Re: Position Paper: Old Medics vs. New Medics

[Guest guest]

In a message dated 10/5/2011 8:08:12 P.M. Central Daylight Time,

inf_pn@... writes:

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics.

I understand " Old " is subjective, so let me just say I consider myself an

old medic (twentieth year). For those of you not familiar with a Position

Essay let me explain. Basically, there are two sides and each must be

weighed objectively and a conclusion made. You of course are permitted to make

voice opinion, but remember to substantiate your argument while being

careful to weigh both sides of the argument.

So, what I am asking of those of you willing to help me is your position

on " Old Medics vs. New Medics. " Tell me why one is better or worse than the

other and why. I sincerely appreciate the assistance. This should make

for an interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

Tony: This is a bit sideways from what you are trying to get at, but maybe

it will help define things a bit better.

Start with the idea that there are some medics who suffer from the

syndrome of 1 years experience (five) (ten) (fifteen) (twenty) or even (twenty

five) times over. I suspect that all of us have known medics (and

administrators, nurses and physicians) with this problem.

Once you sort them out, look for the folks who not only perform with grace

under pressure, but can actually perform with compassion and gentle

humor....

Once you've selected those folks out, look for the ones who can also teach

and mentor as well as do the job themselves....I submit that those folks

are the ones who are truly the medics we want to treat our own families and

bring up the next generation of medics.

There is a line in a Science Fiction novel by Lois McMaster Bujold,

quoting one Aral, Count Vorkosigan on the subject of mentoring, to the effect

that you can teach the young folks all they can absorb of what you know, and

show them how to do it right, but you are still terrified the first time you

have to turn them loose on their own....

The flip side is when they come back, wagging their tails like frisky

pups....and they've actually done a good job....so satisfying!

S. Krin, DO

Retired FM/EM/EMS Physician; Author and Educator

Also Old School: EMT-A 1976, 91B2F 1979-83, later, CPT, MC, USAR

[Guest guest]

Really tony?? Well if you look at it there's no good or bad side. Each can learn

from eachother. I'm pretty sure one will be stuck in their ways and cease to

grow from the other but the newer one can learn that there's more than one way

to skin a cat. Its not all one way.....

Sent from my iPhone

> Peers,

>

> I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

>

> So, what I am asking of those of you willing to help me is your position on

" Old Medics vs. New Medics. " Tell me why one is better or worse than the other

and why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

>

> May the battle begin!

>

> Tony , EMT-P

> Old School

>

>

[Guest guest]

Since I have been out of 911 EMS for so long, and my last encounter with CPR was

about 1998, I would have to say it would be about CPR protocol. And I have

detailed this before. 30-2 is insane. Yes I have read all the docs on the

theory, but they are all flawed. Circulating unoxygenated blood is useless. I

have ONE " Save " under my belt, and that was done as 2 man 5-1. I literally

collapsed from exhaustion after 25 minutes of that current protocol, but the

patient survived. Had it been under current protocol, we would have given up

much earlier and the PT would have remained dead.

I am leaving EMS and going into Surgical Technology next Fall. I will take and

pass the current CPR guidelines, but I do not agree with them.  Giant strides

have been made within the Pre Hospital Care industry, since I was first

certified, most all of them good. But in my opinion, CPR protocol has taken a

giant step backwards.

Cougar!!

I'll keep my Guns, my Freedom and my MONEY,

You can keep the " CHANGE. "

Subject: Position Paper: Old Medics vs. New Medics

To: " texasems-L " texasems-L >

Date: Wednesday, October 5, 2011, 8:08 PM

 

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics.  I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year).  For those of you not familiar with a Position Essay

let me explain.  Basically, there are two sides and each must be weighed

objectively and a conclusion made.  You of course are permitted to make voice

opinion, but remember to substantiate your argument while being careful to weigh

both sides of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. "   Tell me why one is better or worse than the other and

why.  I sincerely appreciate the assistance.  This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

I had about an hour long conversation with Dr. O. Saylak of the Texas A&M

Medical Center in College Station. At the time, he was the D.O. there. I had a

conference with him about what to do about the current changes,.....he

said...... " tear up your CPR cards......I want it done old school. "

And since he gave that order, I never re-certified. Since then....American Heart

has gone ahead and INCREASED the difficulty of the provider to perform

CPR.......in their eyes... " correctly " .

