Is CHANGE COMING to EMS?

[@kyle_moore02]

Change is important in this field. As populations increase and we have more and more people coming into areas that’s were previously considered small, the demand for EMS providers increases as well. We already lack the manpower in this industry so I 100% agree with you.

[@TheParamedicCoach]

Thanks for tuning in Kyle!

[@kyle_moore02]

@@TheParamedicCoach No problem. Your videos helped me pass my national registry and I’m soon going to medic school so I’ll be sticking around

[@ShariahThomas]

@@TheParamedicCoachpeople keep being mean to me what should I do 0:17

[@KarlPHorse]

As an EMT, I have never been more offended by something that I 100% agree with.

[@RickyOHD]

I thought the same thing in EMT school. I'm in a 5 month program at a fire department, and I immediately thought why couldn't be just extend or add on certain skills to make us a little more valuable as an EMT. And hey maybe that's all you want to do in the ems world. I think it would be a nice middle ground for departments. Because now it's EMT (very limited care) or medic. I wouldn't mind at all taking on an additional couple months to enhance my skills and be able to do more like start an IV at least lol.

[@zakh7675]

Anybody can be trained to start an IV, intubate, decompress a chest, or many of the other flashy medic skills. The real work is in training someone to assess a patient and recognize what is happening and what is needed. That's something that only comes with a lot of education and experience. That said, I would like to see EMTs with an expanded scope of skills that could only be performed under the direction of a medic. So like when I'm trying to run an arrest with 4 basics and I'm the only medic I could have one do a line, one do meds, one intubate

[@XxXgamerkidXxX1]

@@zakh7675 AEMT school was just EMT school with extra skills and a little more in depth in A&P. 80-90% of AEMT school was a review of EMT school

[@zakh7675]

@@XxXgamerkidXxX1 I guess AEMT would satisfy this role I'm coming up with, but I prefer them not to perform ALS interventions on their own. Most AEMTs I've worked with have had serious shortfalls in their diagnostic knowledge

[@xidaho4485]

I am in emt school right now and just got done with my finals. I totally agree with this. It would be a huge boost for us to be able to give more medications, start ivs, and read an ekg.

[@randomamerican3287]

ECG wouldn't be included for obvious reasons, but yeah.

[@kuqqhd]

@@randomamerican3287 Why not? knowing basic rhythms can be beneficial if your medic is busy doing other things, you can identify whether if there is st elevation or a 3rd degree heart block. Faster intervention can be done

[@xidaho4485]

@kuqqhd yes totally agree the faster we can find this kind of stuff out the more we can help the patient.

[@TheParamedicCoach]

Thanks for tuning in, welcome!

[@DylanLey]

I think your idea of having AEMT as the base level and having medic school dive into critical care/flight medic content is a pretty good idea. It would essentially push EMS, as a whole, forward in terms of knowledge and care. I've been watching you since I was in EMT school and have now been an EMT for 9 months now. I'm approaching 1 year and have I have started to plan my path to medic school. I feel like there is a big leap between EMT and Medic school. I always get nervous thinking about it since there is so much more you need to learn and dial down in medic school. I feel like if I was an AEMT right now, it would help bridge the gap between EMT and Medic. I definitely agree with your second idea in the video. I actually fee like this could apply to MANY careers and not just EMS/first responders! College Degrees today don't really have the same value they used to a decade ago. Especially with how pricy tuition can be, plus getting forced to take so many classes outside your major just to complete "general ed". Getting people into the workforce with hands-on work and evaluating them as they work is a much better way of moving people forward in their careers rather than just based off degrees/credentials. Experience and hard work outranks everything!

[@anthonycerroni7603]

As a paramedic instructor, I've been saying that. It all comes down to politics!

[@sarcoed]

Thanks to your videos I just passed my NREMT and I'm open to continuing education for advancing EMTs to the A level. However don't cut the tree down when it's still a seedling. People can graduate up through the levels at there own pace.

[@TheParamedicCoach]

Congrats on your success here!

[@chuckstump9581]

I just finished Paramedic School, and am in the process of taking the NREMT. I totally agree with you. I run for a volunteer squad and the area I live in is very short on help. I know being 58 years old I will probably never get a full time job as a medic, but I am ok with that at this point. We need younger, up and coming people to join our forces.

[@clumsycajun]

Video vault is worth every penny!! Get it. You’ll pass your exam on the first try and then he keeps adding so you continue learning!

[@TheParamedicCoach]

Congrats on your success!

[@Bsmith99]

In the state of Oregon where I live. You have to either A: have an associates degree before getting your paramedic. Or B: you have to get your prerequisites for an associates and transfer your credits to a college that teaches paramedic or be taking your prerequisites at a college that has a paramedic program. I’m a EMT that will be getting my medic. However because of this extra steps I have to wait another year before I even start going to medic school.

