[quote name='ppfd' post='61682' date='Dec 26 2006, 16:16 ']Ed,
as a long time paramedic in Ohio and West Virginia. I have too say I wish more places would adopt this mind set Boston EMS has. I cant count how many times I've crossed state lines to "assist" a W.Va. BLS squad sitting 5 minutes from thier local ED! Or meet a W.Va. or Ohio BLS squad enroute to our ED 5 mins away! These EMT's in our areas are trained not to think. If its dyspnea or chest pain then by god we need ALS! Never mind I can see the hospital from where I'm sitting.[/quote]
Unfortunately, the 1994 DOT EMT-B curriculum (referred to as the dumbed down version by many Instructors, including myself) places an emphasis on early activation of ALS for just about any patient presentation, and is presented in such a way that it produces EMT robots....see this, do that. It's very difficult to teach the course and still ingrain the theory of taking in the big picture. I usually go many hours above and beyond the 110 hour core course to share some pathophysiology of things like left vs right sided CHF, hypo vs hyperglycemia, the carboxyhemoglobin dissociation curve and the like, which I feel results in a much better prepared basic, but there are still many instructors out there churning out cookie cutter courses, which will frustrate advanced providers for a long time to come.
Just a certification point, I'm an EMT-B, and have completed the didactic potion of my medic course with the clinical to follow, but I've been including these things in my courses since long before I started my advanced training, so it goes to show that even basics can be trained to do the right thing. <img src='http://www.firepics.net/groupboards/public/style_emoticons/<#EMO_DIR#>/biggrin.gif' class='bbc_emoticon' alt='
' />
as a long time paramedic in Ohio and West Virginia. I have too say I wish more places would adopt this mind set Boston EMS has. I cant count how many times I've crossed state lines to "assist" a W.Va. BLS squad sitting 5 minutes from thier local ED! Or meet a W.Va. or Ohio BLS squad enroute to our ED 5 mins away! These EMT's in our areas are trained not to think. If its dyspnea or chest pain then by god we need ALS! Never mind I can see the hospital from where I'm sitting.[/quote]
Unfortunately, the 1994 DOT EMT-B curriculum (referred to as the dumbed down version by many Instructors, including myself) places an emphasis on early activation of ALS for just about any patient presentation, and is presented in such a way that it produces EMT robots....see this, do that. It's very difficult to teach the course and still ingrain the theory of taking in the big picture. I usually go many hours above and beyond the 110 hour core course to share some pathophysiology of things like left vs right sided CHF, hypo vs hyperglycemia, the carboxyhemoglobin dissociation curve and the like, which I feel results in a much better prepared basic, but there are still many instructors out there churning out cookie cutter courses, which will frustrate advanced providers for a long time to come.
Just a certification point, I'm an EMT-B, and have completed the didactic potion of my medic course with the clinical to follow, but I've been including these things in my courses since long before I started my advanced training, so it goes to show that even basics can be trained to do the right thing. <img src='http://www.firepics.net/groupboards/public/style_emoticons/<#EMO_DIR#>/biggrin.gif' class='bbc_emoticon' alt='
' />
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