EMT to Paramedic

[Guest guest]

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however in

the

fire service, if I am to understand correctly, you have to be a Fire Basic FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic be

higher?

just my .02

Ron

[Guest guest]

In a message dated 3/30/2006 10:26:56 A.M. Central Standard Time,

hypnoron@... writes:

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however

in the

fire service, if I am to understand correctly, you have to be a Fire Basic

FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

higher?

just my .02

Ron

[Non-text portions of this message have been removed]

Yahoo! Groups Links

AMEN

[Guest guest]

To play devil's advocate, should lawyers spend a few years as paralegals or as

legal secretaries before becoming lawyers? Should physicians be nurses or

physcians' assistants first?

EMS will never advance as a true profession so long as we we have a stairstep

structure that requires you to jump through various licenses before reaching the

terminal level of certification/licensure. This is more like an apprentice

plumber becoming a journeyman plumber who finally becomes a master plumber than

it is a profession.

I will say, however, that I support intensive field training before one is

considered ready to treat patients without " supervision. " The real problem that

I see is the amount of EMS services that find that " a patch and a pulse " are all

it takes to provide patient care. Personally, I'd like to see some assurances of

competency before a newly hired paramedic is given the keys to the ambulance and

the the keys to the controlled drugs.

I'm looking forward to the day when someone has the option to go to college, get

a bachelor's degree and their paramedic licensure simultaneously. More

importantly, I'm looking forward to the day when we recognize that EMS education

rightfully involves more than just EMS classes.

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however in

the

fire service, if I am to understand correctly, you have to be a Fire Basic FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic be

higher?

just my .02

Ron

[Guest guest]

I agree with you Ron all the way. When I talk to EMT's about becoming a

paramedic most want to rush right to it. I try to tell them that when they

are doing their rid outs, as a rule the medics make it look easy. I do tell

them that is because the medics have been doing the job for a few years now

and have a good idea and the how, who, what and whys of the job. Most of the

time one or two ride outs cure the young EMT for such lofty ideas. Yes, I

think there should be a waiting period between cert levels. Nothing is

better the hands on experience. Some exceptions should and do apply such as

rural setting and fire departments when the medic is told to go right

through or else.

lawrence

[Guest guest]

Wes:

That is an apples and oranges comparison. Currently, clinical exposure in

EMT school (per the DOT) is about 24-48 clinical hours and a 24-hour

ride-along. This often coincides or follows a fairly intense didactic

session. Before becoming a good paramedic (and I do not mean getting 70 or

better on paramedic school examinations), you need experience. Experience

improves judgment. While I don't think TDSHS should restrict the practice,

going from EMT school to paramedic school without an intervening experience

in the field promotes problems. First, the most important prehospital skills

(BLS skills) are never mastered. Second, the greater time commitment and

depth of paramedic education will foster a practice where ALS skills are

assumed to be necessary. Most paramedic programs never require practice of

BLS skills to the point of mastery.

Then, there is the absurd. Most will complete paramedic school and then

take one of the myriad CCEMT programs. Now, you have an individual

presumably trained in numerous skills although mastery was never achieved in

most. In Canada and Australia EMTS may wait years before becoming

paramedics. Then, after several years of paramedic experience the best are

selected for critical care education which usually lasts a year (unlike the

Mickey Mouse CCEMT programs we have in the States). It is totally

unreasonable to take even a bright 18-year-old and send them to EMT school,

immediately followed by paramedic school, and immediately followed by CCEMT.

They never develop the required judgment, skills mastery and experience.

Good EMTs and Paramedics must be independent thinkers. Relying on protocols

and other cookbook-type rules makes for bad patient care. The EMT must be

able to problem solve when the patient does not fit the protocols. We (EMS

educators and regulators) did EMS a great disservice many years ago by

dumbing down the EMT curriculum and we are now suffering the consequences.

With all due respect, I would not want a 20-year-old EMT-P/CCEMT-P putting a

central line in my patient or trying to aspirate a pericardial sac. Once

they have gained experience and wisdom, and I have verified this, then

certainly.

