Emergency Medical Technician Basic

[medic4life]

The plan would not involve ALS agencies per say. The majority of time would be spent with BLS agencies. If time allowed and the students fulfilled their BLS pre-hospital requirements, then they could schedule time with an ALS agency.

[ResTech]

That sounds like a really good idea and could prob work really well.

Sexyemschic, the meaning of my comment "back in the day it actually meant something to receive your EMT and now it doesnt really mean near as much", was referring to the perception of other healthcare providers and even ones peers. Itz no secret that basics have lost respect over the years due to the dumbing down of the EMT program and arent looked at as highly as they once were. Least in my opinion. Last I heard the medical director for the southern EMS departments would not permit epi to be placed onboard an ambulance. Why is that? See where this perception comes into play and why? And this isnt the only medical director that shares that same feeling. You have pride which is great and sounds like you believe 100% in what you do as a provider.

And to answer your question no, I am not "active" in Franklin County anymore only Adams County for my job. Kids and a social life are my priority so I dont have time to hang at a fire/ems station.

[Bill]

Good evening to all!

The link for this discussion has been forwarded to the following individuals: Walt Kelch, Rob Bernini, Jerry Ozog, Bryan Smith, Holly S. Millsaps, C. Steve Lyle

It is my belief that all would benefit from reading your thoughts and ideas. I would like to take a moment to thank each and everyone for sharing them!

Happy New Year to all!

Bill L.

[ResTech]

Thought this was relevent to the conversation and helps prove alot of points that were made....


AS READ ON EMS RESPONDER.COM

A new EMT curriculum offered in Lancaster puts the brains back into emergency medicine. Over the years, when executive director C. Robert May interviewed potential employees for Lancaster Emergency Medical Services Association, he found they couldn't make the grade.

"I would say two-thirds of those we interviewed failed the basic competency," May said. Even though emergency medical technicians and paramedics must pass a course and state exams to work in the field, LEMSA officials found their own screening process weeded out most potential employees.

"Over the last several years, we've noticed a steady decline in employable people," said LEMSA operations manager Dave Nitsch, who also is an EMT instructor. "(EMT courses) tend to only train people how to pass the (certification) test. They're shifting away from educating people and toward training people."

A year ago, LEMSA made a call to Lancaster General College of Nursing & Health Sciences to see if there was interest in creating a beefed-up EMT curriculum. Just a few months later, details were being worked out. On Jan. 9, the first EMT courses start at the college. The process flowed because the college is in the business of teaching health care and LEMSA is in the business of saving lives.

"It's a dovetailing of philosophies," May said of the collaboration. "It meets our needs, and it meets their needs." This isn't the stuff most EMT courses offer, though. The 244 class hours are double those of most EMT courses. And at $450 for the basic course, it's nearly double the cost of most EMT classes. But students at this EMT program will come out with more than certification.

"With current EMT programs, students aren't coming out with critical-thinking skills," said Christina Baumer, chair of continuing education at the college. "They're not trained to know what to do if the first thing they try doesn't work." Most certification programs don't include clinical time with sick people or time riding with ambulance crews, so often the first time graduates encounter a sick person is their first day on the job. Some students find by the time they actually get their first job and see what it's all about, the stressful field just isn't for them.

The new curriculum for students at the college includes clinical time in Lancaster General Hospital's emergency department and practical experience riding along with LEMSA crews. "If you have clinical time built in, students actually get to see what the job really involves," Baumer said. "That's only fair to students and to the public, also. The public expects that person on an ambulance to be well trained and know what to do for them. Anything less is not really putting the patient first."

Students won't be dumped at the scene of an traffic accident, though. Students in the new EMT curriculum will be trained on high-tech dummies that sweat, bleed, speak, vomit and do just about anything else an ailing human does. The human-patient simulators look like mannequins and react to medical treatment. They have heartbeats, their pupils dilate, their tongues swell, they react to drugs and fluids when students administer aid, and they even have a microphone so instructors can speak for the patient during interaction with students. The college obtained grants and donations to buy the human-patient simulators long before the EMT course was even considered, but EMT students also will reap the benefit. It's a far cry from most EMT classes, in which students pretend to be ill while other students pretend to treat them.

"The human-patient simulators offer a nice buffer between healthy people in class playing as if they're sick and the real thing," Nitsch said. If developers of this curriculum had any doubts about the interest in a harder, longer, costlier EMT course, the first round of student registration convinced them it might be just what the doctor ordered. More than 25 students are signed up for two upcoming classes - the evening class on Mondays and Thursdays from 6 to 10 p.m. and the morning class on Tuesdays and Fridays from 8 a.m. to noon.

"We had said if we could get five people in each class we'd be happy," Baumer said. "This little fire just took off. Obviously, there's a need out there, and people are looking for a quality program because they just migrated to it." For LEMSA's part, Nitsch and May are happy about the prospect of all those potential graduates, too. Not only are they aligned with the nursing school's reputation, graduates might decide to take advantage of their LEMSA affiliation by going to work there after graduation.

