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    Quote Originally Posted by ffscm72 View Post
    It is as shallow as I make it. Our treatments are limited & so our or skills....& for proper reason. Why? cause we do not have the proper medical analysis tools required nor proper facilities. Why? cause we are only meant to stabilize & get them to that facility. To think you do more than that is only fooling yourself into believing you are part of the end solution. You stabilize...I stabilize. That's it...nothing more, nothing less. Know your role in the bigger scheme & you'll become better member of what you are meant to do.[/b]
    I'll go back to my MI argument. What does an ER physician use to diagnose an MI? A 12-lead EKG. None of the other millions of dollars of equipment in the ER that we don't have. What do we have on an ALS ambulance with the ability to transmit to the ER? A cardiac monitor with 12-lead capacity. The same cardiac monitor the ER will use to diagnose the MI.

    I spend an average of 45-50 minutes with my patients. Yes, I perform interventions to best stablize my patient; Oxygen for hypoxia, IV with fluids for hypotension, intubation for respiratory failure/arrest. I assess and diagnose my patient by looking at skin presentation, vital signs, mental status, and EKG. And I begin the definitive treatment for them as well based on that diagnosis; I give Aspirin, Nitroglycerin, Morphine, and most notably Plavix. After transmitting my 12-lead EKG to the ER and giving them my radio report, I will transport my patient straight to the cardiac cath lab and completely bypass the ER. The ER physician never sees the patient.

    Your responses reek of resentment of the Fire Service's role in EMS, like you were forced to get your EMT-Basic license to be a firefighter. Somebody that doesn't want to practice EMS and surely doesn't want to see it occupy any more of your time than absolutely necessary. And it's people who become EMTs so they can be firefighters that hold back EMS for those who want to truly make it a career instead of a stepping stone into the fire service, nursing, or med school. Please go back to your BRT and leave EMS to the professionals.

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    SMH... Where do you get your orders from?
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    Quote Originally Posted by FFMedic31 View Post
    I'll go back to my MI argument. What does an ER physician use to diagnose an MI? A 12-lead EKG. None of the other millions of dollars of equipment in the ER that we don't have. What do we have on an ALS ambulance with the ability to transmit to the ER? A cardiac monitor with 12-lead capacity. The same cardiac monitor the ER will use to diagnose the MI.
    And what caused that MI? might I ask?...You'll never know, unless you go back & ask...because you are limited to the EKG. You don't have the medical equipment needed to dig further into the problem. Because your training is limited. As it should be. You don't need to know it all...Just what little you can do to make the patient comfortable/stable enough.

    Quote Originally Posted by FFMedic31 View Post
    I spend an average of 45-50 minutes with my patients. Yes, I perform interventions to best stablize my patient; Oxygen for hypoxia, IV with fluids for hypotension, intubation for respiratory failure/arrest. I assess and diagnose my patient by looking at skin presentation, vital signs, mental status, and EKG.
    All signs & symptoms of a larger problem for which you have no training to diagnose....keep proving my point. Makes my job easier.

    Quote Originally Posted by FFMedic31 View Post
    And I begin the definitive treatment for them as well based on that diagnosis; I give Aspirin, Nitroglycerin, Morphine, and most notably Plavix. After transmitting my 12-lead EKG to the ER and giving them my radio report, I will transport my patient straight to the cardiac cath lab and completely bypass the ER. The ER physician never sees the patient.
    All meds given to you a medic to help stabilize. They are not always the definitive treatment. Any drugs you have been given are under orders a doctors orders.

    I highly doubt you bypass the ER to the cath lab without some sort of orders...Verbal or written. The ER physician might not see the patient but i pretty darn sure another physician is waiting for him that you have to answer to.

    Quote Originally Posted by FFMedic31 View Post
    Your responses reek of resentment of the Fire Service's role in EMS, like you were forced to get your EMT-Basic license to be a firefighter. Somebody that doesn't want to practice EMS and surely doesn't want to see it occupy any more of your time than absolutely necessary. And it's people who become EMTs so they can be firefighters that hold back EMS for those who want to truly make it a career instead of a stepping stone into the fire service, nursing, or med school. Please go back to your BRT and leave EMS to the professionals.
    I ride proudly...but in a humble manner, you should try it. You might find your skills will increase because you are always trying to perfect the job you have been set out to do & not worrying about what everyone else is doing around you.

