New Ohio EMT-I Curriculum

[ff7134]

http://www.state.oh.us/odps/division...Curriculum.htm

I just wanted to see what you all thought about the new curriculm. After looking it over they are teaching these bridge class people how to push drug without really understanding Pharmacology. I know I finished up that section a while ago...and it was like 16plus hour just on that then we go over everything again when we get to sections that deal specifically with those drug.

It seems to me the state and the small departments that have no Paramedics are trying to extend the boundries of their ALS skill. Now I have no problem with this as long as they have proper training, but lets get real...40 to encompass all the update. Why would someone want to be a Medic if they can push drugs as a Intermediate?

[pfd3501]

I agree with the idea

the implementation leaves something to be desired

If not requiring the time with medics, they should at least hook you up with people you can ride with to gain the experience

[firenresq77]

I believe the INITIAL plan was to wee dout the EMT-Is, and just have Basics and Medics. So that's why they were doing these bridge courses. This will be the 2nd one in the last 3 years or so for the Intermediates.

At least I thought this was the plan until I saw a letter about a class coming up in NW OHio here for the full EMT-I class.......

[pfd3501]

The Intermediates are largely on rural departments, where you might want more care than basic level, but the vollies might not have time for the full medic school, and the departments might not have the money to fund paramedic school.

[ff7134]

My whole issue is if yo are going to train them...train them right. Don't teach them how and when to puch drugs but not what the drugs do.

Thats a lawsuit waiting to happen.

[pfd3501]

Originally posted by ff7134
My whole issue is if yo are going to train them...train them right. Don't teach them how and when to puch drugs but not what the drugs do.

Thats a lawsuit waiting to happen.

My instructor taught what to push when, indications, contraindications, systems affected, and what the drugs do. Was it to the level that medics get indoctrinated? No, but the instructor did do well in the allotted amount of time.

Not happy with what you learned?

There's a zillion sources of info.

My biggest beef? The state didn't make provision "for when the rubber hits the road"

But then again, years ago, giving my first dose of drawn up epi for a wasp sting reaction, I didn't have a Medic looking over my shoulder, and I don't think anyone died of it.

I think the state did it knowing many medical directors wouldn't give the full list.

This was meant to help the rural communities. I look for continued expansion of the intermediates scope.

[Weruj1]

In a very recent meeting up here with our Medical Director, (who is for many entities in a tri county region) he is NOT going to allow EMT-I's some scope of that practice. He concurs that for rural areas this may be the way to go ..........either to give care until they meet an ALS intercept or as previously staed maybe they dont have people that can attend all that medic schooling. One thing we all did agree on..................40 hours wasnt enough.

Also this will not directly effect my deaprtment as we run only medics and bascis.

[ff7134]

Originally posted by pfd3501


Not happy with what you learned?

There's a zillion sources of info.

Actually I am happy with what I have been taught so far in PARAMEDIC school. My whole issue is that this is going to create some "Wannabe" Paramedics. If you want to push the big boy drugs then you need to go to big boy school. Now don't get me wrong I have worked with some great intermediates but with the states piddily little 40 hr bridge lets get real. Any instructor that is worth a damn is going to realize that the amount of information needed and the time alotted are not working. I know that our 2 local schools that are teaching the Bridge are making theirs a few more hour than the 40 just to make sure they get taught correctly. I can't wait to see the poor scmuck that gets his hand smacked because he went past his scope of practice due to poor instruction.

[pfd3501]

Originally posted by ff7134

If you want to push the big boy drugs then you need to go to big boy school.

Not even through medic school and you've already caught the "medic god" syndrome?

I've stated earlier, I'm not real happy about the implementation of this. But expanding the scope of intermediate practice is meant to help rural volunteer squads that do not have medics.

Also, the drug list is pared down considerably from what the paramedics use. The entire drug list of the new intermediate scope of practice is probably less than 1/3 of our current paramedic drug license as approved by our medical director. And they are what are considered to be "relatively safe" drugs. Many squads will probably only get a few of these drugs put into their intermediate protocols.

[ff7134]

Nope actually......my philosophy is to push drug only when needed and get them to the hospital in at least as good as shape as I found them.

