A call to arms! EMT-B's defend yourself!

[AnthonyM83]

Is that more beneficial than a person beginning as a Basic and not being looked down on while they perfect those skills before moving on to the next level of patient care?

This is one area I feel should be addressed. If we were to remodel the system and do away with Basics in 911, there should be a system in place to allow people to test the waters in in EMS. My reasoning is that paramedicine is, as Pyroknight put it, skills performance under stress AND education.

If a nurse goes through the RN program and realizes she just really sucks in emergency situations, I'm assuming she could just not work the ER. There's various non-emergency RN positions.

If a paramedic isn't made and/or can't adapt to emergency scenes, driving code, rapid decision making, sight of gushing blood, grief counselling on-scene or whatever else EMTs get weeded out for, he can't really get a job on the physical therapy and rehab floor of the hospital as a paramedic (least not a career job).

It would be a waste of money, resources, proctor's time, patient's time, effort, etc for this guy to pay and study for all those prereqs, for the medic school itself, then flunk out during internship.

Maybe a prereq for medic school could be a certain number of hours riding as a Basic with a dual medic crew?

[pyroknight]

Maybe a prereq for medic school could be a certain number of hours riding as a Basic with a dual medic crew?

Once again economics comes into play. Even agencies fortunate enough to have dual medic crews can likely not afford to pay EMT-Bs to ride third person. If they do not get paid, then they are basically volunteers. We are right back where we started.

EMT-Bs, in a perfect world, should get their experience and hone their skills (like building rapport, documentation, and transfer of care) doing interfacility transfers and transporting patients that have been assessed and deemed appropriate for BLS-level care. In an IMperfect world, there are plenty of opportunities for EMT-Bs to get experience and hone their skills while working with a paramedic partner on EMT-B/EMT-P staffed ambulances.

[Dustdevil]

Okay, Dust. I am going to stick my head up out of the foxhole here. I would argue it is not about skills OR education - it is about having skills proficiency AND the knowledge (acquired through both education AND experience) to know when to apply those skills.

Excellent summation! That is actually my point. Skills do not exist in a vacuum. They are only one part of a much larger picture. And without that complete picture, they are worse than useless. They are dangerous.

BLS transports should be handled by BLS-staffed AMBULANCES. It is a tremendous waste of resources in many systems to have two highly educated, highly trained paramedics trucking granny back and forth to the MRI suite. Every patient should be evaluated by a paramedic, NP, PA, DO, MD, or the like. Those who need continued advanced level care should be transported by ALS, those who need a horizontal taxi can go BLS.

Totally agreed. The back and forth taxi ride from MRI should not involve EMS at all, at any level. EMS should not be trying to finance their operations by running taxi services any more than the fire service should be trying to fund their operations by selling bottled water. But anybody who calls reporting an emergency should receive personal evaluation (not phone triage) by an educated medical professional, not an EMT. Although I read a lot of horror stories about paramedics dumping patients who should be ALS on BLS crews (coughLAcountycough), I believe that kind of system does have the potential to work with properly educated medics. Conversely, I have much less faith in the potential of a system that sends out EMTs to evaluate whether or not a patient needs ALS care, and am really not confident that it can work to my satisfaction.

[Dustdevil]

:shock: Well if that wasnt an ass kickin I dont know what was

Gotta love the dominance. Let me rest up and I'll be back for another round..

Excellent!

If you go away, we both lose. These discussions keep us both thinking instead of getting too comfortable with the status quo. In 6000 posts here over the last two years, you can bet I have been schooled a few times myself. But I value those learning experiences, and count them among the very best reasons to stay here.

Well... that and the hott chicks.

[Dustdevil]

Once again economics comes into play. Even agencies fortunate enough to have dual medic crews can likely not afford to pay EMT-Bs to ride third person. If they do not get paid, then they are basically volunteers. We are right back where we started.