[@TheParamedicCoach]

Thanks for sharing Braiten!

[@SparrowSimeon]

Just passed my NREMT today. First T baby!!! Did it in 70 questions!!! Thank you!!

[@TheParamedicCoach]

Congrats! That's how you do it!

[@RescueEMS]

You are a career coach and excellent at what you do. The EMR level is not a career "course" in CA. While 55 hours of courses are required, there are simply very few paying jobs in CA for an EMR. The Red Cross trains EMR's and most are "part time & unpaid". They staff medical tents during marathons and other community events and provide true First Responder services during the Rose Parade events annually. EMR is not supported in CA as a real level for EMS. Many EMR's do complete EMT school and volunteer as described above. Your idea would eliminate EMR's and many basic EMT's as most EMR's & EMT's pay for their classes and books. Making it 6 months just to be certified for EMS is quite a commitment for most people. The idea of having what we have today is to give some people the chance to serve in Emergency Services and still hold down a paying job. I am interested what rural America would think of this proposal. Do they have plenty of EMT's? We have 6 EMR's in the Red Cross just in my region in SoCal that have saved lives just in the past 6 years. If they had not been EMR's, their patients wouldn't have survived.

[@spacemaster13]

Only truths were spoken 💜💜just passed my nremt last week first try after using your vids to refresh my memory

[@TheParamedicCoach]

Congrats let's go!

[@hunterdrake6920]

Thank you paramedic coach! I recently passed my nremt with the help of your program.

[@TheParamedicCoach]

Let's go, congrats Hunter!

[@markgutierrez551]

your the best couch ever your 100% right on this keep up the good work couch

[@TheParamedicCoach]

Thanks for your support, Mark!

[@murm8736]

In Colorado this is changing, as most agencies require you as a EMT to have your IV/IO cert upon application or within 90 days of being in that company. I’m currently in the process of obtaining my IV/IO cert thanks to your videos! They really helped me pass EMT school and keep helping as I transition to my first EMS role thank you!

[@xbritny]

Every EMT & Medic at my company always says to skip the ALS and just go to Medic school after EMT. You’re absolutely onto something.

[@jolenebaca2392]

Hi Even! First and foremost "You are AWESOME! I've really have learned Alot from you!! I totally agree with you on this..I'm in the EMT Academy in New Mexico and have purchased your video vault.I want to say thank you and God Bless..

[@TheParamedicCoach]

Thanks for your support, happy you caught this episode!

[@matthew53690]

Great idea. I feel like this would also weed out the not so great emts. Any old joe can get his emt. This industry needs more professionalism before we get taken more serious.

[@guitarmanplayzloud936]

Dude I totally agree with you it make make ALS care way more available

[@TheParamedicCoach]

Thanks for tuning in!

[@zitkanaduza.89]

I think to keep 3 ranks: EMR, EMT, Paramedic. But train EMTs to AEMT level, with same time constraints you suggested. In MN, EMTs, can start extremity IVs and humeral/tibial IOs. They can also give Glucagon, D5W, D10W, Normal Saline, oral Benadryl, and draw up IM Epi. We can do King Airways and I-Gels. Last we can do Smart Cannula and Invasive ETCO2 monitoring. All in all an excellent skill set to provide a higher level of care to patients. And to be more of assistance to Paramedics.

[@jamesboone3678]

What I don't understand is in rural towns where I have my second home, the firefighters and Paramedics don't get reimbursed for gas. Gas is $7.00 a gallon up there. at least give them $50 for gas. But you make a great point. I haven't even started class yet and that was my first question.

[@markanthonypar-wise1499]

100% agree . I've seen this being talked about on Instagram with the EMS community. Where I live we actually use a lot of AEMTs because paramedics are hard to come by. In my area at least

[@raidermatt8398]

Do you think the Pay will ever be higher for EMS?

[@jackiepeck5770]

I love your idea of having a longer EMT course covering more advanced meds and procedures that would relieve some of the necessities for paramedics. We live in WV and the need for paramedics is on the rise. Mountain areas make the response time longer for more advanced u it’s to get to the scene. Having more advanced EMTs in the FDs around would help this issue get believe. I just got my NREMT license in March. I am highly considering going for my paramedic certification.

[@TheJwalk1234]

I agree with the 2nd and Last point 100%. In our fire department you can have a bachelor in farming and get the promotion over the 20 year veteran with way more field knowledge and experience

[@gregtaylor3432]

I have over 45 years experience in EMS ranging from (in your terms) first responder to paramedic level. In my considered opinion the major obstacle to improving EMS is our society's refusal to recognize the value of EMS and treat personnel appropriately. (This ranges from lack of livable salary and benefits compensation to dismissive "ambulance driver" and "The work is different" comments) There is a shortage of EMS, nurses and teachers (among others) in this country because of these societal attitudes. In response to your headline comment: "Change is mandatory improvement is optional!"

