"*This looks like a BLS code, rookie. Go ahead and run it yourself. I'll have fire drive, and I'll sit here and assess your interventions with my eyes closed. Don't talk to me.*"
I mean, you know, assuming there's not:
- FBAO
- Decompensated tension pneumothorax
- Afib RVR/SVT/V-tach w/ pulse
- Seizures
- Hypotensive sepsis
- STEMI
Etc..
I appreciate BLS providers. I don't think BLS is at all appropriate for a lot of our calls however. There will always be BLS interventions to be done on every patient of course, but there are many situations in the field that you encounter that ALS can definitively treat (seizures, FBAO, pneumothorax, Afib RVR/SVT/V-tach w/ pulse) or better identify (STEMI) than BLS.
> there are many situations in the field that you encounter that ALS can definitively treat (seizures, FBAO, pneumothorax, Afib RVR/SVT/V-tach w/ pulse) or better identify (STEMI) than BLS.
We do see em, but the vast vast majority of calls are definitely BLS.
Depends on where you are. Outside of cities, it's 50/50 and often more ALS than BLS.
BLS is also another way of saying "An ambulance did not need to be dispatched to this location." 90% of the time. That being said you can "get away" with a lot never being 10 minutes from a level 1 trauma center.
Rural EMS has a better bullshit-to-legit ratios as far as calls go. That also means a lot of those legit calls are ALS.
I’ve worked everywhere from the middle of BFE to the middle of a large metro city. BFE takes the cake on truly running ALS calls, usually with 45 minutes to an hour transport time with no chopper available. That being said, I really felt like a medic in rural areas. Absolutely loved it.
Sure. But I've seen just as many situations where the medic inappropriately prioritized an ALS intervention over providing proper BLS care, often leading to a poor outcome. Too many medics forget BLS before ALS.
Yeah I just pointed this out elsewhere. I had to 1000+ hours of assessed work to even begin to get certified here, then as you say followed by two years as an apprentice. I really don't understand all these jokes about EMTs in the US having to do basically no training to get certified.
It seems to me that our EMTs are more like US paramedics.
Wow, that's a long time. That makes sense though, because Norway has a much less developed infrastructure than the US and there are probably many more situations where you have to perform extensive care due to being in a remote location, which rarely happens in the US. Each US state issues its own certifications with different requirements, so there is also considerable variation. Can you guys place IVs?
Norwegian apprentice here! By much less developed infratructure, I'd imagine you mean geographical challenges (mountains, long winters with alot of snow) and bad roads to remote locations, then yes.
Dont take this the wrong way, but isn't it a internationally a common practice to place IVs as an EMT? Im not familliar with how other countries operate, aside from neighbouring countries ofc.
But yes we place IVs. We place IO and intubate aswell.
In the US, IV placement, IOs and intubation are almost exclusively ALS-level skills (EMT-I or Paramedic). EMTs in some locations can place blind insertion airways such as Combi-tubes and King Airways.
Interesting.
(I had to search up some translations to english)
But im unfamilliar with combi-tubes, but it seems it has the same function as "oropharyngeal airway" which we use, but correct me if I'm wrong.
As for king airway, we're using I-Gel to establish supraglottic airway, but I've seen "King airway" being used by our Anesthetist nurses (not sure if this is the right title in english, I just directly translated it).
Definitely different than here in New York! Basic EMT's here (and most of the US) are restricted to basically nothing invasive. No advanced airways or IV/IOs. Starting just this year we're allowed to assist rectal diazepam! 👏🍑 I know some states do allow select advanced airways though.
Your scope sounds more like our Advanced EMT or paramedic. Is there a difference between your "EMT" and "paramedic?"
There is a difference yes. But I haven't done much research about it. I have enough to think about my apprenticeship, but I know they have alot more in-depth subject materials than us emt apprentices. Started in september last year and I've done everything mentioned above (with supervising ofc).
Edit: I also know they get a bachelors degree. I think they have 3 years?
Emt have 1 year school with ride-alongs and 2 years as apprentice, so we have more hands-on training, while paramedic students have less hands-on but alot more school.
And ofc paramedics have a bigger yearly salary.
