Re: Progressive services?

[Guest guest]

On Saturday, April 3, 2010 08:26, krin135@... said:

> you will note that I didn't make any case for the practicality of said

> system, nor the dilution of Medic experience that it implies.

Very practical. In fact, probably cheaper than all the money that is wasted on

the administration of a pointless " SSM " system, once you include the cost of all

the gas and vehicle wear. But far too many administrators know that it's easier

to get money for hi-tech panaceas than for boots on the ground, so they

compromise.

Dilution of skills? I don't see how paramedics evaluating more patients than

they currently evaluate dilutes their skills. Patient assessment is the most

important and neglected of all the so-called " skills " . The more you do, the

better you get.

And with three EMS personnel on an ambulance, we'd save all the money now being

wasted on fire first responders and their apparatus, allowing for more

ambulances on the street and more patient contacts. Good luck fighting the IAFC

on that one though.

Rob

[Guest guest]

On Saturday, April 3, 2010 08:26, krin135@... said:

> you will note that I didn't make any case for the practicality of said

> system, nor the dilution of Medic experience that it implies.

Very practical. In fact, probably cheaper than all the money that is wasted on

the administration of a pointless " SSM " system, once you include the cost of all

the gas and vehicle wear. But far too many administrators know that it's easier

to get money for hi-tech panaceas than for boots on the ground, so they

compromise.

Dilution of skills? I don't see how paramedics evaluating more patients than

they currently evaluate dilutes their skills. Patient assessment is the most

important and neglected of all the so-called " skills " . The more you do, the

better you get.

And with three EMS personnel on an ambulance, we'd save all the money now being

wasted on fire first responders and their apparatus, allowing for more

ambulances on the street and more patient contacts. Good luck fighting the IAFC

on that one though.

Rob

[Guest guest]

Oh I get it everybody but Rob has to practice evidence based medicine. He is so

good that his opinion is the standard.

Rick

Sent via Blackberry

________________________________

From: texasems-l texasems-l >

To: texasems-l texasems-l >

Sent: Sat Apr 03 08:31:34 2010

Subject: Re: Progressive services?

On Saturday, April 3, 2010 08:23, " Grayson "

Grayson902@...> said:

> Define " best " systems, and provide proof of your assertion.

" Best " is defined by my personal observations and opinion of what is ideal. The

proof is in my opinion, nothing else. Feel free to disprove it.

> I know of at least one premier EMS systems that uses EMT-Basics for the

> majority of their calls.

Now, define " premier " and provide proof of your assertion, as well as the

relevancy of the term " premier " .

Rob

[Guest guest]

Oh I get it everybody but Rob has to practice evidence based medicine. He is so

good that his opinion is the standard.

Rick

Sent via Blackberry

________________________________

From: texasems-l texasems-l >

To: texasems-l texasems-l >

Sent: Sat Apr 03 08:31:34 2010

Subject: Re: Progressive services?

On Saturday, April 3, 2010 08:23, " Grayson "

Grayson902@...> said:

> Define " best " systems, and provide proof of your assertion.

" Best " is defined by my personal observations and opinion of what is ideal. The

proof is in my opinion, nothing else. Feel free to disprove it.

> I know of at least one premier EMS systems that uses EMT-Basics for the

> majority of their calls.

Now, define " premier " and provide proof of your assertion, as well as the

relevancy of the term " premier " .

Rob

[Guest guest]

Oh I get it everybody but Rob has to practice evidence based medicine. He is so

good that his opinion is the standard.

Rick

Sent via Blackberry

________________________________

From: texasems-l texasems-l >

To: texasems-l texasems-l >

Sent: Sat Apr 03 08:31:34 2010

Subject: Re: Progressive services?

On Saturday, April 3, 2010 08:23, " Grayson "

Grayson902@...> said:

> Define " best " systems, and provide proof of your assertion.

" Best " is defined by my personal observations and opinion of what is ideal. The

proof is in my opinion, nothing else. Feel free to disprove it.

> I know of at least one premier EMS systems that uses EMT-Basics for the

> majority of their calls.

Now, define " premier " and provide proof of your assertion, as well as the

relevancy of the term " premier " .