    Your responses reek of excuses for your lack of commitment to the real job you so desire. So you created a superiority complex trying to make yourself bigger than what you are.

    Please go back to school & become an RN or DR. Stop kicking yourself in the butt for not having the testicular fortitude to really be that GOD you so wish to be. & leave the EMS to the people that understand their role in the larger scheme, the true professionals. It's pathetic seriously.
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    Quote Originally Posted by ffscm72 View Post
    And what caused that MI? might I ask?...You'll never know, unless you go back & ask...because you are limited to the EKG. You don't have the medical equipment needed to dig further into the problem. Because your training is limited. As it should be. You don't need to know it all...Just what little you can do to make the patient comfortable/stable enough.
    You're right, we don't have the equipment to dig further into that type of issue and you're probably the only person who thinks we (paramedics) are trying to dig further.



    All signs & symptoms of a larger problem for which you have no training to diagnose....keep proving my point. Makes my job easier.
    Sorry, but the only point that is being proven is your ignorance.



    All meds given to you a medic to help stabilize. They are not always the definitive treatment. Any drugs you have been given are under orders a doctors orders.
    Some of our medications are geared towards stabilization, however others are the definitive treatment for their problem.

    The vast majority of the medications that I administer to my patient's are not given due to direct physician orders, but rather based on protocol and my discretion, based on my assessment of their condition.

    I highly doubt you bypass the ER to the cath lab without some sort of orders...Verbal or written.
    True, there is probably a mechanism that allows that to happen rather being solely his discretion to bypass the ER.

    The ER physician might not see the patient but i pretty darn sure another physician is waiting for him that you have to answer to.
    Of course another physician will be waiting, who else is going to do the cath?

    I ride proudly...but in a humble manner, you should try it. You might find your skills will increase because you are always trying to perfect the job you have been set out to do & not worrying about what everyone else is doing around you.

    Your responses reek of excuses for your lack of commitment to the real job you so desire. So you created a superiority complex trying to make yourself bigger than what you are.

    Please go back to school & become an RN or DR. Stop kicking yourself in the butt for not having the testicular fortitude to really be that GOD you so wish to be. & leave the EMS to the people that understand their role in the larger scheme, the true professionals. It's pathetic seriously.
    The only thing pathetic I'm seeing in this discussion is your ignorant opinions.

    The vast majority of providers that I've had contact with know exactly what our role is in the grand scheme of all things medical. You seem to be the one that's confused.

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    Quote Originally Posted by FireMedic049 View Post
    You're right, we don't have the equipment to dig further into that type of issue and you're probably the only person who thinks we (paramedics) are trying to dig further.
    No I'm just the only one with this thinking. I'm just only one willing to tell you cause I'm not here to kiss your rear end. & just because a few of your buddies agree with you does not mean you are correct.

    Some of our medications are geared towards stabilization, however others are the definitive treatment for their problem.
    True some of your medications that you are allowed to give, are used by physicians as a long term treatment....But when it is used in the EMS field it is only meant as a short term stabilization tool.
    You are only allowed to use those drug under a physicians guidance. Either thru standing orders, verbal orders.

    The vast majority of the medications that I administer to my patient's are not given due to direct physician orders, but rather based on protocol and my discretion, based on my assessment of their condition.
    Your protocols aren't just something you medics talk about in a cute lil meeting. They written by a physician(s). They allow you to do your job. Nothing is left to your discretion. You must (or at least should) follow within ur defined scope of practice.

    True, there is probably a mechanism that allows that to happen rather being solely his discretion to bypass the ER.
    Sweet god we agree on something!

    Of course another physician will be waiting, who else is going to do the cath?
    not you....but at the rate some of these newer medics are going they are going to want to do it!...lol

    The only thing pathetic I'm seeing in this discussion is your ignorant opinions.
    I don't understand why you are getting worked up...they are my opinions. I am not alone. Thus beauty of the debate!

    The vast majority of providers that I've had contact with know exactly what our role is in the grand scheme of all things medical. You seem to be the one that's confused.
    That's a biased statement because I feel safe in saying these people you had contact with have the same opinions that you do. Talk to someone with a different view from yourself. & you might find you were right or wrong.

