If there were no EMT-B certification .....

[Outbac1]

If there were no EMT-B certification as a starting point. Would you still try to get into EMS.

Here in Canada we have Primary Care Paramedic, (PCP), as our BLS level on ambulances. It is about a 1500 hour course with about 800 hours didactic/lab, 200 hours of hospital clinical and 500 hours as a student on an ambulance. The course costs about $12,000.00 (plus your living expenses) and takes about 10 months to complete.

If you knew you could get a job paying double the minimum wage plus benefits, would you quit your current job and make the time and monetary investment to be in EMS? Or does that kind of commitment scare you away?

 

[Hastings]

I just went straight from nothing to Paramedic without any experience in between anyway. I skipped Basic all together. And while some may believe that's a poor way of doing it, I have no complaints. I admit that it took a bit longer than the experienced basics to get comfortable with patient assessments, but other than that, I was quickly at the level of any other paramedic.

So the answer is yes. I skipped Basic, and from my own experiences, I can confidently say that I didn't miss out on anything. Basic isn't required training for paramedic.

Edit: All together, 2 years non-stop full-time schooling. Not paid.

 

[mikeylikesit]

I would have liked to skip basics. but around here in Colorado that wasn't an option for me. i think basics was like...college prep. you get everything that you need to learn at a semi comfortable level before attempting bigger things.

 

[seanm028]

The problem out here is that there really aren't any schools that accept non-firefighters. Anyone can go get their EMT training, but if you aren't currently employed by a fire dept or private ambo company, you can't even go near the paramedic classes.

 

[Alexakat]

If there were no EMT-B certification as a starting point. Would you still try to get into EMS.

If you knew you could get a job paying double the minimum wage plus benefits, would you quit your current job and make the time and monetary investment to be in EMS? Or does that kind of commitment scare you away?

I am a volunteer, so unlike many on this forum, I do not make my living in EMS (not sure if you were looking for an answer from someone in my situation).

Yes, if there were no EMT-B cert. as a starting point, I believe I would still get into EMS. I am not willing to give up my current job, though, for a job in EMS. I'm just not ready to give up the kind of money I currently make. I looooove EMS, but I guess not enough to change the way I live now--too comfortable. Commitment doesn't scare me away---I chose to put my time & monetary investment into a college degree.

 

[MMiz]

If I wasn't able to take an EMT course over the summer, then unfortunately I wouldn't be an EMT. My EMT-B course was 300 hours, including 72 hours of clinicals.

Hastings, where did you go for your cert? Lansing Community College?

 

[Jeremy89]

The problem out here is that there really aren't any schools that accept non-firefighters. Anyone can go get their EMT training, but if you aren't currently employed by a fire dept or private ambo company, you can't even go near the paramedic classes.

There's one in Mesa where I went for my Basic. they were ready to accept me out of basic school. In fact, a classmate of mine went on to that class, tryin to do the medic-RN thing. I thought about it, but I'm going to get my BSN, just to have the degree.

 

[CFRBryan347768]

If there were no EMT-B certification as a starting point. Would you still try to get into EMS.

Here in Canada we have Primary Care Paramedic, (PCP), as our BLS level on ambulances. It is about a 1500 hour course with about 800 hours didactic/lab, 200 hours of hospital clinical and 500 hours as a student on an ambulance. The course costs about $12,000.00 (plus your living expenses) and takes about 10 months to complete.

If you knew you could get a job paying double the minimum wage plus benefits, would you quit your current job and make the time and monetary investment to be in EMS? Or does that kind of commitment scare you away?

Absolutely, the more I think about it I really can't do much for my pt's as an EMT-B

 

[Hastings]

The problem out here is that there really aren't any schools that accept non-firefighters. Anyone can go get their EMT training, but if you aren't currently employed by a fire dept or private ambo company, you can't even go near the paramedic classes.

Actually, I got my spot in paramedic school and at the agency I work because I am NOT a firefighter. Those who are dedicated to the medical side only are extremely attractive these days, believe it or not.

