Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 The fact is Rob after 16 years I have formed opinions and beliefs. But if someone has a different opinion or belief than me I am fine with that. If they can show me scientific evidence that I am wrong then I will revise my opinion. You don't seem to do that. Anytime someone disagrees with your point of view you spend time telling them why you are right and they are wrong. I have never seen you agree that someone with a different point of view could be right and while I have no doubt that you are a very intelligent person you cannot be right 100 percent of the time. Rick Sent via Blackberry ________________________________ From: texasems-l texasems-l > To: texasems-l texasems-l > Sent: Sat Apr 03 09:30:08 2010 Subject: Re: Progressive services? On Saturday, April 3, 2010 09:06, rick.moore@... said: > Sorry but it seems to me that's your MO as well. You just attack broadly based on > the patch color. Well then you are going on feelings instead of fact, because I have not attacked anyone. The fact that paramedic care is a higher level of care than BLS care is just that, a fact. Sorry if that makes anyone " feel " attacked, but it's fact, confirmed by state law, not just my opinion. > Seriously though did you not just say that all of this is based > on your personal opinion of right? Sure did. After over thirty years of experience in this nonsense, one tends to develop very definite opinions of what works and what doesn't, and what might improve the status quo. Don't know how long you've been at it, but I'm sure you too have some opinions that you have formed through experience that you feel strongly about. Feel free to join the conversation and articulate them. But ad hominem attacks don't contribute to the dialogue. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 The fact is Rob after 16 years I have formed opinions and beliefs. But if someone has a different opinion or belief than me I am fine with that. If they can show me scientific evidence that I am wrong then I will revise my opinion. You don't seem to do that. Anytime someone disagrees with your point of view you spend time telling them why you are right and they are wrong. I have never seen you agree that someone with a different point of view could be right and while I have no doubt that you are a very intelligent person you cannot be right 100 percent of the time. Rick Sent via Blackberry ________________________________ From: texasems-l texasems-l > To: texasems-l texasems-l > Sent: Sat Apr 03 09:30:08 2010 Subject: Re: Progressive services? On Saturday, April 3, 2010 09:06, rick.moore@... said: > Sorry but it seems to me that's your MO as well. You just attack broadly based on > the patch color. Well then you are going on feelings instead of fact, because I have not attacked anyone. The fact that paramedic care is a higher level of care than BLS care is just that, a fact. Sorry if that makes anyone " feel " attacked, but it's fact, confirmed by state law, not just my opinion. > Seriously though did you not just say that all of this is based > on your personal opinion of right? Sure did. After over thirty years of experience in this nonsense, one tends to develop very definite opinions of what works and what doesn't, and what might improve the status quo. Don't know how long you've been at it, but I'm sure you too have some opinions that you have formed through experience that you feel strongly about. Feel free to join the conversation and articulate them. But ad hominem attacks don't contribute to the dialogue. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 The fact is Rob after 16 years I have formed opinions and beliefs. But if someone has a different opinion or belief than me I am fine with that. If they can show me scientific evidence that I am wrong then I will revise my opinion. You don't seem to do that. Anytime someone disagrees with your point of view you spend time telling them why you are right and they are wrong. I have never seen you agree that someone with a different point of view could be right and while I have no doubt that you are a very intelligent person you cannot be right 100 percent of the time. Rick Sent via Blackberry ________________________________ From: texasems-l texasems-l > To: texasems-l texasems-l > Sent: Sat Apr 03 09:30:08 2010 Subject: Re: Progressive services? On Saturday, April 3, 2010 09:06, rick.moore@... said: > Sorry but it seems to me that's your MO as well. You just attack broadly based on > the patch color. Well then you are going on feelings instead of fact, because I have not attacked anyone. The fact that paramedic care is a higher level of care than BLS care is just that, a fact. Sorry if that makes anyone " feel " attacked, but it's fact, confirmed by state law, not just my opinion. > Seriously though did you not just say that all of this is based > on your personal opinion of right? Sure did. After over thirty years of experience in this nonsense, one tends to develop very definite opinions of what works and what doesn't, and what might improve the status quo. Don't know how long you've been at it, but I'm sure you too have some opinions that you have formed through experience that you feel strongly about. Feel free to join the conversation and articulate them. But ad hominem attacks don't contribute to the dialogue. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 On Saturday, April 3, 2010 14:30, rick.moore@... said: > If they can show me > scientific evidence that I am wrong then I will revise my opinion. You don't seem > to do that. Anytime someone disagrees with your point of view you spend time > telling them why you are right and they are wrong. Didn't you just contradict yourself? > I have never seen you agree > that someone with a different point of view could be right... Then quite obviously, you simply aren't paying attention. I have agreed with several different points of view, from at least three different people, in this discussion alone. Perhaps you have a personal bias that prevents you from reading my posts objectively. That's okay. Just don't put words in my mouth or misquote me. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 On Saturday, April 3, 2010 14:30, rick.moore@... said: > If they can show me > scientific evidence that I am wrong then I will revise my opinion. You don't seem > to do that. Anytime someone disagrees with your point of view you spend time > telling them why you are right and they are wrong. Didn't you just contradict yourself? > I have never seen you agree > that someone with a different point of view could be right... Then quite obviously, you simply aren't paying attention. I have agreed with several different points of view, from at least three different people, in this discussion alone. Perhaps you have a personal bias that prevents you from reading my posts objectively. That's okay. Just don't put words in my mouth or misquote me. