Bsc Emergency Medical Science commencing Sept 2015

D Trent · 21-01-2014 4:28pm #1

http://www.ucd.ie/medicine/ourresearch/researchcentres/centreforemergencymedicalscience/diplomainemergencymedicalscience/

NEW DEVELOPMENTS: Bachelor of Science in EMS.
UCD Centre for Emergency Medical Science are planning an Honours Degree - Bachelor of Science EMS (BSc EMS). This is scheduled to commence in Sept 2015 and the programme and syllabus are being finalised. Entry paths for school leavers, mature students and exisiting emergency services staff, and recognition of prior learing are also being determined at this stage. The syllabus and admission criteria will be posted on this website as soon as it is available. Please check back regularly.

So what are people's thoughts about this?
Anymore will HSE recruit only graduates from this course instead of public recruitment drives for Student Paramedics?
What effect will this have on the current ICO staff?

BoonDoc · 21-01-2014 4:55pm

I am saddened that Ireland has fallen to the University programme. What extra clinical skills are taught during the three year programme ? What skills will they have that they don't have now? Will PHECC Paramedics be up the international standard?

In the UK they moved away from the IHCD Paramedic and added a lot of university coursework to the IHCD without additional skills.

This is a racket. It is a way for the academic institutions for getting more money out of the paramedic educational system.

You can go through this programme and still not be able to cannulate, provide ALS skills, or have more than the EMT level of drugs.

How about using this money to teach these paramedics up to the standard that everyone else has. That way, if I have a heart attack in South Kerry I may have a fighting chance instead of an EMT level practitioner showing up without the ability to treat my arrhythmia?

At the moment they can only hold my hand on the 90 minute drive to Tralee.

I have already accepted that I will die in the back of an ambulance during a long commute. I would at least like to have competent and well trained paramedics with internationally recognised skills.

D Trent · 21-01-2014 4:58pm

BoonDoc wrote: »

I am saddened that Ireland has fallen to the University programme. What extra clinical skills are taught during the three year programme ? What skills will they have that they don't have now? Will PHECC Paramedics be up the international standard?

In the UK they moved away from the IHCD Paramedic and added a lot of university coursework to the IHCD without additional skills.

This is a racket. It is a way for the academic institutions for getting more money out of the paramedic educational system.

You can go through this programme and still not be able to cannulate, provide ALS skills, or have more than the EMT level of drugs.

How about using this money to teach these paramedics up to the standard that everyone else has. That way, if I have a heart attack in South Kerry I may have a fighting chance instead of an EMT level practitioner showing up without the ability to treat my arrhythmia?

At the moment they can only hold my hand on the 90 minute drive to Tralee.

I have already accepted that I will die in the back of an ambulance during a long commute. I would at least like to have competent and well trained paramedics with internationally recognised skills.

From what i've heard it will be a 4 year programme

Bang Bang · 21-01-2014 5:09pm

BoonDoc wrote: »

I have already accepted that I will die in the back of an ambulance during a long commute. I would at least like to have competent and well trained paramedics with internationally recognised skills.

There are plenty of competent well trained paramedics with ALS skills in Ireland that may well keep you alive for you on that long journey, it does happen.
There are over forty new Advanced Paramedics qualifying in Ireland each year, be positive;)

BoonDoc · 21-01-2014 5:48pm

Bang Bang wrote: »

There are plenty of competent well trained paramedics with ALS skills in Ireland that may well keep you alive for you on that long journey, it does happen.
There are over forty new Advanced Paramedics qualifying in Ireland each year, be positive;)

Yes, and two who work in all of Kerry...... I am not holding my breath......

Bang Bang · 21-01-2014 5:52pm

BoonDoc wrote: »

Yes, and two who work in all of Kerry...... I am not holding my breath......

At the last count I believe there are more than two advanced paramedics in the Kerry region so to tarnish the region with your anecdotes is in my opinion wrong.

I wouldn't go saying that I have accepted I will die in a hospital corridor based on the one or two not so competent doctors that I have met.

BoonDoc · 21-01-2014 6:06pm

Bang Bang wrote: »

At the last count I believe there are more than two advanced paramedics in the Kerry region so to tarnish the region with your anecdotes is in my opinion wrong.

I wouldn't go saying that I have accepted I will die in a hospital corridor based on the one or two not so competent doctors that I have met.

Fair enough mate, I meant two at one time. I would guess that there are in fact more than two but there is one in Tralee and one in Killarney.....if we are lucky.