I'm sorry, but...although I might have to prove efficiency to pass a CPR class,

I will stick to the 15-2 5-1 theory, while on the street. Heck.....riding the

rail, there IS no counts. It is non stop compressions, and the bagger gets a

breath in occasionally.

Cougar!! 

I'll keep my Guns, my Freedom and my MONEY,

You can keep the " CHANGE. "

Subject: Position Paper: Old Medics vs. New Medics

To: " texasems-L " texasems-L >

Date: Wednesday, October 5, 2011, 8:08 PM

 

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics.  I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year).  For those of you not familiar with a Position Essay

let me explain.  Basically, there are two sides and each must be weighed

objectively and a conclusion made.  You of course are permitted to make voice

opinion, but remember to substantiate your argument while being careful to weigh

both sides of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. "   Tell me why one is better or worse than the other and

why.  I sincerely appreciate the assistance.  This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

I had about an hour long conversation with Dr. O. Saylak of the Texas A&M

Medical Center in College Station. At the time, he was the D.O. there. I had a

conference with him about what to do about the current changes,.....he

said...... " tear up your CPR cards......I want it done old school. "

And since he gave that order, I never re-certified. Since then....American Heart

has gone ahead and INCREASED the difficulty of the provider to perform

CPR.......in their eyes... " correctly " .

I'm sorry, but...although I might have to prove efficiency to pass a CPR class,

I will stick to the 15-2 5-1 theory, while on the street. Heck.....riding the

rail, there IS no counts. It is non stop compressions, and the bagger gets a

breath in occasionally.

Cougar!! 

I'll keep my Guns, my Freedom and my MONEY,

You can keep the " CHANGE. "

Subject: Position Paper: Old Medics vs. New Medics

To: " texasems-L " texasems-L >

Date: Wednesday, October 5, 2011, 8:08 PM

 

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics.  I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year).  For those of you not familiar with a Position Essay

let me explain.  Basically, there are two sides and each must be weighed

objectively and a conclusion made.  You of course are permitted to make voice

opinion, but remember to substantiate your argument while being careful to weigh

both sides of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. "   Tell me why one is better or worse than the other and

why.  I sincerely appreciate the assistance.  This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

Cougar,

Respectfully, just because you and your doctor friend choose to ignore facts,

it does not make them any less true.

Please read the literature, study the physiology involved, and I think you will

see that the " old way " was the bad way.

Unfortunately, there are still those who believe the " 30 second rule " for

intubation attempts. That is wrong also.

Science is science. Facts are facts. Ignore them at your peril.

Gene

Position Paper: Old Medics vs. New Medics

To: " texasems-L " texasems-L >

Date: Wednesday, October 5, 2011, 8:08 PM

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. " Tell me why one is better or worse than the other and

why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

Cougar,

Respectfully, just because you and your doctor friend choose to ignore facts,

it does not make them any less true.

Please read the literature, study the physiology involved, and I think you will

see that the " old way " was the bad way.

Unfortunately, there are still those who believe the " 30 second rule " for

intubation attempts. That is wrong also.

Science is science. Facts are facts. Ignore them at your peril.

Gene

Position Paper: Old Medics vs. New Medics

To: " texasems-L " texasems-L >

Date: Wednesday, October 5, 2011, 8:08 PM

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. " Tell me why one is better or worse than the other and

why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

Unfortunately, I cannot say that paramedic education is much better today than

it was 30 years ago when I became a paramedic. Yes, we have more toys, and some

programs have progressed mightily, but many are still woefully short on

fundamentals such as A&P and basic science.