    I will back up a moment...& apologize I stooped down to a level of name calling I should not have done...& which I apologize as I don't know you. I've placed you into a broad spectrum of a (hopefully) small group of co-workers I just can't stand. No fair to you. But I stand by my opinion until it can be proven otherwise. Maybe one day when I step up into the roll of paramedic I might have a change of mind...But from my perspective it's just kind of silly to make something so hard out of something that is so dang simple. I like to live by the KISS method. IMHO
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    Quote Originally Posted by ffscm72 View Post
    No I'm just the only one with this thinking. I'm just only one willing to tell you cause I'm not here to kiss your rear end. & just because a few of your buddies agree with you does not mean you are correct.
    You might want to rework this one because most of it doesn't make much sense or help your position.


    True some of your medications that you are allowed to give, are used by physicians as a long term treatment....But when it is used in the EMS field it is only meant as a short term stabilization tool.
    Please name a few and we can discuss them.

    You are only allowed to use those drug under a physicians guidance. Either thru standing orders, verbal orders.


    Your protocols aren't just something you medics talk about in a cute lil meeting. They written by a physician(s). They allow you to do your job. Nothing is left to your discretion. You must (or at least should) follow within ur defined scope of practice.
    You clearly know very little about what you are talking about with regards to the paramedic level. Treatment protocols are written by physicians, this is true. However, you are absolutely wrong that "nothing is left to (my) discretion" when treating a patient.

    I'm a little familiar with your County's paramedic service and their reputation and I'm pretty confident in saying that they are also allowed to exercise their discretion in treating patients.

    I don't understand why you are getting worked up...they are my opinions. I am not alone. Thus beauty of the debate!
    Trust me, I'm not "worked up". I understand they are your opinions, however I feel that most of these opinions are born out of not knowing what you are trying to talk about.


    That's a biased statement because I feel safe in saying these people you had contact with have the same opinions that you do. Talk to someone with a different view from yourself. & you might find you were right or wrong.
    I'm more than willing to talk to people with different views, however in my 18+ year career, providing EMS in 2 states and a fair number of EMS organizations and EMS systems, you are the only person that I have encountered that thinks paramedics really want to be doctors and try to act that way when providing EMS care.

    I will back up a moment...& apologize I stooped down to a level of name calling I should not have done...& which I apologize as I don't know you. I've placed you into a broad spectrum of a (hopefully) small group of co-workers I just can't stand. No fair to you.
    Thanks, but I'm not sure when the name calling occurred.

    But I stand by my opinion until it can be proven otherwise. Maybe one day when I step up into the roll of paramedic I might have a change of mind...But from my perspective it's just kind of silly to make something so hard out of something that is so dang simple. I like to live by the KISS method. IMHO
    I'm sure your perspective will change if that occurs. I agree that this job really isn't all that complicated and that we aren't doctors, but many of the statements you have made seem to devalue and show a lack of comprehension of what the job actually is beyond the BLS level.

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    Quote Originally Posted by FireMedic049 View Post
    You might want to rework this one because most of it doesn't make much sense or help your position.
    Man I hate it when the keyboard batteries dies...lol no was supposed to be not...lol Just as bad as auto correct on the "smart" phones...lol



    Please name a few and we can discuss them.
    We can start with the ones you discussed earlier...
    Morphine- pain relief (short term)
    Plavix- blood thinner (usually given to pt w/ CVA)
    Nitro- dialator (short acting med for cardiac pt)

    I'm open to hear more what you all do w/ these.

    You clearly know very little about what you are talking about with regards to the paramedic level. Treatment protocols are written by physicians, this is true. However, you are absolutely wrong that "nothing is left to (my) discretion" when treating a patient.

    I'm a little familiar with your County's paramedic service and their reputation and I'm pretty confident in saying that they are also allowed to exercise their discretion in treating patients.
    Yes you can do what is within your standing orders. But can you just add meds to your list w/o approval from a physician...heck no. Heck in some cases you can't administer the meds you have now w/o approval from a physician.


    I'm more than willing to talk to people with different views, however in my 18+ year career, providing EMS in 2 states and a fair number of EMS organizations and EMS systems, you are the only person that I have encountered that thinks paramedics really want to be doctors and try to act that way when providing EMS care.
    then why do you fight my opinions so hard. You are defending a whole system....I speaking of a few members not only in the ALS system but in BLS system as well. I've been doing this for 12+ years, I've been in 2 states as well & like you a fair number orgs & systems. I like a lot of what I see. I just think its heading in the wrong direction sometimes, mostly because I see BLS & ALS wanting more & more without being proficient at what they got & know now.