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 On Saturday, April 3, 2010 14:30, rick.moore@... said: > If they can show me > scientific evidence that I am wrong then I will revise my opinion. You don't seem > to do that. Anytime someone disagrees with your point of view you spend time > telling them why you are right and they are wrong. Didn't you just contradict yourself? > I have never seen you agree > that someone with a different point of view could be right... Then quite obviously, you simply aren't paying attention. I have agreed with several different points of view, from at least three different people, in this discussion alone. Perhaps you have a personal bias that prevents you from reading my posts objectively. That's okay. Just don't put words in my mouth or misquote me. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Two years of school does not a competent medic make. I've met medics that refused to do anything but BLS because every time they did, they screwed up in an epic way. Their BLS p Alyssa Woods, NREMT-B/FF Sent from the itty bitty keyboard on my iPhone On Apr 3, 2010, at 12:52, " rob.davis@... " rob.davis@... > wrote: > On Saturday, April 3, 2010 12:22, " Grayson " > Grayson902@...> said: > > > Here's my theory: All EMT training programs are not created equal. > I'm > > sure you've seen the products of some bad ones, as have I. But > > regardless of the quality of the training program, a major factor in > > quality is the experience they gain on the street. If you give them > > adequate supervision, solid CQI and the freedom to work, you wind up > > with strong ones, like in Boston. And they go on to become strong > medics > > who understand, from long experience, the importance of BLS. > > Now, just imagine how much more they would get from that experience > if they had two more years of educational foundation behind them > before hand. Are you suggesting that it would hurt them instead of > helping them? > > Does Boston do well? Apparently so. But that shouldn't stop anyone > from doing better. > > Rob > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Two years of school does not a competent medic make. I've met medics that refused to do anything but BLS because every time they did, they screwed up in an epic way. Their BLS p Alyssa Woods, NREMT-B/FF Sent from the itty bitty keyboard on my iPhone On Apr 3, 2010, at 12:52, " rob.davis@... " rob.davis@... > wrote: > On Saturday, April 3, 2010 12:22, " Grayson " > Grayson902@...> said: > > > Here's my theory: All EMT training programs are not created equal. > I'm > > sure you've seen the products of some bad ones, as have I. But > > regardless of the quality of the training program, a major factor in > > quality is the experience they gain on the street. If you give them > > adequate supervision, solid CQI and the freedom to work, you wind up > > with strong ones, like in Boston. And they go on to become strong > medics > > who understand, from long experience, the importance of BLS. > > Now, just imagine how much more they would get from that experience > if they had two more years of educational foundation behind them > before hand. Are you suggesting that it would hurt them instead of > helping them? > > Does Boston do well? Apparently so. But that shouldn't stop anyone > from doing better. > > Rob > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Two years of school does not a competent medic make. I've met medics that refused to do anything but BLS because every time they did, they screwed up in an epic way. Their BLS p Alyssa Woods, NREMT-B/FF Sent from the itty bitty keyboard on my iPhone On Apr 3, 2010, at 12:52, " rob.davis@... " rob.davis@... > wrote: > On Saturday, April 3, 2010 12:22, " Grayson " > Grayson902@...> said: > > > Here's my theory: All EMT training programs are not created equal. > I'm > > sure you've seen the products of some bad ones, as have I. But > > regardless of the quality of the training program, a major factor in > > quality is the experience they gain on the street. If you give them > > adequate supervision, solid CQI and the freedom to work, you wind up > > with strong ones, like in Boston. And they go on to become strong > medics > > who understand, from long experience, the importance of BLS. > > Now, just imagine how much more they would get from that experience > if they had two more years of educational foundation behind them > before hand. Are you suggesting that it would hurt them instead of > helping them? > > Does Boston do well? Apparently so. But that shouldn't stop anyone > from doing better. > > Rob > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Here's where I really put your knickers in a twist: Yeah, I think it actually can hurt, at least in the area of skill dilution. Let's say we have, in a metropolitan area, the opportunity to perform 200 endotracheal intubations a year. Each one of those patients can be effectively bagged by BVM (ie BLS care), but we'll just say that they all need that next step on the Airway Continuum for whatever reason. The BLS airway management is, for the purpose of the hypothesis, just a temporizing measure until ALS airway management can be done. Now divide those 200 tubes by 100 medics. That's two tubes a year, per medic. For patients who were being effectively ventilated by BLS means prior to their arrival, mind you. Now, all other BLS being equal, divide those same 200 tubes by 20 medics. That's 10 tubes a year, per medic. Which bunch do you think will be more proficient? I'm suggesting to you that Boston does so well *because* they have less medics, not *in spite of* that fact. No doubt you will disagree, but the possibility at the very least merits consideration. > > On Saturday, April 3, 2010 12:22, " Grayson " Grayson902@... > > said: > > > Here's my theory: All EMT training programs are not created equal. I'm > > sure you've seen the products of some bad ones, as have I. But > > regardless of the quality of the training program, a major factor in > > quality is the experience they gain on the street. If you give them > > adequate supervision, solid CQI and the freedom to work, you wind up > > with strong ones, like in Boston. And they go on to become strong medics > > who understand, from long experience, the importance of BLS. > > Now, just imagine how much more they would get from that experience if > they had two more years of educational foundation behind them before > hand. Are you suggesting that it would hurt them instead of helping them? > > Does Boston do well? Apparently so. But that shouldn't stop anyone > from doing better. > > Rob > > -- Grayson, CCEMT-P www.kellygrayson.