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Just Plain Ruff

should we do away with EMT certification

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ok, this came up to me in a discussion that I had a couple of weeks ago with a colleague at Shock Trauma in Baltimore.

Should we just do away with EMT certification and only go with paramedic?

Arguments for: One certification only. Consistency in teaching standards. Enhanced patient care

Arguments against: cost, time, grandfathering in old emt's, numbers of students already in emt class.

anyone else have thoughts.

By the way this person I talked to was all for doing away with EMT and going only with EMT-P.

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I think a paramedic certification needs to become an actual license. RN's are licensed and we know their pay is much better than a paramedics. Make a two year degree mandatory to become a licensed paramedic. How's that for cut and dry?

Shayne

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I agree that it needs to be a license. Make it a license not a certification.

But I am in agreement with my friend in Baltimore that EMT needs to go away and have one licensure for each state.

Will it happen? not in my lifetime and it has about as much chance as the fair tax to get implemented in my lifetime but this might be one step closer to consistency and such.

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I also believe that the Paramedic with a 2 year degree should be the entry level for Emergency MEDICAL Services. Then, extra education and certs for specialties such as CCT, flight and community health can then be obtained to build from that "basic" education.

However, there are still people who need some type of EMT training or advanced first-aide for their professions. Examples are Firefighters, industrial safety officers, loggers, commercial fishing boats, mine workers etc who are the first to reach a patient and get them to safety and to the paramedics. Many of these professions do require some of their workers to take the EMT-B class even though it is not their profession. Would then each profession develop their own (miners do expand in their job related expertise) programs or enlist the services of agencies such as the ARC to assist in developing industry specific programs? The ARC has done an excellent job with several school teachers, camp counselors and disaster shelter workers in some parts of the country.

I believe it is Texas that has both a certification and a license for the Paramedic with the difference being a degree education.

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In my state all EMS is licensed. The Basic, Intermediate, and the Paramedic are each licensed through the State Department of Health and the license is governed by State Law just like the RN, the electrician, plumber, physician., etc..

I do not agree of removing the EMT; but rather the Basic level should be placed as a medical first responder only. Not included in the Paramedic curriculum at all. That it is what their curriculum is aimed for, nor what their primary job is for. This means they are NOT for continued care, or for transporting injured or ill patients. Again, rather for stabilizing until professional help arrives.

One will never remove EMT in some areas. Sorry, that is the fact of life. Just like some areas will never have a local hospital, or have a orthopedic surgeon, or neurosurgeon some may never have ALS capabilities. Unless the government wants to fund the EMS and possibly rotate medics through to keep proficient in skills then we will never see such. Yes, the areas that the need them the most will not have them and since EMS is a business and as professional medics we would like to have comparable pay, whom or what would pay for areas of of a call volume of < 100 calls a year or a population < 10,000 in 900 square miles?

What does anger me is those areas and communities that can provide such services but rather keep the service as BLS or utilize volunteers strictly based upon tradition and self inflated ego's. No exploration of upgrading ALS or placing professional Paramedic services, rather keeping status quo with no regard of patient care.

So what could be done?....

Again, change the EMT level as a first responder emphasis only. Not associated with Paramedic education at all. Only in rare and very remote areas (it would have to be proven/documented) that they be allowed to progress or transport and perform additional skills due to transport time to ALS provider. This would be an exception instead of the norm.

Require the Paramedic to be at the least an associate degree level. With the same general education as other science degrees. No exception or "technical" degrees. Each State would license through a board of EMS within their own state, like the nursing and other health care professionals. National license would never occur, but the NREMT could be improved and used as a standard organization to test and used as a reference center allowing easy transferring of license from state to state.

Will this ever occur ? Probably not as fast as I want it to. I do believe when the NREMT starts their requirement of accreditation facilities we will see a major shift and change. Other educational facilities that are not even NREMT will have to follow or be left behind per professional standards or peer pressure. With the requirement and emphasis of having it placed into a true educational facility we will see many of the technical or trade schools loose their ability to teach anything but basic and intermediate level.. thus producing those that are not in demand and with time increase the flooding of the market, and finally dying out themselves.

R/r 911

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Rid I think that this is where i was going.

