NEWLY CERTIFIED EMT BASIC!

[whit72]

Dust wrote:

Whit, you could have just simply said, "my system sucks," and saved yourself three paragraphs of typing.

I agree in general most EMS systems suck. However it has nothing to do for the most part with education or training. Usually it has alot to do with the lazy ass atitude of people in general. EMS not withstanding. You are under the assumption that education breeds competence.

[chbare]

My rebuttal would be to ask, "why do they have that lazy attitude?" :wink:

Take care,

chbare.

[Dustdevil]

I agree in general most EMS systems suck. However it has nothing to do for the most part with education or training. Usually it has alot to do with the lazy ass atitude of people in general. EMS not withstanding. You are under the assumption that education breeds competence.

I didn't say your field personnel sucked. You didn't really tell me anything about them.

I said your system sucks. And you have told us plenty about it over the last year.

And you seem to agree, so obviously I wasn't slamming you or your co-workers.

[Asysin2leads]

Well, my EMT course was 200 hours. That's in New York City. And then I also took the 80-hour Israeli MADA course that was a complete bullshit. But the 80-hour course still allowed me volunteer :-)

Their 200-hour course also allows you to start IV lines. There's very little theory. Just practice.

You know, its funny, I have a degree in paramedicine from an NYC institution, I work here professionally, and consider myself very up to date on municipal, city, and national standards for EMS practice, but, still, somehow, these mystery courses that allow people to do things others don't (i.e. EMT-B's with IV's) just continue to befuddle me. Batjka104, I suggest you take a serious look at this 200 hour course, its instructors, and refresh your knowledge of NYC REMAC protocols before playing with the IV's. If this 200 hour course was offered by, oh, I don't know, some volunteer EMS service who like to play by their own set of rules, I humbly suggest you don't listen to them about the whole IV thing before you are arrested, sued, or worse.

Bottom line is this, volunteer, paid, or superhero, if you don't have an NYS EMT-B card, you shouldn't be putting on a band-aid withing the five boroughs, and if you don't have a NYS EMT-P card, and a NYC REMAC paramedic certification, sticking someone with an IV is tantamount to practicing medicine, assault in the 1st degree, and anything else the guys down at Centre Street would like to throw at you. There is no getting around it, those are the facts, and that is the law.

[whit72]

Well dust as the self proclaimed director of EMS for EMT city. I stated most EMS systems suck. Not always due to the educational standards. People in general are lazy, miserable, inconsiderate, and really just dont give a shit. This is not soley an EMS problem, but since this is an EMS forum it relates to EMS as well. I believe that is more of a problem with EMS then ALS vs. BLS.

As far as education goes,and the level at which you operate in your systems. I have worked in both and prefer the tiered system better. Thats my opinion. I am entitled to it and you to yours.

Lets face it I know most would disagree with this however being in EMS for over a decade. 75% of the people I transport need a ride not an EMT never mind a medic. Most of them would fair just fine in a personal vehicle. ALS providers ahould be left to ALS complaints. BLS providers to BLS complaints. It has been proven over and over in studies. You guys like studies. Als providers that for the most part tend to ALS emergencies have far better succes rates when an ALS intervention is warrented. Most here discard those studies because having a medic on every ambulance must equal better care. We are seeing now it dosent. A properly educated and competent BLS provider can handle the majority of calls that arise. When a more educated provider is needed one can be summoned. Of course ever system has its own unique needs, and should be devised to cater to them.

[spenac]

75% of the people I transport need a ride not an EMT never mind a medic. Most of them would fair just fine in a personal vehicle.

Almost sounds like you agree with me that we should deny transport to more people. Can't call them patients because they have no real need of ambulance or for that matter the ER.

Sorry got off track, I'll let ya'll return to the scheduled fight, oops discussion I mean.

[whit72]

The thing is you cant deny pt's transportation. We live in a world where everyone is looking for a "get rich quick" way out. So it is safer both health wise and liability wise to just transport. I also dont have very long transport times, so its easy for me to say just get in the truck we will have your stubbed toe looked at in the emergency room, you sally.

It is a slippery slope though. If the public was educated on the proper use of the EMS system. Some would wait to long to call, some wouldnt call at all. I much rather take a person now with some shortness of breath then to have them wait till their completely full and not moving any air, to decide its time for an ambulance ride. I am sure the ER would too.

So we try not to deter anyone from calling, no matter the complaint. The knucleheads that calls at 3am because they slammed their finger in a door two days ago and now they want an x-ray, are just what you have to deal with. Whatever, its not a big deal everything has its downfalls. Nature of the beast.

[Dustdevil]

Lets face it I know most would disagree with this however being in EMS for over a decade. 75% of the people I transport need a ride not an EMT never mind a medic. Most of them would fair just fine in a personal vehicle. ALS providers ahould be left to ALS complaints. BLS providers to BLS complaints. It has been proven over and over in studies. You guys like studies. Als providers that for the most part tend to ALS emergencies have far better succes rates when an ALS intervention is warrented. Most here discard those studies because having a medic on every ambulance must equal better care. We are seeing now it dosent. A properly educated and competent BLS provider can handle the majority of calls that arise. When a more educated provider is needed one can be summoned.

Whit, your statistics and observations are absolutely valid. I don't have a problem with those at all. It is the conclusions you draw from them that are shaky.

Skills-wise, yes, a basic is more than adequate for the vast majority of runs out there. But the problem you then run into has been covered here over and over and over. I'm not sure how you have managed to miss the point.

• It is about the ability to render a sophisticated medical evaluation that can determine what is probably wrong with this patient, as well as what his medical needs are. I don't care if your EMT-B school was five-hundred hours long. It simply is not enough education to provide you with the knowledge to do a medical evaluation of a patient. In fact, it wasn't ever designed to. It was designed to give you enough first aid knowledge to give the basic ABC's to critical patients on the way to the hospital. Is that enough to get most patients there okay? Absolutely. But any Basic (with no other medical education) who thinks he is sophisticated enough to determine who needs ALS and who doesn't is a dangerous person who I don't want working in my system. And any system that puts Basics in that position in the first place just plain sucks.

[itku2er]

Well seems as though i have made 2 enemies on the boards i feel so lucky.

ca·reer (kə-rîr')

n.

A chosen pursuit; a profession or occupation.

A path or course, as of the sun through the heavens.

adj.

Doing what one does as a permanent occupation or lifework: career diplomats; a career criminal

defination of career so it works here unless she got her EMT and dont use it.

Then hey I am all for nursing school, I personally feel that its the only way to go. Forget EMT BASIC and go straight to nursing school.

and to you what can I say but you betrayed me.....

Terr

[brentoli]

I agree and disagree on the EMT as a career.

In and of itself, I pray no one makes a career out of being an EMT-B.

On the other side, it has to be a stepping stone. All paramedics were a basic at one time.

You can be an EMT-B as a "hobby" no problems. Part time PRN work, as long as you keep up on your skills. Do you read EMS magazines? Do you keep up on more CE then you need? When you are on duty do you pick the brains of your partners and work with your equipment?

Dust, what are your opinions on part time and PRN work, if it is paid? I know you are against volunteering, but I am curious about that, I don't think I have seen you mention it.

If you want EMS as a career, think hard about it. Get some experience as a basic, learn how to take a good history. Its the best thing you can do as an EMT-B. You are the researcher for the medic. Nothing more, nothing less. Can you take that BP under any condition? Can you communicate with the 80 year old stroke pt who never got full speech back?

If so, then go on to become that paramedic. If not, keep working until you can.