You are correct. I would much rather have a PHECC Paramedic treat me than some of the doctors that I have met. Both the paramedic and the doctor have four years of university behind them. They must be good.....

palmtrees · 22-01-2014 6:44pm

Where does it say that this degree will result in the award of Paramedic level status? Sounds like an AP standard course in my opinion.

Edit: I agree that it's madness that a paramedic cannot cannulate

D Trent · 22-01-2014 7:12pm

palmtrees wrote: »

Where does it say that this degree will result in the award of Paramedic level status? Sounds like an AP standard course in my opinion.

Edit: I agree that it's madness that a paramedic cannot cannulate

Who are you asking? ie to whose post are you replying?

palmtrees · 22-01-2014 7:18pm

D Trent wrote: »

Who are you asking? ie to whose post are you replying?

boondoc

BoonDoc · 22-01-2014 7:24pm

Are you sure that they will be APs?

Why would someone go through 4 years of uni and only be a paramedic? Why not spend one more year and be a doctor?

Even in the UK there are still two year uni degrees for paramedic (APs). Why four years? What do they teach during those extra years that make them a better paramedic?

The UK went through this by moving from the IHCD to the Uni based paramedic. Graduates from both programmes have the same skills. In fact, Uni graduates are not getting jobs in the offshore industry because they suck at patient contact. Sure they can write essays on how they feel about ethics but can they actually deal with patients???? NO! Uni paramedics are not getting more patient contact time.... they are only getting more essays and paperwork.

Do you know what makes a good paramedic? Patient contact time.

palmtrees · 22-01-2014 7:33pm

BoonDoc wrote: »

Are you sure that they will be APs?

Why would someone go through 4 years of uni and only be a paramedic? Why not spend one more year and be a doctor?

Even in the UK there are still two year uni degrees for paramedic (APs). Why four years? What do they teach during those extra years that make them a better paramedic?

The UK went through this by moving from the IHCD to the Uni based paramedic. Graduates from both programmes have the same skills. In fact, Uni graduates are not getting jobs in the offshore industry because they suck at patient contact. Sure they can write essays on how they feel about ethics but can they actually deal with patients???? NO! Uni paramedics are not getting more patient contact time.... they are only getting more essays and paperwork.

Do you know what makes a good paramedic? Patient contact time.

I am. A phone call to UCD CEMS confirmed that it would be AP standard.

The equivalent AP course in the UK is 3 years, and they get far less holidays than we do in Ireland so it's roughly 3.5 years equivalent for us. Same with nurses, nurses do 3 years in the UK, they do 4 here. Same qualification at the end. Why don't nurses do another year and become a doctor? If they want to be a doctor they will try to become a doctor.

...did you just equate not being able to get a job in the offshore industry with not being able to deal with patients?

The biggest problem with this course is not the standard of training, that will only improve. The biggest problem, in my opinion, is 17/18 year olds being put into an AP course. There should be an interview process for this because I'm sure you will agree that a lot of 17/18 year olds would find it difficult to cope with the stress and horrific scenarios that go with this job.

pk10216 · 22-01-2014 8:32pm

This is disappointing to say the least. I have been a member of OMAC for the last 2 years with a view to becoming a paramedic and this new UCD Bachelor of Science in EMS has quenched my dream. Returning to college is financially out of reach for me, by the looks of it the recruitment drive last year is the end of the in house training. Anyone else in the same boat?

sjb25 · 22-01-2014 9:55pm

pk10216 wrote: »

This is disappointing to say the least. I have been a member of OMAC for the last 2 years with a view to becoming a paramedic and this new UCD Bachelor of Science in EMS has quenched my dream. Returning to college is financially out of reach for me, by the looks of it the recruitment drive last year is the end of the in house training. Anyone else in the same boat?

I would have been in the same boat as you I couldn't afford to go back to college but thankfully I made the panel from the last recruitment drive all I can say to you is what was said to me when I was worrying if I'd make it or not and that is it's goin to take either 2 or 3 years to qualify people from this course and all goin wel most of this most recent panel will b used by then so would be possible May be another recruitment now I stress that's an opinion of somebody only obviously anything could happin but keep the faith

antichrist · 22-01-2014 10:47pm

palmtrees wrote: »

I am. A phone call to UCD CEMS confirmed that it would be AP standard.

From talking with the prof and others involved in the course it is a Paramedic course, after working as a paramedic you go back and get your G.Dip to work at AP standard.

AP is a Level 9 on framework of qualifications, Bsc is an 8.

D Trent · 22-01-2014 11:11pm

pk10216 wrote: »

This is disappointing to say the least. I have been a member of OMAC for the last 2 years with a view to becoming a paramedic and this new UCD Bachelor of Science in EMS has quenched my dream. Returning to college is financially out of reach for me, by the looks of it the recruitment drive last year is the end of the in house training. Anyone else in the same boat?