There is wide variance in the quality of EMS education programs. Some feel that

national accreditation is the answer. I do not believe that national

accreditation guarantees a good paramedic education; however, if the program is

willing and eager to improve, it is a way to identify weaknesses and correct

them. Unfortunately, many see accreditation as a necessary evil, like a JCAHO

visit, where much work goes into preparation for the visit, then everything

returns to normal.

We still teach many things in EMS that have no foundation in medicine, such as

the over-use of spinal " immobilization " and other toys like KEDs, traction

splints, the " 30-second rule for intubation attempts " and that if some oxygen

is good, more must be better.

Few paramedics know what MAP or CPP are, how to compute them, and why they are

important. Few can explain the differences between oxygen saturation, oxygen

pressure, and oxygen content in the blood and why the differences are important.

Few know what normal CO2 levels are and how to interpret wave-form capnography.

And I could go on and on.

Yes, progress is being made in some quarters, but much more needs to be made.

Old habits are hard to change, even when we know they are detrimental to our

patients.

Medics resent it when physicians do not trust them to interpret ECGs, for

example, but many could not explain the concept of vector in a meaningful way,

nor could they identify signs of right heart strain, why it's important to do a

right sided ECG when there are signs of an inferior infarct, and so on. Many

cannot tell you which coronary arteries serve what portions of the heart and how

occlusion of one affects the ECG. Many will say that this is not important.

" Don't need to know it. We'll never use it. " How many times have we heard that

refrain?

I ask this question in one of my scenario exams: " Does a good knowledge of

anatomy and physiology help you in your assessment and treatment of patients? "

Sadly, many answer in the negative. Hand me the blue box, please.

Gene Gandy

Re: Position Paper: Old Medics vs. New Medics

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

Unfortunately, I cannot say that paramedic education is much better today than

it was 30 years ago when I became a paramedic. Yes, we have more toys, and some

programs have progressed mightily, but many are still woefully short on

fundamentals such as A&P and basic science.

There is wide variance in the quality of EMS education programs. Some feel that

national accreditation is the answer. I do not believe that national

accreditation guarantees a good paramedic education; however, if the program is

willing and eager to improve, it is a way to identify weaknesses and correct

them. Unfortunately, many see accreditation as a necessary evil, like a JCAHO

visit, where much work goes into preparation for the visit, then everything

returns to normal.

We still teach many things in EMS that have no foundation in medicine, such as

the over-use of spinal " immobilization " and other toys like KEDs, traction

splints, the " 30-second rule for intubation attempts " and that if some oxygen

is good, more must be better.

Few paramedics know what MAP or CPP are, how to compute them, and why they are

important. Few can explain the differences between oxygen saturation, oxygen

pressure, and oxygen content in the blood and why the differences are important.

Few know what normal CO2 levels are and how to interpret wave-form capnography.

And I could go on and on.

Yes, progress is being made in some quarters, but much more needs to be made.

Old habits are hard to change, even when we know they are detrimental to our

patients.

Medics resent it when physicians do not trust them to interpret ECGs, for

example, but many could not explain the concept of vector in a meaningful way,

nor could they identify signs of right heart strain, why it's important to do a

right sided ECG when there are signs of an inferior infarct, and so on. Many

cannot tell you which coronary arteries serve what portions of the heart and how

occlusion of one affects the ECG. Many will say that this is not important.

" Don't need to know it. We'll never use it. " How many times have we heard that

refrain?

I ask this question in one of my scenario exams: " Does a good knowledge of

anatomy and physiology help you in your assessment and treatment of patients? "

Sadly, many answer in the negative. Hand me the blue box, please.

Gene Gandy

Re: Position Paper: Old Medics vs. New Medics

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

Gene,

The concept of nation registry being better would only make sense if all the

program out there would follow the same curriculum in the same manner with the

same results.   The issue with that would be there are some that only teach

what is needed to pass the test, some that teach what is in the book for you to

read and understand and if you don't oh well and then there are those that teach

the book, the patient, the responses and the real life aspect of what we do. 

