BLS, ALS... Are we doing it right?

[actanonverba]

"You know, I've been an EMT for 24 years and I often find that a competent EMT can out-treat an RN in an emergency situation. Those RN's NOT being E.R. nurses mind you. It's all in your experience and knowledge base. How many times have you rolled up on an accident scene to find a nurse or doctor there, doing absolutely nothing or running around hysterically, while we calmly handle the job? I think we should have our scope of care expanded to include the LMA's and we should be able to do a friggin' finger stick for blood sugar for God sake! As always, NJ takes baby steps!"

I. I really don't think that you can even compare an experienced EMT, and an RN or doctor.. If you threw an EMT in an oncology, surgical unit and told them to manage the acute and chronic care, nutrition, and rehabilitation of the patient, I'm sure they'd look at you with a gaze. It's simply not what you learn about in EMT school. Likewise, the nurse or doctor who just wants to help at an accident scene is doing just that, trying to help out. Further, what do you mean by out treat? Perhaps out-manage, but I really don't think you can gauge treatment due to standing orders and medical control...

II. Expanding the role of the EMT-B... Isn't that why we have paramedics? As Craig said above, the EMT school teaches you how to not kill somebody, and get them to the hospital safely. If you wanna do advanced skills, become a medic or an RN, NP,or an MD DO whatever.
What will giving EMT-B's LMA's do? How often do you use them? Why an LMA?
Yea, they're blind insert. But they neither provide long term airway patency, and shouldn't be used if the patient is likely to aspirate. So make sure you ask your coded patient if they've eaten recently?

[gotothelight]

Of course, an EMT in an oncology unit would be dumbstruck.... But I am referring to RN's working in MD's offices, Extended care facilities, etc... who fail to do the basics that any EMT would do for someone in acute distress. How many times have you walked into a nursing home for a respiratory and found a patient barely breathing, but on 2 litres of o2, or with none at all. same with doctor's offices... Some of the biggest bonehead moves I've seen have been done in doctors' offices. All I'm saying is take any of us out of our "comfort zone" and we would have problems operating as we normally would.

I'm not gonna argue the points of LMA's, just saying, let's be a little more progressive in NJ. Unfortunately, the EMT curriculum puts out EMS robots, who are no longer taught to think too hard about anything, just react to what you find. I would also be more than happy to become a paramedic, but the cost is ridiculous, and I make more money as an EMT anyway. But we have an excellent contract and unfortunately are the exception to the rule.