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

[speedygodzilla 8]

I think it boils down to a few things. Of course the one on top is money. I believe that many counties choose to have just BLS units due to money. It sucks for the patient as the level of care basics has is very limited. But providing BLS care is better than having none.

Also why two medics? I don't know as much about what the paramedics do or can handle as many of you do. Is there many times when two medics is needed?

Do you think two medics could bump heads? With a EMT partner his level of care and responsiblities or know and are separate from the paramedic. You know who is cleaning the ambulance, who driving, do base line vitals, grabbing the back board, etc. I would think your EMT partner is not going to bump heads as much as a paramedic partner would.

If every ambulance need two paramedics wouldn't there be a shortage? They can't produce paramedics as fast as the semester corse for EMT.

The same reason we have CNA in the hospital. Maybe CPA would be a better name for it .

[scratrat 14]

I love reading some of these replies.

I don't think this will answer any questions, but I try my little input.

Basics are good for managing none life-threatening calls. Where I came from, we had ALS seperate and responded in Ford Explorers and such. We met up with BLS if it was needed. The reason I like this approach, is because my time is watsed on calls like a stubbed toe. There is no reason that a BLS provider cannot handle that call.

Now, I run with either an EMT or (my full time partner is a paramedic) paramedic. If it's an EMT, they treat the calls that are BLS. If it's a dual medic truck, we alternate calls but still go on everything, including that stubbed toe.

I know that doesn't quantify why basics are important, per se, but I think they have a role. I try not to forget where I started. EMT first, then paramedic school after I got some experience under my belt.

As a side note, I just have to share this because I almost fainted. My PARAMEDIC partner and I were having a discussion and my continuing education. We went on a call to an office where drugs reps were present. I said, that's what I should do. Big money. My question was, at the time, I don't understand why you need a drug rep to represent albuterol and Zoponex. *That's what they were pushing*. I said, they are basically the only two fast acting inhalers widely in use, save for Atrovent, but that's still usually mixed with albuterol. Her reply to me was, "Well, there's also Proventil." I almost fainted. I had to fight with her to get her to understand that Proventil and albuterol were the same damn thing. So, that being said, I couldn't care less if my partner is a medic or EMT. Some medics scare me, frankly, and I don't see the difference between an EMT and a paramedic who doesn't recognize albuterol and Proventil. She's also competent enough to administer NTG to EVERY single CP no matter what the origin of that CP. I don't see the difference. And this is someone with supposedly 4-5 years of experience at the medic level.

[scratrat 14]

And another thing referencing education/training....

I will be the first to admit that after 2 years in paramedic school, and 7 years on the street as a paramedic, I am still learning. I don't think I put two and two together until my field internship. I was taught about everything. But until you practice it in the field, it doesn't matter. To me, all that education made sense once I saw real people and began to come up with treatment modalities. Reference the above post, that person went to school for 2 years, has been a paramedic for 4-5 years, give or take, and is still a retard. I think it falls more into how well you can equate your education into field use. That goes for everyone. EMT's can't function if they don't understand what they were taught and put it to field use. Paramedics, nurses, doctors, all the say. I don't care what letters follow your name. If you can't figure out how to translate that information into field use, you are useless. A nurse can have a MSN after his/her name and still not function in an emergency setting.

I have no idea what all that had to do with anything in this post....

[pyroknight 0]

I had an acute coronary syndrome event in January which gave me the unfortunate opportunity to increase my empathy capacities as both an EMS provider and a nurse. Part of this wonderful experience was my trip to the cath lab. Like an ambulance, my cath lab was staffed by TWO providers. Interestingly, they were trained to different levels of expertise! One cardiologist performed the catheterization and flooded my coronary arteries with radioactive dye then called the second cardiologist (the "interventionist") in to place the stent.

Shouldn't ALL cardiologists be trained to the interventionist level? No thank you. Give me the guy who SPECIALIZES in placing the stents. There's still a risk, but I am much less likely to wake up in recovery with the highly experienced guy leaning over my bed explaining to me how there was "a complication" and how they accidentally perfed my LAD and had to cut me open from chin to groin to go in and fix it.

There is a place in EMS for EMT-Basics just like there is a place in the cath lab for cardiologists who are not interventionists. In high traffic, metropolitan settings (side note: many of the people who post in here ranting about an "all EMT-P" system remind me of the talking heads at the NREMT who often fail to address the needs of providers outside the populated states in the Northeastern US - one size does not fit all), dual-medic ambulances are completely justified. I would even argue they are the standard of care. When you move your focus out of the urban areas, however, and look at the call volumes in rural settings, the situation becomes much more complicated.

I digress. Back to the question at hand - what makes a good basic? A good basic:

• - remembers that "EMT" is 75% of "EMT-P" and makes sure that good BLS is provided for any "ALS-centric" partners,

- knows enough about the paramedic's "job" to allow them to anticipate their partner's needs (set up IV lines, apply electrodes, open the drug box (at least know which drugs are which colors, preferably know what they're used for),

- has provided BLS care in the back of an ambulance and knows how to drive so as to provide an environment that is safe to work in, and

- does not tolerate anyone with a higher level of credential belittling them.

