qualified and essentially incapable of providing outstanding patient care. But when you are presented with and EMT-B who goes out of his way to increase his skills and knowledge so as to better serve his patients, you say that is the exception. Please show the statistic that says that the majority of Basics do not work very hard to provide excellent patient care and work regularly to increase the level of that care. Also, one mistake that both you and DD make is to indicate that because a medic has more hours of training than a Basic, that care rendered by a Basic is "inferior." Obviously neither of you understands the word inferior. It means of a lower quality. Because a Paramedic can provide a great number of interventions in no way correlates to the quality of the care any more than it would to say that because one provider is a nurse and one is a doctor that that nurse is inferior. They are two separate sets of training. One is called BLS and one is called ALS. While ALS is by definition more advanced, it does not mean that the BLS provider is inferior. Simply more limited. An example would be a basic and a paramedic packaging a patient with potential c-spine injuries. Simply because one provider is a basic does not mean that his level of care in packaging that patient in line with protocols for suspected/possible spinal injuries is inferior simply because he is a basic. Its just a fallacious argument. I agree that it might be a good thing to have Basic education increased to require a two year degree, but it should be an associate of applied science and not just a general AA degree with EMT training tacked on. But if we are going to essentially quadruple the amount of education for basics (the usual basic course takes about 6 months by the time all is said and done), then lets quadruple it for paramedics. So instead of the average year and a half, lets make it six. By doing this we can ensure that neither basics nor medics are providing inferior care.

So now you know what I would do in a situation or that I do what's easy for me? Would I call for an ALS intercept in needed if I were running on a BLS only service. Sure I would. Would I call for a helo dust off if one were needed. You bet ya? Do I do what's easy for me or the absolute bare minimum to get and keep my certs? Not on your life. I keep up and improve my skills and skill and knowledge set by doing more CEU hours (practical and academic) in one year than my state requires in 4. Last month alone I completed 60 CEU hours. So please, whatever you do, do not assume that you know that I take the easy road or for that matter that all basics do. That kind of smacks of another paramedic/DD notion that all Basics are really just wannabe Medics who cant hack it. In my situation, there are three paramedic programs in my area and there are constant waiting lists for them. We have one program that has a 3 year waiting list. I do plan on becoming a paramedic when it is feasible and suits me to do so. That is to say, when I want to. But not all basics are just wannabe paramedics who cant hack it. Some basics have no intention of ever becoming a medic. We have a basic in one of our systems who has been a EMT-B for 25 years and is VERY good at what he does and has no intention of ever becoming a paramedic. One of the other problems with the kind of arguments that Dust makes is ASSUMING that Basics arent capable of doing anything but driving. It is a hugely common assumption that paramedics make and its a stupid one. The reason that so many Basics end up pushing the cot and driving is because their so called superior paramedic partner never bothers to find out what they are capable of. Most medics dont ask. A Basic has alot to contribute during a call, but to hear alot of medics tell it, they would he happier to run the entire call themselves, without assistance and then jump up and drive the rig themselves too.