I understood Anthony to be saying something different than you did. I think he is talking about a sort of "pre-internship" ridealong programme for potential paramedic students just to test if the atmosphere is their cup of tea. To see if the job is really what they think it is from watching Turd Watch, and if that is something they are really cut out for. Not to really "work" as a team member, but to do some integrated observation before taking the plunge. I see a good deal of value in that. We did that in pre-med. Students were sent to the county hospital family practice clinic to shadow doctors all day long doing mundane, routine doctor's office care, not just the sexy and exciting ER stuff we see on the tele. It wasn't "work." And it wasn't "volunteering" either. Just exposure.

Again, Anthony is talking about a scenario where there is no longer an EMT position in EMS, so the ability to "check it out" as a basic for awhile no longer exists. It would indeed be advisable for us to have a system for our prospective medics to gain exposure. Currently, the system of letting them get that exposure as an actual crewmember causes our profession a terribly unstable workforce because of all the tourists taking up jobs. Anthony's suggestion is a much better one.

[JPINFV]

Naw, people do definitely get slammed her. There's definitel ya difference between disagreeing and slamming someone. Check out Dust's response, for example. Not saying whether it's warranted or not...but slammage definitely does happen here

True, but there are, unfortunately, people out there that take any disagreement personally.

[sassy_emt]

Being an EMTB and reding the various posts in regards to defending the position has been most eductional. I must say that when I took my course to become an emt it was because for almost 18years prior I was responding to falls,chest pain cases, suicide situations and other prehospital calls and loving the feel of satisfaction in being there for my patiens. I just felt that I needed more training to help these folks out. Now I have that training.....

I have experience as a first responder dealing with some of the same calls as I now do as an EMT_B but I have access to better means of assistance an stablization methods. I love what I do!

I would love to one day have my paramedics certification and beome a flight medic but until that time I just want a chance to do what I was trained and have experience doing. I have read in these posts( and if I am reading them wrong please let me know) that is some places folks don't want emtbs in their companies......Why?

We are usually the ones first on the scene who have calmed the patient down.....checked out the scene and surveyed what caused symptoms......we are the ones who can turn to a medic and give you a complete report on what is gong on....what was seen when first on scene.....stablizing the patient for you so we can transport.....

In my very humble Emt-b opinion Paramedics need us in the field.....not just for straight bls calls but aso for those times when you can't get there fast enough or when you need an extra hand calming a patient or a family member.........teach us how you feel comfortalbe handling things on a call but don't shut s out of the field......there are those of us who bring so much life experience to this field and all we want is a chance to prove how much of an asset we can be.

[spenac]

Being an EMTB and reding the various posts in regards to defending the position has been most eductional. I must say that when I took my course to become an emt it was because for almost 18years prior I was responding to falls,chest pain cases, suicide situations and other prehospital calls and loving the feel of satisfaction in being there for my patiens. I just felt that I needed more training to help these folks out. Now I have that training.....

I have experience as a first responder dealing with some of the same calls as I now do as an EMT_B but I have access to better means of assistance an stablization methods. I love what I do!

I would love to one day have my paramedics certification and beome a flight medic but until that time I just want a chance to do what I was trained and have experience doing. I have read in these posts( and if I am reading them wrong please let me know) that is some places folks don't want emtbs in their companies......Why?

We are usually the ones first on the scene who have calmed the patient down.....checked out the scene and surveyed what caused symptoms......we are the ones who can turn to a medic and give you a complete report on what is gong on....what was seen when first on scene.....stablizing the patient for you so we can transport.....

In my very humble Emt-b opinion Paramedics need us in the field.....not just for straight bls calls but aso for those times when you can't get there fast enough or when you need an extra hand calming a patient or a family member.........teach us how you feel comfortalbe handling things on a call but don't shut s out of the field......there are those of us who bring so much life experience to this field and all we want is a chance to prove how much of an asset we can be.

Welcome to the field and thank you for a clear presentation of your thoughts. I to feel that we need basics, though I recommend they continue education.

[medicare-emr]

Hi there

well where does one start in this situation? so much has been said, and yet i find myself thinking, man these guys should be in politics.

basic life support is what it is, basic - there's no doubt about it, but the important thing is that it is a set of skills designed to save a life. that's right guys it can save a life!

