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What industry secret are you aware of that most people aren't?
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this post was submitted on 24 Jun 2024
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Asklemmy
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Emergency Medical Service/Ambulances are a ridiculously low qualified in a fair shair of industrial nations, especially the US,France, or Austria.
Even in the countries with more training/physician based services (Germany, Belgium, Italy)the actual qualification of the responders varies widely - most of them wouldn't be allowed to care for a single emergency within a hospital on their own.
In the US, at least, there are two levels of medical emergency responders. An EMT is a basic first responder, and receives 170-200 hours of training. A paramedic has more advanced training (1200-1800) and is able to perform more procedures and administer medicine. Most ambulance crews are one EMT and one paramedic.
A EMT is in no way qualified to handle emergencies on their own (and yes,I know their curriculum very well). And no, the majority of ambulances are not paramedic-staffed in the US - Actually only 25% of all licenced providers are Paramedics and there are large areas which have only BLS available in a reasonable timeframe. Or no EMS at all, as ambulance services are NOT an essential service in most states. (Only 11 States see it differently).
So no, not even remotely "most ambulances" are paramedic staffed. Mathematically impossible.
Besides: The shortest current timeframe in the US for paramedic training is 6 months.
That is incredibly short in international comparisons, especially when one does compare it to the skills allowed with it.
Comparison: Australia: 3 year bachelor degree to even make it on a Emergency ambulance (not counting very rural WA&NT), a master degree for the more serious skills.
Germany: 3 Year apprenticeship to be in command in the ALS ambulance, but emergency physicians are tasked to more serious cases
Switzerland: 3 year degree, emergency physicians being somewhat common, though, often additional nursing and critcare degree required for more serious cases.
Hungary: 2 Year EMT course for EMT, 4 year Bachelor for Paramedic
Poland: 3year Bachelor as minimum.
South Africa: 1year minimum for the entry, 2 year's for most jobs, 4 years for paramedic.
I have an EMT license in America and am currently in medical school. EMT training is entirely centered around "stabilize the patient and get them in front of a physician". They have a limited range of capabilities, but the training they do have is focused on the things that will kill you quickly, and a brief overview of other things.
Do you know, has it always been this way, or has the gap gradually widened with the enshitification of medical services to maximize profit?
Both.
The US never had a comprehensive EMS system as it was never seen as an essential service, both because EMS is expensive to run (especially in the healthcare/insurance/taxation environment the US has) and because there was significant lobbying against it (there is money in EMS on a large scale if you operate it in a very cut-throat way).
But the recent downturn in healthcare availability and county-tax-income in rural regions and the dwindling volunteer numbers and enshitification of medicine have all done their part in making the whole situation so much worse.
There is actually a good study showing "ambulance deserts". (Just as a reminder: That does not mean that no Advanced life support provider comes..it means that no Ambulance is available at all. So not even one staffed by an EMT-B and an emergency medical responder. And we're not talking about "what happens if we need two ambulances at the same time)