1. I do not deny that I am an extremely opinionated and blunt person. Ive never denied that and I dont see it as a bad thing, either in myself or in DD. If you think that's my problem with him and what he posts, you've missed my point. 2. It isnt MY response team. It belongs to the people of the State of Illinois. They pay for it. And though I dont remember making personal attacks or insulting individuals, I wont deny that I may have done it. I will go back to and read that thread and if I made insulting comments, I wish to issue an apology for it. Alot of people got upset by what I said because I said that local fire departments, EMS agencies, police departments and hospitals would rapidly become overwhelmed (in an event like what is being discussed in the New Madrid thread), but I dont remember saying that those agencies were useless and were the reason that EMS is failing and has only been getting worse for 30 years. If you listen to DDs interview, he states that as a fact. He states that EMS has been in a decline for 30+ years and that people who do EMS as a "hobby" (ie volunteers) are the reason for it. He also makes statements which are not based in fact. When he states that there havent been any advances in EMS in 30 years, thats just plain wrong and a silly thing to say. IV access, defibrilators, I/O drills, VorTran ventilators...it seems to me that these are huge advances and they are only the tip of the iceberg. But to say that they were advances wouldnt fit his egotistical paradigm of the decline and fall of EMS. If you listen to him, what he is saying is that Basics and Volunteers are the primary reason for this downfall because they responsible for the lack of EMS professionalism. 3. What stuns me, is that every single person who is an EMT-Basic, or a fire service based EMT or Paramedic or a volunteer EMS provider is not outraged and offended by his constant insults. Time and time again, I have asked him to provide facts that say that Basics cannot provide excellent BLS, BTLS and BCLS care. Ive asked him to show why the quality of care given by volunteers is less than that of paid responders. Ive asked him to demonstrate why EMT-Bs should be eliminated or relegated to status as drivers. Its not just that he does not provide this information, its that he cant because it isnt based in documentable fact. And of course he is entitled to his opinion just as everyone is. But when he starts to be derogatory to Basics, to tell them they are worthless idiots who arent worthy of taking vital signs, youre damn right I take that personally. And something that is even more upsetting is that he seems to view himself above the mandate placed by the moderators that bashing of Basics, volunteers and fire fighters cease. He simply doesnt care. He believes that rules of common courtesy dont apply to him. He delights in being not only derogatory and insulting, but demeaning. Anyone who says that teenage EMTs are alright as partners are acceptable as long as they are hot and willing to have sex with him deserves to be called out in public. As I said, since I made my original post in this thread, I have received several PMs telling me that people appreciate what I said and that I am not the only one who feels the way I feel, that I am not the only one who is sick and tired of hearing him spout his constant demeaning garbage. And youre right. There is a certain personal aspect to this. For a long time, I saw DD as both a good friend and a valued mentor. I was so in awe of him that I asked for a flag that he had worn to place on my uniform to honor the wonderful work that he does. But things pile up. His insults and slams become intolerable. The bad outweighs the good. At this point, I am saddened to have lost him as a friend but there are things that over-ride friendship and when someone tells you that you are worthless because you are a volunteer or a basic, that person is certainly not your friend and is not worth of being a mentor. I respect Dust for his service as I respect anyone that wears the uniform and does the work of their country or state or community. But that respect pales in comparison not to the personal insult I feel over what he says, but to his pompous and demeaning attitude and the notion that because he has been involved in EMS for 35 years that he is some sort of god and as such we should not only accept his constant vitriol against others but thank him for the privilege. I'll take a Basic any day as a partner before I would take some like DD for whom the term "paragod" isnt even sufficient to cover the base and hideous way he speaks about others who only want to serve others in their time of need.