Hastings, where did you go for your cert? Lansing Community College?

That's the one. Great program.

 

[Flight-LP]

If there were no EMT-B certification as a starting point. Would you still try to get into EMS.

Here in Canada we have Primary Care Paramedic, (PCP), as our BLS level on ambulances. It is about a 1500 hour course with about 800 hours didactic/lab, 200 hours of hospital clinical and 500 hours as a student on an ambulance. The course costs about $12,000.00 (plus your living expenses) and takes about 10 months to complete.

If you knew you could get a job paying double the minimum wage plus benefits, would you quit your current job and make the time and monetary investment to be in EMS? Or does that kind of commitment scare you away?

I would absolutely love to see a similar program here in the states. U.S. folks, take notes! Our friends to the north know how to educate EMS providers.........................

And they compensate them appropriately!

So much for the that myth being spewed as false by some..............................

 

[mikeylikesit]

Actually, I got my spot in paramedic school and at the agency I work because I am NOT a firefighter. Those who are dedicated to the medical side only are extremely attractive these days, believe it or not.



That's the one. Great program.

I agree with you on this Hastings, the oral boards and interview process here makes it very difficult unless they believe that your going to stayt in the profession for a few years and not just use it as a stepping stone.

 

[Outbac1]

Alexakat: Yes I'm looking for answers from everyone.

Please don't get me wrong, our systems here are not perfect, and I know there are some very well run services in the US.

There has been so much "discussion" here on EMT-B I'm curious as too how many would make the commitment to a higher level,(but not EMT-P), if they only had a higher level of course to take. Much harder to "try it to see if I like it".

Please keep your comments coming.

 

[mikeylikesit]

Alexakat: Yes I'm looking for answers from everyone.

Please don't get me wrong, our systems here are not perfect, and I know there are some very well run services in the US.

There has been so much "discussion" here on EMT-B I'm curious as too how many would make the commitment to a higher level,(but not EMT-P), if they only had a higher level of course to take. Much harder to "try it to see if I like it".

Please keep your comments coming.

I would like the idea of not having a basic but rather it start out in a level that takes 1-2 years of school to complete. reason being is that i think it would almost weed out all of the ones who are doing this jobs because
1. they thinks its cool.
2. only takes a few weeks to be a "trained professional"
3. they use it as a stepping stone just to get on a FD and then forget what they learned in class but still attempt it in error.
I think that if EMS was a lot harder to get into for schooling like nursing programs then we would weed out the individuals who would say "oh two years plus a wait time just to get through school, I'm doing something else." however if everyone had to go through with 2 years of school just to start out in the job then they would inherently expect better pay...which i don't foresee in the near future.

 

[Ridryder911]

If there were not EMT/B's then just think we would have ALS on all calls. Seriously, we would had progressed into the next stage or step up. As I have mentioned, in the early years of EMS, it was assumed that communities as well as the EMS community the next step would be to improve patient care..... not to become stagnant.

Also why would communities want to deliver routine general care to their citizens? If they can afford water, sanitation and law enforcement then they can afford EMS. It is the public has a choice, which is unfortunate and of course we (EMS) directed the citizens which route and to direct them into what was supposed to be best for their health. They trusted us.. and we failed.

As well, I believe if there were not EMT/B there would be another term or categorization. This would be probably be more appropriate as again the MFR role. Stabilize and perform initial care until more advanced medical care arrives. This could be per multiple type agencies and not really even associated with EMS. Call it what you may, but without the EMT/B level, I personally believe EMS would had advanced further and definitely into a more profession.

R/r 911

 

[daedalus]

If there were no EMT-B certification as a starting point. Would you still try to get into EMS.

Here in Canada we have Primary Care Paramedic, (PCP), as our BLS level on ambulances. It is about a 1500 hour course with about 800 hours didactic/lab, 200 hours of hospital clinical and 500 hours as a student on an ambulance. The course costs about $12,000.00 (plus your living expenses) and takes about 10 months to complete.