How we save a life is not necessary putting a line up or tubing a patient, it is how we handle the call. what makes a good ALS paramedic is the basics. without them he is of no use really. and providing his level of treatment without the basic would be going in blind, putting the patient at risk and himself. just by BLS arriving on scene we do the basics and establish the condition of the patient, their VITALS, give them OXYGEN, comfort them etc. this will give us a platform to use the GCS scale to establish what level of care would be required for the patient, we are their advocate remember, we are there for them and need to make decisions on their behalf, for their best interests.

where i live getting an ambulance within the first hour is non existent, getting help within 3 hours is probable. so yes as a basic EMT, i do have a value in this world. i am passionate about life, i value life and provide my community with immediate responses and a basic life support. at least they are getting some care, as much as my experience has taught me over the years, i am still a BLS practitioner. i cant further my studies as much as i would like to due to politics in the EMS industry in South Africa. Yes South Africa, i would like to invite you to come join me and see what its like knowing that your patient is requiring advanced levels of care but having to wait 3 hrs for help to arrive after you have instructed the call centre of the situation. As you sit their monitoring your patient, watching the life slowly slip through your fingers is the most frustrating thing.

the skills shortage in this country is shocking, but i'm not going to go into that cause there is not much i can do for the situation in the country, but there was a lot i could do for my community. i established a medical response company to combat the poor response times by the services in the area. we are not an ambulance service but are just a response and stabilisation service. i have in the interim obtained a partner who shares the same passion as i do, and he is an ALS practitioner. this ensures we have a better chance of keeping our patients alive, we work hand in hand, and we are on a call, i know what is expected of me, to do the basics, give oxygen, get the vitals, run a line if necessary, etc. its about team work, its about providing the patient with the best of your capabilities and a caring attitude.

yes reputation is important, but not as important as integrity. so i challenge you Dustdevil and old bush wacker from oz to get out your cozy situations of having 1st world country EMS systems and come join me in the no1 Trauma Capital in the World, South Africa, and come see what we have to deal with on a daily basis. the lack of resources, having six patients crammed into an ambulance and receiving a priority one call and having to do a response with them in the back of an ambulance and trying to do a resus in a crowed ambulance, blood everywhere.

So as an BLS i stand proud to be apart of the EMS industry, saving lifes and giving the best i can do in my scope of practice, with the resources we dont have.....

i leave you with the following...

why are you in the EMS industry, what is driving you, what do you choose to do in the morning when you wake up in the morning, do you choose to get involved and make a positive difference or do you choose to go to your job, is it a job or is it a way of life?

for me its a way of life, i live by it and will die by it!

do it for the right reasons, not for the reputation.

regards

DaMadMedic

ps: choose life, love life, LIVE!!!

[Dustdevil]

We are usually the ones first on the scene who have calmed the patient down.....checked out the scene and surveyed what caused symptoms......we are the ones who can turn to a medic and give you a complete report on what is gong on....what was seen when first on scene.....stablizing the patient for you so we can transport.....

In my very humble Emt-b opinion Paramedics need us in the field.....not just for straight bls calls but aso for those times when you can't get there fast enough or when you need an extra hand calming a patient or a family member.....

It sounds like we absolutely agree on this. An EMT-B is valuable for all of the above reasons. But what you are describing is a first responder role, not a transporting EMS role. I respect and appreciate the job an EMT does as a first responder. But once the medics arrive and take the patient away, your job is done.

...teach us how you feel comfortalbe handling things on a call but don't shut s out of the field......there are those of us who bring so much life experience to this field and all we want is a chance to prove how much of an asset we can be.

Nobody's trying to shut basics out of the field. We're trying to find the optimal application for their limited usefulness. That application is as a first responder. You're still doing all of the things you have said you want to do. None of that is taken away from you. But again, the only people on the crew of an EMS ambulance should be highly educated medical professionals. EMTs simply do not even come close to meeting that definition. But, if it makes you feel any better, neither do most paramedics in the U.S. Yet. And that is what we are trying to change. That change will never happen if you can still be one of us with a 3 week first aid course.