I do empathise with people like you. I am a member of CD. I really think that HSE will only run internal student paramedic recruitment drives anymore, after using the panel that is already there now. So I wud advise you to try get EMT qualification thru OMAC. Then apply for nxt intake of Intermediate Care Operatives they will get priority

BoonDoc · 23-01-2014 6:26am

antichrist wrote: »

From talking with the prof and others involved in the course it is a Paramedic course, after working as a paramedic you go back and get your G.Dip to work at AP standard.

AP is a Level 9 on framework of qualifications, Bsc is an 8.

So....4 years to be a paramedic. At the moment you can do that after six months of classroom followed by 1200 hours..... WTF do you learn in those extra three years?

BoonDoc · 23-01-2014 6:32am

pk10216 wrote: »

This is disappointing to say the least. I have been a member of OMAC for the last 2 years with a view to becoming a paramedic and this new UCD Bachelor of Science in EMS has quenched my dream. Returning to college is financially out of reach for me, by the looks of it the recruitment drive last year is the end of the in house training. Anyone else in the same boat?

This.

This is why making paramedic training a uni based system is wrong. Paramedic should start out as a technical college training like the US. Then, once you are on the job, you can upgrade to the uni degree.

These greedy feckers at universities are taking away the chance for people to become paramedics who either cannot do uni or cannot afford uni.

Again I ask: What is being taught during those extra three years of uni that will make a PHECC Paramedic a better clinician? They will still only be PHECC Paramedics.

In 20 weeks you can become a US Paramedic with 60 drugs, intubation, cannulation, chest drains, ACLS protocols, foleys and surgical airways.
Why is Ireland going backwards in medical training????

antichrist · 23-01-2014 1:14pm

BoonDoc wrote: »

This.

This is why making paramedic training a uni based system is wrong. Paramedic should start out as a technical college training like the US. Then, once you are on the job, you can upgrade to the uni degree.

These greedy feckers at universities are taking away the chance for people to become paramedics who either cannot do uni or cannot afford uni.

Again I ask: What is being taught during those extra three years of uni that will make a PHECC Paramedic a better clinician? They will still only be PHECC Paramedics.

In 20 weeks you can become a US Paramedic with 60 drugs, intubation, cannulation, chest drains, ACLS protocols, foleys and surgical airways.
Why is Ireland going backwards in medical training????

Who said it's 4 years? Not UCD.......you're relying on a guy that mentioned something on the internet.....he could have said 8 years, it still doesn't make it true. I already know he is wrong about post course qualifications so he's probably wrong about this too.

As far as I know the course will be structured like nursing and will be 2-3 years Long.
Skills have nothing to do with college duration, nursing is 4 years but at the end of it what procedures can you perform or what medication can you administer based on your own assessment? plus from what I remember about when I was in college, the days were short and well spaced out.

To be honest you sound quite negative and bitter regarding qualifications in Ireland, Just leads me to assume (be it right or wrong) that you have had issue with your own qualifications here and have been left with a bad taste in your mouth.

19hz · 23-01-2014 2:38pm

I wouldn't rule out the HSE ever recruiting directly again.

The UK hire mostly from uni students but some trusts still hire student paramedics.

I imagine there won't be enough college paramedics in Ireland for a good few years, if the degree is decent enough they'll be gone abroad.

D Trent · 23-01-2014 2:56pm

antichrist wrote: »

Who said it's 4 years? Not UCD.......you're relying on a guy that mentioned something on the internet.....he could have said 8 years, it still doesn't make it true. I already know he is wrong about post course qualifications so he's probably wrong about this too.

Actually you are wrong. if you bothered emailing UCD like I did two weeks ago, you would have been told this is a 4 year course. it's not a rumour, thats directly from the people in charge of finalising the details doe the course. cemshelp@ucd.ie

antichrist · 23-01-2014 5:49pm

D Trent wrote: »

Actually you are wrong. if you bothered emailing UCD like I did two weeks ago, you would have been told this is a 4 year course. it's not a rumour, thats directly from the people in charge of finalising the details doe the course. cemshelp@ucd.ie

As an AP the course means nothing to me, all I'm going on is what the Prof has said.

GoProGaming · 23-01-2014 6:45pm

if it is a four year course i'd be pretty pissed off if i only came out as a paramedic, i'd be expecting AP status on the register. it would be interesting to see how they will extend a 270 hour course( +phtls and internship) into a full bsc program without dragging things out.

antichrist · 23-01-2014 7:15pm

GoProGaming wrote: »

if it is a four year course i'd be pretty pissed off if i only came out as a paramedic, i'd be expecting AP status on the register. it would be interesting to see how they will extend a 270 hour course( +phtls and internship) into a full bsc program without dragging things out.