Rob

[Guest guest]

On Saturday, April 3, 2010 08:44, rick.moore@... said:

> Oh I get it everybody but Rob has to practice evidence based medicine. He is

so

> good that his opinion is the standard.

Stooping to pointless personal attacks isn't a particularly credible way to make

your case, Rick.

[Guest guest]

On Saturday, April 3, 2010 08:44, rick.moore@... said:

> Oh I get it everybody but Rob has to practice evidence based medicine. He is

so

> good that his opinion is the standard.

Stooping to pointless personal attacks isn't a particularly credible way to make

your case, Rick.

[Guest guest]

On Saturday, April 3, 2010 08:44, rick.moore@... said:

> Oh I get it everybody but Rob has to practice evidence based medicine. He is

so

> good that his opinion is the standard.

Stooping to pointless personal attacks isn't a particularly credible way to make

your case, Rick.

[Guest guest]

I'm not really sure where the two of you are disagreeing. I hear you

both say Basics are important, but then every now and then, one of you

seems to say something to the effect of paramedics being inherently

better.

Regardless, and as much as I fear getting twelve cents back for my

two, in my mind, here's what it all comes down to:

1 - Good basics can save even the best medics.

2 - A good medic is needed on some, but not all calls.

I have seen medics get on the scene of a pt with a little too much

ETOH, or other substances. (They took the police officer's word on

that.) ...And the basic is the one who puts together that the

patient's blood sugar is dangerously low. (Now, admittedly, that's

because the basic isn't thinking about Narcan and IV fluids, because

they can't do that; they're thinking within their limitations.) And

basic treatments are what helps the patient. Simultaneously, I've been

on a scene where a medic was badly needed, and called for, however,

the medic that showed up was unable to place a 12-lead on the patient.

That medic, while admittedly a paramedic, was unable to handle the

patient.

And ultimately, in a perfect world, we would all have good paramedics

running all the calls. But look at your own systems and ask yourself

how many people you would put in that... Top 2% category. The best

paramedics you know. Not everybody can be like that. And if everyone

was, then they would be setting the standard, and we'd have an

entirely different category. Instead of intubation success, we'd be

looking at ability to read an ultrasound or something a little more

advanced.

But, unfortunately, this world is not perfect, and we are limited by

the resources with which we work. This isn't just in the sense of

supplies, but in the sense of knowledge. But just like in the sense of

supplies, sometimes you can do more with less. A good basic knows how

to do that.

Sorry this is so long, and sorry if it's a complete left turn.

Alyssa Woods, FF/NREMT-B

> On Saturday, April 3, 2010 08:23, " Grayson "

> Grayson902@...> said:

>

> > Define " best " systems, and provide proof of your assertion.

>

> " Best " is defined by my personal observations and opinion of what is

> ideal. The proof is in my opinion, nothing else. Feel free to

> disprove it.

>

> > I know of at least one premier EMS systems that uses EMT-Basics

> for the

> > majority of their calls.

>

> Now, define " premier " and provide proof of your assertion, as well

> as the relevancy of the term " premier " .

>

> Rob

>

>

[Guest guest]

I'm not really sure where the two of you are disagreeing. I hear you

both say Basics are important, but then every now and then, one of you

seems to say something to the effect of paramedics being inherently

better.

Regardless, and as much as I fear getting twelve cents back for my

two, in my mind, here's what it all comes down to:

1 - Good basics can save even the best medics.

2 - A good medic is needed on some, but not all calls.

I have seen medics get on the scene of a pt with a little too much

ETOH, or other substances. (They took the police officer's word on

that.) ...And the basic is the one who puts together that the

patient's blood sugar is dangerously low. (Now, admittedly, that's

because the basic isn't thinking about Narcan and IV fluids, because

they can't do that; they're thinking within their limitations.) And

basic treatments are what helps the patient. Simultaneously, I've been

on a scene where a medic was badly needed, and called for, however,

the medic that showed up was unable to place a 12-lead on the patient.

That medic, while admittedly a paramedic, was unable to handle the

patient.