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Here's where I really put your knickers in a twist: Yeah, I think it actually can hurt, at least in the area of skill dilution. Let's say we have, in a metropolitan area, the opportunity to perform 200 endotracheal intubations a year. Each one of those patients can be effectively bagged by BVM (ie BLS care), but we'll just say that they all need that next step on the Airway Continuum for whatever reason. The BLS airway management is, for the purpose of the hypothesis, just a temporizing measure until ALS airway management can be done. Now divide those 200 tubes by 100 medics. That's two tubes a year, per medic. For patients who were being effectively ventilated by BLS means prior to their arrival, mind you. Now, all other BLS being equal, divide those same 200 tubes by 20 medics. That's 10 tubes a year, per medic. Which bunch do you think will be more proficient? I'm suggesting to you that Boston does so well *because* they have less medics, not *in spite of* that fact. No doubt you will disagree, but the possibility at the very least merits consideration. > > On Saturday, April 3, 2010 12:22, " Grayson " Grayson902@... > > said: > > > Here's my theory: All EMT training programs are not created equal. I'm > > sure you've seen the products of some bad ones, as have I. But > > regardless of the quality of the training program, a major factor in > > quality is the experience they gain on the street. If you give them > > adequate supervision, solid CQI and the freedom to work, you wind up > > with strong ones, like in Boston. And they go on to become strong medics > > who understand, from long experience, the importance of BLS. > > Now, just imagine how much more they would get from that experience if > they had two more years of educational foundation behind them before > hand. Are you suggesting that it would hurt them instead of helping them? > > Does Boston do well? Apparently so. But that shouldn't stop anyone > from doing better. > > Rob > > -- Grayson, CCEMT-P www.kellygrayson.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Here's where I really put your knickers in a twist: Yeah, I think it actually can hurt, at least in the area of skill dilution. Let's say we have, in a metropolitan area, the opportunity to perform 200 endotracheal intubations a year. Each one of those patients can be effectively bagged by BVM (ie BLS care), but we'll just say that they all need that next step on the Airway Continuum for whatever reason. The BLS airway management is, for the purpose of the hypothesis, just a temporizing measure until ALS airway management can be done. Now divide those 200 tubes by 100 medics. That's two tubes a year, per medic. For patients who were being effectively ventilated by BLS means prior to their arrival, mind you. Now, all other BLS being equal, divide those same 200 tubes by 20 medics. That's 10 tubes a year, per medic. Which bunch do you think will be more proficient? I'm suggesting to you that Boston does so well *because* they have less medics, not *in spite of* that fact. No doubt you will disagree, but the possibility at the very least merits consideration. > > On Saturday, April 3, 2010 12:22, " Grayson " Grayson902@... > > said: > > > Here's my theory: All EMT training programs are not created equal. I'm > > sure you've seen the products of some bad ones, as have I. But > > regardless of the quality of the training program, a major factor in > > quality is the experience they gain on the street. If you give them > > adequate supervision, solid CQI and the freedom to work, you wind up > > with strong ones, like in Boston. And they go on to become strong medics > > who understand, from long experience, the importance of BLS. > > Now, just imagine how much more they would get from that experience if > they had two more years of educational foundation behind them before > hand. Are you suggesting that it would hurt them instead of helping them? > > Does Boston do well? Apparently so. But that shouldn't stop anyone > from doing better. > > Rob > > -- Grayson, CCEMT-P www.kellygrayson.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 et all you research minded folks. Are there also not a few studies that show multiple Medics on a call leads to negitive outcome for a given ALS Patient as well? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > Here's where I really put your knickers in a twist: Yeah, I think it > actually can hurt, at least in the area of skill dilution. > > Let's say we have, in a metropolitan area, the opportunity to perform > 200 endotracheal intubations a year. Each one of those patients can be > effectively bagged by BVM (ie BLS care), but we'll just say that they > all need that next step on the Airway Continuum for whatever reason. > The > BLS airway management is, for the purpose of the hypothesis, just a > temporizing measure until ALS airway management can be done. > > Now divide those 200 tubes by 100 medics. That's two tubes a year, per > medic. For patients who were being effectively ventilated by BLS means > prior to their arrival, mind you. > > Now, all other BLS being equal, divide those same 200 tubes by 20 > medics. That's 10 tubes a year, per medic. > > Which bunch do you think will be more proficient? > > I'm suggesting to you that Boston does so well *because* they have > less > medics, not *in spite of* that fact. No doubt you will disagree, but > the > possibility at the very least merits consideration. > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > Grayson902@... > > > said: > > > > > Here's my theory: All EMT training programs are not created > equal. I'm > > > sure you've seen the products of some bad ones, as have I. But > > > regardless of the quality of the training program, a major > factor in > > > quality is the experience they gain on the street. If you give > them > > > adequate supervision, solid CQI and the freedom to work, you > wind up > > > with strong ones, like in Boston. And they go on to become > strong medics > > > who understand, from long experience, the importance of BLS. > > > > Now, just imagine how much more they would get from that > experience if > > they had two more years of educational foundation behind them before > > hand. Are you suggesting that it would hurt them instead of > helping them? > > > > Does Boston do well? Apparently so. But that shouldn't stop anyone > > from doing better. > > > > Rob > > > > > > -- > Grayson, CCEMT-P www.kellygrayson.