The other is what the students do after they get out.  do they try to better

themselves, stay up with the times, continue to learn, or do they reside the

fact that they are certified and do the minimum to stay that way.

The field we are in is a constant changing arena, and for us to do the right job

and treat the best we can we must take the time to ensure we know the best

techniques and treatments for the patients we encounter.  

The best advice I ever got was always keep your mind open to new things, learn

each day and if anyone talks like they know it all run the other way.

Armitage

________________________________

To: texasems-l

Sent: Thursday, October 6, 2011 5:45 AM

Subject: Re: Position Paper: Old Medics vs. New Medics

 

Unfortunately, I cannot say that paramedic education is much better today than

it was 30 years ago when I became a paramedic. Yes, we have more toys, and some

programs have progressed mightily, but many are still woefully short on

fundamentals such as A&P and basic science.

There is wide variance in the quality of EMS education programs. Some feel that

national accreditation is the answer. I do not believe that national

accreditation guarantees a good paramedic education; however, if the program is

willing and eager to improve, it is a way to identify weaknesses and correct

them. Unfortunately, many see accreditation as a necessary evil, like a JCAHO

visit, where much work goes into preparation for the visit, then everything

returns to normal.

We still teach many things in EMS that have no foundation in medicine, such as

the over-use of spinal " immobilization " and other toys like KEDs, traction

splints, the " 30-second rule for intubation attempts " and that if some oxygen

is good, more must be better.

Few paramedics know what MAP or CPP are, how to compute them, and why they are

important. Few can explain the differences between oxygen saturation, oxygen

pressure, and oxygen content in the blood and why the differences are important.

Few know what normal CO2 levels are and how to interpret wave-form capnography.

And I could go on and on.

Yes, progress is being made in some quarters, but much more needs to be made.

Old habits are hard to change, even when we know they are detrimental to our

patients.

Medics resent it when physicians do not trust them to interpret ECGs, for

example, but many could not explain the concept of vector in a meaningful way,

nor could they identify signs of right heart strain, why it's important to do a

right sided ECG when there are signs of an inferior infarct, and so on. Many

cannot tell you which coronary arteries serve what portions of the heart and how

occlusion of one affects the ECG. Many will say that this is not important.

" Don't need to know it. We'll never use it. " How many times have we heard that

refrain?

I ask this question in one of my scenario exams: " Does a good knowledge of

anatomy and physiology help you in your assessment and treatment of patients? "

Sadly, many answer in the negative. Hand me the blue box, please.

Gene Gandy

Re: Position Paper: Old Medics vs. New Medics

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

While I agree the education now is possibly better, I think nothing can be

better than experience in the field. Experience comes with years in the field

I have been a paramedic for 24 years and I see all the time the new paramedics

always get better and better every year. At first they believe their skills and

knowledge is better than an old paramedic but even they realize after a while

it's not the case. If we try we can all learn from each other.

Thanks

Marty Outlaw, Captain, Infection Control Officer

Humble Fire Department

108 West Main

Humble Texas,77338

Sent from my iPhone

On Oct 5, 2011, at 8:08 PM, " Tony "

inf_pn@...inf_pn@...>> wrote:

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. " Tell me why one is better or worse than the other and

why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

Thank you, Gene. With current research, as well as proven results and

statistics, if your statement below is taken to heart (no pun intended), and is

implemented anywhere that it currently is not, you probably saved more lives

than your's and my direct patient care combined. (75 years?) Does that make us

old medics, now, new medics? (I'm so confused) It sure was good to see you at

Expo. I'm awful sorry to hear about Mr. .

