EMS public safety of healthcare.

[fortsmithman]

Is EMS public safety or health care or both. Personally I think it's a bit of both. Based on the little requirements it takes in the USA and in some Canadian provinces. If we want to be considered health care then we need this as a minimum for BLS at least 2 years post secondary as is required in Ontario. With a 4 yr bachelors degree being the ideal requirement for BLS. For ALS amasters degree. Along with requirement for a masters degree for ALS the ALS providers would be authorized to order lab tests for pts.

 

[TransportJockey]

Or get rid of the silly ALS vs BLS argument altogether.

 

[dstevens58]

Although I am a firm believer in education, IMHO mind you, if you start requiring bachelor's and master's level degrees for work in EMS, you'll price your education out of the hands of the trench workers.

I'm having trouble enough now trying to scrape up enough cash for an 8-10 month course for paramedic, let alone me trying to come up for 4-8 years of college. Preferably, I would like to come out of training not owing anything in student loans.

 

[BEorP]

Although I am a firm believer in education, IMHO mind you, if you start requiring bachelor's and master's level degrees for work in EMS, you'll price your education out of the hands of the trench workers.

I'm having trouble enough now trying to scrape up enough cash for an 8-10 month course for paramedic, let alone me trying to come up for 4-8 years of college. Preferably, I would like to come out of training not owing anything in student loans.

Though I understand your desire to stay out of debt, I think there is another way to look at this. Going into debt for professional education is not a big deal and is generally accepted for many health professions in the United States, especially medicine. Many residents are well over $100,000 in debt, but they are entering a healthcare profession where they will be able to pay this off. If paramedicine continues towards further professionalisation then going into debt to pay for the professional schooling should not be considered a roadblock since the wages should correspond to the level of education.

Of course, there are a number of important points to add while saying this. First is that the debt has to correspond to the earning power of the profession and it wouldn't be reasonable for a paramedic to leave school with as much debt as a physician. Another point is that while increased education standards are good, degree creep is not. If we have bachelor's or master's level programs, they need to actually be to that level. Specifically I am thinking of how quickly the "doctorate" level NP and PT programs have some to be. And of course there is the issue of how a higher level education program could get significant uptake when the earning power isn't there, but then how can the earning power increase when the educational requirements are so lax. For that, there isn't an easy answer.

 

[sir.shocksalot]

Why isn't there an option for neither?

 

[subliminal1284]

Im all for improving education but ask yourself this fortsmith, In reality how much would patient care improve if you had a 4 year course for BLS? In my opinion not much if at all since the majority of those years are going to be filled with 'Filler' general study courses that have no relation to EMS. In the end they are still going to be performing the same procedures they have now.

With that said I am all for greatly improving the EMT Basic program, I believe it should contain an A&P class, Psychology, and it should teach more advanced procedures from the start like basic IV starts instead of being a 3 month long first aid class.

 

[fortsmithman]

As I stated in the beginning 4 yrs for BLS would be ideal but 2 yrs should be the minimum as it is in the province of Ontario.

 

[fortsmithman]

Why isn't there an option for neither?

There is except I called it the I don't care option or the fourth choice.

 

[BEorP]

Im all for improving education but ask yourself this fortsmith, In reality how much would patient care improve if you had a 4 year course for BLS? In my opinion not much if at all since the majority of those years are going to be filled with 'Filler' general study courses that have no relation to EMS. In the end they are still going to be performing the same procedures they have now.

With that said I am all for greatly improving the EMT Basic program, I believe it should contain an A&P class, Psychology, and it should teach more advanced procedures from the start like basic IV starts instead of being a 3 month long first aid class.

Of course it won't improve "BLS" care, but part of the shift would be to get rid of this idea of there being a BLS provider. When people call for an ambulance, they expect a healthcare provider, not a first aider. Many people on this forum refer to Ontario's two years of education for "BLS" PCP. PCP is not BLS. To your point of it not changing practise, I think that is where the systems we work in need to embrace the idea of paramedics being healthcare providers who should practice more under guidelines rather than rigid protocols that do not allow providers to use their brains.

As for the EMT Basic program, the best way to improve it is to eliminate it.

 

[subliminal1284]

Well he stated he would like to see a 4 year degree but atleast a 2 for BLS, I would like to know how that would improve anything at all? They would still be at the same level, doing the same care, the only real difference would be the 4 or 2 year program would have an mother load of general studies tacked on to that will have no relation to EMS. How would that improve anything even in the slightest bit? Youre pretty much just dragging a course out way beyond what it needs to be, but to be fair thats pretty much what all college courses do I just dont agree with it and believe its simply a way for the colleges to make even more money by charging students for classes that have no relation to the profession they wish to be in.