[@LarryMiller5003]

Yep, I agree. I have said almost the exact same thing for years. Only NR levels that all follow the national scope of practice.

[@EMSGuy]

Simple answer is some ppl just don't wanna go that far. And some states don't recognize AEMT. That being said I totally agree with you. I went through all 3 certs now I'm a Medic and I completely agree AEMT should be the jumping off point

[@missgrimm6807]

I asked the same thing in medic school. My instructor said because no one wants to go to school for the extended period of time to obtain an AEMT.

[@jamesf6391]

I'm just finishing up my Advanced right now and definitely agree. A lot of medical directors here essentially do it anyway but changing the national scope would be great.

[@TheParamedicCoach]

Thanks for tuning in James!

[@lonigeffre6309]

Basics are needed in the field also. And sometimes people are already scared off by basic levels. Some would never even try that might try a basic level

[@josephstrait980]

I have been advocating for EMTs in West Virginia to be able to start an IV for a while now. In West Virginia, EMTs are slowly being allowed to do more and more IM stuff.

[@amandaswords6748]

I am part of a Volunteer Ambulance Company. We are assigned hours, but only paid for transports. So our turn over rate of EMT's is huge. I think if we did put that much study effort on Paramedic level, i think people would think differently about dropping it so fast. You're already putting in the work, just keep going. On the other hand companies like mine couldnt replace the turn over rate as fast as they do know by signing up new classes.

[@ace77755]

in Florida they phased out AEMT, it’s just EMT, depending on county we learn to read ECG’s/EKG’s, we can even start IV’s. We cannot push meds however starting an IV is HUGE help to the paramedic. Florida seems to be on the right path, hope the pay goes up!

[@markanderson5077]

I'm an EMT in South Florida. FL does not recognize/license AEMT level. For personal development I looked at ramping up to the AEMT level, but couldn't find a course to make the leap from basic EMT to the advanced level without re-doing EMT school. My thought to increase throughput, get people through EMT and the NR (16 weeks in FL). Then have a process to get the advanced certificaion on-line and do labs within the existing EMT-Medic certification system after being a practicing EMT for six months or so. Most of the EMTs in my class plan to get hired by a county fire department and then go to paramedic school. I'm retired and a volunteer EMT just looking to acquire more skills.

[@autumnn.215]

My respect for you is higher than ever

[@WarriorBane]

EMS pay? saving lives deserves more IMO especially when many are overworked, this is a big reason why there is a EMS crisis with employment, retention, etc some states are doing things like increasing minimum wage, tax credits, etc. I know career firefighter with medic/emt training is better than just medic/emt. I plan on doing volunteer emt & firefighter not for the money but wage doesn't feel right to me.

[@sirwhitecrayon2499]

The EMS region I am in Basics are expanded scope trained through system and medical control. Basics are trained and can establish IV or IO access, and are able to give Dextrose and Zofran IV. It helps take the pressure off the medic in an ALS call when most of our crews run a basic and a medic. We are in review to allow intubation as well.

[@randomamerican3287]

Intubation definitely shouldn't be an EMT skill. It takes many repetitions to be anywhere near capable or competent. IGels and LMAs are fine imo.

[@markanthonypar-wise1499]

Yeah my teacher purposely taught us more on the intermediate level of EMT and wanted us to really exceed the basic standard

[@zekemendoza7343]

I AGREE SO MUCH!!! This is my philosophy too! We should be pushing for this!!! EMT-B is almost useless and created in the 60s before we understood EMS

[@kenkauffman3522]

Exactly. EMT and Paramedic. Makes perfect sense

[@coyote_loco]

I think it's crazy that (at least in NV), you have to spend around $1500 to go to EMT school, pay $100+ to test for NR, and then pay another $100 for health district certification testing, JUST to earn $10-12/hr

[@jamesringler987]

Thats disturbing part of it all the pay dont reflect the skills training and responsibility

[@clumsycajun]

It’s $15 here and still such an insult.

[@iworshiptodaystudios]

I 100% agree with this. This definitely needs to change!!! Let the EMT-B have the opportunity to advance if they want to. I would be willing to go for EMT class a bit longer so we can have more capabilities under our belt so we won't have to take an entire paramedic out of service just to give the patient fluid or for a diabetic patient.

[@vashtisymonette9986]

Coach we just graduated emt school in the bahamas but we are also certified in iv insertion and ecg monitoring acls so yes ems is changing

[@TheParamedicCoach]

Congrats on your success!

[@paulpannell7179]

I agree. Georgia plays musical chairs with their certifications. I am an EMT-I trained to the old 95 level . Now I'm looked down on for being an EMT-I. When Iooking for work, services want the AEMT cert. Any way enough about that. In our state, transport services hire a lot of EMR's because they will not or cannot pay for higher levels. I totally agree with you. Keep it simple.