We in EMS are like Boy Scouts. The more merit badges the better. In

emergency medicine, we are saying the opposite. We are board-certified in

emergency medicine and gaining additional merit badges is a waste of time.

I see EMS going this way:

1. There will be a greater emphasis on BLS with several major fire

departments and urban EMS systems going primarily BLS. There is no way big

cities like Dallas, Houston and San can maintain skills mastery for

thousands of firefighter/paramedics.

2. There will be fewer paramedics in the urban setting usually assigned to

rapid response vehicles.

3. There will be a push for more paramedics in the rural setting if the

problems with initial education and skills maintenance can be addressed.

4. True critical care paramedics will be few and far between. They will only

enter education after a period of experience and education and certification

will only be offered if there is a position available on a critical care

transport vehicle or helicopter. Education will approach that of the CCRN

and approach a year in length. Before long, many of these helicopter

operators will go away and there will be a renewed emphasis on ground

transport and the remaining helicopter operations will be better and become

a part of the EMS system.

5. By 2010, paramedics will need some sort of degree. The National Registry

has already stated that by 2010 they will probably mandate that all people

sitting for their exams be graduates of fully-accredited programs (not

simply state-approved programs, but programs who are accredited by a

national organization).

6. There will be an expansion in advanced practice paramedics in the areas

of occupational medicine, sports medicine, tactical medicine, and primary

care. There may be some sort of merger between PA and paramedic. Again, a

bachelors or masters degree will probably be required.

I'll bet I am more right than wrong. But then I also thought Bucky would

have been kicked off American Idol last night.

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however

in

the

fire service, if I am to understand correctly, you have to be a Fire Basic

FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

higher?

just my .02

Ron

[Guest guest]

Sorry my answer was not quite in depth.

" Bledsoe, DO " wrote:

Wes:

That is an apples and oranges comparison. Currently, clinical exposure in

EMT school (per the DOT) is about 24-48 clinical hours and a 24-hour

ride-along. This often coincides or follows a fairly intense didactic

session. Before becoming a good paramedic (and I do not mean getting 70 or

better on paramedic school examinations), you need experience. Experience

improves judgment. While I don't think TDSHS should restrict the practice,

going from EMT school to paramedic school without an intervening experience

in the field promotes problems. First, the most important prehospital skills

(BLS skills) are never mastered. Second, the greater time commitment and

depth of paramedic education will foster a practice where ALS skills are

assumed to be necessary. Most paramedic programs never require practice of

BLS skills to the point of mastery.

Then, there is the absurd. Most will complete paramedic school and then

take one of the myriad CCEMT programs. Now, you have an individual

presumably trained in numerous skills although mastery was never achieved in

most. In Canada and Australia EMTS may wait years before becoming

paramedics. Then, after several years of paramedic experience the best are

selected for critical care education which usually lasts a year (unlike the

Mickey Mouse CCEMT programs we have in the States). It is totally

unreasonable to take even a bright 18-year-old and send them to EMT school,

immediately followed by paramedic school, and immediately followed by CCEMT.

They never develop the required judgment, skills mastery and experience.

Good EMTs and Paramedics must be independent thinkers. Relying on protocols

and other cookbook-type rules makes for bad patient care. The EMT must be

able to problem solve when the patient does not fit the protocols. We (EMS

educators and regulators) did EMS a great disservice many years ago by

dumbing down the EMT curriculum and we are now suffering the consequences.

With all due respect, I would not want a 20-year-old EMT-P/CCEMT-P putting a

central line in my patient or trying to aspirate a pericardial sac. Once

they have gained experience and wisdom, and I have verified this, then

certainly.

We in EMS are like Boy Scouts. The more merit badges the better. In

emergency medicine, we are saying the opposite. We are board-certified in

emergency medicine and gaining additional merit badges is a waste of time.

I see EMS going this way:

1. There will be a greater emphasis on BLS with several major fire

departments and urban EMS systems going primarily BLS. There is no way big

cities like Dallas, Houston and San can maintain skills mastery for

thousands of firefighter/paramedics.

