Crew Members Under 18 / High School Age Members

[JPINFV]

In another thread (post 1, post 2 clarifying), a member here stated that, while comfortable with a patient alone, he felt even more comfortable because he had a "junior member" on the ambulance. A junior member was defined as a person under the age of 18. The purpose of this thread is not to debate that call, case, or poster though. There is also the case of the high school responders in Darien CT. (link goes to Youtube)

So, I propose the following question, "Should people under the age of 18 be considered anything more than an observer on an ambulance?"

 

[Ridryder911]

We had EMT programs in vocational schools (H.S.) and finally the last one was shut down. There were several reasons for this. Those that finished the course rarely took the license test, then those that did could not find a job (being < 21), .

Personally, I do not know why we must feel that we place children into an emergency experience or should have to "share" on what we see and do. This is not a usual profession that is exposed on the normal day to day routine events of non-graphic or even emotional and potential physically damaging events. As truly healthcare providers why would we want to even allow for such an occurrence.

Ironically, we would never consider placing our children with a LEO, or aboard an engine company or even a mortuary business due to the potential effects, but EMS... let everyone that wants to has an interest or nosy feeling be allowed. At the same time, possibly exposing them to those professions.

Yes, I maybe hypocritical. I started working in ER when I was 14 and was a Paramedic before I was 18. So, I do know the effects and as well know the mind of a teenager and youth being exposed and demands placed upon them.

I used to be very pro-active in ride along for the youth. I was in a Medical and EMS Explorer Post myself and even a Post Advisor for several years, so I am very familiar with the such programs. My mind set has changed from years of experience of seeing the after effects of those being exposed to environments that was dangerous, physically, mind or potentially psychologically damaging (GSW to head w/brain exposure, child abuse, etc..) that even mature non-developing minds have a difficulty dealing with. Again, would we allow any other children to be allowed to do such? In fact, many may argue it may be abusive to have children to deal or be exposed to such...we have debriefing and counseling for children exposed to such events.

So as an observer other than seeing in real time, what good is such programs? As well, for the patients privacy, why should we allow "non wanted visitors" be allowed to view treatment? Maybe, that patient did NOT want anyone else to know about their hx., where they lived, or personal details.

Again, amazing EMS feels it has to be different and careless. You do not see tag along in medical schools, or nursing programs, respiratory therapy programs and they have students that enter the profession (and actually enter, stay and perform in it longer than EMS does). So the argument of " they would be interested in it more, or this allows "exposure" should not be validated.

If one is really interested in a career, they would investigate, read and discuss with professionals the role.

There is no need to have an audience brought in when we attend to our patients.

R/r 911

 

[Nocturnatrix]

In ny we have youth squads for members 14-18 who want to be a part of the ambulance co.... you have to be 16 to ride but they are students only!

We do have certified first responders at 17 but you have to be 18 to be an emt. the responders usually have a medic or emt with them from what i hear in neighboring departments i don't have any members under 18 in my dept.

Sometimes the students im my dept get very nervous when dealing with patients and my district gets a lot of OD's and drunks and i believe that they shouldn't be put at risk so if they are on a call with the risk of violence i ask them to sit away from the patient or up front if i believe she/he will become violent. We also try to prepare them the best we can in there classes for this!

basically i think they should be able to observe and help as a student but they have to be protected and supervised! i remember being a youth member at 16 riding on the ambulance... this is what got me into ems
At first i was just hanging out with my friends but then i really got into it!
I have been with ems since i was 14 and riding since 16 and i cant think of anything better for kids to do! this will keep kids off the streets!

ok im ranting now! but i think its wonderful that some kids are getting into ems! its a great thing for them and we should encourage it!

 

[jordanfstop]

As the OP I figure I should chime in.

In New Jersey one can become an EMT at seventeen, which this particular Junior Member was. Where my corps is (in NY) we're about five miles from the NJ border and he goes to school in NJ as well, so he became a NJ EMT and is doing reciprocity in March (he's also a NYS CFR.) This particular member has a few hundred calls under his belt and is going to become cleared before the ink will dry on his card. So technically, yes, he's still an observer for our corps, however if the crew chief feels that it's appropriate then he or she allows Junior Members or Senior Corps observers to "tech" the job. The crew chief (and the state) won't allow them to administer particular interventions, e.g. giving ASA, albuterol, EpiPen, or allow them to write the official PCR. So technically in NYS they can't be anything more than an observer. In other states, I'm not sure how I'd feel about it. This particular member would be a cleared EMT if the NYS minimum age was seventeen, as I imagine other states have members that are of this caliber at their age.