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 et all you research minded folks. Are there also not a few studies that show multiple Medics on a call leads to negitive outcome for a given ALS Patient as well? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > Here's where I really put your knickers in a twist: Yeah, I think it > actually can hurt, at least in the area of skill dilution. > > Let's say we have, in a metropolitan area, the opportunity to perform > 200 endotracheal intubations a year. Each one of those patients can be > effectively bagged by BVM (ie BLS care), but we'll just say that they > all need that next step on the Airway Continuum for whatever reason. > The > BLS airway management is, for the purpose of the hypothesis, just a > temporizing measure until ALS airway management can be done. > > Now divide those 200 tubes by 100 medics. That's two tubes a year, per > medic. For patients who were being effectively ventilated by BLS means > prior to their arrival, mind you. > > Now, all other BLS being equal, divide those same 200 tubes by 20 > medics. That's 10 tubes a year, per medic. > > Which bunch do you think will be more proficient? > > I'm suggesting to you that Boston does so well *because* they have > less > medics, not *in spite of* that fact. No doubt you will disagree, but > the > possibility at the very least merits consideration. > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > Grayson902@... > > > said: > > > > > Here's my theory: All EMT training programs are not created > equal. I'm > > > sure you've seen the products of some bad ones, as have I. But > > > regardless of the quality of the training program, a major > factor in > > > quality is the experience they gain on the street. If you give > them > > > adequate supervision, solid CQI and the freedom to work, you > wind up > > > with strong ones, like in Boston. And they go on to become > strong medics > > > who understand, from long experience, the importance of BLS. > > > > Now, just imagine how much more they would get from that > experience if > > they had two more years of educational foundation behind them before > > hand. Are you suggesting that it would hurt them instead of > helping them? > > > > Does Boston do well? Apparently so. But that shouldn't stop anyone > > from doing better. > > > > Rob > > > > > > -- > Grayson, CCEMT-P www.kellygrayson.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 et all you research minded folks. Are there also not a few studies that show multiple Medics on a call leads to negitive outcome for a given ALS Patient as well? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > Here's where I really put your knickers in a twist: Yeah, I think it > actually can hurt, at least in the area of skill dilution. > > Let's say we have, in a metropolitan area, the opportunity to perform > 200 endotracheal intubations a year. Each one of those patients can be > effectively bagged by BVM (ie BLS care), but we'll just say that they > all need that next step on the Airway Continuum for whatever reason. > The > BLS airway management is, for the purpose of the hypothesis, just a > temporizing measure until ALS airway management can be done. > > Now divide those 200 tubes by 100 medics. That's two tubes a year, per > medic. For patients who were being effectively ventilated by BLS means > prior to their arrival, mind you. > > Now, all other BLS being equal, divide those same 200 tubes by 20 > medics. That's 10 tubes a year, per medic. > > Which bunch do you think will be more proficient? > > I'm suggesting to you that Boston does so well *because* they have > less > medics, not *in spite of* that fact. No doubt you will disagree, but > the > possibility at the very least merits consideration. > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > Grayson902@... > > > said: > > > > > Here's my theory: All EMT training programs are not created > equal. I'm > > > sure you've seen the products of some bad ones, as have I. But > > > regardless of the quality of the training program, a major > factor in > > > quality is the experience they gain on the street. If you give > them > > > adequate supervision, solid CQI and the freedom to work, you > wind up > > > with strong ones, like in Boston. And they go on to become > strong medics > > > who understand, from long experience, the importance of BLS. > > > > Now, just imagine how much more they would get from that > experience if > > they had two more years of educational foundation behind them before > > hand. Are you suggesting that it would hurt them instead of > helping them? > > > > Does Boston do well? Apparently so. But that shouldn't stop anyone > > from doing better. > > > > Rob > > > > > > -- > Grayson, CCEMT-P www.kellygrayson.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 None that I've seen. Mostly it's just by inference, just like the studies that purport to demonstrate that more paramedics are better. > > et all you research minded folks. > > Are there also not a few studies that show multiple Medics on a call > leads to negitive outcome for a given ALS Patient as well? > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > On Apr 3, 2010, at 15:57, Grayson Grayson902@... > > wrote: > > > Here's where I really put your knickers in a twist: Yeah, I think it > > actually can hurt, at least in the area of skill dilution. > > > > Let's say we have, in a metropolitan area, the opportunity to perform > > 200 endotracheal intubations a year. Each one of those patients can be > > effectively bagged by BVM (ie BLS care), but we'll just say that they > > all need that next step on the Airway Continuum for whatever reason. > > The > > BLS airway management is, for the purpose of the hypothesis, just a > > temporizing measure until ALS airway management can be done. > > > > Now divide those 200 tubes by 100 medics. That's two tubes a year, per > > medic. For patients who were being effectively ventilated by BLS means > > prior to their arrival, mind you. > > > > Now, all other BLS being equal, divide those same 200 tubes by 20 > > medics. That's 10 tubes a year, per medic. > > > > Which bunch do you think will be more proficient? > > > > I'm suggesting to you that Boston does so well *because* they have > > less > > medics, not *in spite of* that fact. No doubt you will disagree, but > > the > > possibility at the very least merits consideration. > > > > On 4/3/2010 12:52 PM, rob.davis@... > wrote: > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > > Grayson902@... > > > > said: > > > > > > > Here's my theory: All EMT training programs are not created > > equal. I'm > > > > sure you've seen the