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your opinion on a manditory 2 year degree for paramedic


2 year degree, good or bad?  

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Okay, I probably didn't word that right. I'm not talking about practicing outside of the scope of medical direction, I'm talking about simply being able to renew my state license without being 'owned' by someone. I can't practice respiratory therapy under my RT license without medical direction, nor can I do nursing care under my nursing license without an MD writing orders somewhere. But I can give the state my money and get my license renewed so long as I keep my cont ed credits up, don't break the law, etc. I don't even have to keep private malpractice insurance.

But here in the state of Washington, you can't get/keep/maintain an EMT-B, EMT-I or EMT-P license if you don't have a 'sponsor'. In my case, yes I do have one. It's the American Red Cross. But they don't have a local medical director I work under, they're simply the folks who have said 'Yeah, she can belong to us' - right now I professionally fall under the MD for the county EMS system. [Not sure what happens if I end up going somewhere/doing something - I'm sure the ARC has something in place, I just don't know about it yet]. And all they do is 'sign' off my 'request for state license' as my 'sponsor' [isn't that such a great, nebulous term? Sponsor?]. They are not my employer like a hospital, an ambulance service or the fire department would be [even a volunteer fire service]. I simply exist under their 'umbrella' because the State has to have that space on their 'request for license' filled in. But they don't *do* anything: keep cont ed records, require me to attend in-services, etc. I do all of that myself. To repay them for their sponsorship [and don't get me wrong, I am *most* glad I have it otherwise I couldn't get back into EMS right now], I owe them "X" number of hours in a year. And those don't even have to be doing EMS - they could be stacking boxes in a warehouse, typing and filing in the office, etc.

So, why can't I do the same for my EMT, et all? Why do I have to 'belong' to someone to simply pay the state money? I have no problems with the need for cont ed and I know it's my responsibility to find it and get it. So as long as I meet the binding cont ed requirements, what's the harm in my simply 'getting my license'?

Interesting food for thought.

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I present the 72 semester hour AS Advanced EMT: (I was nice and made it four full semesters)

Semester I

English Comp I 3hr

College Algebra 4hr

Biology I /w lab 5hr

Chemistry I /w lab 5hr

Medical Terminology 3hr

20hrs

Semester II

A&P I /w lab 5hr

General Pyschology 3hr

Public Speaking 3hr

Physics I Algebra based /w lab 4hr

Nutrition 3hr

18hrs

Semester III

A&P II /w lab 4hr

Pharmacology 3hr

EMT Didadtic 5hr

EMT Practical 6hr

18hr

Semester IV

Pathophysiology 4hr

IV Therapy 2hr (compressed at the beginning)

Basic EKG 2hr (compressed at the beginning)

EMT Hospital Clinicals 5hr (after IV/EKG)

EMT PreHospital Clinicals 5hr (after Hospital)

18hr

Clinicals would be 200hrs.

That first semester will suck without AP credit... but it is guaranteed to weed out the riff-raff.

Course crediting:

Algebra - Test out

AP A&P I&II min score 9 cumulative (5 on one, 4 or 5 on othe other)

AP Bio minimum 4

AP Chem minimum 4

AP English minimum 4

AP Physics (B exam 4) (C exam 3)

*puts on flame proof suit* (but before you flame me too hard I do have 13/18 of those classes, I'm a Basic)

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I present the 70hr AS Advanced EMT:

Semester I

ENG 101 English Comp I 3hr

MAT 101 College Algebra 4hr

BIO 101 Biology I /w lab 5hr

CHE 101 Basic Chem /w lab 5hr

PHY 101 Physics Algebra I /w lab 4hr

21hrs

Semester II

BIO 201 A&P I /w lab 5hr

EMS 201 EMT Didadtic 5hr

EMS 202 EMT Practical 5hr

EMS 135 IV Therapy 2hr

HPR 104 Nutrition 3hr

20hrs

Semester III

BIO 202 A&P II /w lab 4hr

EMS 160 Simple Pharmacology 2hr

BIO 240 Patho Physiology 4

HPR 190 Basic EKG 2hr

EMS 210 Clinicals 8hr

20hr

Summer semster (betwee I & II or II & III)

PSY 101 Gen Pysch 3hr

COM 101 Public Speaking 3hr

HPR 105 Medical Terminology 3hr

9hrs

Clinicals would be 150-200hrs.

That first semester will suck without AP credit... but it is guaranteed to weed out the riff-raff.