And ultimately, in a perfect world, we would all have good paramedics

running all the calls. But look at your own systems and ask yourself

how many people you would put in that... Top 2% category. The best

paramedics you know. Not everybody can be like that. And if everyone

was, then they would be setting the standard, and we'd have an

entirely different category. Instead of intubation success, we'd be

looking at ability to read an ultrasound or something a little more

advanced.

But, unfortunately, this world is not perfect, and we are limited by

the resources with which we work. This isn't just in the sense of

supplies, but in the sense of knowledge. But just like in the sense of

supplies, sometimes you can do more with less. A good basic knows how

to do that.

Sorry this is so long, and sorry if it's a complete left turn.

Alyssa Woods, FF/NREMT-B

> On Saturday, April 3, 2010 08:23, " Grayson "

> Grayson902@...> said:

>

> > Define " best " systems, and provide proof of your assertion.

>

> " Best " is defined by my personal observations and opinion of what is

> ideal. The proof is in my opinion, nothing else. Feel free to

> disprove it.

>

> > I know of at least one premier EMS systems that uses EMT-Basics

> for the

> > majority of their calls.

>

> Now, define " premier " and provide proof of your assertion, as well

> as the relevancy of the term " premier " .

>

> Rob

>

>

[Guest guest]

I'm not really sure where the two of you are disagreeing. I hear you

both say Basics are important, but then every now and then, one of you

seems to say something to the effect of paramedics being inherently

better.

Regardless, and as much as I fear getting twelve cents back for my

two, in my mind, here's what it all comes down to:

1 - Good basics can save even the best medics.

2 - A good medic is needed on some, but not all calls.

I have seen medics get on the scene of a pt with a little too much

ETOH, or other substances. (They took the police officer's word on

that.) ...And the basic is the one who puts together that the

patient's blood sugar is dangerously low. (Now, admittedly, that's

because the basic isn't thinking about Narcan and IV fluids, because

they can't do that; they're thinking within their limitations.) And

basic treatments are what helps the patient. Simultaneously, I've been

on a scene where a medic was badly needed, and called for, however,

the medic that showed up was unable to place a 12-lead on the patient.

That medic, while admittedly a paramedic, was unable to handle the

patient.

And ultimately, in a perfect world, we would all have good paramedics

running all the calls. But look at your own systems and ask yourself

how many people you would put in that... Top 2% category. The best

paramedics you know. Not everybody can be like that. And if everyone

was, then they would be setting the standard, and we'd have an

entirely different category. Instead of intubation success, we'd be

looking at ability to read an ultrasound or something a little more

advanced.

But, unfortunately, this world is not perfect, and we are limited by

the resources with which we work. This isn't just in the sense of

supplies, but in the sense of knowledge. But just like in the sense of

supplies, sometimes you can do more with less. A good basic knows how

to do that.

Sorry this is so long, and sorry if it's a complete left turn.

Alyssa Woods, FF/NREMT-B

> On Saturday, April 3, 2010 08:23, " Grayson "

> Grayson902@...> said:

>

> > Define " best " systems, and provide proof of your assertion.

>

> " Best " is defined by my personal observations and opinion of what is

> ideal. The proof is in my opinion, nothing else. Feel free to

> disprove it.

>

> > I know of at least one premier EMS systems that uses EMT-Basics

> for the

> > majority of their calls.

>

> Now, define " premier " and provide proof of your assertion, as well

> as the relevancy of the term " premier " .

>

> Rob

>

>

[Guest guest]

Sorry but it seems to me that's your MO as well. You just attack broadly based

on the patch color. Seriously though did you not just say that all of this is

based on your personal opinion of right?

Rick

Sent via Blackberry

________________________________

From: texasems-l texasems-l >

To: texasems-l texasems-l >

Sent: Sat Apr 03 08:47:44 2010

Subject: Re: Progressive services?

On Saturday, April 3, 2010 08:44,

rick.moore@... said:

> Oh I get it everybody but Rob has to practice evidence based medicine. He is

so

> good that his opinion is the standard.

Stooping to pointless personal attacks isn't a particularly credible way to make

your case, Rick.