products of some bad ones, as have I. But > > > > regardless of the quality of the training program, a major > > factor in > > > > quality is the experience they gain on the street. If you give > > them > > > > adequate supervision, solid CQI and the freedom to work, you > > wind up > > > > with strong ones, like in Boston. And they go on to become > > strong medics > > > > who understand, from long experience, the importance of BLS. > > > > > > Now, just imagine how much more they would get from that > > experience if > > > they had two more years of educational foundation behind them before > > > hand. Are you suggesting that it would hurt them instead of > > helping them? > > > > > > Does Boston do well? Apparently so. But that shouldn't stop anyone > > > from doing better. > > > > > > Rob > > > > > > > > > > -- > > Grayson, CCEMT-P www.kellygrayson.com > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 None that I've seen. Mostly it's just by inference, just like the studies that purport to demonstrate that more paramedics are better. > > et all you research minded folks. > > Are there also not a few studies that show multiple Medics on a call > leads to negitive outcome for a given ALS Patient as well? > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > On Apr 3, 2010, at 15:57, Grayson Grayson902@... > > wrote: > > > Here's where I really put your knickers in a twist: Yeah, I think it > > actually can hurt, at least in the area of skill dilution. > > > > Let's say we have, in a metropolitan area, the opportunity to perform > > 200 endotracheal intubations a year. Each one of those patients can be > > effectively bagged by BVM (ie BLS care), but we'll just say that they > > all need that next step on the Airway Continuum for whatever reason. > > The > > BLS airway management is, for the purpose of the hypothesis, just a > > temporizing measure until ALS airway management can be done. > > > > Now divide those 200 tubes by 100 medics. That's two tubes a year, per > > medic. For patients who were being effectively ventilated by BLS means > > prior to their arrival, mind you. > > > > Now, all other BLS being equal, divide those same 200 tubes by 20 > > medics. That's 10 tubes a year, per medic. > > > > Which bunch do you think will be more proficient? > > > > I'm suggesting to you that Boston does so well *because* they have > > less > > medics, not *in spite of* that fact. No doubt you will disagree, but > > the > > possibility at the very least merits consideration. > > > > On 4/3/2010 12:52 PM, rob.davis@... > wrote: > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > > Grayson902@... > > > > said: > > > > > > > Here's my theory: All EMT training programs are not created > > equal. I'm > > > > sure you've seen the products of some bad ones, as have I. But > > > > regardless of the quality of the training program, a major > > factor in > > > > quality is the experience they gain on the street. If you give > > them > > > > adequate supervision, solid CQI and the freedom to work, you > > wind up > > > > with strong ones, like in Boston. And they go on to become > > strong medics > > > > who understand, from long experience, the importance of BLS. > > > > > > Now, just imagine how much more they would get from that > > experience if > > > they had two more years of educational foundation behind them before > > > hand. Are you suggesting that it would hurt them instead of > > helping them? > > > > > > Does Boston do well? Apparently so. But that shouldn't stop anyone > > > from doing better. > > > > > > Rob > > > > > > > > > > -- > > Grayson, CCEMT-P www.kellygrayson.com > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 None that I've seen. Mostly it's just by inference, just like the studies that purport to demonstrate that more paramedics are better. > > et all you research minded folks. > > Are there also not a few studies that show multiple Medics on a call > leads to negitive outcome for a given ALS Patient as well? > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > On Apr 3, 2010, at 15:57, Grayson Grayson902@... > > wrote: > > > Here's where I really put your knickers in a twist: Yeah, I think it > > actually can hurt, at least in the area of skill dilution. > > > > Let's say we have, in a metropolitan area, the opportunity to perform > > 200 endotracheal intubations a year. Each one of those patients can be > > effectively bagged by BVM (ie BLS care), but we'll just say that they > > all need that next step on the Airway Continuum for whatever reason. > > The > > BLS airway management is, for the purpose of the hypothesis, just a > > temporizing measure until ALS airway management can be done. > > > > Now divide those 200 tubes by 100 medics. That's two tubes a year, per > > medic. For patients who were being effectively ventilated by BLS means > > prior to their arrival, mind you. > > > > Now, all other BLS being equal, divide those same 200 tubes by 20 > > medics. That's 10 tubes a year, per medic. > > > > Which bunch do you think will be more proficient? > > > > I'm suggesting to you that Boston does so well *because* they have > > less > > medics, not *in spite of* that fact. No doubt you will disagree, but > > the > > possibility at the very least merits consideration. > > > > On 4/3/2010 12:52 PM, rob.davis@... > wrote: > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > > Grayson902@... > > > > said: > > > > > > > Here's my theory: All EMT training programs are not created > > equal. I'm > > > > sure you've seen the products of some bad ones, as have I. But > > > > regardless of the quality of the training program, a major > > factor in > > > > quality is the experience they gain on the street. If you give > > them > > > > adequate supervision, solid CQI and the freedom to work, you > > wind up > > > > with strong ones, like in Boston. And they go on to become > > strong medics > > > > who understand, from long experience, the importance of BLS. > > > > > > Now, just imagine how much more they would get from that > > experience if > > > they had two more years of educational foundation behind them before > > > hand. Are you suggesting that it would hurt them instead of > > helping them? > > > > > > Does Boston do well? Apparently so. But that shouldn't stop anyone > > > from doing better. > > > > > > Rob > > > > > > > > > > -- > > Grayson, CCEMT-P www.kellygrayson.com > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Well that be no real surprise. Since nearly everything done in EMS seems to have little or no evidence. I thought I'd seen that batered about but it would not amaze me if it were conjecture. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > None that I've seen. Mostly it's just by inference, just like the > studies that purport to demonstrate that more paramedics are better. > > > > > > et all you research minded folks. > > > > Are there also not a few studies that show multiple Medics on a call > > leads to negitive outcome for a given ALS Patient as well? > > > > Louis N. Molino, Sr. CET > > FF/NREMT/FSI/EMSI > > Typed by my fingers on my iPhone. > > Please excuse any typos. > > (Cell) > > LNMolino@... > > > > On Apr 3, 2010, at 15:57, Grayson Grayson902@... > > > wrote: > > > > > Here's where I really put your knickers in a twist: Yeah, I > think it > > > actually can hurt, at least in the area of skill dilution. > > > > > > Let's say we have, in a metropolitan area, the opportunity to > perform > > > 200 endotracheal intubations a year. Each one of those patients > can be > > > effectively bagged by BVM (ie BLS care), but we'll just say that > they > > > all need that next step on the Airway Continuum for whatever > reason. > > > The > > > BLS airway management is, for the purpose of the hypothesis, > just a > > > temporizing measure until ALS airway management can be done. > > > > > > Now divide those 200 tubes by 100 medics. That's two tubes a > year, per > > > medic. For patients who were being effectively ventilated by BLS > means > > > prior to their arrival, mind you. > > > > > > Now, all other BLS being equal, divide those same 200 tubes by 20 > > > medics. That's 10 tubes a year, per medic. > > > > > > Which bunch do you think will be more proficient? > > > > > > I'm suggesting to you that Boston does so well *because* they have > > > less > > > medics, not *in spite of* that fact. No doubt you will disagree, > but > > > the > > > possibility at the very least merits consideration. > > > > > > On 4/3/2010 12:52 PM, rob.davis@... > > wrote: > > > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > > > Grayson902@... > > > > > said: > > > > > > > > > Here's my theory: All EMT training programs are not created > > > equal. I'm > > > > > sure you've seen the products of some bad ones, as have I. But > > > > > regardless of the quality of the training program, a major > > > factor in > > > > > quality is the experience they gain on the street. If you give > > > them > > > > > adequate supervision, solid CQI and the freedom to work, you > > > wind up > > > > > with strong ones, like in Boston. And they go on to become > > > strong medics > > > > > who understand, from long experience, the importance of BLS. > > > > > > > > Now, just imagine how much more they would get from that > > > experience if > > > > they had two more years of educational foundation behind them > before > > > > hand. Are you suggesting that it would hurt them instead of > > > helping them? > > > > > > > > Does Boston do well? Apparently so. But that shouldn't stop > anyone > > > > from doing better. > > > > > > > > Rob > > > > > > > > > > > > > > -- > > > Grayson, CCEMT-P www.kellygrayson.com > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Well that be no real surprise. Since nearly everything done in EMS seems to have little or no evidence. I thought I'd seen that batered about but it would not amaze me if it were conjecture. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > None that I've seen. Mostly it's just by inference, just like the > studies that purport to demonstrate that more paramedics are better. > > > > > > et all you research minded folks. > > > > Are there also not a few studies that show multiple Medics on a call > > leads to negitive outcome for a given ALS Patient as well? > > > > Louis N. Molino, Sr. CET > > FF/NREMT/FSI/EMSI > > Typed by my fingers on my iPhone. > > Please excuse any typos. > > (Cell) > > LNMolino@... > > > > On Apr 3, 2010, at 15:57, Grayson Grayson902@... > > > wrote: > > > > > Here's where I really put your knickers in a twist: Yeah, I > think it > > > actually can hurt, at least in the area of skill dilution. > > > > > > Let's say we have, in a metropolitan area, the opportunity to > perform > > > 200 endotracheal intubations a year. Each one of those patients > can be > > > effectively bagged by BVM (ie BLS care), but we'll just say that > they > > > all need that next step on the Airway Continuum for whatever > reason. > > > The > > > BLS airway management is, for the purpose of the hypothesis, > just a > > > temporizing measure until ALS airway management can be done. > > > > > > Now divide those 200 tubes by 100 medics. That's two tubes a > year, per > > > medic. For patients who were being effectively ventilated by BLS > means > > > prior to their arrival, mind you. > > > > > > Now, all other BLS being equal, divide those same 200 tubes by 20 > > > medics. That's 10 tubes a year, per medic. > > > > > > Which bunch do you think will be more proficient? > > > > > > I'm suggesting to you that Boston does so well *because* they have > > > less > > > medics, not *in spite of* that fact. No doubt you will disagree, > but > > > the > > > possibility at the very least merits consideration. > > > > > > On 4/3/2010 12:52 PM, rob.davis@... > > wrote: > > > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > > > Grayson902@... > > > > > said: > > > > > > > > > Here's my theory: All EMT training programs are not created > > > equal. I'm > > > > > sure you've seen the products of some bad ones, as have I. But > > > > > regardless of the quality of the training program, a major > > > factor in > > > > > quality is the experience they gain on the street. If you give > > > them > > > > > adequate supervision, solid CQI and the freedom to work, you > > > wind up > > > > > with strong ones, like in Boston. And they go on to become > > > strong medics > > > > > who understand, from long experience, the importance of BLS. > > > > > > > > Now, just imagine how much more they would get from that > > > experience if > > > > they had two more years of educational foundation behind them > before > > > > hand. Are you suggesting that it would hurt them instead of > > > helping them? > > > > > > > > Does Boston do well? Apparently so. But that shouldn't stop > anyone > > > > from doing better. > > > > > > > > Rob > > > > > > > > > > > > > > -- > > > Grayson, CCEMT-P www.kellygrayson.com > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Well that be no real surprise. Since nearly everything done in EMS seems to have little or no evidence. I thought I'd seen that batered about but it would not amaze me if it were conjecture. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > None that I've seen. Mostly it's just by inference, just like the > studies that purport to demonstrate that more paramedics are better. > > > > > > et all you research minded folks. > > > > Are there also not a few studies that show multiple Medics on a call > > leads to negitive outcome for a given ALS Patient as well? > > > > Louis N. Molino, Sr. CET > > FF/NREMT/FSI/EMSI > > Typed by my fingers on my iPhone. > > Please excuse any typos. > > (Cell) > > LNMolino@... > > > > On Apr 3, 2010, at 15:57, Grayson Grayson902@... > > > wrote: > > > > > Here's where I really put your knickers in a twist: Yeah, I > think it > > > actually can hurt, at least in the area of skill dilution. > > > > > > Let's say we have, in a metropolitan area, the opportunity to > perform > > > 200 endotracheal intubations a year. Each one of those patients > can be > > > effectively bagged by BVM (ie BLS care), but we'll just say that > they > > > all need that next step on the Airway Continuum for whatever > reason. > > > The > > > BLS airway management is, for the purpose of the hypothesis, > just a > > > temporizing measure until ALS airway management can be done. > > > > > > Now divide those 200 tubes by 100 medics. That's two tubes a > year, per > > > medic. For patients who were being effectively ventilated by BLS > means > > > prior to their arrival, mind you. > > > > > > Now, all other BLS being equal, divide those same 200 tubes by 20 > > > medics. That's 10 tubes a year, per medic. > > > > > > Which bunch do you think will be more proficient? > > > > > > I'm suggesting to you that Boston does so well *because* they have > > > less > > > medics, not *in spite of* that fact. No doubt you will disagree, > but > > > the > > > possibility at the very least merits consideration. > > > > > > On 4/3/2010 12:52 PM, rob.davis@... > > wrote: > > > > > > > > On Saturday, April 3, 2010 12:22, " Grayson " > > > Grayson902@... > > > > > said: > > > > > > > > > Here's my theory: All EMT training programs are not created > > > equal. I'm > > > > > sure you've seen the products of some bad ones, as have I. But > > > > > regardless of the quality of the training program, a major > > > factor in > > > > > quality is the experience they gain on the street. If you give > > > them > > > > > adequate supervision, solid CQI and the freedom to work, you > > > wind up > > > > > with strong ones, like in Boston. And they go on to become > > > strong medics > > > > > who understand, from long experience, the importance of BLS. > > > > > > > > Now, just imagine how much more they would get from that > > > experience if > > > > they had two more years of educational foundation behind them > before > > > > hand. Are you suggesting that it would hurt them instead of > > > helping them? > > > > > > > > Does Boston do well? Apparently so. But that shouldn't stop > anyone > > > > from doing better. > > > > > > > > Rob > > > > > > > > > > > > > > -- > > > Grayson, CCEMT-P www.kellygrayson.com > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Looking at this soley from a logistical stand point since there is a shortage of medics yet an increase in call volume from year to year doesn't it make sense to spread your resources over a larger area or staff more trucks? So basically you take one double medic truck split the two medics up and partner them with a basic who is capable of riding BLS level calls you have just doubled the response capability of your service. In addition add a supervisor who is equiped to provide ALS care and if needed you there is your second medic. no system is perfect and we could go on and on for years about what is right and wrong to me it boils down to this -Chris Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone On Apr 3, 2010, at 16:34, " Louis N. Molino, Sr. " lnmolino@...> wrote: > et all you research minded folks. > > Are there also not a few studies that show multiple Medics on a call > leads to negitive outcome for a given ALS Patient as well? > > > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > > >> Here's where I really put your knickers in a twist: Yeah, I think it >> actually can hurt, at least in the area of skill dilution. >> >> Let's say we have, in a metropolitan area, the opportunity to perform >> 200 endotracheal intubations a year. Each one of those patients can >> be >> effectively bagged by BVM (ie BLS care), but we'll just say that they >> all need that next step on the Airway Continuum for whatever reason. >> The >> BLS airway management is, for the purpose of the hypothesis, just a >> temporizing measure until ALS airway management can be done. >> >> Now divide those 200 tubes by 100 medics. That's two tubes a year, >> per >> medic. For patients who were being effectively ventilated by BLS >> means >> prior to their arrival, mind you. >> >> Now, all other BLS being equal, divide those same 200 tubes by 20 >> medics. That's 10 tubes a year, per medic. >> >> Which bunch do you think will be more proficient? >> >> I'm suggesting to you that Boston does so well *because* they have >> less >> medics, not *in spite of* that fact. No doubt you will disagree, but >> the >> possibility at the very least merits consideration. >> >> >>> >>> On Saturday, April 3, 2010 12:22, " Grayson " >> Grayson902@... >>> > said: >>> >>>> Here's my theory: All EMT training programs are not created >> equal. I'm >>>> sure you've seen the products of some bad ones, as have I. But >>>> regardless of the quality of the training program, a major >> factor in >>>> quality is the experience they gain on the street. If you give >> them >>>> adequate supervision, solid CQI and the freedom to work, you >> wind up >>>> with strong ones, like in Boston. And they go on to become >> strong medics >>>> who understand, from long experience, the importance of BLS. >>> >>> Now, just imagine how much more they would get from that >> experience if >>> they had two more years of educational foundation behind them before >>> hand. Are you suggesting that it would hurt them instead of >> helping them? >>> >>> Does Boston do well? Apparently so. But that shouldn't stop anyone >>> from doing better. >>> >>> Rob >>> >>> >> >> -- >> Grayson, CCEMT-P www.kellygrayson.com >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Looking at this soley from a logistical stand point since there is a shortage of medics yet an increase in call volume from year to year doesn't it make sense to spread your resources over a larger area or staff more trucks? So basically you take one double medic truck split the two medics up and partner them with a basic who is capable of riding BLS level calls you have just doubled the response capability of your service. In addition add a supervisor who is equiped to provide ALS care and if needed you there is your second medic. no system is perfect and we could go on and on for years about what is right and wrong to me it boils down to this -Chris Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone On Apr 3, 2010, at 16:34, " Louis N. Molino, Sr. " lnmolino@...