Pat Elmes

ACEP

>

> From: Tony

> Subject: Position Paper: Old Medics vs. New Medics

> To: " texasems-L " texasems-L >

> Date: Wednesday, October 5, 2011, 8:08 PM

>

>

>

> Peers,

>

> I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

>

> So, what I am asking of those of you willing to help me is your position on

" Old Medics vs. New Medics. " Tell me why one is better or worse than the other

and why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

>

> May the battle begin!

>

> Tony , EMT-P

>

> Old School

>

>

[Guest guest]

Thank you, Gene. With current research, as well as proven results and

statistics, if your statement below is taken to heart (no pun intended), and is

implemented anywhere that it currently is not, you probably saved more lives

than your's and my direct patient care combined. (75 years?) Does that make us

old medics, now, new medics? (I'm so confused) It sure was good to see you at

Expo. I'm awful sorry to hear about Mr. .

Pat Elmes

ACEP

>

> From: Tony

> Subject: Position Paper: Old Medics vs. New Medics

> To: " texasems-L " texasems-L >

> Date: Wednesday, October 5, 2011, 8:08 PM

>

>

>

> Peers,

>

> I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

>

> So, what I am asking of those of you willing to help me is your position on

" Old Medics vs. New Medics. " Tell me why one is better or worse than the other

and why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

>

> May the battle begin!

>

> Tony , EMT-P

>

> Old School

>

>

[Guest guest]

I am neither an EMS Educator nor a paramedic, but I do know at least a

little bit about economics, health policy and EMS financing. In my " perfect

world " scenario, A paramedic would have a four-year degree and be paid

$80-100K per year, but inevitably discussions such as these are always

distilled to their unavoidable essence - money.

As education and unrecoverable technology costs continue their upward

spiral, reimbursement for EMS services, which is directly correlated with

EMS worker salaries has been on an inflation-adjusted decline for about 20

years. The result has been an observable suppression of EMS worker's income.

Accordingly, the increasing costs of EMS education, in relation to the given

stagnated in medic's hourly rate results in an ever longer " earn out " time

for a medic to recoup his EMS education cost investment.

For example, when paramedic class used to cost $500 the corresponding hourly

pay increase could recover the $500 investment much faster than today. If

today's paramedic class costs $3,500, and the hourly rate percentage

increase was exactly proportionate to that observed in the 1970's, it takes

a much longer time to recover today's EMS education investment due to

historical inflation and dollar value decline.

The only way to reverse this trend is to pay medics much more in terms of

annual salaries. And, the only way to pay for that is for EMS payers to

express their economic gratitude for what we do through an almost

exponential increase in the EMS reimbursement rates. [i won't pick open the

scab of how that can best be accomplished]

EMS education may well be painting itself into a cost corner. EMS technology

manufacturers already have. There's simply no more pie left.

Bob

> **

>

>

> Unfortunately, I cannot say that paramedic education is much better today

> than it was 30 years ago when I became a paramedic. Yes, we have more toys,

> and some programs have progressed mightily, but many are still woefully

> short on fundamentals such as A&P and basic science.

>

> There is wide variance in the quality of EMS education programs. Some feel

> that national accreditation is the answer. I do not believe that national

> accreditation guarantees a good paramedic education; however, if the program

> is willing and eager to improve, it is a way to identify weaknesses and

> correct them. Unfortunately, many see accreditation as a necessary evil,

> like a JCAHO visit, where much work goes into preparation for the visit,

> then everything returns to normal.

>

> We still teach many things in EMS that have no foundation in medicine, such

> as the over-use of spinal " immobilization " and other toys like KEDs,

> traction splints, the " 30-second rule for intubation attempts " and that if

> some oxygen is good, more must be better.

>

> Few paramedics know what MAP or CPP are, how to compute them, and why they

> are important. Few can explain the differences between oxygen saturation,

> oxygen pressure, and oxygen content in the blood and why the differences are

> important. Few know what normal CO2 levels are and how to interpret

> wave-form capnography. And I could go on and on.

>

> Yes, progress is being made in some quarters, but much more needs to be

> made. Old habits are hard to change, even when we know they are detrimental

> to our patients.