[@craigevans013]

EMS is a healthcare profession and an integral part of the continuum of care. Other healthcare professionals, such as nurses and physicians, have a clear academic path in their field, but not EMS -why? If we want to be more than ambulance drivers to the public and the rest of the healthcare world, then we need to do a few things. First, we need to simplify our titles. Forget about all these levels. How many times have EMTs been called paramedics, or paramedics been called EMTs. It is too confusing. We should all be paramedics. Paramedic I, Paramedic II, Paramedic III, Paramedic IV if you like, but call us all the same thing. A nurse is a nurse, and a physician is a physician. Sure, they specialize in various aspects of healthcare, but they all have the same title. Secondly, we need to stop minimizing the education necessary to enter this profession. I agree that much of higher education may not be specifically tied to the job of being a paramedic. We, however, created that problem by not taking ourselves seriously. We need to develop BS and master programs specific to EMS and elevate the profession. Nurses have the BSN; we should have a BSP, a bachelor's of science in paramedicine. Nurses have an NP. Why not have an equivalent paramedic level that can prescribe medications and treat patients in the field, thereby reducing the load on hospitals. Isn't this the idea of community paramedicine? We try to train hospital-based practitioners to function in the field to elevate the care provided in EMS when field medicine is a specialized area and should become more specialized. I know many paramedics that can stand toe-to-toe with any nurse or even physician on emergency care, but they are treated like the help -a lower class of healthcare provider, because they do not have what is perceived as formal education. I love what you are doing, Evan. I support you 100% and use many of your videos in the classroom, but I think you are on the wrong side of this one. Keep up the good work, brother, and keep elevating the level of education of our providers. Thanks for all you do.

[@simeonr.1903]

PREACH. Remarkable ideas! I thought Physician Assistant would be the next step for Paramedics, but anyone with healthcare experience and the right resume can become one. Yes, a BSP should be created akin to the BSN with the same system. If I went to a 2 year program to obtain my ADN and then did an online BSN, then the equivalent should be done for the EMT and Paramedic education. As a Patient whose PCP is a PA, I really can't call him an "Assistant" no more than I can for an NP based on the same type of care provided by both. If the titles of MD/DO, NP, and PA were removed and all three were well trained and had significant clinical experience, then I wouldn't notice too much of a difference. Paramedic Practitioner? EMS Physician Associate? These are names that are more suitable for these professionals. If there is a DNP for the MSN/NP professionals, then a Doctor of General Medicine(DGM) should be created for the Paramedic-PA. This doctoral degree would only be for those with 5 years or more of experience. The provider should have full autonomy for specific specialties like ER or FM and can be eligible for pay raises. Other stipulations may apply.

[@rebvilla1]

I agree let's do it that way.

[@micke6705]

I agree with mostly all of the above. More EMS with advanced skills makes sense.

[@mitchbooden4409]

Virginia still has some EMT Intermediate but phased out that certification. With that, there is a huge gap between the AEMT and Paramedic. Virginia has started to bridge that gap by giving the AEMT's more tools to work with. AEMT's can administer Versed, EPi (both cardiac and anaphylactic shock), Mag Sulfate, etc. and not have to depend on a paramedic.

[@TheParamedicCoach]

Thanks for the info/details here Mitch!

[@michellecroffutt5800]

I agree with you. However, I completed the EMT-B class last year (4 month program). To me, it was really overwhelming & I have a college degree. The problem I see with it is, some providers might not want to advance. My personal opinion is there should only be basics & paramedics. I think the advance class is a waste of time.

[@Xscentric1]

I think you're absolutely right, and in the future we may see that the BLS Levels may very well all become ALS. Hopefully to the advantage of all of us who are all still in the BLS catagory. And I agree with you that promotions for should not be based on credentials. Your peers respect you because of your actions, and ethics involved when you're in the field. A paramedic is a paramedic. An EMT is an EMT. Degree or no degree, we both have the same scope of practice.

[@OGuselessrogue]

Biggest problem for rural providers is money. Would they be able to afford the medications and equipment required for AEMT?

[@ryanborth3049]

I passed the NREMT!

[@TheParamedicCoach]

Congrats Ryan! Let's go!

[@joyouswoman9514]

I'm terrible at math...I'm not even sure how I will fix that part but I'm having faith I will figure it out! 10:15

[@sappergg]

As a paramedic I ride as a Quick reaction vehicle and sometimes we have 2 units both BLS so I have to go to all calls and assess. Then if they can use fluids then I end up riding the call. Since there is so much a basic can’t ride it would be awesome if everyone could at least start an Iv and give fluids.

[@johnreiman297]

You perhaps should consider that volunteers often will not want to give up 6 months of their life for training. W often can't get people to give 3 months to do fire suppression and EMR training.

