Alex Woo Posted November 8, 2010 Share Posted November 8, 2010 Below is an email and letter I've sent to NYS DOH Bereau of EMS will my concerns and proposal for change. Please leave comments.... Thanks,.... To Whom It May Concern, I'm emailing you a thought I've had for years but did very little to say or do anything about. I've been a NYS EMT since 1996 and a NYS EMT-P since 1998. I've not been around for that long but I've been in the field for enough years to know that EMS care needs to progress faster. I've worked in the proprietary and volunteer services as an EMT and also as an EMT-P. I've worked in the Voluntary Hospital EMS as a EMT-P & managed an EMS Department. After the Berger Commission Report, I was eventually forced out of my position due to the closing of the hospital. I've been a supervisor at a proprietary service ever since. I've been in EMS and AHA education for numerous of years. I've seen positive and negative changes in EMS; which whether I agree with, is irrelevant. I'm asking for EMS certification restructuring with elimination of some EMT certifications. The EMT is the foundation of EMS care. However, the diseases have become even more complex and patients need more than BLS care. The EMT needs to have more hours added, not taken away; skills can't just be added without formal training. The EMT needs to be an 8-9 months long course with Intermediate Training. The EMT-I certification will be eliminated. The EMT-B will be the EMT-I. The EMT-CC will have to certify as an EMT-P but the EMT-P will be an A.S. program with CCEMTP training. A B.S. program must be developed and incorporated; maybe a M.S. program can be on the table. The EMT-CC will be eliminated. Whether this is better care, is not the issue; on paper it will be. Let's look at Nursing; CNA, LPN, RN, NP, & DNP with degrees ASN, BSN, MSN, & PhdN. Its amazing how nursing has really progress from the beginning of modern nursing during the Cremean War. EMS care in NYS can be the blueprint for this change and it will spread 50 states. The EMT program will be an intense 8-9 month long & college equivalent of 6-8 credits. The EMT-P will incorporate CCEMTP training, only available as an A.S. and B.S. degree program in Emergency Medical Paramedicine. If the provider can't complete the upgrade they'll downgrade to the lowest level; so, the EMT who can't complete the EMT-I training will forfeit their certification. The EMT-I will be an EMT; there is no upgrade for the EMT-I. The EMT-CC who can't complete the new EMT-P program will become EMTs. The EMT-P who can't complete the CCEMTP course will downgrade to an EMT. There will be a specific time given to complete the upgrade. My proposal with make the bridge from EMT to EMT-P closer. The CCEMT-P will be able to handle any setting and if one decides to further themselves in healthcare; the new CCEMT-P education will make it easier and with the degree, the prerequisite courses will have been almost met. These changes for the current EMS Providers, will be paid for by NYS Education Fund. This is an idea which can be modified but I hope I will see this change in the near future. I'm going down the path, in which I would like to see happen. Its a long process but it can happen. I'm available to assist in any way I can. Regards, Alexander G Woo NYS EMT-P #214355 Link to comment Share on other sites More sharing options...
Richard B the EMT Posted November 8, 2010 Share Posted November 8, 2010 Alex, it sounds like you want us in NY State to follow some of the European and Australian modes of training for EMS personnel. I have the feeling EMT City members in Canada, and across both the Atlantic and Pacific Oceans, support your concept. Link to comment Share on other sites More sharing options...
Alex Woo Posted November 10, 2010 Author Share Posted November 10, 2010 All I want is for EMS to provider better care..... Thank you.... Link to comment Share on other sites More sharing options...
Alex Woo Posted November 10, 2010 Author Share Posted November 10, 2010 There was a time when the ambulance personel was 2 men just physically strong. The EMT provided basic care if any. Ambulances had basic safety features. There were no Paramedics. No gloves were worn. Mouth to mouth was performed. There was no C-Spine precaution. Care would be sub-standard in today's time... When I became a NYS EMT in 95 we didn't have Epi-pens, Albuterol, & Aspirin. MAST pants were applied for anyone in shock. AED was just recently put into the curiculum.... When I became a Paramedic in 98; pacing was just incorporated. Things change over time. Its time for change.... Link to comment Share on other sites More sharing options...