[Guest guest]

Sorry but it seems to me that's your MO as well. You just attack broadly based

on the patch color. Seriously though did you not just say that all of this is

based on your personal opinion of right?

Rick

Sent via Blackberry

________________________________

From: texasems-l texasems-l >

To: texasems-l texasems-l >

Sent: Sat Apr 03 08:47:44 2010

Subject: Re: Progressive services?

On Saturday, April 3, 2010 08:44,

rick.moore@... said:

> Oh I get it everybody but Rob has to practice evidence based medicine. He is

so

> good that his opinion is the standard.

Stooping to pointless personal attacks isn't a particularly credible way to make

your case, Rick.

[Guest guest]

Sorry but it seems to me that's your MO as well. You just attack broadly based

on the patch color. Seriously though did you not just say that all of this is

based on your personal opinion of right?

Rick

Sent via Blackberry

________________________________

From: texasems-l texasems-l >

To: texasems-l texasems-l >

Sent: Sat Apr 03 08:47:44 2010

Subject: Re: Progressive services?

On Saturday, April 3, 2010 08:44,

rick.moore@... said:

> Oh I get it everybody but Rob has to practice evidence based medicine. He is

so

> good that his opinion is the standard.

Stooping to pointless personal attacks isn't a particularly credible way to make

your case, Rick.

[Guest guest]

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

[Guest guest]

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

[Guest guest]

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

[Guest guest]

" A basic EMT is not qualified to competently determine ALS needs.

They simply do not know what they do not know. "

That is too broad just because the patch on their shoulder says they

are EMT does not mean they are ignorant, Sorry Rob but paramedics

don't really know more because the chapter in their book was a little

longer and had bigger words, sure they may have a few more tricks but

that does not make them that much more " educated. " Now you can

misquote me all you want because of that but when it all comes down to

it this field as it stands this min. is still a tech job that requires

little more than a diploma, people " learn " what it takes to pass the

NR test then get in the field where the real " education " starts. What

I mean by that is alot of ems programs teach thier students to pass

that test not to be medics that is learned at the service level, we

may be working to change that but it hasn't happened yet. Red on your

shoulder does not make you a fixall, it means you passed a test, and I

think too many people forget when it comes down to it, it is about

putting the patient in the truck and going to the hospital if you

don't do that then nothing you do in the field is really all that

helpful.

-Chris

Sorry for the spelling and punctuation this was typed on tge tiny

keyboard on my iPhone

On Apr 3, 2010, at 8:29, " rob.davis@... "

rob.davis@...

> wrote:

> On Saturday, April 3, 2010 08:20, " Grayson "

> Grayson902@...> said:

>

>> If I am in control of patient care, and don't feel comfortable

>> delegating it to someone else, I don't. I retain control of the

>> patient.

>> But ultimately, that decision is driven by the individual's skill

>> level,

>> not their general level of certification.

>

> Absolutely! But look at what you just said. You are there to make

> that educated and informed decision. When a BLS unit responds to

> make that decision, you are indeed turning over responsibility of a

> patient you never even evaluated to someone else of lesser education

> and capabilities.

>

> No, I don't believe that every patient needs ALS paramedic care.

> But I do believe that they all need ALS paramedic evaluation to

> determine what level of care they need. A basic EMT is not

> qualified to competently determine ALS needs. They simply do not

> know what they do not know. If you want to turf your patient to

> them after a thorough patient evaluation, I'm good with that. What

> I am not comfortable with is EMT basics doing that evaluation and

> making that decision themselves.

>

> For clarification, we are talking about EMS here, not non-emergency

> transfers and in-facility care, so let's not get off on irrelevant

> tangents.

>

> Rob

>

>

>

> ------------------------------------

>

>

[Guest guest]

" A basic EMT is not qualified to competently determine ALS needs.