[@simeonr.1903]

Always thought this should be implemented. In nursing, too. For those serious about EMS and/or Nursing, let the AEMT and LPN be the first rank with a 1 year commitment. Maybe less for the AEMT unless more info is added to it. For those not interested in pursuing the education further, let the EMT-B and CNA be an option to test out after about 6 months in either program. Here's an example, let's say Arnold was interested in being an AEMT to eventually become a Medic after 1 year of exp. He isn't good with IVs and needs help putting an EKG on a patient. AEMT is perfect for him. Amy wants to be an RN, but also wants exp as a nurse for 1 year. With the LPN, she is able to do much more than a CNA in the hospital. She'd help ease the workload of the RN with medication administration, charting, ADLs, and other tasks. 1 yr Bridge programs for both the LPN and AEMT should be available at all community colleges. Year two of both bridge programs lead to becoming a Paramedic and/or RN. We'd have more help overall!

[@antmanf691]

currently doing my AAS in ems and some of the math and English courses I had to take were pointless

[@xx-knight-xx2119]

My county system just switched to a tiered response so we have 1 or 2 lower level trucks out of 5 staffed with advanced due to a paramedic shortage with a paramedic chase qrv.

[@glitcherPROXx]

I agree with you im in cali and i would love to get my AEMT license

[@StridorPup]

I’m an EMT in socal, socal is absolutely saturated with paramedics, most of which are in the fire department, many of which don’t care about medical. Not all, but many. Talking to some medics in the EMS company I work for, I’ve heard and agreed that having FDs have AEMTs on their engines instead of paramedics would benefit the service as a whole and leave medics in EMS instead of many seeing paramedic as a stepping stone to step up in pay in a fire department. It’d be cool If AEMT was the beginning of professional EMS, I think it’d benefit everyone.

[@Ninjabeast35]

Here in texas for the most part you don’t need any classes to start EMT or go to paramedic. There are highschool EMT programs here. Literally just show up at community college and you are automatically in the program

[@channelname12345]

I absolutely agree that more education and higher standards are always important. But based on most research we should focus on giving more of a background on anatomy/physiology and proper assessment to EMTs rather than expanding the scope of practice - high quality BLS (emphasis on high quality) is the most important thing for most emergencies (and then we can keep paramedics fresh for the issues they handle best). EMTs will also know better when to call for ALS since they have a better understanding of the MOI/NOI and how it has affected the patient, vs. teaching them new skills they might not be using often.

[@Savage_Carlos]

Nice channel btw medic coach, what are your thoughts of AI entering the ems field in the near future?

[@TheParamedicCoach]

Thanks Carlos! That certainly will be interesting, it is entering every field.

[@marksmadhousemetaphysicalm2938]

Definitely agree…I’m an old medic…it sort of worked this way long ago…you just added skills over time…but it varied from state to state (no NREMT anything in my day) I got my BSN and worked emergency and trauma…and was working on my np till I was in an accident…had to leave EMS…and emergency nursing due to losing my right leg and serious nerve damage to my left hand…now I’m working on my neuroscience nurse practitioner…but I think you’re right…EMT should include IV skills and some ALS medications and medic should be at least a two year degree…perhaps a paramedic practitioner as a 6 year degree with independence from OLMC … kind of like they have in the UK…

[@Speetlebeetle]

Here in Colorado as an EMT we can do IV/IO access and Med-Administration after getting IV Certified through a class, this means that here in CO you don't have an AEMT level because it's unnecessary since we can do what an AEMT can do. Also if you want to become a Firefighter here you need to pass the EMT and IV classes to become a career one. It's really nice, but good luck getting a job without your IV certification (but realistically you should have your cert anyways here)

[@manuelablanco3285]

It is good to know someone shares the same thought, EMS is a field underpaid and not all full credential professionals have what is mainly needed in this field and that is COMPASSION, something no degree/subject/ textbook teaches. Why not make it more simple and less “ranking” and more to the POINT. Anyways just MY OPINION…

[@AyyeeeTony]

I agree. AEMT should be the new EMT. Us emt be able to help out our medics with reading ecgs getting IV started and be more helpful in ways than pushing a gurney. With disasters and MCI AEMTs would be able to provide more in those situations.

[@TheParamedicCoach]

Agreed Tony, welcome!

[@mikesaephanh1247]

Agree 100%

[@THEBARBER772]

Yes!!!! My FD only hires EMTs (EMTs in medic school) or Medics

[@wounded_knees6654]

Good idea, but EMT basic is now around 6mos in MD. And MD doesn't allow much of anything. And nobody wants to do 2yrs in medic school, that's also a living hell. Which is the teacher's fault. It doesn't have to be as hard as it is. When you can just skip it all, go to nursing, and triple your income for the same amount of schooling essentially.

