Another Idiot Opposes Progress in NJ EMS Standards

[Kiwiology]

I think the "driver only" concept is an absolute disgrace and a total cop out.

Our fantastic twenty-four week part time trained "Ambulance Technician" is also a bit dodge if you ask me.

[uglyEMT]

another provider whose training is inadequate for the job they have to do.

HUH? An EMT-B is inadequatly trained to do their job? Sorry but thats just plain wrong on so many levels! Weren't you a B at some point in your profession? Not everyone has to be a paramedic to be a quality prehospital care provider!!

Sorry but.....

I think the "driver only" concept is an absolute disgrace and a total cop out.

Sorry I was a disgrace while attending school at least I got a great learning experience before becoming certified.

Edited April 19, 2010 by UGLyEMT

[WolfmanHarris]

HUH? An EMT-B is inadequatly trained to do their job? Sorry but thats just plain wrong on so many levels! Weren't you a B at some point in your profession? Not everyone has to be a paramedic to be a quality prehospital care provider!!

Sorry I was a disgrace while attending school at least I got a great learning experience before becoming certified.

My fail for not providing context.

I'm not in the USA. I'm in Ontario, Canada. Here BLS = Primary Care Paramedic, a two-year college program. ALS = Advanced Care Paramedic, a further one year of college and Flight/CCT = Critical Care Paramedic (Flight) a further year and a half. Our system including education is not without it's issues, but here EMS is almost entirely paid (save remote areas where ground EMS may be volunteer backed up by Air) and paid quite well.

The closest equivalent to EMT-B in Ontario is the Emergency Medical Responder course an 80-100 hour advanced first aid course used by industry and FD's for first responder training. So I was at one point similar to an EMT-B, when I was a member of my campus First Aid team during university. But this was non-transporting first response backed up by professional County EMS.

I will try not to hijack this further if you search previous discussions on education we've covered it well but I don't believe that if EMS is to have a true place in healthcare that is can rely on such short, technician type education. The focus on skills means that as research progresses the provider becomes obsolete. A focus on knowledge and depth of education means that you have a professional provider that can adapt to the changing field while still being useful and relevant.

[uglyEMT]

My fail for not providing context.

I'm not in the USA. I'm in Ontario, Canada. Here BLS = Primary Care Paramedic, a two-year college program. ALS = Advanced Care Paramedic, a further one year of college and Flight/CCT = Critical Care Paramedic (Flight) a further year and a half. Our system including education is not without it's issues, but here EMS is almost entirely paid (save remote areas where ground EMS may be volunteer backed up by Air) and paid quite well.

The closest equivalent to EMT-B in Ontario is the Emergency Medical Responder course an 80-100 hour advanced first aid course used by industry and FD's for first responder training. So I was at one point similar to an EMT-B, when I was a member of my campus First Aid team during university. But this was non-transporting first response backed up by professional County EMS.

I will try not to hijack this further if you search previous discussions on education we've covered it well but I don't believe that if EMS is to have a true place in healthcare that is can rely on such short, technician type education. The focus on skills means that as research progresses the provider becomes obsolete. A focus on knowledge and depth of education means that you have a professional provider that can adapt to the changing field while still being useful and relevant.

OK I understand now. Gotcha. Sorry about the misunderstanding.

[paramedicmike]

I guess I am now seeing why you all look at us like jokes, sure sounds like we are. I guess my big problem is putting down vollies, dont understand why anyone would? We save tax payers money, are grounded in our communities, and are just as certified as any paid EMT.

Yes NJ policies are screwed up but dont blame the EMT, blame administration. We just follow protocol.

This is exactly what is wrong with EMS, and NJ EMS in particular.

First, the EMTs are exactly what is wrong. Their insistence on volly squads only fuels the FAC which pretty much, almost single handedly in fact, keeps NJ EMS in the dark ages. The idea that "we just follow protocol" demonstrates that you (volly EMS, not you individually) are not smart enough to think independently. Not being able to think independently is a pretty significant problem in itself never mind how it binds you to blindly do things without understanding or knowing why you're doing them.

As for the first part of your post and not understanding why people would put down vollies, there are *MANY* discussions in these forums detailing why volly EMS is a plague upon this industry. Please look around and see what you can find. You have a lot of reading and learning to do.

[Kiwiology]

HUH? An EMT-B is inadequatly trained to do their job? Sorry but thats just plain wrong on so many levels! Weren't you a B at some point in your profession? Not everyone has to be a paramedic to be a quality prehospital care provider!!

Like Doc I am not in the US (New Zealand) and agree with him. A 120 hour course in advanced first aid or a 24 week part-time course in "Ambulance practice" (and I use the term liberally) is not adequate for the job of being a prehospital medical professional. Unfortunately New Zealand is unable to get its thumb out its ass and do away with "volunteers" and move towards a totally college-level education system unlike Australia, Canada and the UK (which we oddly have done for Paramedic and Intensive Care Paramedic).

Define "quality care" for me please? Is it "quality" care if you have to wait 20 or 30 minutes for advanced pain relief because you don't even carry entonox? Is it "quality" care for somebody to wait with crushing chest pain because you cannot give GTN? How many times a minute would you ventilate an astmatic patient who is catatonic and respiratory arrested, 10, 12, 15? Is it "quality" care if you cause them to have a PEA arrest?

I was a disgrace while attending school... at least I got a great learning experience before becoming certified.

Did I say that you personally were a disgrace? No, I did not so don't take it so personally.

Define "great learning experience" for me?

The driver only concept is a disgrace. It is disgraceful that system administrators, funders and operatives consider it appropriate in a first world nation, in the twenty first century, to staff a prehospital medical resource with somebody who has no independant clinical ability and is only there to drive.

Lets say there is you, the EMT, and Wheels the Driver. Can Wheels do CPR? Can he help you apply a traction splint? What about extricate somebody from a car using a KED? How about treat the other person in the car because there are only the two of you there?

This is simmilar to what the UK has done with its Emergency Care Assistant program in that it places a huge onus on the crew member who has some actual clinical ability because they must take charge of a scene almost solo and attempt to supervise or instruct Wheels the Driver in helping them while making decisions around patient assessment and treatment.

That is not safe clinical practice and is a huge risk for clinical error.

[Chief1C]

The slang, Volly, Vollie, et al., offends me.

[Kiwiology]

The slang, Volly, Vollie, et al., offends me.

How come? What about ambo, or para, or medic?

Ambo is common here in NZ and also in Oz

Para is quite common in Australia

Medic is quite common in the US

[Chief1C]

Everyone on the ambulance, needs a minimum level of knowledge, before they get on the ambulance. Paramedics, EMT's, FR's, Attendants, Operators, etc. They all need to be able to *at least, set up or assist in application of X, for the patient provider. While I support my opinion, that an ambulance operator does not need to be a highly certified EMS person, I do believe in a minimum level of care on their part.

[Kiwiology]

Everyone on the ambulance, needs a minimum level of knowledge, before they get on the ambulance. Paramedics, EMT's, FR's, Attendants, Operators, etc. They all need to be able to *at least, set up or assist in application of X, for the patient provider. While I support my opinion, that an ambulance operator does not need to be a highly certified EMS person, I do believe in a minimum level of care on their part.

I also support your opinion, what do you think that minimum level of knowledge should be?