> wrote: > et all you research minded folks. > > Are there also not a few studies that show multiple Medics on a call > leads to negitive outcome for a given ALS Patient as well? > > > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > > >> Here's where I really put your knickers in a twist: Yeah, I think it >> actually can hurt, at least in the area of skill dilution. >> >> Let's say we have, in a metropolitan area, the opportunity to perform >> 200 endotracheal intubations a year. Each one of those patients can >> be >> effectively bagged by BVM (ie BLS care), but we'll just say that they >> all need that next step on the Airway Continuum for whatever reason. >> The >> BLS airway management is, for the purpose of the hypothesis, just a >> temporizing measure until ALS airway management can be done. >> >> Now divide those 200 tubes by 100 medics. That's two tubes a year, >> per >> medic. For patients who were being effectively ventilated by BLS >> means >> prior to their arrival, mind you. >> >> Now, all other BLS being equal, divide those same 200 tubes by 20 >> medics. That's 10 tubes a year, per medic. >> >> Which bunch do you think will be more proficient? >> >> I'm suggesting to you that Boston does so well *because* they have >> less >> medics, not *in spite of* that fact. No doubt you will disagree, but >> the >> possibility at the very least merits consideration. >> >> >>> >>> On Saturday, April 3, 2010 12:22, " Grayson " >> Grayson902@... >>> > said: >>> >>>> Here's my theory: All EMT training programs are not created >> equal. I'm >>>> sure you've seen the products of some bad ones, as have I. But >>>> regardless of the quality of the training program, a major >> factor in >>>> quality is the experience they gain on the street. If you give >> them >>>> adequate supervision, solid CQI and the freedom to work, you >> wind up >>>> with strong ones, like in Boston. And they go on to become >> strong medics >>>> who understand, from long experience, the importance of BLS. >>> >>> Now, just imagine how much more they would get from that >> experience if >>> they had two more years of educational foundation behind them before >>> hand. Are you suggesting that it would hurt them instead of >> helping them? >>> >>> Does Boston do well? Apparently so. But that shouldn't stop anyone >>> from doing better. >>> >>> Rob >>> >>> >> >> -- >> Grayson, CCEMT-P www.kellygrayson.com >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2010 Report Share Posted April 3, 2010 Looking at this soley from a logistical stand point since there is a shortage of medics yet an increase in call volume from year to year doesn't it make sense to spread your resources over a larger area or staff more trucks? So basically you take one double medic truck split the two medics up and partner them with a basic who is capable of riding BLS level calls you have just doubled the response capability of your service. In addition add a supervisor who is equiped to provide ALS care and if needed you there is your second medic. no system is perfect and we could go on and on for years about what is right and wrong to me it boils down to this -Chris Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone On Apr 3, 2010, at 16:34, " Louis N. Molino, Sr. " lnmolino@...> wrote: > et all you research minded folks. > > Are there also not a few studies that show multiple Medics on a call > leads to negitive outcome for a given ALS Patient as well? > > > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > > >> Here's where I really put your knickers in a twist: Yeah, I think it >> actually can hurt, at least in the area of skill dilution. >> >> Let's say we have, in a metropolitan area, the opportunity to perform >> 200 endotracheal intubations a year. Each one of those patients can >> be >> effectively bagged by BVM (ie BLS care), but we'll just say that they >> all need that next step on the Airway Continuum for whatever reason. >> The >> BLS airway management is, for the purpose of the hypothesis, just a >> temporizing measure until ALS airway management can be done. >> >> Now divide those 200 tubes by 100 medics. That's two tubes a year, >> per >> medic. For patients who were being effectively ventilated by BLS >> means >> prior to their arrival, mind you. >> >> Now, all other BLS being equal, divide those same 200 tubes by 20 >> medics. That's 10 tubes a year, per medic. >> >> Which bunch do you think will be more proficient? >> >> I'm suggesting to you that Boston does so well *because* they have >> less >> medics, not *in spite of* that fact. No doubt you will disagree, but >> the >> possibility at the very least merits consideration. >> >> >>> >>> On Saturday, April 3, 2010 12:22, " Grayson " >> Grayson902@... >>> > said: >>> >>>> Here's my theory: All EMT training programs are not created >> equal. I'm >>>> sure you've seen the products of some bad ones, as have I. But >>>> regardless of the quality of the training program, a major >> factor in >>>> quality is the experience they gain on the street. If you give >> them >>>> adequate supervision, solid CQI and the freedom to work, you >> wind up >>>> with strong ones, like in Boston. And they go on to become >> strong medics >>>> who understand, from long experience, the importance of BLS. >>> >>> Now, just imagine how much more they would get from that >> experience if >>> they had two more years of educational foundation behind them before >>> hand. Are you suggesting that it would hurt them instead of >> helping them? >>> >>> Does Boston do well? Apparently so. But that shouldn't stop anyone >>> from doing better. >>> >>> Rob >>> >>> >> >> -- >> Grayson, CCEMT-P www.kellygrayson.com >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2010 Report Share Posted April 5, 2010 Rob, Please explain to me how it is that an ALS provider can preform a better assessment than a BLS provider. What initial assessment does a ALS provider do that a BLS doesn't? In every service I have worked I have used the same method of preforming an initial assessment as the medic I have worked with. It isn't until this initial assessment is preformed that the medic puts on the cardiac monitor. And generally the monitor isn't put on until after the blood pressure, cbg, pulse rate, and so forth are obtained by the BLS provider. So please explain to me where I am not following you on this line of thought. AP Quote Link to comment Share on other sites More sharing options...
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