They simply do not know what they do not know. "

That is too broad just because the patch on their shoulder says they

are EMT does not mean they are ignorant, Sorry Rob but paramedics

don't really know more because the chapter in their book was a little

longer and had bigger words, sure they may have a few more tricks but

that does not make them that much more " educated. " Now you can

misquote me all you want because of that but when it all comes down to

it this field as it stands this min. is still a tech job that requires

little more than a diploma, people " learn " what it takes to pass the

NR test then get in the field where the real " education " starts. What

I mean by that is alot of ems programs teach thier students to pass

that test not to be medics that is learned at the service level, we

may be working to change that but it hasn't happened yet. Red on your

shoulder does not make you a fixall, it means you passed a test, and I

think too many people forget when it comes down to it, it is about

putting the patient in the truck and going to the hospital if you

don't do that then nothing you do in the field is really all that

helpful.

-Chris

Sorry for the spelling and punctuation this was typed on tge tiny

keyboard on my iPhone

On Apr 3, 2010, at 8:29, " rob.davis@... "

rob.davis@...

> wrote:

> On Saturday, April 3, 2010 08:20, " Grayson "

> Grayson902@...> said:

>

>> If I am in control of patient care, and don't feel comfortable

>> delegating it to someone else, I don't. I retain control of the

>> patient.

>> But ultimately, that decision is driven by the individual's skill

>> level,

>> not their general level of certification.

>

> Absolutely! But look at what you just said. You are there to make

> that educated and informed decision. When a BLS unit responds to

> make that decision, you are indeed turning over responsibility of a

> patient you never even evaluated to someone else of lesser education

> and capabilities.

>

> No, I don't believe that every patient needs ALS paramedic care.

> But I do believe that they all need ALS paramedic evaluation to

> determine what level of care they need. A basic EMT is not

> qualified to competently determine ALS needs. They simply do not

> know what they do not know. If you want to turf your patient to

> them after a thorough patient evaluation, I'm good with that. What

> I am not comfortable with is EMT basics doing that evaluation and

> making that decision themselves.

>

> For clarification, we are talking about EMS here, not non-emergency

> transfers and in-facility care, so let's not get off on irrelevant

> tangents.

>

> Rob

>

>

>

> ------------------------------------

>

>

[Guest guest]

" A basic EMT is not qualified to competently determine ALS needs.

They simply do not know what they do not know. "

That is too broad just because the patch on their shoulder says they

are EMT does not mean they are ignorant, Sorry Rob but paramedics

don't really know more because the chapter in their book was a little

longer and had bigger words, sure they may have a few more tricks but

that does not make them that much more " educated. " Now you can

misquote me all you want because of that but when it all comes down to

it this field as it stands this min. is still a tech job that requires

little more than a diploma, people " learn " what it takes to pass the

NR test then get in the field where the real " education " starts. What

I mean by that is alot of ems programs teach thier students to pass

that test not to be medics that is learned at the service level, we

may be working to change that but it hasn't happened yet. Red on your

shoulder does not make you a fixall, it means you passed a test, and I

think too many people forget when it comes down to it, it is about

putting the patient in the truck and going to the hospital if you

don't do that then nothing you do in the field is really all that

helpful.

-Chris

Sorry for the spelling and punctuation this was typed on tge tiny

keyboard on my iPhone

On Apr 3, 2010, at 8:29, " rob.davis@... "

rob.davis@...

> wrote:

> On Saturday, April 3, 2010 08:20, " Grayson "

> Grayson902@...> said:

>

>> If I am in control of patient care, and don't feel comfortable

>> delegating it to someone else, I don't. I retain control of the

>> patient.

>> But ultimately, that decision is driven by the individual's skill

>> level,

>> not their general level of certification.

>

> Absolutely! But look at what you just said. You are there to make

> that educated and informed decision. When a BLS unit responds to

> make that decision, you are indeed turning over responsibility of a

> patient you never even evaluated to someone else of lesser education

> and capabilities.

>

> No, I don't believe that every patient needs ALS paramedic care.

> But I do believe that they all need ALS paramedic evaluation to

> determine what level of care they need. A basic EMT is not

> qualified to competently determine ALS needs. They simply do not

> know what they do not know. If you want to turf your patient to

> them after a thorough patient evaluation, I'm good with that. What

> I am not comfortable with is EMT basics doing that evaluation and

> making that decision themselves.

>

> For clarification, we are talking about EMS here, not non-emergency

> transfers and in-facility care, so let's not get off on irrelevant

> tangents.