If you knew you could get a job paying double the minimum wage plus benefits, would you quit your current job and make the time and monetary investment to be in EMS? Or does that kind of commitment scare you away?

With respect, PCP is no comparison to EMT, and it is not fair to compare them. It is the only option for us in california. We MUST become an EMT for six months before advancing to paramedic (if one wants to go to a respectable school, such as Ventura College or UCLA daniel freeman)

 

[MedicAngel]

If there were not EMT/B's then just think we would have ALS on all calls. Seriously, we would had progressed into the next stage or step up. As I have mentioned, in the early years of EMS, it was assumed that communities as well as the EMS community the next step would be to improve patient care..... not to become stagnant.

Also why would communities want to deliver routine general care to their citizens? If they can afford water, sanitation and law enforcement then they can afford EMS. It is the public has a choice, which is unfortunate and of course we (EMS) directed the citizens which route and to direct them into what was supposed to be best for their health. They trusted us.. and we failed.

As well, I believe if there were not EMT/B there would be another term or categorization. This would be probably be more appropriate as again the MFR role. Stabilize and perform initial care until more advanced medical care arrives. This could be per multiple type agencies and not really even associated with EMS. Call it what you may, but without the EMT/B level, I personally believe EMS would had advanced further and definitely into a more profession.

R/r 911

I disagree with you that we are basically giving the community a bad set of skills to give them EMT-B's. While I can only speak for myself, I am glad I am starting from the bottom so to speak and working my way up. We have not failed our communities nor or citizen's by giving them basics, what we have done is failed them if we have not trained them to have strong skills and to know when to call for ALS.

I have heard of more ALS providers failing their hands on skills when being tested because they forgot their basic set of skills. I think each level is well needed, none should be forgotten and all should work as a team. We can advance further if we wish, but we have to do it with the citizen's in mind and with our community and believe me, I have also seem more crappy ALS providers who get the big eye and don't see the whole picture or get attitudes and egos because they are the ALS provider. Doesn't make you any more valuable than I, as I worked just as hard and put in just as much time and effort as you did, mayhaps not as much class hours but learning and sharpening my skills and volunteering to be on that rig at any time of the day or night or asking questions and going to extra classes when offered.

So please, don't discount the EMT-B. We are needed, some just don't want to see it or care to acknowledge us.

 

[Hastings]

I'm fine with having Basics to send out on the 90% of calls that are BS and don't require ALS.

However, to make the suggestion that Basics can run advanced calls effectively is simply wrong.

 

[mdkemt]

If there were no EMT-B certification as a starting point. Would you still try to get into EMS.

Here in Canada we have Primary Care Paramedic, (PCP), as our BLS level on ambulances. It is about a 1500 hour course with about 800 hours didactic/lab, 200 hours of hospital clinical and 500 hours as a student on an ambulance. The course costs about $12,000.00 (plus your living expenses) and takes about 10 months to complete.

If you knew you could get a job paying double the minimum wage plus benefits, would you quit your current job and make the time and monetary investment to be in EMS? Or does that kind of commitment scare you away?

This is a generalization here! In Canada it is different from province to province not only on levels but with the skill sets you get from each level. Alberta uses EMR EMT EMT-Paramedic, SK uses EMR PCP ICP ACP.

The PCP, ICP, ACP programs have not been passed through federal legislature yet and made equal. This is a goal they want to go for but as it stands right now it still isnt equal throughout. Yes our level of Education is higher as a PCP compared to US EMT-Basic but I am not entirely positive on the skill sets they all have. I know a lot of it is similar. Also provincial legislation has just recently passed the bill to use PCP ICP and ACP in SK.

If you just go to the Paramedic Association of Canada you go to each provinces site to see there levels and skill sets.