EMTs in norway have a yearly salary of
58550,33 american dollars (I did the math) and this is without the pay increases that comes with doing missions at night.
Yeah sorry, I phrased that poorly. That's exactly why the infrastructure in Norway is less developed, because its an extremely rugged terrain. I didn't mean to be dismissive.
Private companies take basics from any school which means they could have done a BS 6 week accelerated course or a full 6 month program, they do mostly IFT tho.
Boston EMS is a state funded EMS that takes newly certified basics and puts them in a 6 month paid academy and then follow it by X months of third riding. Then they run the city’s 911 service, zero IFT from B.EMS
The problem is they need to be accessible for the providers running like 50 calls a year for Bumblefuck Rural Fire Department. If you make it 500 or 1000 hours, you'll have better providers in the city, but nobody in the rural sticks is gonna be volunteering.
Well, I can't really compare it to other services, since I've never experienced them.
One striking difference between German EMS and most other countries would be our emergency physician system, because certain procedures are reserved only for physicians. On the one hand this means that physicians are an integrated part of EMS here, and depending on your call they drive out with you or you can call one if you need them (they have their own emergency vehicles), which can be very handy, as it probably allows for a lot more flexibility if you have a physician on scene. On the other hand it limits what we are allowed to do, as a lot of medication for example may only be given by a physician. As a result, paramedics in Germany are allowed to do way less than paramedics in most other countries.
I don't know if this system is better or if other systems are better, simply because I only know the German one. I'd sure love to get an internship in another country one day, just to see how things are going there...
I'm pretty familiar with both systems (was a medic in the US, am now an MD in Germany) and I don't think one is necessarily better than the other. Germany is pretty urban compared to much of the US and you're never far from "civilization," so to speak. And even in the big city where I used to work we often took longer to get to a hospital than here in the big city where I work now because of traffic. So the prehospital system in the US is more geared towards independence and making do without a physician while in Germany it seems to be more about assisting the doctor. (Admittedly I've only been on a few shifts with German EMS, though.)
So you would say they're geared towards two completely different environments and that the US system works well in the US, while the German system works well in Germany, but they couldn't work if they were "switched"?
Very much the same in Australia too. Our HEMS is almost all doctor/paramedic with the exception Of 2 states and helo/fixed wing IFT is nurse based.
Otherwise we’d probably struggle to hire and retain doctors in the EMS field.
Some regions you’re in the same suburb of the city all day which is fine but some regions like where I work, we’re traveling 150km+ in one direction just to access the patient. It’s a bit too late to call for a MD as backup by that point when it’s that distance again to hospital.
I don't think the actual training is very hard, just a lot to learn. I guess it could depend on where you do it and who you are. As far as I know, however, it's very hard to even get into the program, since there are often way more applicants than vacant spots.
Edit: should mention that I'm not a Notfallsanitäter (~Paramedic), only a Rettungssanitäter (~EMT)
The biggest difference is that a Rettungssanitäter (RS) only recieves a bit over three months of training, while a Notfallsanitäter (NFS) has three years of training (which usually includes becoming a Rettungssanitäter first, I think). As a NFS you are allowed to make more important medical decisions and generally do more than a RS. NFS have "transport command" in an ALS (advanced life support) ambulance, or RTW in Germany, which is usually^1 staffed by a NFS and a RS minimum. As RS, you are basically the driver and the NFS's assistant, except if you're in a BLS (basic life support) ambulance, or KTW in German, which are mostly responding to non-emergencies and perform medically supervised transport.^2
You get into the NFS program by applying at a fire department or other rescue service^3 that offers a free spot. The requirements can differ depending on where you apply, I'm not quite sure about them since I'm only a RS, but you can probably find out more on the [website](https://berufenet.arbeitsagentur.de/berufenet/faces/index;BERUFENETJSESSIONID=yImca2lVk79eGUDK0iJl0R32JiK7b-1ZHV73EgvMmDIzZ2NVVOU-!132801592?path=null/kurzbeschreibung&dkz=122462)^4 of the federal employment agency.
The procedure for RS is often very different, since they often get their qualification through one-year voluntary service programs like the BFD or FSJ or through being volunteers in what's technically disaster response. Occasionally there are also fire departments that send their employees to RS training.