"We're doing this selfishly," Nitsch said. "We'll be getting a stream of better-trained students out of this." Baumer said she expects the EMT continuing education course to evolve into an associate degree program at the college. LEMSA and the college also are adding a continuing education paramedic course in the fall semester, which begins in mid-August. By then, May and Nitsch hope the public will better understand that the crew members are more than ambulance drivers - they are paid, trained, educated and certified to do what they do.

"We want to get away from the 'ambulance driver' concept that the public has," Nitsch said. "This course gets into the whys of treating people, not just the hows." For more information about the EMT program or the fall paramedic course, call the college at 544-4912.

[firetach2005]

i can remember when i took my EMT-B class that is was a requirement to be a member of ambulance dept or fire dept that had ems for in order for someone else to pay for it. other than yourself. mostly 20 runs to get the companys money worth.

[Brian McCaffrey]

firetach2005 said:

i can remember when i took my EMT-B class that is was a requirement to be a member of ambulance dept or fire dept that had ems.

I'm not aware that this was ever a requirement for EMT-B. A suggestion, yes, but not a requirement.

ResTech,

I really like the idea that LEMSA is goinw in this EMT class. It is no surprise that they are finding fewer decent employable EMT's. Our last round of interviews yielded one "employable" prospect out of 15 or so interviews. We found a few we can work on until they meet what we want, but this is a sad tribute to the current classes.

Caff

[SubZeroSapphire]

<sup>i can remember when i took my EMT-B class that is was a requirement to be a member of ambulance dept or fire dept that had ems.



I'm not aware that this was ever a requirement for EMT-B. A suggestion, yes, but not a requirement.</sup>

It was never specified which state that person was from, so that may have been the case that they were required to be a part of a FD. I was originally certified in Washington state, in which you had to be affiliated with a dept before the medical director would sign off on your certification.

[Brian McCaffrey]

Point taken, my dear Sapphire.

I did not inquire about the state, I simply assumed it was PA. I will try harder next time.

That is an interesting point, though. I know of several people who took the class (way back when I did) that simply wanted to better themselves. I do encourage anyone taking the class to join a local EMS dept or FD that has EMS, but some simply take the class for their employer for no simple reason at all.

[Bill]

The following was received by me via email over the holidays. Just thought I'd share it with you:

Yes some very interesting discussion on the local tabloid. It would be nice if people would say who they are in these little dissertations. It would also be good if they had a better understanding of the liability that hospitals would incur the cost to underwrite insurance to allow students to do clinical time in a hospital facility or on a paid ambulance. We could expand the program 10 fold to incorporate hours needed to do all these programs and I don’t disagree they would not be of value, however we have a difficult time filling classes now because of the time frame needed and they feel the cost is already too high, the additional fees needed to do a program of this magnitude would be incredible. There would also need to be formal agreements between the college and every entity “Willing” to participate, in addition to the costs and verification of multiple immunizations that each facility would require. Oh yes and each hospital would require a formal in-service of their facilities rules on confidentiality, infection control, and social skills…if you will…what kind of time are we now looking at...

I am quite familiar with the Maryland System which I am presuming many of these folks are saying they trained in and work in. I have precepted new paramedics coming through the system and if you talk to students they will tell you to a man that the training they received in PA is every bit as good clinically as what they received with our counterparts to the south. It is a time driven system for graduation, not skill driven at the ALS level. I have many friends in the Maryland system and I am not trying to diminish their training, just pointing out it is different as well...and both states produce quality providers within the parameters of the systems they work in. People coming into any form of EMS or fire want instant training, the first question with each class is …Are we going to be here all night? How much time can I miss and still pass? I am going on vacation or taking a rescue class, if I just read information is that ok? You have been there as long as I have Bill and you know these are true statements. I am glad that the folks in Franklin County want a better product on the street. I do to. The folks that this note and your note is being sent to are all dedicated to making the system better…turning out a better EMT which in turn will turn out a better medic or nurse or doctor down the road. Their goal is to work within the system we have been given and make changes as best we can…but it is not as easy as many may think when you are talking about State regulations. There are currently several good, progressive, active committees tasked to just what they want…improvement to the system, but I can tell you improvement will not be gained by taking shots at the current system… What is needed is constructive criticism and solid, thought out suggestions and answers..I encourage anyone to get involved…that is how change works the best.

One last thought and then I will stop. I found it interesting the constant references to the “old days”… I went through the old days like you…we did our ER time during which we observed and maybe took a blood pressure or two if we were brave…and ALS did not exist in my EMT days…we did go to the salvage yard…and broke many tools which the companies had to absorb on their own…We also did our time when litigation in the healthcare field was minimal and people went to the hospital because they were really sick…Now, litigation runs a large portion of what we do as we react to the potential of law suits. When I graduated as an EMT, I was really no better prepared than the students of today...the difference was that the companies I belonged to did not and would not put me out on the ambulance the day I received my patch. The company took responsibility for bringing me along, teaching me the ropes and the right way to deal with patients…ambulance crews consisted of four members, not two. We did not have ALS to depend on, or ALS to tell us to get out of the way or out of our own ambulance as is the current practice in many areas, I will argue that point with anyone…that ALS is very much responsible for the performance or lack thereof as perceived by many of the BLS providers in the State. Many of my counterparts have forgotten their roots and where they came from. And yes I have been active in the system for 27 years and a medic for 18. My point however, is that the companies accepted the responsibility for the growth of new EMT’s, nurturing and teaching them…In not one of the comments you forwarded was there any mention of company responsibility… What is the responsibility of the departments? Do they have any? Should they have any? I hope so, mine did…I rode for almost a year before taking on calls as the primary EMT, I got the chance to learn from some of the best people in my company. They taught me how to do it right. EMS is a constantly changing and evolving science. It is not exact and no two calls are alike…EMT class teaches just that…basic principles… the rest comes with time…and experience… you cannot teach experience, but those that are active veterans, if they so chose, can share their experience instead of pointing out shortcomings of new graduates…