>

> Medics resent it when physicians do not trust them to interpret ECGs, for

> example, but many could not explain the concept of vector in a meaningful

> way, nor could they identify signs of right heart strain, why it's important

> to do a right sided ECG when there are signs of an inferior infarct, and so

> on. Many cannot tell you which coronary arteries serve what portions of the

> heart and how occlusion of one affects the ECG. Many will say that this is

> not important. " Don't need to know it. We'll never use it. " How many times

> have we heard that refrain?

>

> I ask this question in one of my scenario exams: " Does a good knowledge of

> anatomy and physiology help you in your assessment and treatment of

> patients? " Sadly, many answer in the negative. Hand me the blue box, please.

>

> Gene Gandy

>

>

> Re: Position Paper: Old Medics vs. New Medics

>

> Ok what I forgot to add is this, The education is much better but it all

> comes down to the indiviual medic. Wiether fast tracked or not a good clear

> head will do a good job. Who is better? Neither. Who is worse? Neither they

> are differnet due to the education, they are the same due to the job they

> do.

>

>

[Guest guest]

I am neither an EMS Educator nor a paramedic, but I do know at least a

little bit about economics, health policy and EMS financing. In my " perfect

world " scenario, A paramedic would have a four-year degree and be paid

$80-100K per year, but inevitably discussions such as these are always

distilled to their unavoidable essence - money.

As education and unrecoverable technology costs continue their upward

spiral, reimbursement for EMS services, which is directly correlated with

EMS worker salaries has been on an inflation-adjusted decline for about 20

years. The result has been an observable suppression of EMS worker's income.

Accordingly, the increasing costs of EMS education, in relation to the given

stagnated in medic's hourly rate results in an ever longer " earn out " time

for a medic to recoup his EMS education cost investment.

For example, when paramedic class used to cost $500 the corresponding hourly

pay increase could recover the $500 investment much faster than today. If

today's paramedic class costs $3,500, and the hourly rate percentage

increase was exactly proportionate to that observed in the 1970's, it takes

a much longer time to recover today's EMS education investment due to

historical inflation and dollar value decline.

The only way to reverse this trend is to pay medics much more in terms of

annual salaries. And, the only way to pay for that is for EMS payers to

express their economic gratitude for what we do through an almost

exponential increase in the EMS reimbursement rates. [i won't pick open the

scab of how that can best be accomplished]

EMS education may well be painting itself into a cost corner. EMS technology

manufacturers already have. There's simply no more pie left.

Bob

> **

>

>

> Unfortunately, I cannot say that paramedic education is much better today

> than it was 30 years ago when I became a paramedic. Yes, we have more toys,

> and some programs have progressed mightily, but many are still woefully

> short on fundamentals such as A&P and basic science.

>

> There is wide variance in the quality of EMS education programs. Some feel

> that national accreditation is the answer. I do not believe that national

> accreditation guarantees a good paramedic education; however, if the program

> is willing and eager to improve, it is a way to identify weaknesses and

> correct them. Unfortunately, many see accreditation as a necessary evil,

> like a JCAHO visit, where much work goes into preparation for the visit,

> then everything returns to normal.

>

> We still teach many things in EMS that have no foundation in medicine, such

> as the over-use of spinal " immobilization " and other toys like KEDs,

> traction splints, the " 30-second rule for intubation attempts " and that if

> some oxygen is good, more must be better.

>

> Few paramedics know what MAP or CPP are, how to compute them, and why they

> are important. Few can explain the differences between oxygen saturation,

> oxygen pressure, and oxygen content in the blood and why the differences are

> important. Few know what normal CO2 levels are and how to interpret

> wave-form capnography. And I could go on and on.

>

> Yes, progress is being made in some quarters, but much more needs to be

> made. Old habits are hard to change, even when we know they are detrimental

> to our patients.