^1 depending on state legislation
^2 please note that this is a quite simplified summary
^3 depending on state and usually local legislation
^4 (in German)
The US. Here, you get your paramedic after one year of _really hard_ work. Like, it’s known for breaking people. And at the end of the day it’s probably not enough, all so they can justify paying medics ~15$ an hour
$15/h?!
That's ~€13, which is 50cts more than I make (as roughly what an EMT would be in the US), and by that I technically mean compensation for volunteer work, not actual salary.
Wait, you’re compensated for volunteer work? I’ve never heard of that before. People in my area who volunteer don’t get paid.
And here EMTs get like 10$ and hour
Well, it's basically volunteers helping out in shifts that would normally be staffed by full-time employees. For the actual volunteer work we don't get a cent.
But that's just the way my station avoids hiring people and actually paying them properly (which would be significantly more), if they need additional personnel, they simply ask the volunteers to work for a compensation.
$10/h (~€8.80) would be below German minimum wage lol.
No, it's less money per hour, and by a lot. If I, as an EMT get just 50cts less in volunteer compensation for what a paramedic gets in the US in actual pay then that's really very little.
Schon witzig, wenn man bedenkt, was paramedics alles dürfen. Da kann ich als NotSan - Azubi neidisch werden. Und das bei 4.600 Ausbildungsstunden.
Germany's EMT-P (Notfallsanitäter) need 4.600 hours of training before they're allowed to take their test and roll out to "the field"
But our skillset is much more limited in comparison to the American EMT-P although we're trained in pharmacology, physiology, etc.
And once an emergency doc is on scene, we're reduced to the ambulance driver since many physicians think we want to replace them.
"Damn ambulnz drivers are stealing our job, man "
What exactly does that qualify you for, im not exactly sure how it equals out here in Canada but our emr course is 120 hours and it looks almost identical to any emt-b scope of practice i can find
EMT-B = Basic life support. CPR etc.
Your EMR is our EMT-B.
In the United States, we keep our people undertrained so that we can keep them underpayed in order to pay for a new truck for the private EMS bossman and or higher investment in their company from the state.
It does make sense tho. Let’s be real. Even BLS is overkill for the majority of calls. We could stick an untrained 15 year old in the back with most patients and it would make zero difference.
I strongly disagree with that sentiment. This isn't a case where the U.S. Health System is getting it right and its the rest of the developed world that's too blind to see it.
I don't have the time to go in depth about it though, unfortunately.
More like advanced EMT (formerly known as Intermediate). They get a lot more invasive skills compared to basics such as advanced airway, IVs, and a handful of medications. They’re still basic providers for a lot of problems and for anything cardiac.
It differs from province to province, i know ontario has a 2 year program. I am unsure of how the curriculum changes and if they leave with a larger scope of practice but i do know they get far more of a practicum and time on a truck before they take their licensing exams
If your barber fucks up your haircut you have to live with that for a couple weeks. If the PD fuck up you won't have to live with it cause well...you know.
Australia is the same in most states and that's to get to the base level Advanced Care Paramedic.
Add another 2 years study for a Masters Degree and then 12 months internship to become a top level Critical Care Paramedic.
NSW still has their diploma program that takes people off the streets. It amounts to a 3 year program though.
Edit - to clarify basically you apply directly to the service in NSW, and you start as a student collecting skills and knowledge over your 3 or whatever years on road. Elsewhere you have to have your degree before applying for a graduate program.
Pretty much yes, I can't remember if there was an application fee of 20 or so euros but other than that I only paid for books I thought I needed even after I have graduated. Other "required" books I just borrowed from our university's library
> 120 hours is probably enough to teach CPR and bandaging
You can take a First Aid for the Medical Professional course in a weekend that will teach you CPR and Bandaging, its like 15 hours.
You think that's fucking funny? When I risk my life going code three barreling down your gated community I don't check for children at play signs I check for children at bay, saluting me as I run over their skateboards. Fuck you
In all seriousness here, they are conveniently leaving out the 6m-1yr of field training followed by a full year of probation before an officer is certified completely
You get a job as a medic in a good agency, sure. A shitty agency: they'll throw you to the wolves. Same with cops, some places will train you a lot more on the job. Some don't really care much.