Also, I know a few particular Junior Members who use riding at this corps as an escape from the other things that go on in their life. One particular member tells me all the time that if he wasn't riding, he'd still be with some friends smoking weed and getting into trouble. They're pressured in doing better in school (they're required to have a minimum GPA in school as well the corps has checkups with parents.) These youth programs motivate the kids to get into EMS and the medical field abroad; they're our future.

 

[Ridryder911]

It would be interesting to see the real percentages of EMT's that come from such programs or if it is strictly anecdotal findings.. now consider how many enter without such programs.

Sorry, children should never be involved in patient care. Having someone "observe" is no value to the care (as another responsibility and body on a call, as well as potential danger to them) and truthfully disrespectful to the privacy of the patient.

I really doubt that EMS is ever going to keep kids off the street or quit smoking weed. I know too many EMT's.. (hint: EMS has one of the highest alcohol and substance abuse professions).

R/r 911

 

[Jolt]

I'm a 17 year old EMT from Connecticut (I got certified at 16 and no, I don't work in Darien) and, as such, I know my opinion won't really matter in this conversation, but I figured I might as well introduce myself in case anyone wanted to ask something.

Thanks.

 

[Asclepius]

Ironically, we would never consider placing our children with a LEO, or aboard an engine company or even a mortuary business due to the potential effects, but EMS... let everyone that wants to has an interest or nosy feeling be allowed. At the same time, possibly exposing them to those professions.

Not true. Many Law Enforcement agencies have very active ride along programs. My hometown does one, I think they call it an Explorer group or something along those lines. Same with Fire Department's.

Kids these days see more in a movie or video game than they'll see in the typical day riding along with us. We're perfectly willing to send our children into a combat zone at 18, but not so willing to let them buy alcohol. My issue is that we can't have it both ways. They're either mature enough to handle it or they're not. I'll not make that decision alone, but it's unfair to have it both ways.

 

[Ridryder911]

I would hope those "ride alongs" are under direct supervision where the children are not directly placed into an endangerment area. Can one imagine the outcry if a tragic event occurred?

Sorry, there is still NO reason for children to be at the scene nor involved in patient care ... period!

I have worked in such Posts that had Fire & LEO, but they were never placed into the direct working environment. Rather, they assisted in such of patrols of large crowds, search for missing children, clean up of gear, rolling hoses, etc. Never were they placed in arms danger nor into a working fire, haz-mat, nor stand-off situations or assisting in arresting or handling a subject. Video games do not produce blood borne exposures, nor a TBI being strucked by an assailant or by a speeding auto as they go through a MVC scene or police pursuit. Again, there is a much psychological difference of knowing that the images on the video game and seeing real brain matter and 100% burn patients.

In regards to the military, when they are 18 they are no longer a child, as well they have made the determination to enter a profession thats main objective is to fight in wartime. Again, if they are 18 or over and want to be an EMT they are of legal age have made that determination.

Why do we want to pawn off the responsibility of patient care to children, and possibly endangering both of them? Is the business in so much need to have to resort to children providing care? Can you imagine going to surgery, only to see that the initial care will be provided by a 14 year old? What would the public perception be of the profession as well as confidence? Again, why do we in EMS allow non-adults attempt to perform the job? Is there not enough adults interested, that we have to attract junior or high school students? Should we be marketing students to go to school to enter EMS? A definite yes... but alike other health care professions, can be done without them entering direct patient care.

We have been discussing in-depth the dangers of EMS and the need of wearing bullet proof vests and even heated debate of having self protection, and have been discussing the "sudden change" that might occur in patients demeanor, yet let's expose and place children in the line of fire? Again, like you described , you can't have it both ways... either it is a dangerous profession (which statistics have proven it is) or it is not and if it is (which we have discussed) one should not be placing minors into it.