2. There will be fewer paramedics in the urban setting usually assigned to

rapid response vehicles.

3. There will be a push for more paramedics in the rural setting if the

problems with initial education and skills maintenance can be addressed.

4. True critical care paramedics will be few and far between. They will only

enter education after a period of experience and education and certification

will only be offered if there is a position available on a critical care

transport vehicle or helicopter. Education will approach that of the CCRN

and approach a year in length. Before long, many of these helicopter

operators will go away and there will be a renewed emphasis on ground

transport and the remaining helicopter operations will be better and become

a part of the EMS system.

5. By 2010, paramedics will need some sort of degree. The National Registry

has already stated that by 2010 they will probably mandate that all people

sitting for their exams be graduates of fully-accredited programs (not

simply state-approved programs, but programs who are accredited by a

national organization).

6. There will be an expansion in advanced practice paramedics in the areas

of occupational medicine, sports medicine, tactical medicine, and primary

care. There may be some sort of merger between PA and paramedic. Again, a

bachelors or masters degree will probably be required.

I'll bet I am more right than wrong. But then I also thought Bucky would

have been kicked off American Idol last night.

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however

in

the

fire service, if I am to understand correctly, you have to be a Fire Basic

FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

higher?

just my .02

Ron

[Guest guest]

Waiter tater. Isn't the current burnout rate about 8 years? How can you

demand to " up " the training and demand more time in service, if in 8 years, your

getting out?

Or, do you think that by putting a time restriction on the transition from

EMT to Medic ,for the sole purpose of experience, would change the burnout

time period?

just my .02

Ron M

In a message dated 3/30/2006 2:34:22 P.M. Central Standard Time,

texaslp@... writes:

EMS is a strange in amalgamation of the two. EMS is more than a trade, but

far less than a profession. The real question is… Are we willing to invest

in the, “long and intensive academic preparation†that defines a

profession?

Only time will tell………

[Guest guest]

Fair enough, Dr. Bledsoe. What would you think about the EMT-B being a separate

and distinct certification primarily for first responder organizations and

turning paramedicine into a degreed program where the entire curriculum is

integrated, rather than the current paradigm of taking the EMT-B class, then

taking the EMT-P class?

-Wes Ogilvie

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however

in

the

fire service, if I am to understand correctly, you have to be a Fire Basic

FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

higher?

just my .02

Ron

[Guest guest]

In a message dated 3/30/2006 2:34:22 P.M. Central Standard Time,

texaslp@... writes:

EMS is a strange in amalgamation of the two. EMS is more than a trade, but

far less than a profession. The real question is… Are we willing to invest

in the, “long and intensive academic preparation†that defines a

profession?

Only time will tell………

In a message dated 30-Mar-06 17:12:23 Central Standard Time,

hypnoron@... writes:

Waiter tater. Isn't the current burnout rate about 8 years? How can you

demand to " up " the training and demand more time in service, if in 8 years,

your

getting out?

Or, do you think that by putting a time restriction on the transition from

EMT to Medic ,for the sole purpose of experience, would change the burnout

time period?

just my .02

Ron M

well, in my case, moving up after a few years had allowed me to stay 'On The

Job' for over 30 years...

Maybe having a more professional background past Basic would reduce the

severity of burnout?

ck

S. Krin, DO FAAFP

[Guest guest]

Wes,

To play the devils other advocate, I believe what you ask already exists

exactly as you questioned. Lawyers complete Law School, but are they then

allowed to become a full partner in a prestigious law firm? Of course not!

They start off as a pee-on, staff associate working the drudgework cases. These

cases are the real bread & butter of the firm. Eventually they become a

non-equity partner. After additional years of hard work and dedication they

become a junior partner. Hopefully before they die, they are granted full

partner status, and just maybe they will be allowed to be a Senior Partner.

What about the various Board Certifications and / or license to practice in the

various levels of state court, other states, or the federal system? These also

take additional time and “sweat equity”.