[Bill]

And more email:

Lancaster General College of Nursing & Health Sciences
Emergency Medical Technician Program
$450 - Basic EMT only.
$600 - Basic EMT with Hazmat, EVOC, and ALS Assistant certifications.

Doesn't the old adage go, "You get what you pay for."

"Let's get those Relief Association Coffers open!"

[OldDog]

Bill,
Thanks for sharing the response you got via e-mail
Too many youngsters (experience not necessarily age) today have become ALS dependent. They need to realize that their BLS skills will save lives also and that while ALS is nice to have around they can function without it when they have to. It's kinda like walking a tightrope without the net.

The writer made an excellent point when he said it's up to the veterans to mentor the next generation as it comes along. While I work hard at my EMT skills to stay at a good level, I sure didn't start out that way fresh out of class. I also realize that I can learn from anybody, even a newbie.

We all need to keep working for the good of the profession (and our communities).

[Brian McCaffrey]

Bill, I also thank you for reprinting that email. They make several good points, and I do agree that litigation has gone haywire in recent times.

Not only is it the responsibility of the experience EMT to mentor the "newbies", but it is most certainly the responsibility of the "newbie" to pay attention to the mentor. As a senior preceptor/mentor at my department, I see too many young EMT's (experience, not necessarily age, as OldDog puts it) brush off our experiences as war stories or anecdotes. Now, just because I walked ten miles to school, uphill both ways, does not mean I am senile and don't know what the hell I'm talking about. Wait a minute...what were we talking about again?

It is not our position to look down on new EMT's, although I fear that is what we do all too often, myself included. I still feel that the program has been dumbed down, although the email above seems to justify such a process. I guess it is up to us to counteract that in the field, which is what I thought we had been talking about all this time.

Caff

P.S. OldDog, I'm glad you're around. While you may not use many words, you sure say alot. Thanks.

[sexyemschic]

This has been a good productive link guys..... there's only one thing I think we ALL forgot.....
WE WERE ONCE THAT NEW INEXPERIENCED EMT WHO MAY OR MAY NOT HAVE BEEN SCARED TO DEATH ON THEIR FIRST CALLS!!!!!!!!!!!!!!!!!

Every single one of us was a new EMT once, we had mentors & preceptors that I know I personally will never forget all that they taught me, good, bad, right or wrong. Everyone starts somewhere & works their way up. For some of us who are now that preceptor or mentor just remember there's a point behind our stories, I always tell my new EMT's about my first pediatric call, I was dispatched for a 3 yrs old in cardiac arrest, I was so scared I shook on the way to the scene, I was thankful to get there and have the father hand me a post-dictal 3 yr old in the driveway instead of a cardiac arrest!!! It's ok to be scared at first, even oldtimers have been there.

[Brian McCaffrey]

sexyemschic said:

...It's ok to be scared at first, even oldtimers have been there.

Me? Scared? Whachoo talkin' bout, Sexy?

;D ;D

This thread isn't about being scared. It's about being unprepared. I don't worry about someone being scared, even an experienced EMT. It happens. What started this whole thread was the common opinion among us that the newer EMT's are not as prepared as they used to be. It's a skill thing, not a confidence thing.

[medic4life]

Well... my intention certainly was NOT to ruffle anyone's feathers, but apparently I did. I have recently been informed by a few EMT students that the EMT instructors made several comments pertaining to my post here about EMT's not being prepared for the field. I do not recall EVER referring to the classroom training being under par. I simply stated that EMT students should NOT be placed in the field before having patient contact, and I will say it again. I understand all of the legal and logistical issues that go along with clinical education, that's why I volunteered to create a clinical coordinator position and be the liason for the class. But apparently that has fallen on deaf ears. My intention was and is to help take the system to a better level than it is right now. I'm just making suggestions and being willing to step up and help out. I'm sorry if I offended anyone.

I absolutely agree that a new EMT graguate should be further trained by their department. Agencies need to have programs implimented to continue a new graduate's education. However, I strongly disagree that students should be able to graduate a class and receive state certification without ever touching a patient or experiencing the pre-hospital environment.

All I am suggesting is something that will enhance what is already in place. But, if I am offending people then maybe I will obtain my EMT instructor and teach myself. Thank you to those who commented on this issue. Best of luck out there and stay safe.

L8R