The Day EMS Died ..........................

[crotchitymedic1986]

There is a lyric in the song American Pie (Don McClean) that talks about the day the music died. I can definitively pinpoint the day Competent EMS Care Died, and it was the day that ACLS became a "cant fail" class. I can remember people puking in anticipation of having to pass ACLS, because it was so difficult. Now, ACLS is so easy that you can bring a citizen with no medical training whatsoever into the class, and they could become certified 16 hours later. So sad !

Forget the 4 year degree, if you want to improve EMS, make the 16 hours of ACLS count again.

[tniuqs]

AGREED!

[VentMedic]

Now, ACLS is so easy that you can bring a citizen with no medical training whatsoever into the class, and they could become certified 16 hours later. So sad !

Forget the 4 year degree, if you want to improve EMS, make the 16 hours of ACLS count again.

Other healthcare professions have moved on to more educaton and put little weight on the "training" they get from a weekend cert class. ACLS should only be used for an update on what's new and that may not even be necessary. Many involved in resuscitation in professoinal organizations, be it EMS or the hospital, are either well read or informed of changes by their Medical Directors. These organizations may also conduct their own ACLS class and while they still keep within the guidelines set by the AHA, they also are made aware of any deficiencies with their employees.

However, some still need the formality of going through such a class or they would be unlikely to get any updates if it depended on them reading something. Or, they just wait for the recipe change by their Medical Director.

[mobey]

I don't know how other places do it, but when I asked my Cardiology instructor when we take our ACLS course she repiled "It is included in your Cardiology course". The same goes for my ITLS, we don't take a specific amount of time out of our regular education to "Dumb it down" for the extra cert, it is covered within the entire Paramedic course.

I agree with Vent, the actual ACLS or ITLS "badge" is just to recert, to hold providers accountable for some form of competency (low as that may be).

I can definitively pinpoint the day Competent EMS Care Died, and it was the day that ACLS became a "cant fail" class.

To withold a knee jerk defencive reaction, could you clarify this statement? I read it to say "since the ACLS exam was "Dumbed down" there has been no competent ems provided." Which of course as a Paramedic student I would have to defend.

[spenac]

I would say EMS was definitely circling the drain way before ACLS was dumbed down. Perhaps it did put the final nail in the coffin.

[WolfmanHarris]

Sounds like ACLS is mirroring education throughout the western world. Can't fail anyone, lots of positive feedback and no constructive criticism, a million and once chances to do anything and the primacy of self-esteem have damaged education. ACLS is just a symptom of it in EMS. The cult of "that's okay. You tried."

Not every educator buy this load of BS though. And when they get together and start influencing each other couldn't it start being done right in an area? I know as it stands with the amount of resistance coming from services, associations and the like and the lucrativeness of medic mills that's a lot of inertia to overcome, but there's always small victories.

[VentMedic]

Sounds like ACLS is mirroring education throughout the western world.

Don't lump all professionals into that category of declining education. As I stated before, other healthcare professions have raised their education standards and don't place an emphasis on an ACLS cert when they get much more "ACLS" education through their own education programs either in school or at work.

This basically concerns some in EMS who are worried they will eventually have one less "cert" to declare or their easy "recert" might again be replaced by something worthwhile.

[WolfmanHarris]

Sorry when I was referring to declining standards in education I was talking beyond EMS and healthcare, though I do believe as grade inflation worsens and we rely more and more on curriculum and systems of evaluation that concerns themselves with a combination of self-esteem and standardized tests the effects will be felt even more within higher education. (though they are already) Our education system (Canada and the United States) does not prepare students for higher education or the real world, forcing higher education to fill in more and more holes in the first year. This of course is a losing proposition as it supports the decreased standards and even less onus is placed on high schools to prepare students properly. Not to mention that University and College is so lucrative that if the undergrads who were not prepared for their first year were just flunked the revenue would drop rapidly.

I don't teach in a classroom, though for many years I was pressured to become a teacher. Many of closest friends and family are teachers. I do continue to teach outdoor education, swimming, lifeguarding, first aid, etc. and as a result I have a continued interest in education. It remains the most depressing moment in any of my teaching when I receive comments from participants or parents along the lines of "Wow, you work them really hard!" or "I like that you actually tell me what I have to work on and make me do better next time." etc. I don't think I do anything other than teach to the standard; but they're all so used to games and play and having smoke blown up their ass that being taught and having to work are surprises. My friends that are new teachers are already frustrated by how little they can do if a student does not do their work, or isn't capable or progressing. But I suppose that's neither here nor there.

Since I've lost online access to my University library I don't have access to some of the journal articles I previously bookmarked. I do however have a list of a few other links that illustrate the underlying problem in education that affects us all, EMS or not.

Decline in Education (as seen in University Physics)

Hoover Institution: Decline and Fall of American Education

Decline and Fall of American Higher Education

University of Lethbridge: Grade Inflation

Grade Inflation: Admittedly NOT well sourced

"Why Johnny Can't Fail" Ontario Secondary School Teacher's Federation

Social Promotion Policies Fail Students

"Why Johnny Can't Fail" A similar article by a teacher

And just for filler context info

No Child Left Behind (Wiki)

There is a lot more information out there and if you have access to a good University library and can read their journals online there's some excellent studies on this. These are just the bookmarks I have that aren't dead links or I can still access.

EMS education is worse of than others, but it's hardly alone in subpar education.

I'm not saying that there aren't still programs, school and individual educators who keep the bar high and don't fail their students, but I worry that they'll become the minority.

So ya ummm... all ranting aside I agree that ACLS should be a worthwhile course that keeps one current in a specific skill set as part of CME. So should all the other merit badge courses.

Cheers,

- Matt

[crotchitymedic1986]

No, I was not saying that there hasnt been ANY competent care since ACLS became a "no fail" class, as there will always be the medics who wont settle for the status quo, and will take other classes to improve their skills. My point was that when ACLS was so tough that you could fail (and most physicians did, so thats why it was changed to a no fail), you atleast had a minimum standard in EMS for a period of time. You had to know the drugs backwards and forwards and atleast be able to read 80% of EKGs shown to pass. It was a course that you had to study for to pass, even if you were a good medic. The last 3 or 4 times I took it, I didnt even open the book; I didnt study at all.

If you think departmental training is bad now, it was almost non-existent then, so ACLS was the only way to insure that medics had any training whatsoever.

[VentMedic]

You had to know the drugs backwards and forwards and atleast be able to read 80% of EKGs shown to pass. It was a course that you had to study for to pass, even if you were a good medic. The last 3 or 4 times I took it, I didnt even open the book; I didnt study at all.

If you think departmental training is bad now, it was almost non-existent then, so ACLS was the only way to insure that medics had any training whatsoever.

So you are relying on one little weekend course to insure "training" and "competency" for the Paramedics?

And, if ACLS is not hard enough where you do not study, you don't study or stay current for the sake of doing good patient care?

Even when it was a difficult class, our medical director arranged other training under his direction to assure competency.

It is irresponsible to rely on just a "cert" class to prove ones competency or have it be the only time one reviews ACLS protocols.

I don't blame the AHA. I blame the Paramedics who get such a "cert" mentality that they forgo true education. Once one is truly educated in what ACLS is all about, one should only need a periodic update or review. If one is not responsible enough to maintain the basic concepts through their own education, then they are doing the Paramedic patch a disservice.