>

> Medics resent it when physicians do not trust them to interpret ECGs, for

> example, but many could not explain the concept of vector in a meaningful

> way, nor could they identify signs of right heart strain, why it's important

> to do a right sided ECG when there are signs of an inferior infarct, and so

> on. Many cannot tell you which coronary arteries serve what portions of the

> heart and how occlusion of one affects the ECG. Many will say that this is

> not important. " Don't need to know it. We'll never use it. " How many times

> have we heard that refrain?

>

> I ask this question in one of my scenario exams: " Does a good knowledge of

> anatomy and physiology help you in your assessment and treatment of

> patients? " Sadly, many answer in the negative. Hand me the blue box, please.

>

> Gene Gandy

>

>

> Re: Position Paper: Old Medics vs. New Medics

>

> Ok what I forgot to add is this, The education is much better but it all

> comes down to the indiviual medic. Wiether fast tracked or not a good clear

> head will do a good job. Who is better? Neither. Who is worse? Neither they

> are differnet due to the education, they are the same due to the job they

> do.

>

>

[Guest guest]

Tony,

I believe you are so right in this statement.  I have seen this technology

cause the issue of things changing.  I have seen the overseers pushing to check

it all use it all and push away the basics.  Is it not a saying that a basic

will save a paramedic as they take use back to the basic of our jobs. 

But also and not only in our wonderful profession is that the work ethics of the

different age ranges is more of what is going on I believe.  I have seen the

newer generation not wanting to put it all into the profession they have chosen.

Part of this is the profession is not paying them what they want to get to have

in their time off to play with.   But we all have been there and to put

someone with years on the job and place them next to the younger generation then

we can plainly see there is a difference. 

Now I am not by any means saying all are the same, because I have had some

younger partners that I would go to the end with, but I have had some I felt I

had to be in a day care with as well.  WE are all adults in here but some sure

dont show it in the way they work.

________________________________

To: " texasems-L " texasems-L >

Sent: Thursday, October 6, 2011 6:40 PM

Subject: Position Paper: Old Medics vs. New Medics

 

I suppose I will chime in with some observations now.  Interesting responses by

the way.

Based on my personal observations older medics tend to be better at patient

assessment, more detail oriented, have far better documentation, are more

proficient at skills, and have more pride in their work.  On the other hand we

tend to resist technology and in general are a bit fed up, perhaps burned-out! 

While I personally have tried to re-invent myself repeatedly over the years by

doing everything from rural ems and teaching to clinical settings and

consulting.  I have expressed frustration at the quality of medics entering the

field over the past several years.  Now, I understand some institutions are

providing high-quality education and training, but in general I feel we have

regressed.

As for the new medics it seems they rely to heavily on technology.  I have

found that too many new medics fail to take accurate vital signs or provide

appropriate patient care.  While requirements approach 1200-1400 hours + now

versus 400 some fifteen to twenty years ago, the quality appears to be

lacking.  Technology has made check boxes more common and well-written

narratives a thing of the past, for the most part.  

Now, before people start giving me a lashing, I have had these conversations

with medics in urban and rural settings, flight medics, physicians, nurses and

educators.  Almost without hesitation and seldom disagreeing, the same comments

are made over and over.

Tony , EMT-P

[Guest guest]

Experience can be either good or bad, depending on how it's gained.

I frequently have to break medics who have been working for a while as Basics of

very bad habits they have learned from the medics they work with.

Don't get me wrong. There are some dynamite great medics out there, and they

are great mentors to the medics who work with them, but there are also some

horribly lazy, dumb, and bad ones.

Gene

Re: Position Paper: Old Medics vs. New Medics

While I agree the education now is possibly better, I think nothing can be

better than experience in the field. Experience comes with years in the field

I have been a paramedic for 24 years and I see all the time the new paramedics

always get better and better every year. At first they believe their skills and

knowledge is better than an old paramedic but even they realize after a while

it's not the case. If we try we can all learn from each other.