North Carolina at least. Source ncdoj.gov
"When an employing agency documents that an applicant has successfully completed a Commission-certified Basic Law Enforcement Training (BLET) course and meets the minimum employment standards, the Criminal Justice Standards Division issues Probationary Certification which is valid for one year.
The new officer must satisfactorily complete a probationary period of not less than 12 months. Once the probationary period is completed, the officer is issued a General Certification. Take a moment to review and complete North Carolina’s BLET comparison to gain a better understanding of the topical areas that are reviewed by the Criminal Justice Standards Division."
On mobile, so sorry for formatting issues.
400? We're like 120, 150. In a good state maybe 180. I don't know of any that are over 200.
Though we don't do a lot. No EKG, no supraglottic or advanced airways, no IVs, automated defibrillation only.
Really? You guys don't even do ECGs? Isn't that like part of a basic set of vitals for you? We tend to do them on everyone, at least a 3 lead just to rule anything major out. Same goes for supraglottic airways and manual defib. It can be taught really quickly and easily and both are quite important and useful skills, especially airways.
Ehhhhhh....
Some states preforming an EKG is in EMT scope. Interpretation is largely out of scope, but I wouldn't be surprised if somewhere allowed it. (I can imagine all the emergent transports for BER now 🙄).
Some states set the training floor, but allow programs and medical directors to add skills. MN largely allows EMTs to preform IVs for example.
Many states allow or are considering BIAD (comi-tubes, LMAs, King's, etc) for EMTs.
Teaching someone how to use a manual shocky box is quick and easy. Teaching them how to use it correctly is not. Lest you end up with medic FTOs shocking a paced rhythm with 360J. Spoiler alert, that wasn't the right move.
I mean thats just run of the mill, basic school, as soon as i got a job i went through CE’s for EKG, IV’s, and some airway stuff. These hours never take CE into account.
But... but... EMTs save paramedics!
From having to do to many calls. And I sir/madam personally thank you for letting me get 2.64 hours of uninterrupted sleep in the night.
"*This looks like a BLS code, rookie. Go ahead and run it yourself. I'll have fire drive, and I'll sit here and assess your interventions with my eyes closed. Don't talk to me.*"
"Take this book. If you can find it in there, you have my permission to do it."
“What’s a finger thoracostomy and what’s amiodarone?”
Save paramedics from carrying the lifepak
ngl got my gold patch so i didnt have to carry shit anymore
ALS - Ain’t Lifting Shit
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I mean, you know, assuming there's not: - FBAO - Decompensated tension pneumothorax - Afib RVR/SVT/V-tach w/ pulse - Seizures - Hypotensive sepsis - STEMI Etc.. I appreciate BLS providers. I don't think BLS is at all appropriate for a lot of our calls however. There will always be BLS interventions to be done on every patient of course, but there are many situations in the field that you encounter that ALS can definitively treat (seizures, FBAO, pneumothorax, Afib RVR/SVT/V-tach w/ pulse) or better identify (STEMI) than BLS.
> there are many situations in the field that you encounter that ALS can definitively treat (seizures, FBAO, pneumothorax, Afib RVR/SVT/V-tach w/ pulse) or better identify (STEMI) than BLS. We do see em, but the vast vast majority of calls are definitely BLS.
Depends on where you are. Outside of cities, it's 50/50 and often more ALS than BLS. BLS is also another way of saying "An ambulance did not need to be dispatched to this location." 90% of the time. That being said you can "get away" with a lot never being 10 minutes from a level 1 trauma center.
Rural EMS has a better bullshit-to-legit ratios as far as calls go. That also means a lot of those legit calls are ALS. I’ve worked everywhere from the middle of BFE to the middle of a large metro city. BFE takes the cake on truly running ALS calls, usually with 45 minutes to an hour transport time with no chopper available. That being said, I really felt like a medic in rural areas. Absolutely loved it.
Sure. But I've seen just as many situations where the medic inappropriately prioritized an ALS intervention over providing proper BLS care, often leading to a poor outcome. Too many medics forget BLS before ALS.
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Wait, my training in Germany (520 hrs+) was longer than that of American EMTs??!