Many, many, MANY years ago when I was an EMT-B, nothing made me more proud than to illustrate my second point. I would stand back, take in the scene, and watch the gaggle of paramedics working on the patient. I would quietly gather the next piece of equipment they would need and hand it to them when they asked (or, usually, shouted) for it.

[chaser 11]

... I would stand back, take in the scene, and watch the gaggle of paramedics working on the patient. I would quietly gather the next piece of equipment they would need and hand it to them when they asked (or, usually, shouted) for it.

=D>

[pyroknight 0]

Whether you are an EMT-B or a PhD, people will respect your posts a LOT more if:

a) you use spell-check and

you use the "preview" button (for crying out loud, people - at least proof-read your replies ONCE - spell-check will not catch substituting "are" for "our")

[Richard B the EMT 303]

Perhaps I can take this in a different direction.

Is this a mention of the so called "Mensa Medics?" This is something FDNY EMS is discussing, yet again, at length.

Mensa Medics would be Paramedics teamed with EMTs. theoretically, it could be extended to an EMT teamed with a Certified First Responder.

Unless my union has changed it's position, they oppose Mensa Medics, because, for an example, if a Paramedic is unable to start a line, due to a variety of reasons, their partner can make an attempt, hopefully successfully. An EMT, currently under NYS DoH rules and regulations, is not allowed to even transport a patient with an IV attached without a Paramedic aboard the ambulance.

Also, two paramedics can act as a safety check for each other, if one has hit a mental bump in the road ("Sam, do we use Narcan or Nitro in this type case, I seem to have forgotten").

(Don't lie, at any level of training, we've all had a "smack self in forehead with palm of hand" moment, this is a given.)

I also remind all of the joke, that it is a "Pair-A-Medics".

[vs-eh? 19]

Setting up a drip set, attaching leads, driving safely, or knowing what colour boxes are for what! (WOW, my opinion of US EMS system went down a tonne if you honestly use colours to designate drug orders). If these are some hallmarks for a good BLS partner, you my friends have much bigger fish to fry...

Seriously, that is sad...

And sorry the 75% of EMT-P is EMT and the BLS before ALS garbage? Refer to the above. If people are considered "good" EMT-B's for the whole hour to takes to show them how to place leads on, set up a bag or know what colour brown or purple is, I don't expect them to know how to properly manually manage an airway or bag some one.

Yikes people.

[AnthonyM83 39]

So again, the point here is to tell us why this three week class makes you an indisposable element of prehospital care system from an operational and medical standpoint.

I'll take a jab at it.

It's easier to complete an EMTB class than it is an EMTP class, so there are more EMTBs available and will accept lower pay. It might be easier to run a 911 system with EMTs as first responders. Even though LA EMS sucks arse (as Dusty would put it), their response system seems to be working. Every coverage zone has one BLS unit, then an ALS unit that covers 2 or 3 zones depending on how busy each zone is. ALS unit ride with the basics to the hospital, then leave for their next call...while the basics can 'hold the walls' at the hospitals for up to 3 or 4 hours until their patients gets a bed.

Now, this isn't necessarily THE best system. But it's what they're using now to keep things flowing, so at least for LA it's integral to have those first responders.

Sure EMTs are only a little better than a person off the streets, but I'd much rather want an EMT (from my company, at least...hiring process is harder than IFT companies...I'm taking a medic prep class and was surprised the top four in the class have been from our company) than a person off the street if I were in critical condition.

[pyroknight 0]

Setting up a drip set, attaching leads, driving safely, or knowing what colour boxes are for what! (WOW, my opinion of US EMS system went down a tonne if you honestly use colours to designate drug orders). If these are some hallmarks for a good BLS partner, you my friends have much bigger fish to fry...

vs - Stop going off half-cocked. If you have a tackle box or a Pelican case or a soft bag filled with medications, you can pull out each box and read the label or you can KNOW what color some of the medications are. If you are working a code, I would like my EMT partner to know the epinephrine boxes are grey so that when I need an epi, he or she does not have to pull out each drug to find one.

How can anyone logically argue that BLS is NOT the majority of what EMS does? For every serious ALS call EMS agencies run 20 or 30 BLS "emergencies". It's all about economics. I live in a community (island, more or less) of 30,000 people. We have zero cardiologists and zero neurologists. If you need sophisticated medical care you fly for nearly three hours. Would it be acceptable for a Cinncinati or a Tucson or a Savannah to not have at least one hospital with a neurologist and a cardiologist on call? No way. Would it be acceptable for those municipalities to have single medic ambulances? Not in my opinion. When you have agencies with call volumes in the double-digits, however, I think a BLS partner is justifiable.