1) Levels of Certification
There should be two levels of certification:
• EMT-Basic
• EMT-Paramedic
Skill level will remain unchanged. Basically, this will eliminate “mid-level” EMT’s, who are kind of Medics, but not quite, yet still more certified than a Basic. They should be given the choice of supplementing to the level of Medic, or be downgraded to Basic. A problem that I've actually seen happen due to theses mid-level EMT-I/AEMT’s is the dispatcher forgets or doesn't know that the unit responding is not true ALS, and because of that, the patient will not have ALS until the EMT-I/AEMT reminds the dispatcher that they can only start a line, not push meds. (I realize that each state has its own protocols, I’m not interested in making this a state-by-state breakdown. I’m being general on purpose.)
2) Continuing Education
Certified EMTs should have a readily accessible Continuing Education system that would allow them to gain additional skills and certifications. EMTs that have completed CE courses should be not upgraded, but “enhanced”. They should not be given new patches, only rockers to go above or below their existing patch. (i.e. if Jon Doe, BLS, finished a course on Tactical EMS, he is not a EMT-T, he is a BLS unit that should be called if there’s a Active Shooter incident. And when he shows up, he’ll be wearing his regular BLS uniform, with a rocker that read TACTICAL above his BLS patch.)
3) Testing Standards
It would be incredibly foolish of me, or anyone that didn’t take the time to do the research, to decide which testing method is the best. But I will say this: The current system is set up that if you fail, you’re most likely so disheartened with the whole thing that you let it fall to the wayside. EMS should be about helping those that need help, by assisting them in the areas where they are lacking. If you fail a practical station, it will not help anyone if the testing official keeps the reason of failure a secret. If a candidate were to fail a station, they should have the choice of meeting with the proctor after the testing of others is complete, and the proctor can explain the candidate’s mistakes, and possible tips on how to avoid them.
4) Lobbying for better EMS laws for patient care and safety.
It is generally accepted that EMS workers are in some form of danger at least once during a shift. Obviously, it would make no sense to press charges against a patient with a psych history, but what about the guy that rammed a ambulance intentionally? Or the drunk driver that swerved around the blocking fire engine, and slammed into a active MVA that was being worked by 4 EMT’s? These are people that should be prosecuted to the maximum extent of the law, and there should be people fighting for our right to be attacked by people. I’ve gone back and forth as to how a theoretical EMS “Main Board” would work…would it be two distinguished EMT’s from every state? Should it rather be a vote? Or should whoever cares come together and have meetings as to how to lobby for better rights for EMS? I don’t pretend to have the answer, but it is out there, and we should have a body of respected EMTs that are out to help us, while we help others.
5) Lastly, the above mentioned “group” should have all states do away with EMS using courtesy lights. I can guarantee you, when that lawmaker’s mother is actively coding, he doesn’t give a damn if you come by parachute, he wants you to be there immediately. The hypocrisy of allowing EMTs to save lives, but not give them all the tools necessary to do so, is plain and idiotic. EMTs should obviously be governed by a station chief, or supervisor, as to making sure they have the proper training and licensure, but they should be allowed to respond with lights and sirens when the situation requires it.