Well, you know its partly the debate about the role of Basics in EMS (or rather whether they have any role whatsoever) but the majority of what makes me just cringe every time I hear Basics, fire fighters and volunteers (both EMS and fire service) absolutely bashed by Dustdevil and then to go to another website, one that has nothing to do with EMS though there was a thread about EMTs in this organization going at the time, and to to just hold forth with the "my opinion is THE opinion" type of attitude that many, MANY of us who are Basics and volunteers have been subjected to since time in memorium. Honestly, long ago it ceased to sound and feel like someone's opinion and more like Bill O'Reilly just talking to hear himself talk whether what he had to say had any validity or not. The facts are these: that if not in the entire US, in most states, EMT-Bs outnumber paramedics. They run a larger percentage of calls in rural and low income areas. The fact is that they also provide much emergency medical care in areas where paramedics are virtually if not totally absent. Volunteers make up huge portions or the fire, rescue and EMS service nationwide and to constantly run off at the mouth just to hear himself talk about how awful they are, how they treat EMS as if it were a hobby and how they are the downfall of EMS and the fact that EMS has been in decline in this country for 35 years and its to intimate that its getting worse because of the high number of Basics and volunteers, well talk about something that will make you throw up. And I have to say if it had been some other random person, it might not have upset me so much. But when we had the conversation some time ago where Dust said that if the leader's of the disaster response team to which I belong were STUPID for putting EMS personnel in harms way (ie in terror or other disaster type situations) that I just had to draw the line. Ive have listen far to much for far too long to the self-proclaimed guru of all things EMS hold forth with his version of what is wrong with the EMS world. Its one thing to hold a strong opinion, its another to only have one note in the song of How Great I Art and its played on the organ of bashing others. Im sorry, but Dustdevil's rants about Basics (and Intermediates) for that matter, fire fighters and volunteers of all sorts has just gone on ad nauseum and unchecked for far to long a period of time and quite frankly Ive just had it. I too drank the kool-aid. I do worshipped at the self-built alter of the Dustdevil for some time. But enough is enough. I gets to be too much to constantly listen to people bow and scrape to him as though he invented emergency medical services. In that interview about professionalism in EMS, he couldnt even resist the opportunity to say that when funeral homes ran EMS with hearses that as a holder of an "advanced first aide card" he was often the most highly trained on the scene. Even then when EMS involved nothing more than stick em in the truck and drive em...when Dust himself was an ambulance driver...even then there was barely room in for his ego and the patient in the same vehicle. As I said to someone who privately told me that they were happy I said what I said because I was not the only one who felt the way I did as expressed in my first posting in this thread, Im just tired, nope, make that exhausted of no matter the constant anything you can do I can do better rantings which have permeated these forums from the golden keyboard of the DustDevil for years. Is he the first medic on the planet? Is the only one to have every combined EMS with nursing and worn his countries uniform? To hear him tell it you sure would think so. Is that what makes him so great; the notion that somehow as a military medic and clinic nurse he saves us all from our undereducated, to stupid to know any better selves? To hear him tell it you would certainly think so. I wear my state's uniform as so many of us do, but simply donning a government uniform doesn't make me the king of all I survey simply because there are countless individuals who are willing on a regular basis to bow down and kiss his pompous...butt. Tell ya what Dust, let ego and bashing of others and more solutions. Less "I would allow a teenage female partner if she were hot and would sleep with me" and more real answers. Its not that you have nothing of value to say, its just that when you temper it with the way in which you say it, the squelch of your adoration fed ego simply dont balance out. There are many people here who have served in this profession far longer than you and yet are able to maintain an attitude of humble civility and dedication to the profession far beyond the "what's in it for me?" attitude. Folks, go back and listen to this much lauded interview. Its a flash in the pan. There is nothing there. It doesnt even have the benefit of tearing apart the posts of others so that he may feed us all the kool aide of EMS created in his own image. Its just so much babble of an individual literally in love with the sound of his own voice. If you are all interested in what someone who serves in the military medical corps has to say and how such an individual can inspire those around them rather than do nothing but tear them down, read "Rule Number Two: Lessons I learned in a Combat Hospital" by Dr. Heidi Kraft. The good doctor cherishes all who are willing to put themselves in harms way for the good of others and not just those who seem to do it as another feather in their own cap, yet another bragging right, yet another sharp edged weapon wielded to demonstrate the inadequacy of others simply because they aint the "DustDevil." And to those of you who are interested in what Dust has to say in an all time low point of bashing...well...everyone who isnt him, you neednt look far. He used the same alias on more than just the City. But I for one refuse to bow and scrape to some Tom Crusian, self-righteous, holy than thou insulting the work and dedication of so many hard working individuals and then having the outright unmitigated gall not to even offer any real, substantive explanation of how things could be improved. I, for one, have had enough and am not afraid to say so. YMMV.

I guess I will be the one with the brass ones to say it: i was pretty disappointed by this interview but not as incensed and outraged at I was by a post Dust made on another non-EMS related site recently once again re-rating Basics. All I heard in the interview was Dust once again telling us how much cool experience he has and saying a lot of "Ummm...we need to be more professional." As for the scathing post about Basics on another site, I guess he had to take it elsewhere since we were all told to stop that bull-durham on this site. So Dust, what are you doing to fix the major problems with EMS professionalism? And before you be-rate me as a 120 hour Basic, I recently checked with my EMS instructor and my class was 280 hours. Why dont you do something instead of just bashing people all the time. I used to really, REALLY look to you for advice and guidance in my EMS career and no I just find your constantly spewed bilge about Basics being the end of EMS so putrid and disgusting that I generally find myself screaming at my monitor every time I read anything you have to write. YMMV.

Also, I would recommend a new instructor. Next class ask him what the total down time was before decompress because if it was as long as your scenario would indicate, he may be more alive but will be living in the produce section.

Im guilty of this myself from time to time, but: MEDIC does not equal PARAMEDIC. Two different beings altogether. Medic is a military/paramilitary "slang" for one type of emergency health care prover or another. Paramedic is the guy (or girl) with all the neat initials after their name and all the bling on their uniforms, who generally complete their interventions in the box of a nice clean ambulance. A medic is not only pre-hospital but is also somewhat of an expert in austere medicine. Many agencies or EMS regions dont teach or barely touch on things like suturing, etc. To me, a medic is someone operating in the field whether a CLS or 68W or what have you. A paramedic is part of an ambulance crews. USCG rescue swimmers are considered medics, but the training they really have is advanced Basic with the addition of some invasive airways, some pain killers. Im not saying its right and that it may not be misleading, but I have seen some DMAT teams call their providers, whether ALS or BLS Medics. I have also seen SWAT teams with a EMT-Basic who has uptrained to being able to start a line and the back of his uniform says Medic.