As I said before......Just look at nursing. The 2 courses may be quite similar.

Edit: yes it is 4 years Long as stated above, most likely along the lines of nursing with the 4th year being on the road placement(internship), Just like nursing.
It won't be mon-fri learning as paramedic courses before but aligned like a regular collage course with half days, study days and semester breaks.

Your final qualification will be paramedic, Just as a nurse will be a rgn.....you can then go on and get your grad. Dip as an AP Just as a rgn can for on and specialize in a&e/Ccu etc.

Elessar · 23-01-2014 7:56pm

So will this be open to CAO applicants?

Part of me is delighted that the closed-shop mentality is finally lifting for PHEC training. On the other hand, if you come out as an AP after the course....how are you supposed to maintain CPC? If the HSE aren't hiring, I doubt the voluntaries or private companies will be able to offer the required CPC once they are announced. I doubt it's going to be as simple as "treat x patients in a year".

BoonDoc · 23-01-2014 8:08pm

antichrist wrote: »

To be honest you sound quite negative and bitter regarding qualifications in Ireland, Just leads me to assume (be it right or wrong) that you have had issue with your own qualifications here and have been left with a bad taste in your mouth.

The "bad taste in my mouth" is the realisation that many patients will die due to lack of skills of the "Paramedic."

Speaking for myself in rural South Kerry, I face the fact that due to the paramedic skills set no one can assess my arrythmias nor give drugs to treat them. It means that my fractured femur goes untreated for pain for the 80 minute bumpy ride to Tralee. It means that the .5% ROSC rate for all of Ireland is abysmal. Add that to the 30-40% ROSC rate in Dublin which means that my chance for survival is just about zero.

Angry? Hell yes. When I can visit third world countries and see better pre hospital care than rural Ireland.
Scared? Hell yes, knowing that I may be on a spine board for ten hours on a trolley in Ireland because no one is willing to teach the NEXXUS protocols for spinal clearing which are TEN YEARS OLD!!!!

All of this can be changed with proper Paramedic training equal to the US with proper CPGs.

antichrist · 23-01-2014 10:57pm

BoonDoc wrote: »

The "bad taste in my mouth" is the realisation that many patients will die due to lack of skills of the "Paramedic."

Speaking for myself in rural South Kerry, I face the fact that due to the paramedic skills set no one can assess my arrythmias nor give drugs to treat them. It means that my fractured femur goes untreated for pain for the 80 minute bumpy ride to Tralee. It means that the .5% ROSC rate for all of Ireland is abysmal. Add that to the 30-40% ROSC rate in Dublin which means that my chance for survival is just about zero.

Angry? Hell yes. When I can visit third world countries and see better pre hospital care than rural Ireland.
Scared? Hell yes, knowing that I may be on a spine board for ten hours on a trolley in Ireland because no one is willing to teach the NEXXUS protocols for spinal clearing which are TEN YEARS OLD!!!!

All of this can be changed with proper Paramedic training equal to the US with proper CPGs.

Phecc registered paramedics can do spinal ruleout.
They can also administer entonox, paracetamol and ibuprofen as well as apply a traction splint to your fractured femur. Not to mention request an AP via medevac112.

Paramedics can assess arrhythmias but I agree are limited in treatment. AP skill set is quite limited in that sense too but hopefully this is changing.

When you Call 999 in south Kerry there is a good chance of getting an AP as there are a few there already, not to mention 1 or 2 more currently getting trained up.

Yes the Irish system isn't perfect, but for a service that only 15 years ago had o2 and nurses while the US had ALS we've come on leaps and bounds in such a short time.

Mycroft H · 24-01-2014 12:45am

PHECC have already been consulted on what the equivalent University semester length it will take for the Paramedic and Advanced Paramedic levels to complete.

In short for Paramedic; 2.5 semesters and 1 year internship. Given that there is usually 2 semesters per University year, that brings up the minimum time taken to 2.5 years. If it's going to be a four year course, that requires an awful and unnecessary amount of padding.

It's also worth pointing out that PHECC state; "It is important to point out that in Ireland there is no direct entry to the Advanced Paramedic course for students. The NQEMT Paramedic plus 2 years clinical practice are the pre‐requisite entry criteria."

So. UCDs course looks like a bit of a joke when it boils down to it. 4 years to become a Paramedic? That's not a Paramedic by US/UK standard? Why would I bother?