[@autumnryn]

I would NEVER go into nursing now days.

[@glhmedic]

Education will decide who is professional and who is blue collar. Skimping on education puts the emt into blue collar category.

[@wounded_knees6654]

​@glhmedic in theory, yes. But now there's a mix of grandfathered EMT's who have less knowledge than an EMR, yet are able to keep their cert. The entire system is screwed up. (Sorry that example stood out) but seriously, imo, it should be an attainable progression. And when you have NREMT'S that are paid less than a McDonald's employee, you have a major issue.

[@wounded_knees6654]

​@@autumnryn I said the same about returning to Law Enforcement. I'm finding EMS is not what it's cracked up to as well. I love the actual job, bot LE and EMS. But it's harder to stay afloat.

[@BWCAPPS]

I agree it should just be two levels. I do believe to be an officers on a fire truck, you should at least have your EMT so you know what’s going on at least on scene and you could determine if everything is being done correctly. But yes the whole credential thing for promotion is out dated and the right people are not getting the promotion they deserve.

[@TheJwalk1234]

Facts it’s just to separate people more

[@jdcrabtree5194]

I never received my hs diploma and now I’m a volunteer ff/emr and want to become an emt…… now I have to get my ged and it’s been years and years since I have been in school

[@coover65]

Watching this and reading comments make me realise just how behind the times the whole EMS industry is in the US, especially compared to the likes of the UK, Ireland, Australia and probably Canada too. It's not the fault of the people, but US federal and state governments really need to re-evaluate EMS. Compare with Australia where we have Advanced Level Paramedic as the base level-EMT level is not recognised as a suitable skill level for emergency ambulances, therefore illegal except for non-emergency patient transports. Everybody who works on an emergency ambulance has a Bachelor of Paramedicine, which in many aspects is similar to a nursing degree. Volunteer first responders exist in remote locations to assist paramedics, but you'd no more see a "Volunteer ambulance" employee in urban or regional areas than you would a volunteer dentist. So why aren't paramedics who can perform blood infusions, field amputations, suturing and prescribing medications common in the US? A lack of funding across the board seems to be holding many US EMS agencies from morphing into professional, highly trained, well financed, well-resourced entities. May your governments back you all with the financial support you all deserve. EMS in other countries is becoming more and more a mobile ER on wheels, rather than an ER just being the penultimate destination for 99% of transported patients. Do you really need to transport a kid with a lacerated foot who needs sutures, a tetanus shot and prophylactic antibiotics to an ER? Not always; many can be treated at home. Equipment like an AED belong in shopping malls, not in the back of an ambulance. A STEMI patient doesn't need an ER, they need a 12 lead ECG, ticagrelor, reperfusion prior to even unloading them in the ambulance bay and on the way to a cardiologist, which may be in a different wing to an ER.

[@NickyKDChaleunphone]

As an EMT, I think they should smash EMT and AEMT for the Vol EMS squads and they would have someone that can start a line but let the medic do more.

[@HamptonsStreetDoc]

As a paid and volunteer FF/paramedic who started as a cfr 17yrs ago, couldn’t agree more. Here on Long Island we have a shortage, big shortage of providers. One reason I believe why is the pay disparity. Along with leaderships, aka chiefs and commissioners and officers not leading by example. With more and more fire districts and ambulance corps hiring more and more providers, volunteer providers are becoming less and less. On another note, as far as needing a bachelor’s degree or anything to become a medic or supervisor, don’t think it’s necessary, especially when we have a shortage of providers and providers leaving the field for other fields like nursing, PA school, etc etc. why make it harder and harder for everyone.

[@jsuperman7672]

the levels/ dregrees are similar on the fire department side if you want to go up the chain. To be an officer your required to be a paramedic, to be a chief you need paramedic and a four year degree. I'm in a metro right now that is making all new hires paramedic level or you go to the next class and take it and if you fail your fired. All for a piece of paper. Cities are continuing to make you do more for less or with less people, or don't grow with the population growing. Back in 17 I challenged the Paramedic Course and was 2 points shy in one area, and there was nothing I could do to correct it or they wouldn't allow it to be corrected. And the entire course was death by power point, high lights from our chapters and basically we were trying to teach ourselves. It is still going on, and no one will change it, because the school only cares about the money.

[@DeJo1078]

I totally agree

[@ianperez5122]

I'd add in that you should be able to take the national test based off of OJT hours instead of formal class hours. I mean, if you know the stuff then you know it. Doesn't matter the medium you used. Every job has changed but the schools haven't. Medicine especially. Advancing the knowledge and the tools an EMT could use (maybe even expanding what BLS means) helps everyone, why not do it. The only thing though, is if I'm doing basically what the level above me is doing, i don't want to be paid less than the cashier at Arby's.

