your opinion on a manditory 2 year degree for paramedic

[Dead_Head]

What is angiotensin? :oops:

[Dave_W]

Final comment about this. Ditch, I agree with you. We should raise the bar, especially for medics. I wish my course was longer than a year, it would have been beneficial, instead of cramming a semesters worth of A&P, pharm, cardiology, etc into six week blocks.

[Dave_W]

What is angiotensin? :oops:

Are you referring to angiotensin I or II?

[THE_DITCH_DOCTOR]

What is angiotensin? :oops:

This should give you some idea:

http://www.auburn.edu/academic/classes/zy/...lute/sld026.htm

http://www.auburn.edu/academic/classes/zy/...lute/sld027.htm

Basically it effects water and electrolyte balance in the plasma and urine, as well as stimulating other pathways that play a large role in fluid balance and blood chemistry and also in blood pressure regulation.

[Dead_Head]

I'll have a look at the web sites. I dont know what 1 or 2 is.. never heard about it before.

[POWNAL RESCUE 7]

Very interesting, I agree, as a NREMT-B I feel we are very poorly trained!!, We are playing with people's lives, not working on the family lawn mower!!!!!!. The bar must be raised!!!

[EMS-Cat]

No, it hasn't. It's always been a thread regarding whether you think we should stay as the voc-tech trained cot jockies everyone thinks we are and with an open door policy to people entering the field just wanting to get their jollies off, or do you think we should require people to be able to have a lot more depth in their education and a little more stringent requirements before allowing any yahoo off the street to earn his credentials.

We can't do anything about people who are already certed, but we can do something about those who are coming into the field and that is exactly our intention. Lead, follow or step aside.

*************************************************

Okay - be prepared - this will be long winded.

I think part of what we've got here is no one is really sure what everyone is referring to as a '2 year program' - that is, what's the makeup of classes involved. I'll cite what I've got locally for my example.

In my area, the local community college gives you two options: a 1 year certification program or a two year AS program. Please understand that both programs require you to have already received your EMT-B and worked at least one year as one before you can even apply. And nothing says you can't get some of the non-EMT-P stuff out of the way before the program starts.

You have to interview before you can even be considered for the program. You have to have people who've actually worked with you recommend you. These are just some of the ways and means to help cull the 'Johnny Gage Syndrome' folks from the incoming class.

Here's the local program's info verbatim from it's site [Note: there are other EMT-P programs in the local area, but they are run internally by either the Fire Dept. or one of the local ambulance companies and I have no information them. This is from the local community college]. And I realize what this doesn't show are the actualy hours spent each quarter in class and hands on. I can dig that out if anyone wants. I think that fact it meets accreditation should suffice as a baseline.

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The Paramedic Education Program at Tacoma Community College educates individuals who provide advanced pre-hospital emergency care to patients. The program is offered as a one-year Certificate course or optional two-year Associate of Applied Science Degree. The core curriculum begins in September of each year with the prerequisite classes being offered in summer quarter. The graduate will have developed competencies in recognition and management of medical and trauma emergencies. Paramedics are typically employed by fire services, hospitals, or ambulance companies.

TCC's Paramedic Education Program is designed to prepare graduates to meet State certification requirements, as well as to take the National Registry EMT-Paramedic examination. The program is fully accredited by the Committee on Accreditation of Educational Programs for The Emergency Medical Services Professions (CoAEMSP)

Upon successful completion of the certificate program, students have the option to pursue an Associate in Applied Sciences Degree by completing 42 additional credits of general education courses as outlined in the curriculum. Those classes may also be taken prior to beginning the Paramedic Education Program

=========================================

Admission/Application Requirements

The following checklist of items is to be completed and included in your application: (Application deadline is March 1st of each year):

1. Completed Allied Health application form

2. Copy of High school diploma or GED certificate

3. Official college transcripts showing successful completion (grade of C or above) of Math 90 (Elementary Algebra) and English 101 (Composition) OR College Assessment scores of Math 90 and English 101 (College Level Reading). Assessment tests can be scheduled through the TCC Assessment Office at (253) 566-5093.

4. Letters of recommendation (2-3) from supervisors or other professionals, who are directly involved and familiar with your work as an EMT (i.e. chief, physician, advisor, etc.). Up to two personal recommendations will also be considered.

5. Photocopy of current EMT-B card (State or National Registry)

6. Photocopy of current (Health Care Provider) CPR card

7. Documentation of active EMT experience on letterhead stationery from the agency(s) where applicant works (or has worked) as an EMT. This should include total years as an EMT, as well as estimated total patient contacts. You must have at least one year of EMT experience prior to the March 1st application deadline in order to apply.

Optional (recommended) documents:

* A recent photograph of the applicant (signed on the back) to assist the selection committee to more readily recall each applicant.

* Photocopies of additional certifications (i.e. ACLS, PALS, PHTLS, etc.)

==================================================

Course Curriculum:

Paramedic Certificate Program

Course Title Credits

Summer Quarter (Prerequisites)

Anatomy & Physiology BIOL 118 5

Medical Terminology I HT 130 3

First Quarter (Fall)

Well Being of the Paramedic EMC 118* 4

Paramedic I (Didactic) EMC 120 12

Paramedic I (Clinical) EMC 130 3

Total Fitness PE 100 2

Second Quarter (Winter)

Paramedic II (Didactic) EMC 121 12

Paramedic II (Clinical) EMC 131 7

Total Fitness PE 200 2

Third Quarter (Spring)

Paramedic III (Didactic) EMC 122 5

Paramedic III (Clinical) EMC 132 9

Total Certificate Credits 64

** Associate Degree Option : Additional Required Courses (37- 40 Credits)

Contemporary Issues in Prehospital Care EMC 200 2

General Psychology PSYCH 100 5

College Freshman Composition ENGL 101 5

Business Math BUS 110 5

Principles of Management BUS 163 5

or Leadership and Human Relations BUS 164 5

Introduction to Critical Thinking COMSK 100 5

Fundamentals of Speech Communication SPCH 100 5

or Public Speech Communication SPCH 101 5

Introduction to Information Technology IT 235 5

Select one:

Survey of Sociology SOC 110 5

Marriage and the Family SOC 152 5

Social Psychology SOC 240 5

Total Associate Degree Credits 106

* Taught between summer and fall quarters during 2-week pre-instructional days.