All taken from here; a PHECC bulletin from September 2013.

http://www.phecit.ie/Images/PHECC/Career%20and%20Education/Qualifications/BLN005%20Minimum%20duration%20and%20essential%20requirements%20of%20PHECC%20recognised%20practitioner%20level%20courses%20leading%20to%20registration.pdf

BoonDoc · 24-01-2014 7:17am

antichrist wrote: »

Phecc registered paramedics can do spinal ruleout.
They can also administer entonox, paracetamol and ibuprofen as well as apply a traction splint to your fractured femur. Not to mention request an AP via medevac112.

Paramedics can assess arrhythmias but I agree are limited in treatment. AP skill set is quite limited in that sense too but hopefully this is changing.

When you Call 999 in south Kerry there is a good chance of getting an AP as there are a few there already, not to mention 1 or 2 more currently getting trained up.

Yes the Irish system isn't perfect, but for a service that only 15 years ago had o2 and nurses while the US had ALS we've come on leaps and bounds in such a short time.

Yes, a couple of tablets of pain meds may help take the edge off but what would they do for 10/10 pain?

Let's compare that to a real paramedic.

For a femur fracture a nice mix of micro dose ketamine with 2.5mg of midazolam. Sorry, entonox just is not good enough. With the new NR-P coming on board in the US they would even do a femoral block.

My fast heart would get quickly assessed and synced and I would be given a drug to slow it down. Here in Ireland? They would hold my hand on the ride to Tralee or Cork.

In my tiny town outside of Kenmare someone dropped with a heart attack right in the middle of the town. It took 20 minutes to get the PHECC Paramedics there. They could only do what the CFR was already doing (pushing and AED). The GP showed up and he couldn't do ALS either. The guy died from PHECC guidelines.

So basically, a one day trained CFR can roughly do just as much as a four year trained paramedic? They can put in an iGel, attach the AED and push......

Let's say I have chest pains. Easy MONA treatment right? Oh, but morphine is an AP skill. So I just have to deal with my chest pain to Cork? For an hour and a half? An the paramedics have no idea what kind of rhythm my heart is in?

So again I ask....what is taught on that 3.5 year Paramedic course that will make them better???? UK Paramedics are still going through a 2 year degree and getting far more skills than even APs.

crackcrack30 · 25-01-2014 1:22pm

The easiest part of my job is (following the adequate training) is dealing with patients...

Its the circus that surrounds prehospital care that grinds me down and should be highlighted more here on this forum IMO to those considering a career as a practioner.

A few headings that I'm you could write a book on ...

-shift work.
-long extended days/nights.
-Droped ambulances, as in not covered.
-Missed breaks /fast food.
-lack of equipment or overworked unreliable vehicles.
-traffic and regulations with regard to blue light driving.
-communications poor dispatch info on nature of call.
-poor directions
-upskilling or lack of.
-Managing Aggressive or c2h50h patients.
-Management of different cultures/nationalities.
-bullying ....yes bullying.
-liason with other professionals such as garda, fire, G.P, triage, nursing, ppci.

Yes there have been improvements but they are slow and hard got even when recommended (i.e midaz). But dropping someone who has just completed 4 years in UCD with little or no exposure to prehospital care into some parts or regions would be like dropping them into the fire...

Tango Alpha 51 · 26-01-2014 9:04pm

BoonDoc wrote: »

Yes, a couple of tablets of pain meds may help take the edge off but what would they do for 10/10 pain?

Let's compare that to a real paramedic.

For a femur fracture a nice mix of micro dose ketamine with 2.5mg of midazolam. Sorry, entonox just is not good enough. With the new NR-P coming on board in the US they would even do a femoral block.

My fast heart would get quickly assessed and synced and I would be given a drug to slow it down. Here in Ireland? They would hold my hand on the ride to Tralee or Cork.

In my tiny town outside of Kenmare someone dropped with a heart attack right in the middle of the town. It took 20 minutes to get the PHECC Paramedics there. They could only do what the CFR was already doing (pushing and AED). The GP showed up and he couldn't do ALS either. The guy died from PHECC guidelines.

So basically, a one day trained CFR can roughly do just as much as a four year trained paramedic? They can put in an iGel, attach the AED and push......

Let's say I have chest pains. Easy MONA treatment right? Oh, but morphine is an AP skill. So I just have to deal with my chest pain to Cork? For an hour and a half? An the paramedics have no idea what kind of rhythm my heart is in?

So again I ask....what is taught on that 3.5 year Paramedic course that will make them better???? UK Paramedics are still going through a 2 year degree and getting far more skills than even APs.