Course crediting:

Algebra - Test out

AP A&P I&II min score 9 cumulative (5 on one, 4 or 5 on othe other)

AP Bio minimum 4

AP Chem minimum 4

AP English minimum 4

AP Physics (B exam 4) (C exam 3)

*puts on flame proof suit* (but before you flame me too hard I do have 13/18 of those classes, I'm a Basic)

Not going to flame anyone. I'm just running the lists and coming up with:

Already have [in a couple of cases at least twice - RT, nursing, ACLS plus an ATA on comp programming/system analysis and had to take several of these 'again']:

ENG 101 English Comp I 3hr -

MAT 101 College Algebra 4hr

BIO 101 Biology I /w lab 5hr

CHE 101 Basic Chem /w lab 5hr

PHY 101 Physics Algebra I /w lab 4hr

BIO 201 A&P I /w lab 5hr

EMS 135 IV Therapy 2hr

HPR 104 Nutrition 3hr

BIO 202 A&P II /w lab 4hr

EMS 160 Simple Pharmacology 2hr

BIO 240 Patho Physiology 4

HPR 190 Basic EKG 2hr

PSY 101 Gen Pysch 3hr

COM 101 Public Speaking 3hr

HPR 105 Medical Terminology 3hr

So, that effectively leaves EMS 201, 202 & 210 out of this program that I can't say I've 'done' [except maybe for the clinical].

I just worked out the number of hours I spent getting my EMT-B: 112. That's not counting 10 hours of clinical ER rotation or the 8+ hours of finals [written and team practical] or the state written exam. Add those and it comes up to over 130 hours. For an EMT-B. No EKG's other than what we cover in AED [and our instructor did go over basic rhythms - he didn't have to but he expects us to be the Paramed's extra hands and knowledge never hurts], basic EMT meds and how they interact with everything else [in my county we use O2, gluc, charcoal, epi, ASA and assist with MDI's and NTG], we do finger sticks as part of our county protocol, etc. This was 130+ hours of nothing but EMT. No speech, nothing else.

So, based on what you've presented, I should be able to add three classes to what I already have on record and qualify for my 'advanced EMT' [not sure what you mean by advanced - EMT-I maybe? Our EMT-I's tube and start lines.]

Now, I have no problem if this scenario would work out - just tell me where you live and I'll be on the next bus there [ :lol: ] . And I realize I'm probably the exception to the rule, but let's face it. I'm in the 50's, want to get back into EMS to teach and don't want to spend an arm and a leg [and my pocket book] going back to school for 2+ years to redo and re-validate stuff I can already prove I know and can do.

So yeah, I want there to be an acceptable 'option' for us 'Old Farts' who have been around since an MA-1 was a brand new ventilator, nobody knew what the hell PEEP or CPAP was and the idea of "Medic One' and the 'Medic Two - citizen CPR program' was just getting off the ground. There's not a lot of us out here, but we've got a personal database of 'real life' that could be helpful and useful out there in the 'Real World' [tm]. I'm sure it sounds terribly selfish to all you young bucks out there, but life is like that sometimes.

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'advanced EMT' [not sure what you mean by advanced - EMT-I maybe? Our EMT-I's tube and start lines.

"AEMT" or whatever you want to call it (just plain old EMT) replaces EMT-B and EMT-I.

Would have a national scope and training for:

Skills (above and beyond what basics do with possibility of standing order or most/all):

IV/SC

BGL

Sellik

Nebs

CPAP

Combitube

3-Lead Monitoring (no interp)

Formulary:

O2

NO

Albuterol

Atrovent

Atropine/2Pam Autoinjector

Epinephrine SC

Diphenhydramine

Naxalone

Glucose

Charcol

ASA (anaglesic and for CP)

NTG

Glucagon

D50

D5W

LR

NS

More advanced assesment. Etc.

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I like! I could go for this. Is it just in the planning-chat stage or is it getting off the ground? Who'd be the certifying body? Local? State? Fed? NAEMT?

You've deff. got my interest.

HOLY CRAP THIS IS JUST A FANTASY! :lol:

A good idea.

I think it should be a goal of a EMS lobbying agency.

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Summit,

Comments:

IM - should be added

IV - I assume you allow bolus in that, with respective chest assessment q volume

CPAP - do alot of services really carry CPAP?

3-lead - meh, with that drug list you should really have the education of 3-lead interpretation. 3-lead means very little anyway.

12-lead - you can do them, just not interpret

Atropine - is that for symptomatic bradycardia? or just cholinergic toxidrome? I would be open to treat for symptomatic brady

Epi - we give it for croup here as well. If you like that as an option

Dimenhydranate - I be open to this

NTG - I assume first time ntg is ok with the line? for chf/pe as well?

Narcan - I still don't understand why narcan is such a big drug elsewhere. We rarely use it, and those times we do it is for known/suspected acute opioid use (i.e. peds) or as a reversal for failed facilitated intubation. But anyways....

Looks good.

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