"You can become a paramedic in Texas with less than 700 contact hours, but it takes between 1,000 and 1,500 [to get a license] to cut hair," said Jay Cloud, an EMS instructor at San Jacinto College in Pasadena. "What's wrong with this picture?"
Only 700 hours is ridiculous. I spent a day a month with the anesthesiologist in the OR doing intubations when I was in a low call volume setting.
But, before anyone starts slamming medics doing intubations. Try watching an average physician (not an ER doc or anesthesiologist) try to intubate a patient in a hospital it is more often horrific than a smooth procedure.
Most often advanced EMS providers are too restricted by their protocols and people die because of it.
“And this screams out for remedy:”
In many parts of the country, the practice of prehospital medicine amounts to little more than human experimentation. EMS medics make very little income when compared to their othther public service counterparts. Most medics only have a high school education.
Medicare and Medicaid (roughly 60% of EMS patients) are paying less and less for EMS services, while the demand for same is increasing at a rate of 8-10% per year. Many have argued that stricter training standards and systems of accountability are the answer, and would produce higher incomes for the medics. However, there is no “new money” in the form of EMS reimbursement that will make this a reality. Thus, there is a nation-wide shortage of qualified medics because thay can earn more by flipping burgers at McDonalds.
I think what is wrong with that picture is that a lot of people want to go into the hair dressing business, enter a relatively non-stressful field with the option of being your own boss someday.
Contrast that against being an EMT, an extraordinarily high stress job that does not pay well considering the emotional and physical stress of the job, the long hours on uneven shifts never knowing what your next call is going to be like, and with very few prospects for running your own business.
Just my take on it.
Additionally, putting in a endotracheal tube is no simple matter even if the patient is unconscious, not flailing and there aren’t hysterical family members screaming in your ear, gang members trying to shoot you or tractor trailers whizzing by.
I have worked in medicine for nearly 20 years, and with all medical procedures, I have found that some people are naturally good at things, some people aren’t naturally good at some things but are smart and work hard to become good at it, some are smart and work hard but don’t get to be the best, and some people are either dumb, lazy or have poor judgement and never get to be good at a task like putting in IV’s or endotracheal tubes and they can cause you pain and hurt you.
The problem is, nearly every medical professional at some point makes mistakes.
Sometimes it is poor judgement.
Sometimes it is poor technique or poor training.
Sometimes it is laziness.
Often it is inexperience.
But sometimes, just sometimes, the person is having an off day. It happens. You aren’t as sharp because you aren’t feeling well and might not have slept more than a few hours, you have a lot going on in your personal life, someone called in sick and you are doing twice the work, whatever.
And you make a mistake.
I no longer work in direct patient care. But I was pretty good at what I did, and often when an IV needed inserting on a difficult patient, I would get called on to do it. I was pretty good at it.
One day, I was putting an IV in a patient to perform a test, and I missed. It just blew up on me. I rarely missed twice, so I buckled down and tried again, and missed again. The patient was very understanding, and I got a different setup to try again, and just couldn’t do it. I couldn’t get drawback on the blood. I tried and tried, to no avail. It was awful for the patient because I kept poking him, and emotionally, terrible for me.
After I had been digging around, something I was loathe to do but was desperate in this case, I realized I had left a stopcock in a off position. I had got so flustered after the two misses that blew up and changed equipment that I simply forgot to open it.
I told the patient immediately what I had done, and he forgave me. That was a simple error in a simple procedure. And I made more money and had less stress than EMT’s.
Owamba may be elected POTUS and has little training in anything, but he sure talks a great story.