Paramedics do 12 leads & can recognise your rhythm, CFR-C's are not allowed use igels. You appear to have a major gripe with paramedics & their training in Ireland ?

BoonDoc · 27-01-2014 5:56am

Tango Alpha 51 wrote: »

Paramedics do 12 leads & can recognise your rhythm, CFR-C's are not allowed use igels. You appear to have a major gripe with paramedics & their training in Ireland ?

Try to keep up, Tango.
http://www.safetyireland.com/cardiac_first_response_advanced.htm
"non inflatable supraglottic airway" = iGel

And being able to read a 12 lead is grand.....but they can't do anything more to the casualty than what a CFR-A can do.

Correct me if I am wrong, mate.....

Tango Alpha 51 · 27-01-2014 11:35am

BoonDoc wrote: »

Try to keep up, Tango.
http://www.safetyireland.com/cardiac_first_response_advanced.htm
"non inflatable supraglottic airway" = iGel

And being able to read a 12 lead is grand.....but they can't do anything more to the casualty than what a CFR-A can do.

Correct me if I am wrong, mate.....

Boondoc,

"Try to keep up" - smart comment don't you think. You didn't state CFR-A in your original comment hence my reply. As a Instructor I'm only too familiar with what the respective levels can & can't do. As a member of the service for over 12 years, I find your comments insulting to the vast majority of staff who do their best day in, day out.

Mycroft H · 27-01-2014 2:12pm

I can see where BoonDoc is coming from. It's 2014. Not 1984.

We shouldn't be providing double crewed Paramedic vehicles who cannot provide an ALS level of care. Therefore, we should be training to an ALS level, not to an intermediate level of care. I just don't see the logic in training to Paramedic level, it's obsolete and not best practice.

If we look at the UK, with the exception of the SAS, they've stepped away from the training of IHCD Technicians and are focusing on the training of Paramedics. Some are recruiting directly from Uni students and some are going the "apprentice" route and still resulting in a Honors Degree qualification.

19hz · 27-01-2014 3:32pm

BoonDoc I see where your coming from man..and it's hard to say the things your saying cause people tend to see it as unpatriotic to talk badly of anything Irish yano..thank god your not in america or you'd be labeled a terrorist! I agree with a lot of what your saying.
It's pretty black and white.

I wonder how many 1st world countries you could travel to with the Irish Paramedic qualification and gain employment as a paramedic.
Does anyone know the answer to that?

Also on the CFR thing BoonDoc, there is two levels of CRF.. basic and advanced, the basic lads don't use the Igel. Just to clear that up. Still a very valid point about the big overlap of care between a CRF-A and a Paramedic.

Tango Alpha 51 · 27-01-2014 3:47pm

19hz wrote: »

BoonDoc I see where your coming from man..and it's hard to say the things your saying cause people tend to see it as unpatriotic to talk badly of anything Irish yano..thank god your not in america or you'd be labeled a terrorist! I agree with a lot of what your saying.
It's pretty black and white.

I wonder how many 1st world countries you could travel to with the Irish Paramedic qualification and gain employment as a paramedic.
Does anyone know the answer to that?

Also on the CFR thing BoonDoc, there is two levels of CRF.. basic and advanced, the basic lads don't use the Igel. Just to clear that up. Still a very valid point about the big overlap of care between a CRF-A and a Paramedic.

Simply put you wouldn't, depending on what state you go to work in, in the US, you'd either be an EMT-B or an EMT-I with the irish Para qual. The AP qual would be obviously the equip to the international paramedic qual with the exception of the different drugs. No disputes this, my point & it's no reflection on Boondoc or anyone else as we're all entitled to an opinion is that we in the service have come along way especially on the last 10years. Yes there's a lot more which could & should be done but I still maintain there is no need to be so negative towards the qualification over here.

stevie06 · 27-01-2014 4:04pm

[quote/]I can seeto where boon Doc is coming from. It's 2014. Not 1984.

We shouldn't be providing double crewed Paramedic vehicles who cannot provide an ALS level of care. Therefore, we should be training to an ALS level, not to an intermediate level of care. I just don't see the logic in training to Paramedic level, it's obsolete and not best practice.

If we look at the UK, with the exception of the SAS, they've stepped away from the training of IHCD Technicians and are focusing on the training of Paramedics. Some are recruiting directly from Uni students and some are going the "apprentice" route and still resulting in a Honors Degree qualification.[/quote]

Yes in an ideal world we could have an AP on every ambulance, but it isn't a case of throwing a switch and "hey presto" we have loads of AP's......... It's a a min 5 years for an AP from walking off the street to finishing your internship!
We have a three teir system, and to be honest it works alot of the time! Not every call needs an AP/ALS, off hand I'd say prob 20% of calls need an AP!
The majority of calls a paramedic is well capable of dealing with!

