Final Draft....

[Nate]

I saw the story on the front page of the site when I logged on, so I opened the pdf document and read ONLY the parts that apply to paramedics. I was happy to see that they removed the "differences" between certificate paramedics and degreed paramedics. (I wrote a lot of letters demanding to know how someone with an AS degree is better than me.)

I think that "national standards" are great and all, but I felt they should have stuck with the titles EMT-B, EMT-I, and EMT-P. Truth is, I don't see to many EMT-I's outside of the transfer industry...mostly because most 911 services around here hire only EMT-B or EMT-P.

Comments on the document?

[joemt]

I'm still not that impressed, although I do like the new "names" or "titles". I have some concern about limiting procedures that EMT-B's, I's and P's already do... and I also have a concern that states can still make their own decisions as to whether or not they follow this. If it's not mandatory then what's the point.. isn't that what we're already doing?????

Anyway, just my opinion... that and 10 cents will buy you a piece of gum.

[Nate]

I hope that Texas stays strong and refuses the ideals offered by this...personally I think the levels are just fine in Texas...we don't need a bunch of people telling us to change it....it already works here.

[DaSharkie]

And what has changed?

Not a whole lot. Another collossal waste of federal funds. It seems pretty cheeply put together too. Like something for a child to understand.

Even better, is that it will change very little regarding any of our jobs in any state.

But that is just my bitterness and cynicism.

[EMSsquirrel]

I never was much of a fan of the national scope of practice thing. But, after Katrina, and after considering other monumental disasters, perhaps we need to more closely examine how we operate. As an EMT-B, I can do more than some folks in some states, and less than some folks in other states. As a jurisdictionally certified IV Tech, I can give IVs, but that doesn't transfer to other counties. When responding as properly requested mutual aid, we can do everything in our state and county protocols. But, does that really help with interoperability? If I went to New Orleans, they would have no idea what I was trained to do or not trained to do.

- Greg

[Nate]

What's wrong with NREMT? Their program is the only one that is really used through out the country. Their tests are based off of the US DOT standards, I fail to see why we can't just conform to what we already have instead of wasting money making new stuff up.

[RyanEMVFD]

I breezed through it as well but something did catch my eye that I didn't notice before. It does have in there that each state controls it's own scope of practice and that they are wanting to have this scope as the minimal for each skill level.

I'm with Nate that I hope Texas doesn't go with it. EMT-I's should still be able to intubate, but I do like all the drugs they can push now. Granted I probably won't be affected by this.

Another waste of taxpayer's money.

[Nate]

I think Texas should move up to the NREMT-I 99 and leave the 80's for good...but that is Texas for you. If our EMT-I's were 99's instead of 86's that would rock.

[EMSsquirrel]

What's wrong with NREMT? Their program is the only one that is really used through out the country. Their tests are based off of the US DOT standards, I fail to see why we can't just conform to what we already have instead of wasting money making new stuff up.

If everybody used NREMT, at least as a base, then I'd support that, and only that. But some states don't. My big concern is interoperability. Somebody just needs to pick something that puts us more or less on an even playing field.

- Greg

[Nate]

If everybody used NREMT, at least as a base, then I'd support that, and only that. But some states don't. My big concern is interoperability. Somebody just needs to pick something that puts us more or less on an even playing field.

- Greg

And if NREMT became the examination board through out the country (much like the nurses have) then we would be on the same playing field. Not to mention that it would solve the problem of helping in other states during an MCI. If everyone is an NREMT medic, then a basic is a basic in New York, Louisana, or Texas. It doesn't matter.

I also think that it would help advance EMS, because then we would start to not only have a standard testing service, but an organization that can lobby for EMS, much like the nursing board does.

[firemedicak]

This final draft is all fluff, pushed through for someone to justify expenditures of taxpayer money - use it or loose it. I agree with DaSharkie... what a collossal waste of money. The first two drafts were at least intriguing.... and, yes, I would be shocked if NHTSA passed it over.