Thanks

Marty Outlaw, Captain, Infection Control Officer

Humble Fire Department

108 West Main

Humble Texas,77338

Sent from my iPhone

On Oct 5, 2011, at 8:08 PM, " Tony "

inf_pn@...inf_pn@...>>

wrote:

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. " Tell me why one is better or worse than the other and

why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

Experience can be either good or bad, depending on how it's gained.

I frequently have to break medics who have been working for a while as Basics of

very bad habits they have learned from the medics they work with.

Don't get me wrong. There are some dynamite great medics out there, and they

are great mentors to the medics who work with them, but there are also some

horribly lazy, dumb, and bad ones.

Gene

Re: Position Paper: Old Medics vs. New Medics

While I agree the education now is possibly better, I think nothing can be

better than experience in the field. Experience comes with years in the field

I have been a paramedic for 24 years and I see all the time the new paramedics

always get better and better every year. At first they believe their skills and

knowledge is better than an old paramedic but even they realize after a while

it's not the case. If we try we can all learn from each other.

Thanks

Marty Outlaw, Captain, Infection Control Officer

Humble Fire Department

108 West Main

Humble Texas,77338

Sent from my iPhone

On Oct 5, 2011, at 8:08 PM, " Tony "

inf_pn@...inf_pn@...>>

wrote:

Peers,

I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

So, what I am asking of those of you willing to help me is your position on " Old

Medics vs. New Medics. " Tell me why one is better or worse than the other and

why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

May the battle begin!

Tony , EMT-P

Old School

[Guest guest]

Same here Pat, great to see you and chat. And sorry about Rob too. A real

loss.

Here in Tucson since they implemented the " new " resuscitation techniques,

uninterrupted CPR, passive inhalation with a NRB and NC for the first 6 minutes,

together with induced hypothermia, they have tripled their " walk out of the

hospital " survival rates.

GG

Position Paper: Old Medics vs. New Medics

> To: " texasems-L " texasems-L >

> Date: Wednesday, October 5, 2011, 8:08 PM

>

>

>

> Peers,

>

> I am writing a position paper and the topic is Old Medics vs. New Medics. I

understand " Old " is subjective, so let me just say I consider myself an old

medic (twentieth year). For those of you not familiar with a Position Essay let

me explain. Basically, there are two sides and each must be weighed objectively

and a conclusion made. You of course are permitted to make voice opinion, but

remember to substantiate your argument while being careful to weigh both sides

of the argument.

>

> So, what I am asking of those of you willing to help me is your position on

" Old Medics vs. New Medics. " Tell me why one is better or worse than the other

and why. I sincerely appreciate the assistance. This should make for an

interesting discussion.

>

> May the battle begin!

>

> Tony , EMT-P

>

> Old School

>

>

[Guest guest]

Well said, .

G

Re: Position Paper: Old Medics vs. New Medics

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

Well said, .

G

Re: Position Paper: Old Medics vs. New Medics

Ok what I forgot to add is this, The education is much better but it all comes

down to the indiviual medic. Wiether fast tracked or not a good clear head will

do a good job. Who is better? Neither. Who is worse? Neither they are differnet

due to the education, they are the same due to the job they do.

[Guest guest]

Points well taken, Bob.

G

Re: Position Paper: Old Medics vs. New Medics

>

> Ok what I forgot to add is this, The education is much better but it all

> comes down to the indiviual medic. Wiether fast tracked or not a good clear

> head will do a good job. Who is better? Neither. Who is worse? Neither they

> are differnet due to the education, they are the same due to the job they

> do.

>

>

[Guest guest]

Points well taken, Bob.

G

Re: Position Paper: Old Medics vs. New Medics

>

> Ok what I forgot to add is this, The education is much better but it all

> comes down to the indiviual medic. Wiether fast tracked or not a good clear

> head will do a good job. Who is better? Neither. Who is worse? Neither they

> are differnet due to the education, they are the same due to the job they

> do.

>

>