Why does EMT level of care exist?

[Carlos Danger]

Drawing up drugs, I will do too, or I instruct someone from the fire department (who show up to help us if needed) to do

By "drawing up drugs", I assume what you really mean is "putting the pre-filled Bristojet together"?

 

[medictinysc]

I am nearly finished with class and after going on several ride alongs and talking with a number of EMT's,I have to wonder... why does this level of care even exist? In my area EMT's are regulated to stretcher fetchers and ambo drivers. It seems to me that doesn't require 4-6 months of training. In my area EMT's can't even do NPA or OPA, Pt contact is literally moving pt's on and off the truck. Why not have a person trained as an "Ambulance technician" drive the truck so medically trained personal can work on the pt in the back? Doesn't make sense to me. Also it seems to me that first responders can perform the same exact things that an EMT (at least in my area) can do, so why would someone bother to get the extra 3-5 months of training?

Isn't this statement a little unfair? I have two questions before I respond. First, are you being trained NATIONAL REGISTRY or state level. Second, Do you not realize how much of an impact a good EMT can have on a true emergency. I believe you discount how valuable your new certification will be. Start now learning interpersonal skills interviewing skills and for GOD sakes a little compassion.

 

[STXmedic]

Isn't this statement a little unfair? I have two questions before I respond. First, are you being trained NATIONAL REGISTRY or state level. Second, Do you not realize how much of an impact a good EMT can have on a true emergency. I believe you discount how valuable your new certification will be. Start now learning interpersonal skills interviewing skills and for GOD sakes a little compassion.

I actually don't see a whole lot wrong with his post. I certainly don't see where he so desperately needs to learn some compassion. In your system, basics may be very involved members of the team. In other systems, basics can be very much like Jon described. I've seen both in my area alone. If that's the extent of basic interaction, then the amount of training needed to do that is minimal. It depends on the system and the individual. Jon noticing this certainly does not make him the inconsiderate, compassionless jerk that you make him out to be.

 

[NomadicMedic]

How much impact DOES a good EMT really have on a true emergency?

Wouldn't a first responder who can do CPR and bleeding control have the same impact?

Wouldn't an "Ambulance Transportation Specialist" (ATS™) be better if the training consisted of extensive driver training, patient movement and interpersonal relations/communications skills? If we added the first responder curriculum to that ATS certification we'd have a much better trained group of ambulance drivers who were concerned less about life saving and more about delivering the patients and paramedics to the hospital safely.

 

[unleashedfury]

How much impact DOES a good EMT really have on a true emergency?

Wouldn't a first responder who can do CPR and bleeding control have the same impact?

Wouldn't an "Ambulance Transportation Specialist" (ATS™) be better if the training consisted of extensive driver training, patient movement and interpersonal relations/communications skills? If we added the first responder curriculum to that ATS certification we'd have a much better trained group of ambulance drivers who were concerned less about life saving and more about delivering the patients and paramedics to the hospital safely.

Could be a Moot point, Where as I agree EMT-Basic should focus much more on the fundamentals and Ambulance Operations, and the Ambulance Transportation Specialist sounds more like what a Basic does. How many providers who are still Ricky Rescue 20 years later would want to give up their EMT-Basic Status to be a ATS..

 

[NomadicMedic]

I don't think it's a matter of want, it should become a mandated change.

The same way it's going to be when intubation is removed from the paramedic scope of practice.

I kid.

But not really.

 

[unleashedfury]

I don't think it's a matter of want, it should become a mandated change.

The same way it's going to be when intubation is removed from the paramedic scope of practice.I kid.

But not really.

I could see that happening supraglottic airways are the next option after 2 failed intubation attempts here. I've seen medics not even waste their time with the tube and just go to the Rescue Airway, Its been an argument for years now and many to come, And if we don't get our heads out of our ***es soon enough along with a solid route to maintain the skill. It'll be gone before we know it.

 

[NomadicMedic]

Right. The times are changing.

So, we as a profession, (term used with tongue planted firmly in cheek) need to change as well.

EMT should evolve to a driving/patient movement specialist. That's my point. I use the vanishing ETT only as an example that we accept EBM as fact, yet still cling to tradition.

 

[vc85]

In my area, EMTs at the basic level can do:

CPR/AED
Oxygen
Blood Glucose Levels
Glucose Administraton
Assisted Nitro
Epi-Pen
Asprin
Albuterol
Epi-Pen for asthma patients when albuterol gives no relief with med control
Nasal Narcan
CPAP* on the way
OPA
NPA
Clotting Sponges
Tourniquets
plus all of the splinting, bandaging, patient movement stuff.

So EMTs in our area should give that all up, especially when paramedics can be coming from 10+ minutes out and become glorified drivers with "interpersonal relations training" hah?

