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- Jan 25, '11 by 954_racerWhat does this community suppose will happen when the paramedic postion evolves into an advance practice role as has been seen in europe, australia, and new zealand. Is it possible the flight companies will do away with flight nurses in favor of these "ditch doctors" ?
- Jan 26, '11 by GilaRRTQuote from 954_racerWhat do you mean by "advanced practice?" Nurses are still involved in transport throughout the world. If anything, evolving the paramedic and requiring additional education can only ensure a better educated provider is providing patient care. Also, what exactly do you mean by "ditch doctors?" I've worked with Australian critical care medics and South African B-Tech medics. My old boss overseas was an OZ Critical care medic. Their scope of practice was roughly comparable to many US flight paramedics with the exception that the OZ and SA medics typically had degrees and much more formal education. Clearly, the scope of practice and medical control issues were different, but they roughly operated at the same level as their US counterparts.What does this community suppose will happen when the paramedic postion evolves into an advance practice role as has been seen in europe, australia, and new zealand. Is it possible the flight companies will do away with flight nurses in favor of these "ditch doctors" ?
- Jan 26, '11 by TraumaSurferQuote from 954_racerAdvanced practice? No, the Paramedics in other countries just have the appropriate education to perform what many U.S. Paramedics do. The Paramedics in other countries have a better understanding of what they are doing and can function under different guidelines with more autonomy. If they want advanced practice at scene, there may be a physician that responds. The protocols in the U.S. EMS system are usually written for the minimum education standard. For flight, a Paramedic may have additional training and/or an RN can be partnered with them. Some Paramedic flight teams have essentially the same protocols as the ground crews with the only difference being the mode of transportation.What does this community suppose will happen when the paramedic postion evolves into an advance practice role as has been seen in europe, australia, and new zealand. Is it possible the flight companies will do away with flight nurses in favor of these "ditch doctors" ?
In Europe, several countries have Physician or nurse led EMS. The nurse led EMS countries include the Netherlands, Spain and parts of Italy which have ALS. The ECP in the U.K. can also be a nurse.
In the U.S., since flight programs may also do critical care IFT, there is a need to have a provider who is educated and experienced in critical care. Right now that happens to be a nurse.
I don't see many changes for EMS in the U.S. except for more accountability in the various systems for the way they use resources to justify funding. I don't see this country even requiring an Associates degree for many years so the education will not catch up with the other countries. Some are even against the changes in the NREMT like calling the Intermediate an Advanced EMT which is a more appropriate description or requiring Paramedic programs to be accredited.
- Feb 2, '11 by Airmed1Depending upon where you practice , your state's scope of practice will be different for a Flight Nurse and a Flight Medic. Both have their own area of expertise and comfort level. Our program does approx 60-70% interfacility transports and 30-40% scene responses. In my experience the Medics tend to take the lead at scenes and the Nurses more so on the interfacility transports (especially the complicated ICU patients with multiple drips being titrated) but we ALWAYS work as a team and utilize each other's strengths. Sometimes it's as simple as where you are located in the aircraft or ground unit in relation to the patient that determines whether you do the intubation or push the drugs. We have the same protocols to follow as a team and we both need to know them as well as each other. We also validate our observations/assessments with each other all the time. As a Flight Nurse I know that our Medics are woefully underpaid in respect to their skills and duties. However our AirMedical program is a non-traditional one in that our pilots and medics are employees of a free standing ground and HEMS service and the nurses are employed by the associated hospital in a joint venture service. A little out of the norm , but the set-up serves us well.
- May 7, '11 by Steve EMT-Bi believe medics are underpaid... whether its air or ground... they are pretty much the doctor in the field here in central, pa and they get paid around what i get paid as a nursing assistant in the hospital were i don't have to worry about being shot or weather... kudos to medics and nurses who run in the field...
- May 7, '11 by TraumaSurferQuote from steve emt-bsteve,i believe medics are underpaid... whether its air or ground... they are pretty much the doctor in the field here in central, pa and they get paid around what i get paid as a nursing assistant in the hospital were i don't have to worry about being shot or weather... kudos to medics and nurses who run in the field...
every time i read a post like yours i realize just how much education needs to be done in ems.
no, paramedics (not medics) are not doctors. they function under protocols which sometimes are very limiting. they do not write prescriptions and they do not have an unlimited scope of practice. the education for a paramedic is between 4 months (with emt-b) and two years. the education for a physician extends past 12 years.
if you and others had a more realistic idea about what the difference between a doctor and a paramedic, ems might be able to move on to the next level instead of believing you have more than enough education to be the doctor in the field. you might also check out the countries and a few places here in the us that do utilize physicians in the field for some enlightenment.
for your pay, an emt-b usually requires only 110 hours of training in most places and you have only one patient at a time. a cna is required to have no less than 75 hours of training by a federal regulation, may have over 400 hours or more if advanced to pct and may be responsible for over 30 patients at one time for the entire shift without a chance to nap.
health care workers in the hospitals are also killed while on duty and there have unfortunately been some very disheartening headlines with violence within the walls of the hospital which has also included death of professionals. the majority of emt-bs in this country do routine transfer and not 911 ems unless they are first responders with a fire department. you might also want to take a look at the new levels that will be out in a couple of years to see exactly where the emt-b will be in the line up.Last edit by TraumaSurfer on May 7, '11
- May 7, '11 by Steve EMT-BI appoligize...Where do I check the emt b levels?
- May 7, '11 by TraumaSurferQuote from Steve EMT-BNo apologies needed. Just catch up on your reading for the future which is coming soon.I appoligize...Where do I check the emt b levels?
Overview from the NREMT newsletter.
More great info at this site:
Another good site to visit
- May 8, '11 by EMTJeremySteve,
I can understand and somewhat agree with what you are saying. EMS plays an important role in the outcome of the patient. Physicians and nurses rely on the pre-hospital assessment to prepare for their patients. A Trauma Code is very different than a finger amputation- Though they'll both likely be going to the OR, different specialists need to be called for each one. It is the pre-hospital report that prepares these resources. Even knowing the difference between a stable and unstable patient can make a world of difference at the hospital.
Our Medical Director for my Volunteer Collegiate EMS squad is from Germany. She said Doctors rode on ambulances there so they can start treatment right away. Since we don't have this in the US, it is the paramedic or EMT that is responsible for not only getting the pt to the hospital but starting what can be life-saving interventions on them
Just my 2c!!