With regards to BoonDoc, a paramedic can deal perfectly well with a heart attack (MI) bar morphine for pain relief. (but we can request an AP for that) But we can recognise MI and implement the correct pathway. The MONA protocol is a legacy from the past and isn't Best practice anymore!
With regards to ALS for cardiac arrest, the majority of cardiac arrest requires CPR and early defib! the CFR is best place to provide this! I think the great thing from your comparison is that CFR s can deal with cardiac arrest with the same skills as a paramedic! This is good for the people of Ireland!! The NAS will never be in a position To provide full coverage of the country! It's a logistics nightmare! Pre hospital care is an evolving thing! We are getting there! BoonDoc if you are worried about the cover in your area, do something about it, start a CFR group! There is a policy in place that will support you! Contact your local Operation officer if you would like to know more!

19hz · 27-01-2014 5:06pm

Tango Alpha 51 wrote: »

Yes there's a lot more which could & should be done but I still maintain there is no need to be so negative towards the qualification over here.

True but it's annoying we are behind yano.
I think people are being more negative towards the college course than the Irish qual in this thread.

It's a bit weird that a ten week classroom course plus placement and internship will yield the same working title as a 4 year degree course.. at least from what seems to be the case at the moment..like what are they putting into a 4 year degree course to bulk it out?..

stevie06 wrote: »

The NAS will never be in a position To provide full coverage of the country! It's a logistics nightmare!

Wholeheartedly agree.
Ireland has a lot of very rural areas and would be unfeasible to cover these areas that may only have a few 999 calls a year.

crackcrack30 · 27-01-2014 7:22pm

"The NAS will never be in a position To provide full coverage of the country!"

I'm going to disagree here......at the moment there are a lot of iorns in the fire that have no place in a patient focused prehospital Emergency Service. (I think we are a necessary service? like refuge collection.)

Politics- Bally-degojump deserves/demands its ambulance .....Ambo does 200 calls a year.
Hospitals- keep the wards moving by all accounts ......two paras sitting on a pts patient in traffic while AS1's holding......brilliant
Regions - Nearest ambulance base to call 10k away but in a different region so ambo comes 50k to pt, f*c* off.
Ampds - A disaster, putting words in the mouths of 999 callers.
G.P's - Its a great doctor that can get ya an ambulance at such short notice......takes letter and follows walking patient to ambulance.
The public- No awareness campaign as to what we do......distance ourselves from the Taxi image.

I could go on...

At the moment we are not a Patient focused Emergency Service.....sadly we are an Ambulance service ......A to B.

miju · 28-01-2014 5:32pm

BoonDoc wrote: »

This is a racket. It is a way for the academic institutions for getting more money out of the paramedic educational system.

Funny enough others would look at it that keeping things as they are would be acting to keep a state organisation in a monopoly position on education for a particular profession.

Anyway, to answer the OP from what I've heard many times the days of being paid to study as a paramedic by the HSE are over.

crackcrack30 · 28-01-2014 5:47pm

The class sizes should be set on a year to year basis on the retirement numbers projected from the NAS/DFB.....lets say 70 paras retire each year there should be a max of 70-90 cao places or trained to give some realistic prospect of employment for all.....and allow for privates, emigration, further education...

19hz · 29-01-2014 5:17am

I reckon 70% of em will abscond to some far off sunny land if the degree will allow them too..

BoonDoc · 29-01-2014 6:51am

19hz wrote: »

I reckon 70% of em will abscond to some far off sunny land if the degree will allow them too.. [/IMG]

I agree that more and more lads are heading out of our borders for work. Sadly, this BSc will only get lads a job as an EMT-Basic or as a PCP in Canada.

No ALS skills= no paramedic jobs.

antichrist · 29-01-2014 6:43pm

Would have gotten back sooner but I was working/drinking/caring about other crap other than this thread!

BoonDoc wrote: »

For a femur fracture a nice mix of micro dose ketamine with 2.5mg of midazolam. Sorry, entonox just is not good enough. With the new NR-P coming on board in the US they would even do a femoral block.

No, this is not a nation wide guideline in the US. From talking with friends over there Ketamine isn't administered let alone getting oversight for mixing Midazolam for pain relief.

Femoral block isn't routinely practiced yet either. Yes it may be on the cards but that counts for nothing if you have a fracture today.

BoonDoc wrote: »

My fast heart would get quickly assessed and synced and I would be given a drug to slow it down. Here in Ireland? They would hold my hand on the ride to Tralee or Cork.