    I'm sure your perspective will change if that occurs. I agree that this job really isn't all that complicated and that we aren't doctors, but many of the statements you have made seem to devalue and show a lack of comprehension of what the job actually is beyond the BLS level.
    So why complicate the simple? How much do I need to comprehend when our job is the same? Stabilize, transport, & tell the doc what you got. It's not brain surgery. I would love to go & go the next level. I just simply can't afford it.
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    For an overweight small town firefighter you seem to be full of opinions.

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    Quote Originally Posted by bossteen View Post
    For an overweight small town firefighter you seem to be full of opinions.
    & can still do the job better than you i'm sure. Unless you have something add, that is of relevance besides cheep insults, just stay out of it.
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    Quote Originally Posted by ffscm72 View Post
    Man I hate it when the keyboard batteries dies...lol no was supposed to be not...lol Just as bad as auto correct on the "smart" phones...lol
    ha ha

    We can start with the ones you discussed earlier...
    Morphine- pain relief (short term)
    Plavix- blood thinner (usually given to pt w/ CVA)
    Nitro- dialator (short acting med for cardiac pt)

    I'm open to hear more what you all do w/ these.
    You mentioned drugs used for long term treatment that EMS uses for short term stabilization. Morphine is predominately for short term pain relief and in CP & CHF for its vasodilation. Morphine really isn't used as a long term treatment. I wasn't the one who brought up Plavix and really can't comment much on it as it's not a pre-hospital medication in my state. Like morphine, nitro is a short term medication in both settings.


    Yes you can do what is within your standing orders. But can you just add meds to your list w/o approval from a physician...heck no. Heck in some cases you can't administer the meds you have now w/o approval from a physician.
    No, we can't just add to the list without approval, however I'm not talking about doing that. I'm discussing whether or not a patient is administered any of the medications or receives any of the procedures we are allowed to perform. We (at least here) have some discretion regarding what treatments the patient will receive and that was the point that you seemed to miss. The protocols are more like guidelines and not necessarily rigid directions for treatment to be followed blindly.



    then why do you fight my opinions so hard. You are defending a whole system....I speaking of a few members not only in the ALS system but in BLS system as well. I've been doing this for 12+ years, I've been in 2 states as well & like you a fair number orgs & systems. I like a lot of what I see. I just think its heading in the wrong direction sometimes, mostly because I see BLS & ALS wanting more & more without being proficient at what they got & know now.
    Because, in my opinion, your statements have not been limited to a "few members" providing ALS or BLS. You've mentioned them specifically, however you've also made comments that, as I've said, seem to devalue the overall system in order to try and make points about that minority.



    So why complicate the simple? How much do I need to comprehend when our job is the same? Stabilize, transport, & tell the doc what you got. It's not brain surgery. I would love to go & go the next level. I just simply can't afford it.
    You are right, it doesn't need to be complicated and it's not brain surgery, however you have a lot to comprehend if you think that EMS at the BLS level is the same job as EMS at the ALS level. If you grossly oversimplify things to the point that we all treat, transport and hand over to the hospital, then sure it's the same job, but that would be a huge misrepresentation of EMS as a whole and specifically the care available at the ALS level.

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    You haven't added anything of relevance. You are a small town EMT with very limited experience and education, otherwise you would understand the importance of increasing educational requirements. The days of scoop and screw are over, have been for a while, the problem is we have providers who are woefully under educated for the increasing job requirements. RSI, 12 lds, Ultrasound, disaster medicine, confined space medicine, dive medicine etc... all have a place pre hospitally. Just like the increasing push for education for fire officers there is an increasing push for education for those pushing drugs that can and are lethal in the wrong hands. I don't know the paramedic that hurt your feelings, but seriously dude, you sound like the LA of the EMS board. Re read some of you posts, you are a small fish in a small pond, there is a whole lot of EMS and firefighting out there that you have no clue about. At 20 I would give you a pass, but 30? Chattanooga will be well advised to pass on a candidate such as yourself.

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    Quote Originally Posted by ffscm72 View Post

    We can start with the ones you discussed earlier...
    Morphine- pain relief (short term)
    Plavix- blood thinner (usually given to pt w/ CVA)
    Nitro- dialator (short acting med for cardiac pt)

    I'm open to hear more what you all do w/ these.

