Basics and Intermediates ONLY No more BLS 911 ambulances?

[Dustdevil]

So why should a major metropolitan city let any moron off the street with a medic ticket practice ALS on their citizens?

Well, my guess would be for the very same reason we don't ask new med school grads to work as a nurse for a couple of years before allowing them to practise medicine. Fruit which is not picked and consumed when it is ripe will wither and spoil. The longer you wait to put your knowledge to use, the less grasp of that knowledge you will retain. And the less of it you retain, the less you have to assimilate into your experience in order to build a practice of intelligent, professional quality.

Any system worth a shyte is putting those new grads directly to work, utilising them to their fullest level, placing them alongside an experienced and proven preceptor, in order to quickly and efficiently develop these people into their fullest potential, to the benefit of the system and their patients. Systems that suck arse will waste years of education and potential by not utilising these people (Boston), or worse yet, stick them out there alone with nothing but an EMT for a partner. Yeah, it's a no-brainer, but brains seem to be a rare commodity in EMS once you get any farther north than Virginia.

Any other simple questions we can clear up for you?

[flight-lp]

The tiered system isn't all that. And sorry, any system that will not allow a Paramedic to act as one and makes them be an EMT-B for a year, makes them reside in the city and then pays them horrible wages, is absolute crap (Boston EMS in case you are still confused).

Did someone reject your application? :roll:

Uhh no..........absolutely no interest in living or working in Boston.

[flight-lp]

Well, my guess would be for the very same reason we don't ask new med school grads to work as a nurse for a couple of years before allowing them to practise medicine. Because the longer you wait to put your knowledge to use, the less grasp of that knowledge you will retain. And the less of it you retain, the less you have to assimilate into your experience in order to build a practice of intelligent, professional quality.

Any system worth a shyte is putting those new grads directly to work, utilising them to their fullest level, placing them alongside an experienced and proven preceptor, in order to quickly and efficiently develop these people into their fullest potential, to the benefit of the system and their patients. Systems that suck arse will waste years of education and potential by not utilising these people (Boston), or worse yet, stick them out there alone with nothing but an EMT for a partner. Yeah, it's a no-brainer, but brains seem to be a rare commodity in EMS once you get any farther north than Virginia.

Any other simple questions we can clear up for you?

[p3medic]

Uhh no..........absolutely no interest in living or working in Boston.

[p3medic]

Working BLS for a year might seem like a bitter pill to swallow for an experienced paramedic, but when you figure its one year from your date of hire, so after the academy and field internship your looking at 6 months. In that 6 months the new hire will have time to learn the system, geography, protocols, etc...The promotion to medic is from within and is very competitive. There is a competitive written, practical and oral exam to get into an ALS internship, usually 4-8 spots with 50 plus applicants. The medic internship is heavy on didactic and clinical rotations, and takes an additional 5-6 months. So, an additional 700-1,000 hrs beyond whatever medic school you came from. Is it the only way to provide ALS? No way, but it does work. I'm sure some 20 year old medic from Houston knows better though.... :roll:

[CBEMT]

Any other simple questions we can clear up for you?

Well, since you know everything else, the meaning of life would be nice. :roll:

[Scaramedic]

Good God how many times have we had this debate? 76,92....

As far as Seattle I am closer than any of you to Seattle and work in Washington. Having said that I don't fully understand the system up there, it's not cut and dry. In fact it reminds me of "Mother, Jugs & Speed" you have multiple non-emergency and back ambulance services all vying for patients. Don't believe me? Keep in mind a few years ago when AMR pulled into the middle of a gunfight looking for patients. Medic 1 has a great PR department but their Medics are not any better than the rest of us.

As far a tiered system goes I am sorry but I think it is stupid. Too many times on these boards I have seen tier system Basics try to justify it by listing what they consider BLS. Too many times I have seen S/S that could be ALS problems, S/S Basics do not have the education to recognize and therefore endanger patients. I have had hiccups caused by MI's, I have had nausea caused by bigeminal PVC's secondary to a congenital heart condition.

A system that has to re-dispatch someone else for ALS is not efficient, put the Medics there first and let them handle the patients. I also can't help notice some of the large ego's here. That attitude tends to create a situation where someone might believe they can handle situations they can't. Large ego=dead patient.

Finally a true cardiac arrest save walks out of the hospital and continues their lives. Anything else is just a BS number for administrators to stroke themselves.

Peace,

Marty

[EMT007]

nice attempt at sniping there mate, but all the education in the world is irrelevent if it is not applicable to the environment in which it is being utilised, ergo your smart ass comment is null and void :?

Further, back that up with paramedic education of 3 months is not education at all, and the vast majority of medics will agree with that.

Hence the part about "emergency medicine-trained". Null and void indeed :wink: Are you saying that a physician's medical education is not applicable to the EMS environment (i.e. patients of all complaints)?

As for the second part, well its a bit confusing so I will just say that many of my friends who have just gone through medic school only had 3 months of classroom training prior to internship. Granted, it was more or less full time (4 days a week), but this is still miniscule compared to the education physicians and nurses receive.

[EMT007]

Yes, it was a nice attempt at early morning humor, however as Bushy stated, your illogical analogy is irrelevent.

Listen to your own belief, an English grammar class would do you well.

It really wasn't so much "early morning humor" as a serious argument (perfectly logical and applicable, btw) meant to show the ridiculousness of the idea that the amount of education is the only important factor in whether someone deserves to be on a 9-1-1 response ambulance and that the more education, the better.

Granted, it was a bit of a long sentence, but its more interesting that the sentence critiquing my grammar made no sense whatsoever. "Listen to your own belief"? :?

[spenac]

Hence the part about "emergency medicine-trained". Null and void indeed :wink: Are you saying that a physician's medical education is not applicable to the EMS environment (i.e. patients of all complaints)?

As for the second part, well its a bit confusing so I will just say that many of my friends who have just gone through medic school only had 3 months of classroom training prior to internship. Granted, it was more or less full time (4 days a week), but this is still miniscule compared to the education physicians and nurses receive.

Doctors are bad news on scene. They do not know how to work with limited equipment and supplys for the most part. I actually have had to kick more than 1 doctor off my scene. Nurses for the most part are not used to having to identify problems and treating them without discussing with the doctor. But with some slight adjustments in education both could adapt and then yes they would be better for the patients. But with the nurse shortage, the limited funds, and the higher probability for a doctor to get sued, not something that will happen anytime in the near future here in the USA.

And while myself as an EMT-I feel that a Paramedic only ambulance would be best for patients, it will be a long time before, if ever it happens nationwide. Until then all of us need to focus on personal education, take a class, read advanced books, read updated books for our level, etc.

If you plan to remain in EMS work to improve our profession. If you are not planning to work to improve our image as healthcare professionals, get out now, we don't need you or want you.