ERDoc Posted November 10, 2010 Share Posted November 10, 2010 As a former NYS EMT, I agree, the standards need to be improved. However, the classes need to be taught to the least common denominator, if you know what I mean. As I have said in the past, I think before EMS in the US undergoes any substantial changes it will need to be taken under the wing of an established organization such as ACEP. To gain any respect the standards are going to need to be brought up to college level. With the flux that medicine as a whole is in right now, I don't see that happening too soon. Just out of curiosity, why is this in the LODD forums? 1 Link to comment Share on other sites More sharing options...
CBEMT Posted November 11, 2010 Share Posted November 11, 2010 APPROPRIATE FORUM FAIL Link to comment Share on other sites More sharing options...
Alex Woo Posted November 13, 2010 Author Share Posted November 13, 2010 IDK..... Its on the EMS Discussion forum; somehow it ended up here & I can't erase it; I've been trying for weeks now.... Plz to all; don't respond on this forum; plz respond to the forum n EMS discussion. I will continue to try to delete this. No disrespect to LODD; I'm sorry about this..... I want and will see change in this..... Link to comment Share on other sites More sharing options...
Richard B the EMT Posted November 16, 2010 Share Posted November 16, 2010 It HAS been moved. Now it is "on the personal side". Link to comment Share on other sites More sharing options...
FredG Posted November 18, 2010 Share Posted November 18, 2010 I don't have a problem with the basic ideas presented. However, before EMS certifiactions turn into college degrees, we need to get EMS standards to become pretty much standard across all states. There also should be a provision for any EMS provider with a college level degree or classwork to easily work across state lines. I have another concern based on seeing the EMS system from both urban and rural settings. I have been an EMT since 1994, 10 years in NYC, then going strictly volunteer in a rural upstate town. By making EMS a degreed program, we will essentially be forcing all of the volunteer squads to go paid. There is nothing wrong with that, on the face of things. However, there is an increasing difficulty in getting medical professionals to live and work in rural areas and by moving EMS into a degreed system, we would probably see the same shortages in EMS staffing in rural areas as there are for doctors and nurses. Another issue I see is the way NYS breaks up the state into different Regional Medical Councils. The regional medical council that I deal with up here is, to put it bluntly, backwards and poorly run. The regional council to the North of my current area is quite progressive and NYC REMSCO is well organized and also fairly progressive. I would love to see the state drop the Regional Medical Councils and go to one statewide council (or maybe 2, one for NYC and one for the rest of the state). Basically, what I am saying is you have to consider the impact of a statewide or nationwide educational standard change on multiple EMS systems, each with different challenges and needs. Link to comment Share on other sites More sharing options...
HERBIE1 Posted November 18, 2010 Share Posted November 18, 2010 As a former NYS EMT, I agree, the standards need to be improved. However, the classes need to be taught to the least common denominator, if you know what I mean. As I have said in the past, I think before EMS in the US undergoes any substantial changes it will need to be taken under the wing of an established organization such as ACEP. To gain any respect the standards are going to need to be brought up to college level. With the flux that medicine as a whole is in right now, I don't see that happening too soon. Just out of curiosity, why is this in the LODD forums? Do you know if the ACEP has an opinion on such ideas? Is this something they might be interested in? Has anything like this ever been proposed? Seems to me that the ACEP would have a vested interest in elevating EMS standards, and would welcome them. Obviously there would be no turf wars as there have been with RN's since there's no comparison between a physician and a medic in terms of education. Issues such as advanced scope of practice could be standardized and addressed,and with proper education and training, prehospital care could even alleviate some of the volume at the local ERs. I agree about elevating the standards, and a group like the ACEP could provide guidance, oversight, training, and a standardization of provider skills. I agree now is a bad time for something so revolutionary- especially with all the question marks with Obamacare, but if/when things settle down, this seems like a good idea. Link to comment Share on other sites More sharing options...
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