    Plavix is used in the MI patient to begin the clot-busting process. Not only is it used in the emergency setting, but many patients continue taking Plavix for at least a year after the MI, if not the rest of their lives.

    Using it in a CVA patient would be dangerous pre-hospital, as differentiating between an ischemic and hemorrhagic stroke pre-hospital seems to be beyond many providers. Exactly where do you know Plavix is given pre-hospital for CVA protocols??

    FireMedic049 covered the other two meds.

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    Quote Originally Posted by FireMedic049 View Post
    You are right, it doesn't need to be complicated and it's not brain surgery, however you have a lot to comprehend if you think that EMS at the BLS level is the same job as EMS at the ALS level. If you grossly oversimplify things to the point that we all treat, transport and hand over to the hospital, then sure it's the same job, but that would be a huge misrepresentation of EMS as a whole and specifically the care available at the ALS level.
    then enlighten me. what more do you do (or would like to do)? I'm just not seeing it I guess.
    I'm not saying the EMS isn't important. A lot of patients wouldn't have chance he** without it. My point is some (maybe not you or some others) don't seem to know there role in the greater scheme & they bring it out in the field where it doesn't belong. There has to be a limit somewhere.

    Quote Originally Posted by bossteen View Post
    You haven't added anything of relevance. You are a small town EMT with very limited experience and education, otherwise you would understand the importance of increasing educational requirements.
    The size a town or city doesn't matter. The game is the same. Am I limited no...different yes.

    I can't argue though about the increasing educational requirements...I just question if it necessarily belongs in a college.

    Quote Originally Posted by FFMedic31 View Post
    Plavix is used in the MI patient to begin the clot-busting process. Not only is it used in the emergency setting, but many patients continue taking Plavix for at least a year after the MI, if not the rest of their lives
    Exactly where do you know Plavix is given pre-hospital for CVA protocols??
    No where as far as I'm aware. I thought I saw it mentioned earlier in these threads & found it odd.
    Now I do know (in some states) they are using as a preventive (if i remember correctly though it must meet some certain criteria or something of that nature). Friend of mine in NJ whom is resident physician for a neurosurgery unit was discussing this during a conversation. He found it odd as well.
    Last edited by ffscm72; 07-20-2011 at 01:34 PM.
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    Quote Originally Posted by ffscm72 View Post
    No where as far as I'm aware. I thought I saw it mentioned earlier in these threads & found it odd.
    Now I do know (in some states) they are using as a preventive (if i remember correctly though it must meet some certain criteria or something of that nature). Friend of mine in NJ whom is resident physician for a neurosurgery unit was discussing this during a conversation. He found it odd as well.
    You think you read it somewhere on these message boards and tried to use it as your own knowledge to try to make yourself appear better educated. Talk about your all-time backfires. All it did was bring your credibility (as an EMT-Basic) even lower in this discussion about Paramedics. If you want to have some credibility, get your Paramedic license. There's student grants and loans everywhere. Get your Fire Department to pay for it, looks like you guys have some pretty good funding. Until then, please leave this discussion to the educated members who have put their time into ALS EMS and please get back to your band-aid station and blood pressure checks. You trying to tell me what my job consists of is like a backstep firefighter trying to tell an Arson Investigator the same thing. I might have a slight idea of what his job is, but I am nowhere near their level in education and experience to speak so out of line.

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    Quote Originally Posted by FFMedic31 View Post
    I spend an average of 45-50 minutes with my patients. Yes, I perform interventions to best stablize my patient; Oxygen for hypoxia, IV with fluids for hypotension, intubation for respiratory failure/arrest. I assess and diagnose my patient by looking at skin presentation, vital signs, mental status, and EKG. And I begin the definitive treatment for them as well based on that diagnosis; I give Aspirin, Nitroglycerin, Morphine, and most notably Plavix. After transmitting my 12-lead EKG to the ER and giving them my radio report, I will transport my patient straight to the cardiac cath lab and completely bypass the ER. The ER physician never sees the patient.
    I knew i read it some where.

    Look I don't know everything you all are doing. But I know it is the same.
    the plavix comment was a misunderstanding on my part. I digress & apologize.