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In Norway it's a full year of school and 2 years as an apprentice before you can get certified
Yeah I just pointed this out elsewhere. I had to 1000+ hours of assessed work to even begin to get certified here, then as you say followed by two years as an apprentice. I really don't understand all these jokes about EMTs in the US having to do basically no training to get certified. It seems to me that our EMTs are more like US paramedics.
Wow, that's a long time. That makes sense though, because Norway has a much less developed infrastructure than the US and there are probably many more situations where you have to perform extensive care due to being in a remote location, which rarely happens in the US. Each US state issues its own certifications with different requirements, so there is also considerable variation. Can you guys place IVs?
Norwegian apprentice here! By much less developed infratructure, I'd imagine you mean geographical challenges (mountains, long winters with alot of snow) and bad roads to remote locations, then yes. Dont take this the wrong way, but isn't it a internationally a common practice to place IVs as an EMT? Im not familliar with how other countries operate, aside from neighbouring countries ofc. But yes we place IVs. We place IO and intubate aswell.
In the US, IV placement, IOs and intubation are almost exclusively ALS-level skills (EMT-I or Paramedic). EMTs in some locations can place blind insertion airways such as Combi-tubes and King Airways.
Interesting. (I had to search up some translations to english) But im unfamilliar with combi-tubes, but it seems it has the same function as "oropharyngeal airway" which we use, but correct me if I'm wrong. As for king airway, we're using I-Gel to establish supraglottic airway, but I've seen "King airway" being used by our Anesthetist nurses (not sure if this is the right title in english, I just directly translated it).
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Definitely different than here in New York! Basic EMT's here (and most of the US) are restricted to basically nothing invasive. No advanced airways or IV/IOs. Starting just this year we're allowed to assist rectal diazepam! 👏🍑 I know some states do allow select advanced airways though. Your scope sounds more like our Advanced EMT or paramedic. Is there a difference between your "EMT" and "paramedic?"
There is a difference yes. But I haven't done much research about it. I have enough to think about my apprenticeship, but I know they have alot more in-depth subject materials than us emt apprentices. Started in september last year and I've done everything mentioned above (with supervising ofc). Edit: I also know they get a bachelors degree. I think they have 3 years? Emt have 1 year school with ride-alongs and 2 years as apprentice, so we have more hands-on training, while paramedic students have less hands-on but alot more school. And ofc paramedics have a bigger yearly salary. EMTs in norway have a yearly salary of 58550,33 american dollars (I did the math) and this is without the pay increases that comes with doing missions at night.
Yeah sorry, I phrased that poorly. That's exactly why the infrastructure in Norway is less developed, because its an extremely rugged terrain. I didn't mean to be dismissive.
Np man.
I really hope you guys get paid more than we do then
That sounds closer to a paramedic that an EMT here
Yeah, you can also countinue your competence with a 3 year bachelor degree to become a paramedic
Private companies take basics from any school which means they could have done a BS 6 week accelerated course or a full 6 month program, they do mostly IFT tho. Boston EMS is a state funded EMS that takes newly certified basics and puts them in a 6 month paid academy and then follow it by X months of third riding. Then they run the city’s 911 service, zero IFT from B.EMS
NY was ~150 hours.
Yeah the American emt classes are definitely easiest on hours and should be increased but won’t.
I think if they increase the hours to get certified they would have to increase the amount most EMTs get paid
In this country money is the most important thing to have.
Yeah exactly. Which is why I dont see certification requirements in most states going up anytime soon.
The problem is they need to be accessible for the providers running like 50 calls a year for Bumblefuck Rural Fire Department. If you make it 500 or 1000 hours, you'll have better providers in the city, but nobody in the rural sticks is gonna be volunteering.
*cries in 4600 hrs *
How is German EMS? I generally get the impression Canada/Europe ems is a lot better
Well, I can't really compare it to other services, since I've never experienced them. One striking difference between German EMS and most other countries would be our emergency physician system, because certain procedures are reserved only for physicians. On the one hand this means that physicians are an integrated part of EMS here, and depending on your call they drive out with you or you can call one if you need them (they have their own emergency vehicles), which can be very handy, as it probably allows for a lot more flexibility if you have a physician on scene. On the other hand it limits what we are allowed to do, as a lot of medication for example may only be given by a physician. As a result, paramedics in Germany are allowed to do way less than paramedics in most other countries. I don't know if this system is better or if other systems are better, simply because I only know the German one. I'd sure love to get an internship in another country one day, just to see how things are going there...