[@VampyreBassist]

We need more resources in EMS jobs. I remember a CE I took from the NAEMT that stated workplace turnover was lesser in high demand high resource jobs than in low demand low resource jobs. I don't think the problem is 100% getting more people in, so much as keeping what you have in while having a stream of new people incoming. Feels like a lot of departments are dropping benefits for flashy toys. A local station got $20k for fans that ionize and sanitize the air, but an employee can't get dental care?

[@akadopeboi]

It would increases wages across the board as demand for AEMTs ensues.

[@jasonm1827]

Fully agree with this, I've been doing phlebotomy for over 11yrs now but am not aloud to do an I.V as an EMT. Also think it's ridiculous that I have to take EMT advance when it should have been covered in the original EMT training.

[@FlankerJackChannel]

The biggest thing to change is to have one agency overseeing us. Right now, it's split among 7 different agencies. Plus, get rid of EMT-B and make everyone an EMT-A

[@darren1412]

I think degrees should be encouraged. There is a lot you can learn like how to conduct research, anatomy and physiology classes, you can learn how to teach EMS, learn about the history of EMS (which is important if we wanna go forward), you can learn about law in EMS and a lot of college programs offer critical care classes. If more people had degrees we could help advocate for higher pay. Regardless this is a field of learning. We can’t just shy away from it. We’re always going to have to learn new things as medicine is constantly changing.

[@darren1412]

In short if we want to elevate EMS we can’t just do the minimum requirements

[@tonybrutal]

Pay needs to change too.

[@mikebayer2332]

I have a slightly different, and possibly more controversial take on this topic. I actually think one of the foundational problems in EMS is that we have too MANY paramedics right now, rather than too few. The reality is that the overwhelming majority of 911 calls do not require ALS level care, and basic EMTs are more highly trained and have a broader scope of practice today than they have ever had before. If we simply focused more time and attention on helping basic EMTs truly master medical and trauma assessment and monitoring techniques, bleeding control, high performance CPR, and really expose them to more patients with common pathologies through beefier internship requirements, a well-trained basic EMT should be able to completely manage more than 50% of the patients that they will encounter without ALS help. Layer on top of that a few key pharmacological interventions like ASA, IN naloxone, 1:1,000 epi, and then maybe even things like nebulizers and CPAP, which are all simple to learn, low risk, and high benefit, and the number of lives a basic EMT can save is really quite high. One thing basic EMTs should really be experts in is assessing and triaging patients. A basic EMT may not be able to definitively treat every patient they encounter, but they should have the tools to be able to recognize the difference between a patient who will benefit from PREHOSPITAL ALS (meaning urgent prehospital ALS interventions that can improve outcomes), and a patient who can safely be transported by BLS, either because they don't need ALS care or because the ALS care they really need is only available at a hospital. Too many patients are being transported by ALS providers today who do not truly need it, and are only getting a prophylactic saline lock and a cardiac monitor during transport. With rapidly developing computerized assessment technology, a basic EMT does NOT need to learn detailed cardiology or electrophysiology. All they need to know (taking the monitor findings, the computerized interpretation, and their assessment findings together) is enough to answer the question: is this patient likely in need of prehospital ALS? Then, the standard ALS level of care should be someplace between a current AEMT and a current Paramedic. Essentially, take an AEMT, add ACLS, PALS, narcotics and benzos for pain and seizure disorders, and beef up their clinical internship training to include more exposure to and experience with higher acuity patients, and you have a provider who can provide nearly all of the lifesaving care that an ALS patient is likely to need before they arrive at a hospital. As far as staffing is concerned, BLS ambulances should have at least an EMT and an EMR, and ALS ambulances should have at least one of these new "AEMT" level providers and an EMT. And that should be the primary level of staffing for 911 trucks. Want to put an AEMT on a fire truck for rapid first response? If you can convince me that ALS providers belong on fire engines, or that fire trucks should be responding to most medicals at all, then fine. But that's a pretty big "if." The highest risk, highest acuity skills that require the most training, experience, clinical judgment, and ongoing practice should be reserved for a Paramedic. The Paramedic should really be akin to what we consider a Critical Care Paramedic, or what other Commonwealth countries call an Intensive Care Paramedic. This is where you gain the ability to intubate, RSI, initiate and manage blood products, place chest tubes, and manage invasive hemodynamics through the use of pressors, VADs, impella pumps, vents, etc. These providers should have a detailed understanding of hemodynamics and pharmacology, rigorous internship/residency requirements, etc., and a scope of practice to match. But here's the key--these providers have to be full time healthcare providers, and NOT working on fire trucks or on a typical ALS ambulance because they will not get the ongoing experience they need to stay proficient in these low frequency, high acuity skills. They should be hospital based, functioning both inside the ER or ICU and on a helicopter, transport truck or flycar to respond to EMT and AEMT requests for critical care assistance with high acuity patients. This level of training, experience, and expertise are not necessary on ~90% of 911 calls, but it should be more widely available than it currently is through HEMS and critical care transport teams. I’m speaking a lot about skills because I’m trying to give a sense of where I think the right levels are, but in general, we as EMS providers really need to stop thinking about provider levels in terms of the skills we as individuals “get” to perform. All of this "in XX state we can start IVs as EMTs," or "my medical director won't let EMTs intubate and I think they should" stuff needs to STOP. We need to think a lot less about ourselves and toys we get to play with, and much more about how we get the right level of care to the right patient at the right time to improve outcomes and reduce cost. More skills does not equal better care. And it definitely does not mean more affordable care.

