I nead your opinions on a MVA call that I went on.Thankx

[whit72]

I will end with this:

Malignent whatever you call yourself. I have a little secret for you.

The word judgment is used in the definition of decision.

EMT s and MEDICS dont practice medicine. Emergency, wholistic, holistic, evidence based........

Doctors do.

Certified technicians do not practice medicine.

Doctors do.

Ignorance is assuming that with a year of training and a handful of college credits that you practice medicine.

The conversation was about extrication, others made it about immobilisation.

Nexus criteria is a in hospital scale used for radiography. Not a criteria for pre hospital immobilization.

As far as dust:

I actually was taken out a hatchback immobilised, the emphasis is on competent immobilisation, not the route in which extricated.

As far as the NIMROD comment, I would expect nothing less from a pushy self proclaimed EMS expert.

I do however enjoy the conversations and your attempts at intimidation. I find them quite humorous.

[Malignant-Hyperthermia]

:banghead:

Its sad to see that the contemporary view of medicine is still determined by the word "Doctor" and denial that pre-hospital interventions is not a form of medicine is not only narrow minded, but is undermining the professional standing that paramedics and EMT's internationally strive for amongst other allied health professionals

The interventions carried out by pre-hospital care providers still appears to be seen as nothing more than a bunch of tricks we pull out. If we are carrying out interventions with appropriate underpinning knowledge and clinical decision making in the field of "Emergency Medicine" what exactly are we doing? Medicine is more than giving drugs, writing pre-scriptions and diagnosis, there is an entirety here most people dismiss. Medicine is a continuum and Pre-Hospital Care is the first point of contact

Certified technicians do not practice medicine.

So what exactly are you doing whit? What does EMS stand for? What does EMT stand for? You can either understand you are in fact practicing a form of medicine, or you can become an advocate for change and degrade the lifetimes of effort others have given so that we may walk amongst the other professionals of allied health. You deny that we practice you deny we are professional

Ignorance is assuming that with a year of training and a handful of college credits that you practice medicine.

Ignorance is also assuming everyone is brought up on the US based model of EMS where 120 hours gets you in the back of an ambulance. Ignorance is assuming that medicine does not appear in many forms. Ignorance is is a failure to grasp or devlope new concepts. Ignorance is to believe that "Emergency Medical Services" have not spent decades, since the first medics stepped onto the field of battle with the roman army, to develope itself into a true profession, and a profession that is built on the provision of emergency medicine

Nexus criteria is a in hospital scale used for radiography. Not a criteria for pre hospital immobilization.

With a 99.8% success rate in assessing patients requirement for c-spine radiography, it can sure as hell determine if they should be immobilised..THATS evidence based medicine, denying this is also ignorant

[hfdff422]

Hey Whit,

Do you perform CPR on and defibrillate everyone you encounter? I know it is an extreme example, but it may be necessary since you do not utilize patient and scene assesment to formulate an idea of what is going on with your patients.

Do all unresponsive people get naloxone? Do you just strap a person down if they are combative without finding out if they are diabetic?

If you were unable to make decisions about patient care, they would not turn you loose without online medical direction for every patient. Do you have to call to give nitro for chest pains? Or do you have to call to intubate someone with a compromised airway?

[becksdad]

Just to enter this debate over whether we practice medicine or not:

One of the people I have considered a mentor since the day I met him has entered a management/leadership role with our agency. Of course, I have always considered him a leader, and he is quite accomplished both in the field and within continuing care settings. This person refers to all of us field providers as "clinicians".

Of course, this proves absolutely nothing. But what it does do, is that the simple attitude shift implied by using the word "clinician" raises the bar, the expectation level, and the respect of our profession.

In turn, we raise the bar for ourselves, raise our own expectation levels, and increases our desire to become better. If we view ourselves as "technicians", that is what we are. If we view ourselves as "professionals", that is what we become.

Qoute from another mentor - "Please do not impose your limitations upon me".

[hfdff422]

It's like the difference between being a whacker and an actual professional. Its all in the individuals attitude. Knowing what is only of use when you know why.

[whit72]

Malignent wrote:

ts sad to see that the contemporary view of medicine is still determined by the word "Doctor" and denial that pre-hospital interventions is not a form of medicine is not only narrow minded, but is undermining the professional standing that paramedics and EMT's internationally strive for amongst other allied health professionals

Its not determined by the word doctor its determined by the 8 or so years of education the 3 or 4 years of internship. We are a trained extension of them. There for a sole purpose. Cilinical decision making is part of that. (judgements) in the scope they provide for us.

What undermines the proffesional standing that paramedics and EMT's strive for, is the burred vision some have with there place in emergency medicine. Yes I agree we play a pivotal role in the chain of survival. However we are what we are, and are training reflects that.