Do you ask the patient prior or get written permission before those that are on ride-a-alongs view the patient? No one has discussed the possibility of privacy or HIPPA violations of ride-a-alongs. This person is not an employ or even a student, rather just a seeker/observer that has no real mission other than to look. Can you imagine going to see your physician or OB/Gyn and having someone that is tagging around to see what the job is like? We can dismiss bystanders at scenes, but to allow them to enter a house and observe treatment, assessments, etc.. without prior written agreement of the patient maybe in violation. Interesting to see what would occur?

I personally have never seen the lack of EMT students, or those that want to enter the profession, usually quite the opposite. Rather, what we do see the lack of interest in staying in the profession and moving upwards. As well, look at the numbers of EMT's and the openings or positions available, there are more EMT's than there are openings. There is definitely not a lack of supply and demand at the entry level.

Maybe the emphasis should be placed upon not so much recruitment but on retainment and promoting furthering the education for those in it or want to enter at the Paramedic level bypassing EMT altogether. Instead of encouraging non adults to perform our job, maybe we should be promoting professionalism within by adult standards . Those of better pay (or being paid), better working hours, career growth, longevity, and promoting that our profession is important and not that just anyone can perform it, and it does requires mature critical thinking skills, that comes along with maturity and life experience.

R/r 911

 

[JPINFV]

As the OP I figure I should chime in....

There's always going to be an exception to the rule (i.e. average, normal, etc), but you can't use the exception to advocate breaking or changing the rule. Hence, I was trying to avoid calling any specific situation or person out with this thread.

 

[bstone]

In Israel many kids around the age of 15 goes through a 40 hour first responder course. This allows them to volunteer on an ambulance. They can take additional courses to increase their skillset, including IV therapy, ETT, EKG, etc. The very motivated can become full medics before they are even 18.

And it works great.

 

[Ridryder911]

In Israel many kids around the age of 15 goes through a 40 hour first responder course. This allows them to volunteer on an ambulance. They can take additional courses to increase their skillset, including IV therapy, ETT, EKG, etc. The very motivated can become full medics before they are even 18.

And it works great.

They also allow females direct combat as well. It appears to work great too, but doubt we will see that immediately as well. When in comparison to what that it works great? Let's compare their system to ours.. as well as other educational requirements.. maybe there are other factors causing this greatness?

Sorry, there is much difference from first responder and actually medical care and knowledge.

R/r 911

 

[BossyCow]

I agree with Rid on this one. I have some serious concerns about letting legal minors provide emergency care. Not that they can't handle stuff they will see on EMS calls, but that they shouldn't have to.

The teenage brain is still developing. The frontal lobe is undergoing massive reorganization at that time of life. While an emergency that is thrust upon them at that time will call up reserves they didn't know they had, there is no reason to subject them to it.

 

[babygirl2882]

This last two years or so when I have been doing ride alongs I have learned things that I would never have learned if I hadn't been riding. I met people that have helped me decided what I need to be doing right now to further my education. I have seen wonderful things happen and have never regretted any of it. I have people who care about what is going on in my life and hope for my future. I have created a place in my community that I would have other wise been unable to do. I have hope that I will become something worthwhile.

I know that I am only 16, that I have no life experience, that I'm still young but I want goals for myself. I have to have a reason to go to school and care. I won't get in trouble because I have too much to look forward to. For some people (probably most) this isn't enough, it isn't good enough. But for me this is what I need and seek. Not being able to do ride alongs now would be devastating. I have seen things that restore my hope for the world, a little old lady who has fallen down and is hurt, there are people who will come and help her. Its not amazing but thats what 98% of the calls in my town are, to that little old lady its all she needed.

 

[Flight-LP]

The truly sad part is the comment that you need something to go to school. This belief in entitlement in todays youth and an absolute lack of social ethics and integrity really chaps me. You need to be in school because it is socially accepted that KIDS get an education. You don't need any other reason. The way I see it is if kids want to help out in EMS, then they can babysit my kids while I work................

If you are under the age of 18, you have no business on an ambulance, if you are under 21, then you have no business driving one. Go to school, get an education, and then become a professional member of the EMS world. Stop trying to hurry your life along to participate in something "cool" with the "blinkies" and the "wooies"................

 

[Ridryder911]

This last two years or so when I have been doing ride alongs I have learned things that I would never have learned if I hadn't been riding. I met people that have helped me decided what I need to be doing right now to further my education. I have seen wonderful things happen and have never regretted any of it. I have people who care about what is going on in my life and hope for my future. I have created a place in my community that I would have other wise been unable to do. I have hope that I will become something worthwhile.