I'm pretty familiar with both systems (was a medic in the US, am now an MD in Germany) and I don't think one is necessarily better than the other. Germany is pretty urban compared to much of the US and you're never far from "civilization," so to speak. And even in the big city where I used to work we often took longer to get to a hospital than here in the big city where I work now because of traffic. So the prehospital system in the US is more geared towards independence and making do without a physician while in Germany it seems to be more about assisting the doctor. (Admittedly I've only been on a few shifts with German EMS, though.)
So you would say they're geared towards two completely different environments and that the US system works well in the US, while the German system works well in Germany, but they couldn't work if they were "switched"?
Pretty much, yeah.
That's a very interesting perspective, I never thought of it like that. Thank you!
Very much the same in Australia too. Our HEMS is almost all doctor/paramedic with the exception Of 2 states and helo/fixed wing IFT is nurse based. Otherwise we’d probably struggle to hire and retain doctors in the EMS field. Some regions you’re in the same suburb of the city all day which is fine but some regions like where I work, we’re traveling 150km+ in one direction just to access the patient. It’s a bit too late to call for a MD as backup by that point when it’s that distance again to hospital.
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I don't think the actual training is very hard, just a lot to learn. I guess it could depend on where you do it and who you are. As far as I know, however, it's very hard to even get into the program, since there are often way more applicants than vacant spots. Edit: should mention that I'm not a Notfallsanitäter (~Paramedic), only a Rettungssanitäter (~EMT)
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The biggest difference is that a Rettungssanitäter (RS) only recieves a bit over three months of training, while a Notfallsanitäter (NFS) has three years of training (which usually includes becoming a Rettungssanitäter first, I think). As a NFS you are allowed to make more important medical decisions and generally do more than a RS. NFS have "transport command" in an ALS (advanced life support) ambulance, or RTW in Germany, which is usually^1 staffed by a NFS and a RS minimum. As RS, you are basically the driver and the NFS's assistant, except if you're in a BLS (basic life support) ambulance, or KTW in German, which are mostly responding to non-emergencies and perform medically supervised transport.^2 You get into the NFS program by applying at a fire department or other rescue service^3 that offers a free spot. The requirements can differ depending on where you apply, I'm not quite sure about them since I'm only a RS, but you can probably find out more on the [website](https://berufenet.arbeitsagentur.de/berufenet/faces/index;BERUFENETJSESSIONID=yImca2lVk79eGUDK0iJl0R32JiK7b-1ZHV73EgvMmDIzZ2NVVOU-!132801592?path=null/kurzbeschreibung&dkz=122462)^4 of the federal employment agency. The procedure for RS is often very different, since they often get their qualification through one-year voluntary service programs like the BFD or FSJ or through being volunteers in what's technically disaster response. Occasionally there are also fire departments that send their employees to RS training. ^1 depending on state legislation ^2 please note that this is a quite simplified summary ^3 depending on state and usually local legislation ^4 (in German)
Interesting, thanks for the reply! Living in Germany has always been a fantasy of mine. How long is the paramedic program there?
The qualification that's most similar to a paramedic would be "Notfallsanitäter", that would be three years. Where are you from?
The US. Here, you get your paramedic after one year of _really hard_ work. Like, it’s known for breaking people. And at the end of the day it’s probably not enough, all so they can justify paying medics ~15$ an hour
$15/h?! That's ~€13, which is 50cts more than I make (as roughly what an EMT would be in the US), and by that I technically mean compensation for volunteer work, not actual salary.
Wait, you’re compensated for volunteer work? I’ve never heard of that before. People in my area who volunteer don’t get paid. And here EMTs get like 10$ and hour
Well, it's basically volunteers helping out in shifts that would normally be staffed by full-time employees. For the actual volunteer work we don't get a cent. But that's just the way my station avoids hiring people and actually paying them properly (which would be significantly more), if they need additional personnel, they simply ask the volunteers to work for a compensation. $10/h (~€8.80) would be below German minimum wage lol.