MDKEMT

 

[Clibby]

No basic will say that

Honestly, I wish the basic program was at least 500 class hours and at least 100-150 clinical. That way we would be prepared to be permitted to do more skilles. Most states allow combitubes for basics, because without a viable airway, the pt is dead: my state doesn't. Now they are planning on allowing us to do it in a couple of years, but w/e all 911 around me have a medic. More than that though, basics cannot run an ambulance without being able to give life saving treatment. We are good for bs calls, assisting a medic, and trauma without a medic (I mean the bad ones where no one but the doctors can do anything except IVs and they just need fast transport.) l think basics should be phased out and EMT-Is should become the new basics. We need to be able to administer more epi and start IVs for anaphalaxis, give more nitro for cardiac pts even if its mith med control. Possibly even atropine and epi for cardiac like NH EMT-Is, but that would have to include ekg interpretation which would essentially be a medic. To be honest though V-fib and A-fib are the easiest rythms to see. We need to be able to give fluids in a trauma and should be able to administer more drugs, even if its only with med control. Narcan though should be a basic skill, even if its nasal narcan. It will save a pt's life and it only has risks with some head traumas and possible strokes. Boston EMS and the surrounding areas are given permission for basics to give it, but noone else in the state. Why do we even have an EMT-I? Those skills are fairly basic and should be considered so.

 

[VentMedic]

I have heard of more ALS providers failing their hands on skills when being tested because they forgot their basic set of skills.

Basic set of skills?

BVM? BP? Backboarding? C-Spine immobilization? Bandaging?

To forget these skills is not the fault of an ALS system but the fault if the individual providers. These skills can and should be refreshed often. However, skills and knowledge that have not be learned are another thing all together. Basing one's "worth" purely on skills is a deadend street. Education is important also.

If you are involved in all the training, education and classes as you claim, you should be able to take the next step to Paramedic. It is too easy to be the backseat quarterback making judgements on a profession that you yourself have not yet accomplished.

If a patient is having chest pain in a hospital room and is sent a couple of CNAs to assess instead of an RN, I don't think that would go over very well. There is an expectation, or should be, from the public even in EMS.

Yes, there is a place for the EMT-B education/training in situations where a basic knowledge and skills are required like FFs, industrial workers and coal miners. BLS transport and transfer trucks are also not going away.

quote by Hastings

I'm fine with having Basics to send out on the 90% of calls that are BS and don't require ALS.

The profession also needs to drop the term "BS" from its vocabulary. Many of those "BS" calls spend weeks in the hospital or die because the EMS (BLS or ALS) provider did not fully assess or have enough education to recognize something very seriously wrong. The term itself can cause one to skew their assessment before even seeing the patient. Does anyone realize how much respect is lost each time you give report in the ED with the term "BS" used? Sometimes that patient is intubated right after the ambulance leaves. There were recognizable signs had they actually went through the motions of assessment. There may even come a day when Paramedics can do more treatment in the communities but not with the "BS" mentality. Repeated use of the term "BS" shows you have no respect for the people of your community and especially not when it is used to describe the elderly in nursing homes. Its time to grow up and be medical professionals.

Yes, there are calls that probably should not require an ambulance. But, if the layperson was to stumble upon any EMS forum just doing their own research about what an EMT or Paramedic is, would they not be shocked to hear some of the views of the providers? Just the derogatory terms used when describing the elderly and nursing home patients are enough to make them see EMS providers in a different light. There have even been "Bash Patients" threads on a couple of forums.

It is rare that you would ever see these comments on the forums of other professionals even though they take care of those BS patients alot longer than the 15 - 30 minute ambulance ride. Nor, by being health care professionals do they cast off patients' complaints until proven otherwise. They may use the term "clinic patients" but would not call a pt "bulls*&#". Has EMS reduced human care to the same mentality as leaving our nearly dead patients lying alone along the roadside like road kill and then making excuses for it?

Bottomline, the people of the U.S. (and elsewhere) deserves to be provided with the best possible healthcare systems. We have become a country of distinct classes of the "haves" and the "have nots".