The interventions carried out by pre-hospital care providers still appears to be seen as nothing more than a bunch of tricks we pull out. If we are carrying out interventions with appropriate underpinning knowledge and clinical decision making in the field of "Emergency Medicine" what exactly are we doing? Medicine is more than giving drugs, writing pre-scriptions and diagnosis, there is an entirety here most people dismiss. Medicine is a continuum and Pre-Hospital Care is the first point of contact

I dont diagree with you entirely, It also takes longer then a year to understand the interventions and under pinning knowledge you speak of.

hfdff422 wrote:

Hey Whit,

Do you perform CPR on and defibrillate everyone you encounter? I know it is an extreme example, but it may be necessary since you do not utilize patient and scene assesment to formulate an idea of what is going on with your patients.

Oh well if you have som spare time, could you teach me that.

Please dont jump in 3 pages later and assume you know whats going on.

Typical EMS'er

[DwayneEMTP]

Qoute from another mentor - "Please do not impose your limitations upon me".

That's a first rate quote right there!

Dwayne

[hfdff422]

Whit,

I read the entire thread! Unlike some here, I do read the entire thread and the entirity of a person's posts before I respond. My response was based on the fact that you started by saying that it is a judgement call then your last post started spouting the robot mindset. So which is it? I was only poking fun at your inconsistency by illustrating the outrageousness of your last response.

No we are not doctors, but we base our treatments on realistic evaluations of our patients. Your initial post(s) indicated that, but when certain portions of your post were rebutted, you eventually reverted to the robot answer of we are not doctors, so I don't diagnose. I am a big believer in BLS transports and gives O2, but I will say that it is important to effectively care for your patient by initiating the assesment and trying to find out what is wrong with them.

[whit72]

Malignent Wrote:

Its sad to see that the contemporary view of medicine is still determined by the word "Doctor" and denial that pre-hospital interventions is not a form of medicine is not only narrow minded, but is undermining the professional standing that paramedics and EMT's internationally strive for amongst other allied health professionals

What is sad is that fact you believe that some education and training, and a few tricks that your allowed to perform, have you confused about the aspects of your proffesion. We play a vital role, no ones denying that.

What is undermining the professional standing that paramedics and EMT's internationally strive for amongst other allied health professionals. Attitude of some EMS proffesionals. Assumption that there owed something they haven't earned. The fact that they ride an ambulance gives them a right to questions every other allied proffesionals decisions. Clamoring about practising medicine.

If you crave respect or acceptance from your so called allied health proffesionals. Do your job competently and proffesionally, people will notice.

Why we don't get respect is the hoards of EMS proffesional who cry and stomp there feet about how much respect they deserve. Respect is deserved when earned.

becksdad wrote:

Qoute from another mentor - "Please do not impose your limitations upon me".

However recognizing your limitations also factors in to the development of a good provider.

hfdff422 wrote:

No we are not doctors, but we base our treatments on realistic evaluations of our patients. Your initial post(s) indicated that, but when certain portions of your post were rebutted, you eventually reverted to the robot answer of we are not doctors, so I don't diagnose. I am a big believer in BLS transports and gives O2, but I will say that it is important to effectively care for your patient by initiating the assesment and trying to find out what is wrong with them.

Actually I believe assessment is the most important tool I have, along with recognition. Those I believe are the most important aspect of our duties. The rest is useless, if those two practises are not mastered.

[Malignant-Hyperthermia]

](*,) ](*,) ](*,) ](*,) ](*,) ](*,) ](*,) ](*,) ](*,) ](*,) :banghead: :banghead: :banghead: :banghead: :banghead: :banghead: :banghead: :banghead: :banghead: :banghead:

What is sad is that fact you believe that some education and training, and a few tricks that your allowed to perform, have you confused about the aspects of your proffesion. We play a vital role, no ones denying that.

and then...

I dont disagree with you entirely, It also takes longer then a year to understand the interventions and under pinning knowledge you speak of.

Again, you Ignorance shows, don't assume everyone is from thew US of A. I assure you education standards in OTHER countries far exceed twelve months

What is undermining the professional standing that paramedics and EMT's internationally strive for amongst other allied health professionals. Attitude of some EMS proffesionals. Assumption that there owed something they haven't earned. The fact that they ride an ambulance gives them a right to questions every other allied proffesionals decisions. Clamoring about practising medicine.

What was your point here? who assumes they are owed something? You owe me nothing, i owe you nothing except some courtesy which your ignorance is beginning to test. I doubt this is a part of this debate, but rather a subtle slap in the face for someone here......jeez i wonder who?

Why we don't get respect is the hoards of EMS proffesional who cry and stomp there feet about how much respect they deserve. Respect is deserved when earned.

And raising the bar is not a way to do this? Becoming less dependent upon protocol and more dependent upon ourselves? There is a certain amount of autonomy and development one must have in order to gain the status of "profession" amongst its peers and we are just starting to scratch that surface. Though i feel we are a profession (in general) i think we have a lot more to prove to other people for this to be accepted, and its their perception of us that is the real test. There is a combination of self image and our image amongst other health professionals we need to obtain, and in some places we are not their yet.

"I think therefore i am" is not quite enough unfortunately......

Becksdad, thats a beautiful post man! Clinicians is the word Id would go for, but i still believe that paramedicine is a form of medicine, though in its infancy. I believe that changes in education standards and slow but progressive move from protocols to guidelines and more autonomy for clinicians in pre-hospital care is starting to prove this a reality.