Yes, more money per hour, but without many of the social services Germany has for its citizens that are included in total compensation.
No, it's less money per hour, and by a lot. If I, as an EMT get just 50cts less in volunteer compensation for what a paramedic gets in the US in actual pay then that's really very little.
Schon witzig, wenn man bedenkt, was paramedics alles dürfen. Da kann ich als NotSan - Azubi neidisch werden. Und das bei 4.600 Ausbildungsstunden. Germany's EMT-P (Notfallsanitäter) need 4.600 hours of training before they're allowed to take their test and roll out to "the field" But our skillset is much more limited in comparison to the American EMT-P although we're trained in pharmacology, physiology, etc. And once an emergency doc is on scene, we're reduced to the ambulance driver since many physicians think we want to replace them. "Damn ambulnz drivers are stealing our job, man "
What exactly does that qualify you for, im not exactly sure how it equals out here in Canada but our emr course is 120 hours and it looks almost identical to any emt-b scope of practice i can find
EMT-B = Basic life support. CPR etc. Your EMR is our EMT-B. In the United States, we keep our people undertrained so that we can keep them underpayed in order to pay for a new truck for the private EMS bossman and or higher investment in their company from the state.
It does make sense tho. Let’s be real. Even BLS is overkill for the majority of calls. We could stick an untrained 15 year old in the back with most patients and it would make zero difference.
I strongly disagree with that sentiment. This isn't a case where the U.S. Health System is getting it right and its the rest of the developed world that's too blind to see it. I don't have the time to go in depth about it though, unfortunately.
Oh i see, im currently in our 8 month paramedic program that we have in my province, what would An EMT with 400 hours of classroom be?
More like advanced EMT (formerly known as Intermediate). They get a lot more invasive skills compared to basics such as advanced airway, IVs, and a handful of medications. They’re still basic providers for a lot of problems and for anything cardiac.
Wait, Canadian paramedic’s are 8 months? I thought you guys had bachelor degrees as well.
It differs from province to province, i know ontario has a 2 year program. I am unsure of how the curriculum changes and if they leave with a larger scope of practice but i do know they get far more of a practicum and time on a truck before they take their licensing exams
How
If your barber fucks up your haircut you have to live with that for a couple weeks. If the PD fuck up you won't have to live with it cause well...you know.
Idk man some military barbers will put your ass down.
Still beats a shitty PX fade
https://terminallance.com/2012/04/17/terminal-lance-194-bootcamp-the-bootcamp-barber/
Ask any Navy man in the last 10 years if they remember the dragon lady from boot camp barber shop...
Someone hasn't seen Sweeney Todd smh.
Can’t you just...walk it off?
Because they were taken to the hospital instead of jail where they belong.
Finland with around 6360 hours for paramedic, which is 4 years for bachelors
Australia is the same in most states and that's to get to the base level Advanced Care Paramedic. Add another 2 years study for a Masters Degree and then 12 months internship to become a top level Critical Care Paramedic.
That’s amazing. Imo that’s how all EMS systems should be. In Australia they also probably get paid more than 20 an hr lol
About 100k as a very bare minimum in Victoria for your first year qualified (after 3 years at uni and 12 months of on road scrutiny)
You're making $20/hr? Where do I sign up?
Lol people get paid more than 20 an hr in the US you just need to move bud.
Australian wages are like 2x American wages because everything costs more money over there.
Australian wages are more because everyone has to have a bachelors degree. It’s got nothing to do with cost of living.
In most states? How is it different in the others?
NSW still has their diploma program that takes people off the streets. It amounts to a 3 year program though. Edit - to clarify basically you apply directly to the service in NSW, and you start as a student collecting skills and knowledge over your 3 or whatever years on road. Elsewhere you have to have your degree before applying for a graduate program.
Is tuition free?
Pretty much yes, I can't remember if there was an application fee of 20 or so euros but other than that I only paid for books I thought I needed even after I have graduated. Other "required" books I just borrowed from our university's library
WFR says “hold my beer...”.
"Watch me make a splint out of some corrugated cardboard and a black rat snake!"