[@surinac7874]

Money . Think about it 1200 to take a EMT course , then about 1000-1200 for AEMT course then 10-15 k for paramedics. Also some employers don’t need AEMT- for private company’s. Especially when they don’t carry a lot of equipment/ meds due to insurance policies.

[@kenkauffman3522]

Its not just people getting scared, it can also raise the price of an already 4 to 6000 dollar program

[@whybeme1212]

The downfall in EMS in the United States, and this is where we fall wayyyy behind in pre hospital care compared to countries like Australia, UK, Canada…it’s the pay..EMTs and paramedics in this country essentially get paid a little more than minimum wage, to have the lives of people in their hands. I’ve been in EMS for over 10 years, and people just don’t stay in this career, average employee stays around 1-3 years, a lot of people go to nursing school, PA, they go to medical school or just change careers completely. Unfortunately because of the way insurance companies reimburse private ambulance companies, I don’t see pay going much higher than what it is now. Unless pre hospital care workers get paid more, there won’t be much change.

[@doneime875]

Why are math and English classes required? Simple. The college makes more money. End of story.

[@StingerV6Stang]

I've said over the last 19 years as an emt that they should make AEMT the basic level

[@johanbach5739]

I think this would be a good change. The issue with EMS in the U.S. is that it feels fragmented and not well organized. Like some states its not even easy to find an advanced emt course. It's mostly just become an emt-b and then become a paramedic, but there's a pretty sizable leap between those two. Just have people do the Advanced emt in 5-6 months and then the paramedic if they wish. It would bring a higher standard.....which would contribute to the next main point. Pay for EMS services in the U.S. is a complete travesty. I think that's the main change above all else. For what we actually have to do on a daily basis as EMT's and paramedics, both physically and mentally, its almost criminal what the pay rates are. The minimum standard pay for an EMT should be $25 an hour, Advanced EMT should be $30 an hour, and paramedics should be 35$ per hour. I'm talking about starting out. The fact that some private ambulance companies start some emts out at $12 an hour and paramedics at $20 an hour is completely insane. Maybe if there was less fragmentation and higher standards of entry as you talk about in the video, we would see a rise in starting pay rates for EMS.

[@TheJwalk1234]

Right you got forklift drivers getting paid more that medics like why tf would I go to school if I’m not going to be paid more than a job I can walk straight out of high school and make more

[@randypennel3731]

Paramedics Save Lives, EMTS SAVE PARAMEDICS

[@oliviakoenes1610]

Yup 100%

[@shoreshidoshi]

I agree with pretty much everything you put forth. I would love to see us combine EMT/AEMT, but the challenge is that taking a 3-month program to 6 months is for many in rural areas just too much time to commit - especially when they are volunteering. I have long thought we should eliminate EMT. I know that is not popular, but if you had EMR as the base and then added AEMT as the next step - you could create a pathway that allows people to get involved and volunteer and then if they have the time, to jump to AEMT. I also agree that having to take a math test or special math classes, when all you need is to learn 5 or 6 formulas for medication math, is silly. I also never saw the benefit of having to obtain a Bachelors or Masters in anything just to get promoted...now if the degree was career specific that might be different.

[@gam3kid]

CA is phasing out Activated Charcoal at the pre-hospital level

[@gasmask7064]

We mostly skipped it in our most recent EMT class.

[@emilyhaase3279]

It’s not even talked about in our EMT book this semester.

[@onlytruthandlove1232]

Agreed

[@emmam8967]

Yes yes yes yes yeeees

[@KouaGXiong]

It's all about money! If you take out Emr and emt, think about all the money that the school, nremt will lose out on. Same with all the pointless general classes you have to take just to get into the program. 💵 💰

[@michaelcornett5449]

Should also change that you don’t need your emt just to be a firefighter! Makes no sense whatsoever if that’s not what you’re practicing everyday! And if you change it to just one set of emt no emr or advanced then these schools need to teach the students so they are no offense to you paramedic coach but paying so much In more schooling to just pass nremt it’s ridiculous. Then the person passes to just make a very low wage!