Transcutanious pacing isn't regularly practiced either. Adenosine would however be administered, a drug not in use in Ireland or the UK for paramedics/AP's. Here an AP would get oversight for Amiodarone.

BoonDoc wrote: »

In my tiny town outside of Kenmare someone dropped with a heart attack right in the middle of the town. It took 20 minutes to get the PHECC Paramedics there. They could only do what the CFR was already doing (pushing and AED). The GP showed up and he couldn't do ALS either. The guy died from PHECC guidelines.

How did you know it was a heart attack? He died from PHECC guidelines? How? Did the guidelines state to do nothing? No one ever died from lack of intubation, just lack of oxygen. As an ALS provider I can state that ALS doesn't get everyone back. You seem to assume that if there was an AP the patient would have survived.

20 minutes for an ambulance isn't great but this is what happens in rural Ireland. If you want an instant response may I suggest moving closer to a hospital or an ambulance base. If you lived 30mins from a fire station would you complain that it took the fire service 30 minutes to get there??

BoonDoc wrote: »

So basically, a one day trained CFR can roughly do just as much as a four year trained paramedic? They can put in an iGel, attach the AED and push.

CFR-A can insert an I-Gel, this is taught to a healthcare worker and not a layperson.

BoonDoc wrote: »

Let's say I have chest pains. Easy MONA treatment right? Oh, but morphine is an AP skill. So I just have to deal with my chest pain to Cork? For an hour and a half? An the paramedics have no idea what kind of rhythm my heart is in?

As I stated before, Paramedics are well capable of dealing with chest pain. Aspirin and GTN are always a first line treatment, if STEMI then clopidogrel is administered. Entonox can also ease the pain. Their protocols would have called for ALS be it by land or by air and the patient would be taken to the PCI lab.

BoonDoc wrote: »

So again I ask....what is taught on that 3.5 year Paramedic course that will make them better???? UK Paramedics are still going through a 2 year degree and getting far more skills than even APs.

A 4 year paramedic course will teach the same as a 4 year nursing course but with the ability to preform more interventions and administer more medications than a nurse can.

Yes...we are behind.....yes...we are playing catch up, but, we need to identify what we are to catch up to. The USA? The UK? Australia? Canada? All these factors get identified before new CPG's are implemented. Do I think the 4 years is the right way to go...no...but...it may yield paramedics with a better ability and more confidence to go forward to the AP course.

Mycroft H · 29-01-2014 6:56pm

For what its worth, there are many EFRs in the red Cross trained to CFR-A standard. Not just limited to healthcare professionals

19hz · 29-01-2014 7:57pm

antichrist wrote: »

Adenosine would however be administered, a drug not in use in Ireland or the UK for paramedics/AP's.

I've been on scene when it was used by a para in the UK (Think it was for wolf parkinsons white).. perhaps only certain trusts use it?...
It was a UK Para not ECP or CCP etc..

antichrist · 29-01-2014 8:07pm

19hz wrote: »

I've been on scene when it was used by a para in the UK (Think it was for wolf parkinsons white).. perhaps only certain trusts use it?...
It was a UK Para not ECP or CCP etc..

We can give it here, with oversight but its not routine

Bang Bang · 01-02-2014 4:32pm

Adenosine is on the SI 518, Seventh Schedule Part 1 for Advanced Paramedics for use in treating SVT. So I guess there are thoughts or plans for its use in the future, but currently AP's don't carry it.

BoonDoc · 01-02-2014 9:29pm

Bang Bang wrote: »

Adenosine is on the SI 518, Seventh Schedule Part 1 for Advanced Paramedics for use in treating SVT. So I guess there are thoughts or plans for its use in the future, but currently AP's don't carry it.

Due to that Japanese study on CPR drugs, Adenosine may be removed when the new AHA update gets published in 2015.
Epi will be gone. They are slowly removing all of the toys and just focusing on push and shock.

Still a good idea to intubate in cardiac arrest along with the EZ IO. There is just no way to really secure that airway other than a definitive option. Thus the need for PHECC Paramedics to join the world of intubation and cannulation.

antichrist · 02-02-2014 7:23am

Actually, this study promotes the use on ACLS drugs

Evaluation of pre-hospital administration of adrenaline (epinephrine) by emergency medical services for patients with out of hospital cardiac arrest in Japan: controlled propensity matched retrospective cohort study
http://www.bmj.com/content/347/bmj.f6829?pmid=24326886&view=long

19hz · 02-02-2014 5:14pm

I suppose we'll have to wait and see what the course content is..
You never know, we might be pleasantly surprised?...

Bsc Emergency Medical Science commencing Sept 2015

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