 

[subliminal1284]

And I agree about eliminating the EMT Basic level as it sits now. I am all for getting rid of the EMT basic title, changing it to simply EMT and adding more in depth A&P, Biology, and IV starts. In fact last I heard Wisconsin is trying to push for that.

 

[usalsfyre]

Well he stated he would like to see a 4 year degree but atleast a 2 for BLS, I would like to know how that would improve anything at all? They would still be at the same level, doing the same care, the only real difference would be the 4 or 2 year program would have an mother load of general studies tacked on to that will have no relation to EMS. How would that improve anything even in the slightest bit? Youre pretty much just dragging a course out way beyond what it needs to be, but to be fair thats pretty much what all college courses do I just dont agree with it and believe its simply a way for the colleges to make even more money by charging students for classes that have no relation to the profession they wish to be in.

The whole point is to allow for "Basics" to actually assess and treat the patient based on that assessment rather than the stupidity we call "BLS" right now.

If you don't believe psychology, A&P, chemistry, biology, physics and english have anything to do with EMS than your either new, or are incredibly clueless.

 

[Handsome Rob]

where you are going to encounter a lot of resistance is in the younger crowd that has a desire to help people, but may not be down for years of schooling to do so.

I am of the mentality that the US really needs to get its act together here and decide what level of care they want. As it stands now, medics can only do a minimal amount in certain places because of protocols. And why do we have protocols? Because we do not have enough education. I see it all the time in medics, basic, and everyone else...they have no clue what they are doing. The education needs to be much better.

I think it is faulty to try an do away with BLS all together, because as most of us have encountered, not only are the majority of 911 calls BLS (BS) in nature, but having BLS lightens the load on ALS services to respond when needed at lower operating costs. Basically, the medics deem the call BLS and transfer care to the EMT for transport...

 

[usalsfyre]

How much more effective would "BLS" be if they could treat pain, nausea, administer breathing treatments, start standard ACS care, perform and interpret ECGs, and direct people down alternate care pathways (urgent care, primary care, psych) rather than just offer a stretcher ride to the ED?

 

[subliminal1284]

The whole point is to allow for "Basics" to actually assess and treat the patient based on that assessment rather than the stupidity we call "BLS" right now.

If you don't believe psychology, A&P, chemistry, biology, physics and english have anything to do with EMS than your either new, or are incredibly clueless.

As I said I have no problem with A&P or any other RELATED courses. Unforunantly if you have a 2 year or 4 year degree for a basic level its going to require alot more than those courses to drag it out for 2 years. Like it or not it is not our job to diagnose in the field that is why the MD's get paid the big bucks, our job is to stabilize and transport so the patient can get definitive care. Our patient contact is usually less than an hour that is no where near enough time to come up with a proper and thorough diagnosis.

 

[subliminal1284]

How much more effective would "BLS" be if they could treat pain, nausea, administer breathing treatments, start standard ACS care, perform and interpret ECGs, and direct people down alternate care pathways (urgent care, primary care, psych) rather than just offer a stretcher ride to the ED?

Unforunantly that will never happen unless we get rid of Paramedics and EMT's all together and just have MD's and Nurses run ambulances. Which hell if youre going for a master degree program to be a medic might as well forget medic and go straight to MD.

 

[TransportJockey]

Getting rid of EMTs would be a start. Make Paramedic the starting for our profession and make it a mandatory Associates as a minimum (like RNs. LPNs don't count since most hospitals are phasing them out quickly)

 

[usalsfyre]

Like it or not it is not our job to diagnose in the field...

Oh dear Jesus will this one just die already?!? How do you treat without doing some form of diagnosis?

...that is why the MD's get paid the big bucks...

Not as big as many people think.

our job is to stabilize and transport so the patient can get definitive care.

How much of the treatment we provide is stabilizing? How often is the ED definitive care?

An entry level degrees provider would not resemble an EMT-B. They would be capable of "diagnosing" and treating. For what EMTs can provide now, they're probably OVERtrained.

 

[BEorP]

Unforunantly that will never happen unless we get rid of Paramedics and EMT's all together and just have MD's and Nurses run ambulances. Which hell if youre going for a master degree program to be a medic might as well forget medic and go straight to MD.

Are you familiar with EMS systems outside of the US? Look to Australia as one example where you will find many well educated paramedics working in the field.

 

[Shishkabob]

Like it or not it is not our job to diagnose in the field

Have you ever given someone a medication? I hope you diagnosed something in order to give that medication...


Have you ever said someone had a compound fracture? Careful! That'd be diagnosing!