>

> Rob

>

>

>

> ------------------------------------

>

>

[Guest guest]

On Saturday, April 3, 2010 08:48, " Alyssa Woods " amwoods8644@...> said:

> But just like in the sense of

> supplies, sometimes you can do more with less. A good basic knows how

> to do that.

>

> Sorry this is so long, and sorry if it's a complete left turn.

Absolutely no need to apologise for a very well thought out and relevant post!

The issues I have are:

1. Why are we comparing good EMTs to poor Paramedics? If your Paramedics suck,

wouldn't a better solution be (if you're not going to replace them) to augment

them with more medics? If you had a bad surgeon, would you rather him be backed

up by a good nurse, or another surgeon? And if your medics are that poorly

trained, what makes you think your EMTs are really any better? I just don't see

the wisdom in trying to get by with the minimum that you can " sometimes " do

with.

2. Yes, not every patient needs a Paramedic for treatment. However, EMTs are

not qualified to competently determine which patient is which. Consequently,

every patient needs to be evaluated by a Paramedic. If that medic determines

that a patient can be dumped (for lack of a better word, since that's exactly

what it is) on an EMT, so be it. It's his licence. But at least the patient

was properly evaluated before that dumping. We've all seen how incompetent the

telephone triage system is at making these decisions without seeing the patient.

As with every single issue confronting EMS today, the answer is education.

Better education will assure that fewer of your medics need to be " saved " by an

EMT or anyone else.

Rob

[Guest guest]

On Saturday, April 3, 2010 08:48, " Alyssa Woods " amwoods8644@...> said:

> But just like in the sense of

> supplies, sometimes you can do more with less. A good basic knows how

> to do that.

>

> Sorry this is so long, and sorry if it's a complete left turn.

Absolutely no need to apologise for a very well thought out and relevant post!

The issues I have are:

1. Why are we comparing good EMTs to poor Paramedics? If your Paramedics suck,

wouldn't a better solution be (if you're not going to replace them) to augment

them with more medics? If you had a bad surgeon, would you rather him be backed

up by a good nurse, or another surgeon? And if your medics are that poorly

trained, what makes you think your EMTs are really any better? I just don't see

the wisdom in trying to get by with the minimum that you can " sometimes " do

with.

2. Yes, not every patient needs a Paramedic for treatment. However, EMTs are

not qualified to competently determine which patient is which. Consequently,

every patient needs to be evaluated by a Paramedic. If that medic determines

that a patient can be dumped (for lack of a better word, since that's exactly

what it is) on an EMT, so be it. It's his licence. But at least the patient

was properly evaluated before that dumping. We've all seen how incompetent the

telephone triage system is at making these decisions without seeing the patient.

As with every single issue confronting EMS today, the answer is education.

Better education will assure that fewer of your medics need to be " saved " by an

EMT or anyone else.

Rob

[Guest guest]

On Saturday, April 3, 2010 08:48, " Alyssa Woods " amwoods8644@...> said:

> But just like in the sense of

> supplies, sometimes you can do more with less. A good basic knows how

> to do that.

>

> Sorry this is so long, and sorry if it's a complete left turn.

Absolutely no need to apologise for a very well thought out and relevant post!

The issues I have are:

1. Why are we comparing good EMTs to poor Paramedics? If your Paramedics suck,

wouldn't a better solution be (if you're not going to replace them) to augment

them with more medics? If you had a bad surgeon, would you rather him be backed

up by a good nurse, or another surgeon? And if your medics are that poorly

trained, what makes you think your EMTs are really any better? I just don't see

the wisdom in trying to get by with the minimum that you can " sometimes " do

with.

2. Yes, not every patient needs a Paramedic for treatment. However, EMTs are

not qualified to competently determine which patient is which. Consequently,

every patient needs to be evaluated by a Paramedic. If that medic determines

that a patient can be dumped (for lack of a better word, since that's exactly

what it is) on an EMT, so be it. It's his licence. But at least the patient

was properly evaluated before that dumping. We've all seen how incompetent the

telephone triage system is at making these decisions without seeing the patient.

As with every single issue confronting EMS today, the answer is education.

