Hi Robbie
US EMT-B are less qualified than UK Ambulance Technician (looking at their
basic syllabus vs. ours)
The US EMT-P takes into account their time on the road reinforcing their
theoretical knowledge. We have not done so, but if we did it would be
comparable.
The US EMT-P syllabus does not take account of thrombolytic care ours does.
The UK Thrombolytic care educations system is a 3 day ECG familiarisation
(US is 5 but includes thrombolyitc education)
We (UK) then have to correctly interpret 5 correct 12 leads without
physician intervention and this needs to be corroborated by a cardiologist
or someone appointed by him/her. If at any time we get ONE wrong we go back
to start.
We then have to administer TNK in the A&E dept under physician control.
Then the paramedic has to sit an exam before going into the field and
practicing
Once this is done we are allowed to administer thrombolyitcs on the road BUT
not autonomously. The 12 lead has to be transmitted to A&E for physician
approval and all the JRCALC questions have to be met to rule out
contraindications.
When and if the paramedic feels comfortable administering thrombolytics
he/she then has to sit final exams before preceding to true autonomous
practice.
This process takes about two years or so.
People like Dave Fletcher, who has posted on this list, were trained on six
month cardiology courses by cardiac consultants, has been performing 12 lead
ECGs for over 20 years. Do not assume that the paramedics that come through
your A&E doors reflect the standard throughout the UK.
In the Westcountry Ambulance Service we have over 500 paramedics who have
been trained in 12 lead ECGs and many of them have been given authority to
thrombolyse. This debate (as Jeremy stated) is academic. Your concerns have
been addressed many years ago by people who at the top of the medical
evolutionary tree. I believe the only real debate that should be continuing
here is the one that Rowley has highlighted - paramedics need support when
it does go wrong - that does not exist at present.
Mike Bjarkoy
From: "Robbie Coull" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, September 25, 2003 5:26 PM
Subject: Re: ECGs at the scene for thrombolysis
> > Not at all comparable, Martyn. Chest pain nurses have mostly been "bred"
> > from CCU backgrounds, where they've spent years dealing solely with
cardiac
> > patients, and interpreting 12-lead ECGs to a high degree of competence.
This
> > is a world of difference from a general paramedic's experience of chest
pain
> > and ECG interpretation.
>
> ...and this brings us round nicely to the fact that paramedic training
needs
> to be beefed up considerably.
>
> Compare with Holland where you need to have been an A&E nurse for at least
> ?2 years before you can train to be a paramedic.
>
> And of course, I still believe that you need to have grades of paramedics.
> Ours single grade is roughly equivalent to US EMT-Bs, we also need a breed
> of paramedic equivalent to EMT-Ps, preferably providing ALS response only
to
> selected calls so they can keep their skills up.
>
> --
> Robbie Coull
> email: [log in to unmask] website: http://www.coull.net
>
> https://www.locum123.com contact locum doctors by SMS and email
>
>
>
|