Coupled with more than a few references that each state controls the ultimate scope of practice, I feel fairly confident that Alaska would never adopt this. We enjoy the stone age in our EMT certification and Paramedic licensure training, regulations and laws; why change something that would require significant amounts of money and reorganization to implement? Don't see it happening up here, regardless if this plan was the best thing since bread.

With all the talk about brining EMS into the 21st Century, we're still stuck in the primordial soup. All the drafts and projects in the world won't move EMS forward until everyone plays on the same deck of cards.

[DaSharkie]

In response to people saying that the NREMT exams should be used by everyone, I tend to agree that one exam, written to the national standard would be great.

However, I know for sure that the Commonwealth of Massachusetts will never do so. To do so would affect its income........I am dropping my certification in Massachusetts (but keeping my National Registry) as it costs - get this - $150 per two years to recertify, and if past trends are any indicator it will go up.

To change to a standard level of certification would cost Mass. A LOT of money. Besides, why would beurocrats do something that makes sense?

[WELLAGEDEMT]

My understanding is that this draft is a national guideline, states do not have to follow unless they so choose. I also believe that the EMS needs a standard test for certification. Whenever there are politics involved you can be sure that someone has an agenda and they are going to benefit from the results eventually. Another aspect to consider, Who wrote this draft???? Do they have any experience outside the "book" and if so, did it cover ALL the different "local" aspects of EMS???????

[EMS Guru]

I personally went to the Public Input Day, and voiced my opinions about the previous drafts, and changes that I felt needed to be made. My main point was that the Advanced EMT level, needed to be more congruent with the NREMT-Intermediate 99 curriculum. This point was seconded by several of the other speakers. I am proud to have my name in the appendix of the final draft, but I really wish that the task force would have taken the NREMT I-99 suggestion more seriously.

Paul Bishop, NREMT
National Scope of Practice Speaker :jig:

[Nate]

That is cool you got to speak; but I have yet to see them bother to come to Texas (Houston) and ask our thoughts/views in person.

[EMS Guru]

That is cool you got to speak; but I have yet to see them bother to come to Texas (Houston) and ask our thoughts/views in person.

Well, it was held at a hotel near Washington, DC; and you did have to sign up, and "request" to speak, and get approved beforehand by a committee. They did have really good representation from Texas:

Tracy Thomas; TAA/American Medical Response (TX)
Pete Wolf, NREMT-P, CCP; Governor’s EMS and Trauma Advisory Council of Texas (TX)
Debbie Fishbeck; Lavaca County Rescue Service (TX)
Ryan Mathews, LP; TransStar Ambulance, NTREMSPA (TX)

And from the other states:
Barbara Brown, NREMT-P; Dale City Volunteer Fire Department (VA)
Jonathan Moore, BA, FF/EMT-P (for Lori Moore); International Association of Fire Fighters (DC)
George Miller; Boone County (MO)
Randy P. Abernathy, NREMT-P; Chair; Professional Development State EMS Advisory Board (VA)
Don Taylor; Spotsylvania Co. Fire, Rescue and EMS Spotsylvania, VA 2 nd V.P., VAGEMSA (VA)
Nikiah Nudell, NREMT-P, CCEMTP; (CA)
Scott Bourn; American Medical Response (CO)
Mark Lindquist, MD; Minnesota EMS Regulatory Board (MN)
Paul Bishop, NREMT; (VA) that's me!
Deborah Akers, NREMT-P; Western Virginia EMS Council (VA)
Richard Beebe; Basset Healthcare/Center for Rural EMS Education (NY) Kevin Brown; State of Connecticut Office of EMS (CT)
Thomas Jarman, NREMT-P; Prince William Co. Department of Fire and Rescue/PSA (VA)

All in all, a good group of people, of whom I enjoyed hearing their different perspective. Although I must say, I am disappointed that not much of a chage happened between the 2nd and final drafts.