Better education will assure that fewer of your medics need to be " saved " by an

EMT or anyone else.

Rob

[Guest guest]

On Saturday, April 3, 2010 10:34, " " aggiesrwe03@...> said:

> That is too broad just because the patch on their shoulder says they

> are EMT does not mean they are ignorant...

First, let me make it absolutely clear to anyone who has not been following

closely that I have never used the term " ignorant " , because, as we see right

here, it is too often misunderstood.

Second, and I hate to play the English teacher card here, but you are wrong. A

lack of knowledge is the very definition of ignorance. But remember, you used

the word, not me. Perhaps you meant to refer to stupidity, and not ignorance.

However, I would never be caught confusing the two terms. But I will certainly

say that no, no patch makes you stupid, or even smart for that matter.

> Sorry Rob but paramedics

> don't really know more because the chapter in their book was a little

> longer and had bigger words, sure they may have a few more tricks but

> that does not make them that much more " educated. "

Not sure I understand the basis of this contention. If someone undergoes two

years of education and doesn't come out knowing more than the guy who didn't,

I'd be really surprised if they passed even the NR exam.

> Now you can

> misquote me all you want because of that but when it all comes down to

> it this field as it stands this min. is still a tech job that requires

> little more than a diploma, people " learn " what it takes to pass the

> NR test then get in the field where the real " education " starts. What

> I mean by that is alot of ems programs teach thier students to pass

> that test not to be medics that is learned at the service level, we

> may be working to change that but it hasn't happened yet. Red on your

> shoulder does not make you a fixall, it means you passed a test, and I

> think too many people forget when it comes down to it, it is about

> putting the patient in the truck and going to the hospital if you

> don't do that then nothing you do in the field is really all that

> helpful.

Well said! I don't disagree with any of that. It is a disgrace to a forty year

old vocation that we still cater to the lowest common denominator, and settle

for the status quo instead of progressing into the realm of a real profession.

I share your disgust with the system as it currently exists. I simply believe

that we should improve it rather than live with it. And until that is done, we

need to utilise what we have in the way that best benefits our patients, not our

egos.

Rob

[Guest guest]

On Saturday, April 3, 2010 10:34, " " aggiesrwe03@...> said:

> That is too broad just because the patch on their shoulder says they

> are EMT does not mean they are ignorant...

First, let me make it absolutely clear to anyone who has not been following

closely that I have never used the term " ignorant " , because, as we see right

here, it is too often misunderstood.

Second, and I hate to play the English teacher card here, but you are wrong. A

lack of knowledge is the very definition of ignorance. But remember, you used

the word, not me. Perhaps you meant to refer to stupidity, and not ignorance.

However, I would never be caught confusing the two terms. But I will certainly

say that no, no patch makes you stupid, or even smart for that matter.

> Sorry Rob but paramedics

> don't really know more because the chapter in their book was a little

> longer and had bigger words, sure they may have a few more tricks but

> that does not make them that much more " educated. "

Not sure I understand the basis of this contention. If someone undergoes two

years of education and doesn't come out knowing more than the guy who didn't,

I'd be really surprised if they passed even the NR exam.

> Now you can

> misquote me all you want because of that but when it all comes down to

> it this field as it stands this min. is still a tech job that requires

> little more than a diploma, people " learn " what it takes to pass the

> NR test then get in the field where the real " education " starts. What

> I mean by that is alot of ems programs teach thier students to pass

> that test not to be medics that is learned at the service level, we

> may be working to change that but it hasn't happened yet. Red on your

> shoulder does not make you a fixall, it means you passed a test, and I

> think too many people forget when it comes down to it, it is about

> putting the patient in the truck and going to the hospital if you

> don't do that then nothing you do in the field is really all that

> helpful.

Well said! I don't disagree with any of that. It is a disgrace to a forty year

old vocation that we still cater to the lowest common denominator, and settle

for the status quo instead of progressing into the realm of a real profession.

I share your disgust with the system as it currently exists. I simply believe

that we should improve it rather than live with it. And until that is done, we

need to utilise what we have in the way that best benefits our patients, not our

egos.

Rob