EDIT: This is in a 911 system. Maybe it is different in the commercial IFT world, I don't know, I don't work in that world

Also, whatever happened to BLS before ALS? Do we want to go to a system like I saw in a training video which showed a medic running an IV, EKG and O2 via NRB for a 16 year old with a dislocated shoulder?

 

[NomadicMedic]

In my area, EMTs at the basic level can do:

CPR/AED
Oxygen
Blood Glucose Levels
Glucose Administraton
Assisted Nitro
Epi-Pen
Asprin
Albuterol
Epi-Pen for asthma patients when albuterol gives no relief with med control
Nasal Narcan
CPAP* on the way
OPA
NPA
Clotting Sponges
Tourniquets
plus all of the splinting, bandaging, patient movement stuff.

So EMTs in our area should give that all up, especially when paramedics can be coming from 10+ minutes out and become glorified drivers with "interpersonal relations training" hah?

Yes.

 

[STXmedic]

So EMTs in our area should give that all up, especially when paramedics can be coming from 10+ minutes out and become glorified drivers with "interpersonal relations training" hah?

EMTs have their place. It's not always feasible to train people up to paramedics in small towns or rural areas, and there's not always a paramedic around the corner. If it works for your area, more power to you. It's definitely not necessary everywhere, though.

EDIT: This is in a 911 system. Maybe it is different in the commercial IFT world, I don't know, I don't work in that world

Excluding CCT, it's entirely different.

Also, whatever happened to BLS before ALS? Do we want to go to a system like I saw in a training video which showed a medic running an IV, EKG and O2 via NRB for a 16 year old with a dislocated shoulder?

Please, do yourself a favor and remove that phrase from your vocabulary. Whatever happened to treat your patient and give them what they need. Go ask a doctor what BLS and ALS is. He's likely going to give you a look of befuddlement. We're the only specialty that uses that misleading, crap terminology. Treat your patient, and try to do the most good with the least intervention possible. If they need "ALS" first, so be it.

 

[uglyjon]

CPR/AED
Oxygen
Blood Glucose Levels
Glucose Administraton
Assisted Nitro
Epi-Pen
Asprin
Albuterol
Epi-Pen for asthma patients when albuterol gives no relief with med control
Nasal Narcan
CPAP* on the way
OPA
NPA
Clotting Sponges
Tourniquets

Yup trained in all of that, but most of it is considered ALS (especially narcan, CPAP, OPA, NPA) I will genuinely be an ambulance driver and a stretcher fetcher. That is just for my area, YMMV.

 

[hogwiley]

Why are there EMTs? You answered your own question. To drive an ambulance and help lift and move patients. That doesn't require a Paramedic license and its viewed as overkill staffing 2 paramedics in some systems. Hence you have EMTs.

As for your suggestion that you shouldn't even have to be an EMT to drive an ambulance and move patients, does it really hurt for these people to have more training than may be needed? Not really. EMTs cant do much more than a first responder but they are expected to know a lot more. As a practical matter does this extra knowledge mean much? Probably not in most cases, but it certainly doesn't hurt.

Its actually the Advanced EMT license that I don't think really needs to exist. If you feel it doesn't take an EMT license to drive an ambulance, why does it take an advanced EMT license? At the end of the day because of their limited scope, its harder for an EMT to kill a patient. An advanced EMT however is allowed to do just enough and taught just enough to make them dangerous. They took Intubation away from EMT I's for a reason, and that's a good thing, but im still not sure the license even needs to exist.

 

[hdarkace]

The EMT-B is basically just that a basic. However if you can remember from chapter one of your textbook EMS system(paramedics may have forgotten since it was so long ago). The EMT basic cert only provides a foundation and the state can expand or constrict the scope of what an EMT basic can do..

The EMR level is really for people who really don't give a crap about a career in medicine, however their job may require them to be first on scene ie (police officers, construction workers, fire fighter)

The EMS agency i plan on working for encourages EMT's to move on to EMT-I and EMT-P and most trucks are ran with two Paramedics. with EMT-B's filling in part time slots (reduces paramedic burnout rates).

Now my opinion. We are an extra pair of hands. I use it as an opportunity to learn as much as i can i ask questions and observe, i answer with yes sir no sir, it is an apprentice position that is needed. I do what my paramedic tells me to do, and a good paramedic will always check what i do. I have seen my paramedics do enough things more than once that i have picked up on it, and i will store it in my memory for the day i'm in paramedic training i can apply classroom concepts with real life observation.

I use to be a commercial pilot before i choose a career in EMS, I started as a First Officer with less than 400 hrs my captains had on average 4000 hrs lol. On 80% of my flight i did the takeoffs and landings (the most critical phase of flight), but i was paid 20k-30k a year less than they did. With that information you can now see why EMT's are needed

 

[cspinebrah]

Jezzz, and I thought the scope for LA County EMT's was bad LOL.