    Quote Originally Posted by FFMedic31 View Post
    You think you read it somewhere on these message boards and tried to use it as your own knowledge to try to make yourself appear better educated. Talk about your all-time backfires.
    I read it from you. U didn't explain what you used it for. DE medics do not have it in there protocols to use.
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    Nowhere did I say it is used for CVA. Nice try. If you had any idea of what we were talking about, you'd understand what a 12-lead EKG is used for, and typically what is done in a CARDIAC cath lab.

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    Quote Originally Posted by ffscm72 View Post
    I knew i read it some where.

    Look I don't know everything you all are doing. But I know it is the same.
    the plavix comment was a misunderstanding on my part. I digress & apologize.



    I read it from you. U didn't explain what you used it for. DE medics do not have it in there protocols to use.

    How can you say you don't know everything we do, then follow it in the next sentence by saying it is the same as what you do? I mean, really dude? You don't have a leg to stand on at this point.

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    Quote Originally Posted by FFMedic31 View Post
    How can you say you don't know everything we do, then follow it in the next sentence by saying it is the same as what you do? I mean, really dude? You don't have a leg to stand on at this point.
    Really? like you don't have an opinion on say..the government. You don't now everything they but you have an opinion anyway.

    No...I don't know all the drugs you use & all the tools. But you do the same thing as BLS (at a higher level, no question there). Assess, treat (with more drugs at your disposal obviously), & transport. That's it. Job done, on to the next 911 call.

    Now...just a moment ago I went up to my firehouse that employs some Paramedics from the county who works with us @ a BLS level. Now I just got into this same conversation with this person & we came to the same conclusion. EMS is EMS no matter the level. I can see I'm not putting my opinion across on here as articulate as did him. So obviously there is a communication problem. Sometimes I hate forums..lol

    I did learn something that I was never aware while speaking w/ him, which leads me to this question to you....He said that some paramedics are licensed to operate on their own behalf (i hope I understood that correctly). Would this be true for your county, state, or whatever level you operate under? 2nd question How does that work? Who do you answer to? Do you have a separate board of physicians or Paramedic you answer to?
    If that's the case then I can see why this has become an argument rather than a discussion.

    I'll have to bow out to the comment of small fish cause I've just never heard of such a thing. I've been to several states & asked about how they operate &, with minor or major differences of course, I can't say i've ever heard of that.
    "Courage is the resistance to fear, the mastery of fear, not the lack of fear." Mark Twain
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    Quote Originally Posted by ffscm72 View Post
    then enlighten me. what more do you do (or would like to do)? I'm just not seeing it I guess.
    I'm not saying the EMS isn't important. A lot of patients wouldn't have chance he** without it.
    I know you aren't saying that EMS isn't important. What you appear to be saying is that the provision of EMS is exactly the same on all levels. That's downright laughable. As I stated before, if you oversimplify it, then yes, we all assess & treat pt to the best of our ability, transport and hand off to the hospital. However, that view overlooks so much important detail.

    My point is some (maybe not you or some others) don't seem to know there role in the greater scheme & they bring it out in the field where it doesn't belong. There has to be a limit somewhere.
    If that's your point, then make that point by discussing actions related to that issue! If that's your point, then you are dragging a whole lot of unnecessary stuff into the discussion and making yourself look bad.


    The size a town or city doesn't matter. The game is the same. Am I limited no...different yes.
    Again, if you oversimplify it, then yes, the "game is the same" because the patient themselves and their complaint can be universal, however there are differences between the provision of small town EMS and large urban EMS.

    I disagree with your assertion that you aren't "limited". As an EMT-Basic, in EMS terms, you are the definition of "limited".

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    My question, as I'm working on EMT-I.

    Who in their right mind would argue AGAINST raising an educational standard?
    Co 11
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    Amateurs practice until they get it right; professionals practice until they cannot get it wrong. Which one are you?

    'The fire went out and nobody got hurt' is a poor excuse for a fireground critique.

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    Quote Originally Posted by ffscm72 View Post
    Really? like you don't have an opinion on say..the government. You don't now everything they but you have an opinion anyway.
    Yes, Really. You're entitled to your opinion and you can keep on spewing them as long as you want to, however we are equally entitled to tell you that your opinion is an uninformed one.

    No...I don't know all the drugs you use & all the tools. But you do the same thing as BLS (at a higher level, no question there). Assess, treat (with more drugs at your disposal obviously), & transport. That's it. Job done, on to the next 911 call.