Get rid of the ability of the EMT to transport or even drive the ambulance. Put them strictly as a first responder which can run the gamut of firefighter, industrial emt, wilderness emt, search and rescue but leave the patient care transporting to those with EMT-P licenses.

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OK, <pedant mode> Every single one of those group you've mentioned transports patients, including by way of motor vehicle. They're probably moving the patient to the actual ambulance, but they are in a sense transporting them. If you're referring to staffing 911 ambulances, wonderful, but there are other folks who still have to be able to package and move people. </pedant mode>

There needs to be something sort of similar to a current day EMT course in terms of content for these type of folks. Obviously the medical professionals need something else.

Anyway, sorry if I sounded like an ass.

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While it is important to note that those of us that are paramedics were not born as medics and had to be an EMT at one point.

It is equally important to state that as paramedics, our feelings of one title, one entry level education and one license comes mostly from years of experience and seeing the benefits that this type of EMS provider structure can have.

I agree with previous posters on having an entry level 2 year degree type license with additional training for other areas in EMS to include recent discussions in some areas on house call type para-medicine.

I also think that by having one title, it will also help the profession grow and expand into what it is capable of. When government agencies both local and above can

understand what we do, it will help us get funding, education and growth support from them, much like fire and law enforcement.

By having us under one title - I think it will help them understand and get on board much quicker.

When will this happen? When we get out of each others way with adding exceptions to the rule, making excuses for small towns to keep EMT based only, supporting the volunteer mentality etc.

We need unity to make this happen, but go to any EMS council and see how everyone protects their small area of responsibility.

Just as a for instance, NJ came up with a report to try and revamp the system that is in poor shape. But leaders of the volunteer sector refuse to give up their status and still say that it works when clearly it doesn’t.

Right now we are so fractured it seems like an impossibility that any significant change will ever come.

We need to get behind a national organization like NREMT that has the recognition with many states and get a huge PR campaign going to increase public awareness. This takes millions of dollars and clever marketing and advertising.

Can it happen in my lifetime? Why not? I still have a good 20 years left in me. If we unify and get the financial support and proper political backing, we can at least lay the foundation for a new future of EMS.

Personally I wish we could just tear it all down and re start from scratch, but I don’t think that will happen. The next best thing is to at least start with a unified organization with standard entry level requirements and standard licensing with an organized body behind us.

Yes with dues, requirements etc, just like any other.

This can be done without hurting anyone’s bread and butter. We need the right people to head it. Most of all we need motivation and desire and not just talk amongst ourselves.

When can we start? Now.

Jim

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In NYS “professionals” (including massage therapists) are licensed through the Department of education,

EMS are Certified through the Department of Health, it is my understanding that the DOH has been petitioned many times to turn the Cert into a license, but they refuse, this is why I state in my previous posts I believe it needs to be taken out of their hands.

National license would never occur, R/r 911

Why not?

While it is important to note that those of us that are paramedics were not born as medics and had to be an EMT at one point….. When government agencies both local and above can understand what we do, it will help us get funding, education and growth support from them, much like fire and law enforcement.

By having us under one title - I think it will help them understand and get on board much quicker…..

Right now we are so fractured it seems like an impossibility that any significant change will ever come.

We need to get behind a national organization like NREMT that has the recognition with many states and get a huge PR campaign going to increase public awareness. This takes millions of dollars and clever marketing and advertising.

Can it happen in my lifetime? Why not? I still have a good 20 years left in me. If we unify and get the financial support and proper political backing, we can at least lay the foundation for a new future of EMS.

Personally I wish we could just tear it all down and re start from scratch, but I don’t think that will happen. The next best thing is to at least start with a unified organization with standard entry level requirements and standard licensing with an organized body behind us.

Yes with dues, requirements etc, just like any other.

This can be done without hurting anyone’s bread and butter. We need the right people to head it. Most of all we need motivation and desire and not just talk amongst ourselves.

When can we start? Now.

Jim

I heartily agree with everything said here, I have said the same many times.

Further I believe we can do it, we just need to figure the “end run” that would get around the road blocks.

This post is so completely “On The Money”, it needs to be published.

As always IMHO

Be Safe

WANTYNU

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Ridryder 911

I understand what you are saying. You and I both being from Oklahoma, do you ever think that will happen? I don't, but what's your take as far as Oklahoma goes.

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