Physicians, go through medical school, internships, residency, fellowships,

etc, and set out into the real world. Are they board certified upon medical

school graduation? Not at all, in fact they are very much the same as the

jurists.

Yes, I’d be for lawyers and physicians both having to work their way through

the various levels before granting them the " top dog " status. I think it would

be a very good thing for them to have to walk in the shoes of their eventual

subordinates. I’d also like to see nursing candidates come only from the EMS

ranks. This would improve their cognitive thinking skills, weed out the slow

thinkers, and make the most of those life and death times that are the most

important. How many times have you walked into a code situation with the

nursing staff standing around doing little or nothing? The Paramedic in them

would not stand there…..

I am wholly against allowing someone to go from nothing to Paramedic in 2

years, much less 90 days. There is absolutely no way anyone can master the

knowledge or skills to be a lead medic in these short timeframes. I am all for

a mandatory degree requirement for new paramedics. I am not sure if I will ever

see it, but that’s the only way this profession will grow and become something

more than a skill or a trade as it is now. If anyone believes otherwise, they

need to remove their blinders.

I can’t think of any “true profession” where a graduate can become the top dog

right out of school….but in EMS we are there now. I too am looking forward to

the day when we recognize that EMS education rightfully involves more than just

EMS classes.

Tater

ExLngHrn@... wrote:

To play devil's advocate, should lawyers spend a few years as paralegals or as

legal secretaries before becoming lawyers? Should physicians be nurses or

physcians' assistants first?

EMS will never advance as a true profession so long as we we have a stairstep

structure that requires you to jump through various licenses before reaching the

terminal level of certification/licensure. This is more like an apprentice

plumber becoming a journeyman plumber who finally becomes a master plumber than

it is a profession.

I will say, however, that I support intensive field training before one is

considered ready to treat patients without " supervision. " The real problem that

I see is the amount of EMS services that find that " a patch and a pulse " are all

it takes to provide patient care. Personally, I'd like to see some assurances of

competency before a newly hired paramedic is given the keys to the ambulance and

the the keys to the controlled drugs.

I'm looking forward to the day when someone has the option to go to college, get

a bachelor's degree and their paramedic licensure simultaneously. More

importantly, I'm looking forward to the day when we recognize that EMS education

rightfully involves more than just EMS classes.

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however in

the

fire service, if I am to understand correctly, you have to be a Fire Basic FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic be

higher?

just my .02

Ron

[Guest guest]

I agree that experience is needed after the formal education. However, when I

graduated law school and passed the bar, I was called a lawyer. Granted, I

didn't get to do the most intricate cases at first.

Seems to me like what we need are paramedicine internships -- in other words, a

better field training process.

-Wes

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however in

the

fire service, if I am to understand correctly, you have to be a Fire Basic FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic be

higher?

just my .02

Ron

[Guest guest]

I hope that there aren't any plumbers on the list, they might take offense to

the reference that they aren't a (true) profession. Interestingly, most

plumbers I know make more money per annum than the line EMS (paid) providers I

know.

>ExLngHrn@... wrote:

>

>>>snipped>>>EMS will never advance as a true profession so long as we we have a

stairstep structure that requires you to jump through various licenses before

reaching the terminal level of certification/licensure. This is more like an

apprentice plumber becoming a journeyman plumber who finally becomes a master

plumber than it is a profession.

>-Wes Ogilvie, MPA, JD, EMT-B

>Austin, Texas

>

> EMT to Paramedic

>

>

>Hello everyone,

>

>I am noticing that there are more people moving from EMT, right to

>Paramedic. I am not knocking those that have negotiated the program, however in

>the

>fire service, if I am to understand correctly, you have to be a Fire Basic FF

>for three years BEFORE you can advance to the next level Fire Intermediate.

>

>Why can't TDH have a regulation where as an EMT must be an EMT for at least

>a year before they advance to Paramedic? Wouldn't the quality of paramedic be

>higher?

>

>just my .02

>

>Ron

>

>

>

[Guest guest]

Plumbers are a trade.

Definition:

Trade: An occupation, especially one requiring skilled labor; craft: the

building trades, including carpentry, masonry, plumbing, and electrical

installation.