    Now...just a moment ago I went up to my firehouse that employs some Paramedics from the county who works with us @ a BLS level. Now I just got into this same conversation with this person & we came to the same conclusion. EMS is EMS no matter the level.
    You're kind of making our point with the first part of this, you don't know the ALS side of the job! At the BLS level, you assess the patient then, for the most part, the only treatment you will actually provide at that level is the administration of oxygen, CPR/AED, maybe assist a patient with taking their own medications, immobilization & bandaging. After that, transport to the hospital with a re-assessment. Pretty much the same stuff whether the pt was BLS or ALS.

    At the ALS level, the patient will be assessed the same way, however there will likely be some additional questions that the EMT may not be trained or know to ask. If the pt is ALS, then additional assessment will be made using our diagnostic tools like EKG/12-leads and Glucometer. The patient will then likely get an IV and anything else BLS would provide. Then if appropriate, the patient would get medication. If the patient is not breathing, then they will get an advance airway. If their heart isn't beating right, then they might get paced or cardioverted to fix the disrhythmia. If their lung has collapsed, then they will get a needle inserted into their chest to fix that. Just to name a few. Yup, sounds like the same job.


    I did learn something that I was never aware while speaking w/ him, which leads me to this question to you....He said that some paramedics are licensed to operate on their own behalf (i hope I understood that correctly). Would this be true for your county, state, or whatever level you operate under? 2nd question How does that work? Who do you answer to? Do you have a separate board of physicians or Paramedic you answer to?
    If that's the case then I can see why this has become an argument rather than a discussion.
    In PA, paramedics are not licensed, they are certified and operate under the direction of a Medical Director (for the service itself) and if needed, with the direction of a Medical Command Physician for a patient. For the most part, it's a permanent certification, however we must do 18 hours of con-ed per year and do a skills demonstration thing in order to maintain our medical authorization in order to provide ALS care.

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    Quote Originally Posted by JohnVBFD View Post
    My question, as I'm working on EMT-I.

    Who in their right mind would argue AGAINST raising an educational standard?
    Oftentimes, those who would not be able to meet the new standard.

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    Quote Originally Posted by FireMedic049 View Post
    Yes, Really. You're entitled to your opinion and you can keep on spewing them as long as you want to, however we are equally entitled to tell you that your opinion is an uninformed one.

    You're kind of making our point with the first part of this, you don't know the ALS side of the job! At the BLS level, you assess the patient then, for the most part, the only treatment you will actually provide at that level is the administration of oxygen, CPR/AED, maybe assist a patient with taking their own medications, immobilization & bandaging. After that, transport to the hospital with a re-assessment. Pretty much the same stuff whether the pt was BLS or ALS.

    At the ALS level, the patient will be assessed the same way, however there will likely be some additional questions that the EMT may not be trained or know to ask. If the pt is ALS, then additional assessment will be made using our diagnostic tools like EKG/12-leads and Glucometer. The patient will then likely get an IV and anything else BLS would provide. Then if appropriate, the patient would get medication. If the patient is not breathing, then they will get an advance airway. If their heart isn't beating right, then they might get paced or cardioverted to fix the disrhythmia. If their lung has collapsed, then they will get a needle inserted into their chest to fix that. Just to name a few. Yup, sounds like the same job.




    In PA, paramedics are not licensed, they are certified and operate under the direction of a Medical Director (for the service itself) and if needed, with the direction of a Medical Command Physician for a patient. For the most part, it's a permanent certification, however we must do 18 hours of con-ed per year and do a skills demonstration thing in order to maintain our medical authorization in order to provide ALS care.
    Let's not leave out surgical crics.

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    Quote Originally Posted by Iceman26 View Post
    Let's not leave out surgical crics.
    Right, I was just trying not to make the job out to be more than it is. After all, we aren't doctors.

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    Quote Originally Posted by JohnVBFD View Post
    My question, as I'm working on EMT-I.

    Who in their right mind would argue AGAINST raising an educational standard?
    Broadening & raising a standard are two different things.

    You want to further your education...by all means...DO IT.

    You want to raise educational standards because you think it will create better medics/intermediates/basics...I fly the BS flag. To me it's just another reason for some EMT's to say, "Hey, I got a degree. Give me more money!"
    I've seen some of the best medics come from a certificate class, & the worst come from a college. Experience can be your best teacher.
    "Courage is the resistance to fear, the mastery of fear, not the lack of fear." Mark Twain
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