ACLS, ACLS-EP, PALS, BTLS, PHTLS, AMLS, NALS, EPC, ABLS, NRP, PEPP. How many of you have heard of some or all of these courses? Everyone one of them is available to paramedics, and most of them are available to EMTs as well. Many people refer to them as “merit badge” courses, since so many people collect the “successful completion” cards for these classes in the same manner other people collect stamps or Quarters for all fifty states. With about the same relevance to work for that matter.
All of these classes share one common trait. They are meant to fill “holes” in BLS and ALS education. Why, you may ask, do these holes exist?
Is it because the subject matter is so intense and intricate that it’s beyond what a new EMT or paramedic student should know?
Is it because they are updated more frequently than the EMT and paramedic programs?
Partially, although I contend that a well constructed refresher should to that.
Is it because both ALS and BLS training programs are too short and cover only the bare minimum of what EMS education should? Is it because compared to other English speaking nations our EMS education is too short and inadequate?
DING, DING, DING! No more phone calls, please, we have a winner.
There is a lot of discussion in the various EMS forums about “professionalizing” EMS. Some people think that trade unions are the answer, others champion degrees along the lines of what nursing has done. While both have merit, I think the real road to professional respect is to revamp the educational foundation of the field.
This would certainly raise the bar and that would certainly provoke a back lash from some.
Remember, the volunteer community insisted upon and got no real increase in the length of the basic EMT course. The 1994 revision took all of the theoretical underpinnings (aka medical knowledge) out of the basic EMT program. Many paramedic programs didn’t and still don’t have a lot of theory in them. They concentrate on skills and protocols, not understanding.
Lengthening both ALS and BLS classes (especially BLS) is not going to be popular in many quarters. Volunteer services have a hard enough time recruiting and retaining people now. Make it more difficult and their task will be much harder. Fire departments have a hard enough time getting new people to take EMT, let alone paramedic training. Not to mention the expense. Non fire employers, both private and public, won’t like the idea because it means that they will not have an inexpensive pool of “trained” and “certified” people to pick from.
I’d guess some, if not many, instructors won’t like it because longer classes are going to mean more work and expense. Not to mention income out of some people’s pockets. That’s the money they make offering and teaching add on courses.
The NAEMT, AHA, and other organizations that offer, and make a lot of money from, these courses also aren’t likely to think much of my idea either.
Still, if there is ever any hope for this thing some of us have taken to calling EMS 2.0 to work, we have to start over from scratch.
EMT courses have to include basic Anatomy and Physiology, trauma care, better burn care education, more detailed medical care education, more pediatrics, and more educatoin and training on elderly and infant specific illnesses and treatments.
Let me be a bit more specific. These changes are not only not likely to be too popular, they are not likely to be implemented. The argument will be not only cost, but the “Most EMTs don’t do emergencies so they don’t need this education.” line of reasoning.
Which brings us to another problem. Not all EMTs do the same work, although we all tend to be lumped in to one group. Not only by the ill informed public, but by hospital staff, doctors, employers, and everyone else. Maybe it’s time to look at that part of the industry too. Maybe we need more than one level of EMT Basic and more than one level of EMT Paramedic.
Something else to think about.