I just have a very bad feeling about the amount of training. I wouldn't have a problem with it...if they were trained sufficently. I went on a mutual aid yesterday with a small rural dept. I know their medical director gave them the full list and they guy in the back that was an EMT-I. I wouldn't let this guy treat my dog much less a person. The person had fallen of a ladder (about 5 foot) they had a angulated arm fx. He had pushed MSO4....but forgot to askdid the person strike their head.

Thats and example, I guess the new EMT-I will be good but the bridge people . And son;t get me wrong I can see the need for the expanded scope of practice, but make sure the people can do the job correctly.

[firenresq77]

I went on a mutual aid yesterday with a small rural dept. I know their medical director gave them the full list and they guy in the back that was an EMT-I. I wouldn't let this guy treat my dog much less a person.

Unfortunately, I came name of a few people of all training levels that I could say the same for. It's sad, but it doesn't matter what level some people are trained to, it still wouldn't change anything.......

[pfd3501]

Originally posted by ff7134
"... I know their medical director gave them the full list and they guy in the back that was an EMT-I. I wouldn't let this guy treat my dog much less a person. The person had fallen of a ladder (about 5 foot) they had a angulated arm fx. He had pushed MSO4....but forgot to askdid the person strike their head.

Then that person, not the program is in error

I know that that is on of the contraindications our bridge class was taught. When our local protocol is updated, that will be in there as well. The indications and contraindications for each med.

The EMT-I you made mention, how was she/he before the bridge? Did they get the details?

A good practitioner will have good skills, and a sloppy person will have sloppy skills, regardless of this 40 hour bridge or any of the training.

[ff7134]

This guy was a goofball (not on calls never been on one with him)....and I have not found out what they are going to do because the medic wrote up a complaint.

I agree it depends on the person, some will make great EMT-I's some will not. I think we are beating a dead horse with this one.....but it is jacking up the State post count

[Ohiovolffemtp]

I'm STRONGLY supportive of the new EMT-I corriculum. As an EMS instructor, I had to fight many of the same battles when I convinced the University of Cincinnati to offer the EMT-I transition course.

There were two compelling arguments:[list=1][*]UC's medic school focuses a large amount of time on cardiology. If you look at the amount of time spent on altered mental status, diabetics, and respiratory problems it's just not that much more than you can do in the 40 hour class.[*]There are a large number of departments in SW Ohio, primarily in Warren, Brown, Adams and futher out counties who will NEVER have medics but already have EMT-I's. EMT-I is an attainable level for volunteers, medic just requires too many hours.[/list=1]
These are not "wannabe" medics. The drug selection permits EMT-I's to manage the most common of medical emergencies dramatically better. That's what it's all about - getting care to our patients sooner.

40 hours is sufficient classroom hours. I'll be glad to share a syllabus to back that up. The one weakness is the lack of clinical time as part of the program. ER time where the EMT-I's could get IV practice and drug pushes would be very helpful.

From what I've seen in Brown co, the doc's have approved everything except needle decompression and pain management. Clermont Co is a bit more restrictive. I'm expecting and hoping that after a year or two, folks will realize that it's working well and move forward.

For all of you medics who are feeling threatened, think hard about what are your frequently used drug therapies, what training you actually had in your medic school, and what you really need to effectively and appropriately use these drugs. I think you'll have to admit that this can work.

[ff7134]

I'm looking more at less time in the back and writing reports. Our Med Directors approved it all...they said needle decompressions are a life/death situation. After setting throught the lecture and Lab on that....its really not that hard. Just ensure your placement and go above the rib.

[pfd3501]

Ohiovolffemtp:
you are echoing many of my points - look at my posts

we agree on the following
With a good instructor/syllabus the 40 hours is enough
The downfall of the program is tha lack of clinical time
this offers the most benefits to rural departments who have EMT-I's but may never get medics

From the fellow intermediates I'm around, I don't think that we'll be pushing meds willy nilly. Most aren't comfortable with it, so they'll check and double check their protocols and field guides.

Stay safe

[Ohiovolffemtp]

PFD-
Yes, we do agree and I respect your perspective.

The only thing that raised the fur on the back of my neck was someone else's "wannabe" comment.

Be safe.