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Oh how I despise the NREMT CBT...

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It is not the responsibility of your employer to keep you current in your job knowledge and skill set. That is entirely up to you. As such, it is your responsibility, just like it is mine, Dwayne's, Ruff's, and everyone else here, to do the homework, reading and research to stay current. The only thing that doesn't change is that things will change. With that it falls to us to take the evidence from our learning and apply that as necessary. This may mean changing our practice. This may mean taking it up the chain to the medical director to get protocols/guidelines/treatment options changed. It may mean changing the information that is taught to new students.

Some of these changes take place at a faster rate than others. Very little changes overnight. EMS is no exception. Sometimes we must be persistent in order for change to be made.

Part of your failing in your past few posts has been assuming that just because your instructor has been doing it for years means that he must be right. It could mean that he just hasn't bothered to keep up with the times. It can be difficult to stay, or become, current on topics about which you're just learning. Part of our job as health care providers, however, such as some of us are, is to make sure we stay current on topics as they are important to our jobs. Even on topics about which we are just learning.

That you're sticking around is a good sign. Don't fall into bad habits about your learning. We aren't kidding when we tell people, as we have often told many here, that once you're out of class is when the real learning starts.

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I really, really get what you're saying.

Medicine is strange as it changes so much. There is so much that makes sense, yet when tested shockingly proves to be wrong.

Many of the things that you were mistaught weren't simply outdated books, but a tendency for those that came before you to want things to stay the same. The fire depts for the most part abhor education and consider it a waste of time, the 'old timers' sometimes feel that they've seen it all and done it all so are offended that anyone would want them to have to relearn something....it's about politics as much as stale textbooks.

Each time that I've had to recert in ACLS (Advanced Cardiac Life Support) there have been changes, sometimes significant. It all works out man..baby steps...

You're doing fine Brother. Just remember that though it's ok to be offended that the EMS educational system isn't what it should be, that changes have to be made slowly and often those with the power to make the necessary changes like things just the way that they are.

You'll become a bit biased and jaded should you choose to continue to come here as you'll be constantly exposed to others above you certification level not just in the U.S. but around the world with better and more sophisticated systems than ours....it's good to know as long as you keep it in context.

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Unfortunately the practice of medicine lags 2-5 years behind the literature. EMS lags about a decade behind the literature. It's not your fault, it's just the way the system is today. Paramedicmike, it's hard for a newbie to know that they need to keep up to date when no one tells them that. When I got into EMS in 1991, I assumed that everything I learned was gospel. No one told me about research and studies, etc. It's hard to keep up to date with something you don't know exists and that is a huge problem with EMS today. When I started, MAST pants were the holy grail of trauma. When they were taken out of our protocols, it just blew my mind. Looking back on it now I realize how naive I was.

Bill, if you really want to stay on top of the field get your obligatory JEMS subscription but also become a member of the National Association of EMS Physicians (naemsp.org) and receive the Prehospital Emergency Care Journal which will keep you up to date on the latest literature (it will take some effort on your part to understand how to read a scientific journal if you don't know how to do so already). It's a little pricey at $160/year for EMS personnel, but the benefits well out weigh this cost.

Now if you will excuse me, I have to go check out the latest edition of Galls.

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