I wouldnt try to explain it because Im not in those fields and they dont concern me.

We ought to be emulating other public safety professions, in particular law enforcement. If I could find a paramedic program in my area with the kind of regimentation we are talking about here, I would do it in a heart beat. The reason we have sloppy, unprofessional and haphazard providers is because that is the way they are trained. EMS is already built on a paramilitary model. Modern EMS is a direct descendant of military field medicine. And yes, I press my uniform shirt and pants, shine my boots and keep my hair cropped short. I also dont wear facial hair in the field. My uniform now is khaki BDUs and while is may not look that way at the end of a tour, it is always squared away when I start. I call everyone I come into contact with whether a paramedic, an EMT-B who is older/has more experience, a patient, doctor or nurse sir or ma'am. If I am put in charge of a team, I dont allow them to be seen smoking in uniform and if they have dropped food or something on their uniform, I tell them to change it. We want professionalism and the respect that goes with it and belly ache when anyone tries to achieve it. In that regard, we are are own worst enemy.

Lets take a quick look at the definition of stable. Stable does not, in and of itself, mean good or bad. It means, to paraphrase Taber's, unchanging over a period or range of time. From what Ive read one BP was given. Another could not be had because he cant sit up (ruling out the ability to check for orthostatic changes). We cannot note a widening or narrowing BP with 1 set of vitals. He has never been to the Dr. before which likely means he has never ridden in an ambulance and you and your partner have your rig sitting in his front yard with your secondaries on. He heard the siren. Your cot is in the house. You are in the house. Perhaps medical types make him nervous. Quite simply, his vital signs cannot be called stable or unstable because we have only one set. As I say, there is good stable and bad stable as in "stable and resting comfortably" or "stable but critical." Also he is in pain which we know drives up vitals and he is reporting a 10/10 on the UPS. I just recently had a doctor tell me that he doesnt freak over BP until he has 5 sets of vitals over 25 minutes and the BP is 230/130 and not going down. Not to long ago I assisted with a 17 year old girl having an anxiety attack because her boyfriend was dating someone else. Her BP was 220/150 because she had been sobbing for two straight hours before our arrival. 10 minutes on 12lpm via NRB and she was at 120/90, respirating a 14 per, pulse 86, PsO2 was 100% on NRB and 98 on room air. When the parents asked the my paramedic if she should be transported, he let her know that what she would get in ER would be more of what she was getting in the living room and though he certainly would not talk her out of going, she seemed to be in much better shape then when we arrived. Another 5 minutes on scene and our patient was talking to me about school and soccer, all vitals within parameter for a girl her age and after further discussion with the paremedic, the parents signed a refusal, we packed up and headed to dinner. Stable is objective and objectivity is not gained with one set of vital signs.

There is a company called Triple Nickel that sells nice white and blue enamel SOL pins for less than $2.00 unless they have raised their price. Sorry I dont have to link handy. I think you can also get them relatively inexpensively at Cops Plus

That has to rank with the most ignorant/offensive posts I have ever seen anywhere. Aside from being discriminatory against religion, it is that kind of thinking that all Muslims are evil and should be "outed." Countless negative points for this one and an appeal to Admin to remove the post,lock the thread and suspend the authors posting ability for a at least a month if not banning the poster altogether.

I have one and am preparing to get another. The first one is a memorial to my grandfather and the other will be EMS related. But like Annie, I keep them confined to places where I can cover them if the situation warrants it. Some people are just plain bothered by them, though the agencies in my city seem to be evenly split. Two require them to be covered and the other 2 allow them to be visible as long as they are not by their nature offensive or vulgar (there goes my pin-up girl). Personally, if I were in a bad MVC and the EMT/Medic taking care of me had tattoos on his face, I wouldnt care as long as I was getting competant care. I do disagree with piercings other than earrings (both for men and women) and if I were ever in a position to hire someone, I would say you need to be able to cover it or take it out. Seems like more folks are bothered by piercings than tattoos. One of my IMERT commanders has both tattoos and earrings but there is certainly no questioning his knowledge and skill as a professional, which is obvious from the fact that he runs the EMS office at one of our local hospital. Im starting a CERT team and will have the same general policy that they can show as long as they are not overboard or vulgar. I worked once with a paramedic who if he was not wearing long sleeves you could see a White Power ink on his forearm. He was given the choice of wearing long sleeves all the time, having it removed or quitting. I believe he chose the latter.