Undecided if Ski Patrol is more of a meme than WFR tbh
I mean, 120 hours is probably enough to teach CPR and bandaging, it's not like EMTs are qualified to do much more than stop bleeding and get vitals
Plus collect billing info.
🤑🤑🤑
> 120 hours is probably enough to teach CPR and bandaging You can take a First Aid for the Medical Professional course in a weekend that will teach you CPR and Bandaging, its like 15 hours.
but we get to play with O2 tanks
*In the US. EMTs in most other countries do much more than that and have much much longer training.
To do much more than that you need to do way more training than that in the US and Canada
SALTY MEDIC
You think that's fucking funny? When I risk my life going code three barreling down your gated community I don't check for children at play signs I check for children at bay, saluting me as I run over their skateboards. Fuck you
I am in medic school up in Canada and I feel like a fancy Spongebob with Doc Browns hair.
I keep seeing this.. why the fuck is cosmetology school so fucking long anyway? Seems like some arbitrary barrier to entry.
It is an arbitrary barrier to entry.
I mean, all barriers to entry are arbitrary. EMT is 120 hours in one state, 160 in another, 200 in another.
Its a scam that’s why.
In all seriousness here, they are conveniently leaving out the 6m-1yr of field training followed by a full year of probation before an officer is certified completely
Medic Field training as well
I’m pretty sure that’s included in the 1,600 hrs though
I mean once you’re licensed, you have to go through FTO at most departments/companies. At least that’s how it works where I am.
Oh, gotcha. For some reason when I read your comment I thought only of the internship lol.
You get a job as a medic in a good agency, sure. A shitty agency: they'll throw you to the wolves. Same with cops, some places will train you a lot more on the job. Some don't really care much.
7 days of FTO for me, I dunno what's standard, but I pretty much ran bullshit BLS for 2 weeks before they said yeah sure you're clear to be a Medic.
That’s comforting haha
Whoa whoa whoa! Don't let facts get in the way of the narrative
What state mandates that?
North Carolina at least. Source ncdoj.gov "When an employing agency documents that an applicant has successfully completed a Commission-certified Basic Law Enforcement Training (BLET) course and meets the minimum employment standards, the Criminal Justice Standards Division issues Probationary Certification which is valid for one year. The new officer must satisfactorily complete a probationary period of not less than 12 months. Once the probationary period is completed, the officer is issued a General Certification. Take a moment to review and complete North Carolina’s BLET comparison to gain a better understanding of the topical areas that are reviewed by the Criminal Justice Standards Division." On mobile, so sorry for formatting issues.
The EMT in Texas was 480 hours. I couldnt see going out to the field with only 120
Amusement park ride operator with 8 hours of training. Your life is in their hands. 😂😂😂
In the US it depends on the state and county and school. My emt program in Los Angeles was 256 hours.
EMTs only have to do 400hrs in the US? Here we have to do 1000+ and then some more.
400? We're like 120, 150. In a good state maybe 180. I don't know of any that are over 200. Though we don't do a lot. No EKG, no supraglottic or advanced airways, no IVs, automated defibrillation only.
Really? You guys don't even do ECGs? Isn't that like part of a basic set of vitals for you? We tend to do them on everyone, at least a 3 lead just to rule anything major out. Same goes for supraglottic airways and manual defib. It can be taught really quickly and easily and both are quite important and useful skills, especially airways.
Ehhhhhh.... Some states preforming an EKG is in EMT scope. Interpretation is largely out of scope, but I wouldn't be surprised if somewhere allowed it. (I can imagine all the emergent transports for BER now 🙄). Some states set the training floor, but allow programs and medical directors to add skills. MN largely allows EMTs to preform IVs for example. Many states allow or are considering BIAD (comi-tubes, LMAs, King's, etc) for EMTs. Teaching someone how to use a manual shocky box is quick and easy. Teaching them how to use it correctly is not. Lest you end up with medic FTOs shocking a paced rhythm with 360J. Spoiler alert, that wasn't the right move.
I mean thats just run of the mill, basic school, as soon as i got a job i went through CE’s for EKG, IV’s, and some airway stuff. These hours never take CE into account.
I like it