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Based on this, I have to take the cert program to earn my EMT-P [i'll suck it up and take med term again - it's only 3 credits...]. I have *no* problem with any of that. It could even be a bit more, in my book. There's always room to learn new stuff.

In regards to the two year AS diploma, however, taking into account the classes I already have on record at other facilities, I would only need 2 or 3 classes to make up the necessary required credits for the degree.

So... do this mean I don't need two years to get a two year degree? Yes. Does this mean I can come out of the one year cert program a good baseline EMT-P? Yes, because you got out of something what you put into it with time after class reading, pushing to get more experience, just one more hour, one more shift.

So ... let's start comparing actual class loads, etc. when we're talking 'one vs two year programs'. It might make things clearer for every here in the discussion.

[THE_DITCH_DOCTOR]

Personally I'm not advocating for a 2yr associate's program (that's fine in the meantime) but rather for a 4 year broad based education for paramedic similar to what yields a BSN.

[djcokely]

I realize that speaking from the point of view from someone who has a B.S. in Psychobiology it is easy for me to say that I think Paramedicine should be a 4 year degree. I recognize that is simply not possible right now. The sad fact is that we need medics desperately and one way to keep them as a source of cheap labor is to not require any type of degree. While one can go to nursing school and just get an R.N, they can make so much more by getting thier BSN. Their really is not that option for Paramedics. A paramedic can get a BS or a BA but not in Paramedicine and therefore the pay scale will be the same.

I work in LA County and we have not progressed since we started the whole concept! Too many doctors who witness bad paramedicine regulate our protocols by stating that "you are always within 10 minutes of a hospital in L.A. Although we all know that time to ER is not time to treatment. They recently got rid of our ability to do Needle Crichs. They stated that of the 20 or so that have been done in the past couple of years, not one was done correctly. Bull. My friend did one correctly. But realy a needle crich is not going to do much of anything, a surgical crich is the only thing worth a damn. But honestly I would not trust most paramedics in LA to do one.

The sad fact is that, especially in urban areas, the need for EMS is so high that we can not impose a 2 year degree restriction on Paramedics because not many people would want to do it. In LA we already have tons of firefighters forced to go to paramedic school that do not want to. Fire based EMS is very much part of the problem. In LA it seems as though the EMS agency and fire departments (and even some of the medics) want to do as little as possible. This dumbing down is insulting. The root of the problem is the fact that in large urban areas like LA 75% of the calls are B.S., 10% are true BLS emergencies and only 15% are true ALS emergencies. Another part of the problem is medics not trusting thier assessment skills and just wanting to transport everything. It increases the amount of runs and decreases the availability of ALS care and thus reduces the scope because medics "have to get available"... Pain management for M.S. Trauma is un-heard of out here because it is not listed as a mandatory ALS skill transport...The ironic part of all of these issues is rooted in this horrible catch 22 ciclical problem...

So I fully agree that Paramedics should need a 2 year degree nation wide and that EMT-B's should have to go to school for 1 year and get to start I'V's and Defibrilate.

Paramedics should have the ability to do more procedures and to have an endless list of medications. You can not give a paramedic these powers without teaching him first and that will not happen in one year. I remember distinctly when most of my class realized that they did not have to pay attention during the GI GU (non-traumatic abdominal pain) because they realized it was very similar treatment - IV access, fluid challenge PRN, O2, monitor, vitals, pain management PRN and transport. No one cared enough to learn about Chrone's Disease or Nephrittis.

Another part of the dumbing down lies in how paramedic school is taught and how the class is structured. In my school passing was 80%. There was a slogan 80=100. Personally I feel that 80% is not adequate if we as paramedics want to advance our knowledge and standing in the allied health field. I think 90% is more realisitic, I mean we are dealing with lives, not someones pay-roll. How would you feel if a medic gave your mother a drug that was contraindicated and he said, "sorry that was part of the 20% I didnt remember".

So while yes Paramedicine should be a 2 year degree, we should start to think of it in terms of it being a 4 year degree because only then will the profession start to gain some respect from doctors and the medical community and once we gain that our self-image will improve and I think a lot of the paramedics who like to dumb things down will either lieave or get forced out by the new group of "educated medics" who will hold their brothers to higher standards than we do now.

[THE_DITCH_DOCTOR]

As I've said before, we don't have a shortage of EMT's and paramedics- we have a shortage of GOOD EMT's and paramedics. When I was a shift supervisor we had no problem finding people who had their certifications and a pulse (all that is required in many places to work as an EMT), but finding people who I was willing to send out in good faith to treat the public and potentially my family and friends was exceedingly difficult.

Maintaining the status quo is not going to remedy the "shortage" we are currently experiencing and therefore the argument about compounding a supposed shortage is a moot point because as was said in one of my previous posts is that if you concern is simply to keep warm bodies on the rigs, expect to see a steady number (or God forbid an increase) of cold bodies coming out of them when they get to the hospital.