I know that I am only 16, that I have no life experience, that I'm still young but I want goals for myself. I have to have a reason to go to school and care. I won't get in trouble because I have too much to look forward to. For some people (probably most) this isn't enough, it isn't good enough. But for me this is what I need and seek. Not being able to do ride alongs now would be devastating. I have seen things that restore my hope for the world, a little old lady who has fallen down and is hurt, there are people who will come and help her. Its not amazing but thats what 98% of the calls in my town are, to that little old lady its all she needed.

Now, would it be devastating or would it be disappointing? EMS is a business and that business is to provide quality medical care.. period. It is not a redeemer, nor a reason to pursue life or anything heroically. If one sets goal for EMS to provide this; they will be sadly disappointed and will soon leave the profession. Hopefully, you would probably pursue EMS no matter if they stopped ride alongs or not. If not, then I would question any one's true interest. EMS is not going to prevent drop outs, nor prevent drug or alcohol abuse nor should be considered a community project.

People go into professions for multiple reasons. We still have those that want to be an astronaut, physician and yes even an EMT enter the profession without direct exposure or performing the job prior to education. Obviously, by current statistics we are NOT lacking getting people to enter or enroll into EMT programs. Again, quite the opposite too many are entering, and there is very little job market for them. Again, as I tell those that find out in the real world, that most professional services require to be age 21 that EMS will still be there when they reach that age, if they are truly interested in EMS.

There are reasons hospitals do not allow minors to provide medical care and to even observe procedures, yet we still have those that want to be in the medical field. Trust between providers is a sacred trust. Having observers there to fulfill their voyeurism is not being professional and truthfully unfounded. Sorry, most patients have a difficult time opening up to physicians, nurses, medics and now we have a minor that is assisting me in simple procedures, is not going to add to my ability to develop this. Many do not even want EMS students, but understand that they will be part of the system & usually will allow it. There are few times that I need an extra set untrained hands, and definitely having them and watching over them, just adds more to my responsibility and increases more pressure. You see in the end.. I am ultimately responsible.

Again, we are a health care profession, no matter if paid or through an FD service. Our actions and promotions should be accordingly to those standards, not excused because we are EMS.

R/r 911

 

[silver]

ehh darien does a pretty good job though. they are supervised by someone over 18, yet they can make the decisions when providing care. Its a great learning tool, not only do they get to see realities in the world, (in Fairfield County is very isolated from realities as it is) but it puts them in a good step forward in developing as a whole person. Supposedly they claim that 50% of their crew goes off to med school.

 

[JPINFV]

ehh darien does a pretty good job though. they are supervised by someone over 18, yet they can make the decisions when providing care. Its a great learning tool, not only do they get to see realities in the world, (in Fairfield County is very isolated from realities as it is) but it puts them in a good step forward in developing as a whole person. Supposedly they claim that 50% of their crew goes off to med school.

So basically, working as a basic is so easy a kid can do it? I think, if anything, that is the most damning piece of evidence that shows that EMS standards are too low. Furthermore, I highly doubt that working in EMS in high school has really just about any relevance to the amount of their students that goes on to medical school over 4 years later. EMS definitely doesn't prepare a student acadmically for a post secondary education.

 

[Meursault]

...if you are under 21, then you have no business driving one....

Honestly, I'd be happy not to be required to.

I'm also glad to see "blinkies and woowoos" becoming a forum staple.

Finally, in before someone else brings up med students (see "Trauma and BLS" for more of that fun).

 

[silver]

So basically, working as a basic is so easy a kid can do it? I think, if anything, that is the most damning piece of evidence that shows that EMS standards are too low. Furthermore, I highly doubt that working in EMS in high school has really just about any relevance to the amount of their students that goes on to medical school over 4 years later. EMS definitely doesn't prepare a student acadmically for a post secondary education.

that was just random information

and who says academically anyway?

 

[JPINFV]

and who says academically anyway?

The fact that there's twice the number of applicants to med school then there are seats says that your extracurricular activities doesn't matter if no one reads your application anyways. There's also plenty of EMT-Bs that apply to med school. Granted, a fair number of them only have the cert and have never worked a job that required a Basic certification (ambulance or hospital job).