Profession: A calling requiring specialized knowledge and often long and

intensive academic preparation

This begs the question, what is EMS?

EMT to Paramedic

>

>

>Hello everyone,

>

>I am noticing that there are more people moving from EMT, right to

>Paramedic. I am not knocking those that have negotiated the program,

however in

>the

>fire service, if I am to understand correctly, you have to be a Fire Basic

FF

>for three years BEFORE you can advance to the next level Fire Intermediate.

>

>Why can't TDH have a regulation where as an EMT must be an EMT for at least

>a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

>higher?

>

>just my .02

>

>Ron

>

>

>

[Guest guest]

I agree that we need a more internships. More in depth, and LONGER.

Tater

ExLngHrn@... wrote:

I agree that experience is needed after the formal education. However, when I

graduated law school and passed the bar, I was called a lawyer. Granted, I

didn't get to do the most intricate cases at first.

Seems to me like what we need are paramedicine internships -- in other words, a

better field training process.

-Wes

EMT to Paramedic

Hello everyone,

I am noticing that there are more people moving from EMT, right to

Paramedic. I am not knocking those that have negotiated the program, however in

the

fire service, if I am to understand correctly, you have to be a Fire Basic FF

for three years BEFORE you can advance to the next level Fire Intermediate.

Why can't TDH have a regulation where as an EMT must be an EMT for at least

a year before they advance to Paramedic? Wouldn't the quality of paramedic be

higher?

just my .02

Ron

[Guest guest]

EMS is a strange in amalgamation of the two. EMS is more than a trade, but far

less than a profession. The real question is… Are we willing to invest in the,

“long and intensive academic preparation” that defines a profession? Only time

will tell………

Tater

" Bledsoe, DO " wrote: Plumbers are a trade.

Definition:

Trade: An occupation, especially one requiring skilled labor; craft: the

building trades, including carpentry, masonry, plumbing, and electrical

installation.

Profession: A calling requiring specialized knowledge and often long and

intensive academic preparation

This begs the question, what is EMS?

EMT to Paramedic

>

>

>Hello everyone,

>

>I am noticing that there are more people moving from EMT, right to

>Paramedic. I am not knocking those that have negotiated the program,

however in

>the

>fire service, if I am to understand correctly, you have to be a Fire Basic

FF

>for three years BEFORE you can advance to the next level Fire Intermediate.

>

>Why can't TDH have a regulation where as an EMT must be an EMT for at least

>a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

>higher?

>

>just my .02

>

>Ron

>

>

>

[Guest guest]

EMS currently...trade.

EMT to Paramedic

>

>

>Hello everyone,

>

>I am noticing that there are more people moving from EMT, right to

>Paramedic. I am not knocking those that have negotiated the program,

however in

>the

>fire service, if I am to understand correctly, you have to be a Fire Basic

FF

>for three years BEFORE you can advance to the next level Fire Intermediate.

>

>Why can't TDH have a regulation where as an EMT must be an EMT for at least

>a year before they advance to Paramedic? Wouldn't the quality of paramedic

be

>higher?

>

>just my .02

>

>Ron

>

>

>

[Guest guest]

Exactly why I bring this up. There has been no clear answer in EMS.

As much as we try to claim profession, do we really fit that definition? Are we

our own worst enemy by resisting more educational requirements?

>

>This begs the question, what is EMS?

>

>

> EMT to Paramedic

>>

>>

>>Hello everyone,

>>

>>I am noticing that there are more people moving from EMT, right to

>>Paramedic. I am not knocking those that have negotiated the program,

>however in

>>the

>>fire service, if I am to understand correctly, you have to be a Fire Basic

>FF

>>for three years BEFORE you can advance to the next level Fire Intermediate.

>>

>>Why can't TDH have a regulation where as an EMT must be an EMT for at least

>>a year before they advance to Paramedic? Wouldn't the quality of paramedic

>be

>>higher?

>>

>>just my .02

>>

>>Ron

>>

>>

>>