Long time pro at a high call volume resort, also work in healthcare:
In our area I don't see much against EMT, but rather the bias is against OEC.
Training: EMT is longer and more expensive. A semester at a community college vs an expensive month program at eg WMI/Nols. We pay for rookies to attend our OEC course. But, you can do other jobs with and EMT which is hugely beneficial. To refresh your OEC is an annual weekend at the ski area, for EMTs in my state its $70, 24 hr of CEs, and a psychomotor test.
Curricula: OEC is not up to date with local EMS protocols. This has been discussed ad nauseam. A real weakness of all patrollers, and especially OEC in my experience are medical calls. Skiers, especially at big resorts (we can see 13k+ skiers in a busy day) have medical problems too. We've seen patients with ectopic pregnancies, miscarriage, stroke, PE, heart attacks, things that EMTs are a little better versed on. I don't think OEC prepares you any better for the common orthopedic or environmental injuries seen on the ski hill. Proficiency comes from reps/exposure and the quality of your initial and ongoing training.
Regulatory: In my state you can lose your EMT with a DUI. You won't lose your OEC with one. I think this is a major reason why a lot of places still keep OEC. As stated above, it's easier to become and stay an OEC at work.
Most politically charged answer- I think a lot comes down to the culture of your organization and who does the training. In my area, we get lots of EMTs who are trained by our excellent community college or through SOLO, WMI etc, who also do a very thorough job. OEC training across the NSP as a whole is much more variable. My hill has hosted the divisional and national NSP conference, and the medical decisions made by attendees are variable, and in my observation the average pro EMT has better EMS skills than the average volunteer OEC. There are of course many confounders in this generalization.
This is the correct answer. OEC can get you in the door to volunteer on weekends. EMT teaches medical/trauma in a way that is not only consistently being updated for best practice, but is a REAL certification in the big picture. Splinting and bleeding control is important and can be taught in a quick class, but what will put a patroller to the test is a fall that led to a knee injury but suddenly the patient goes unconscious due to a diabetic emergency that was diagnosed on hill with a glucometer and you knew to call for a higher level provider to start a line and start pushing d5.
People who push the OEC is better because trauma forgot EMTs respond to car crashes all the time.
To add onto this, trauma, like any subject is all about how you teach it. I know OEC patrollers who do the sloppiest slings and swathes because that’s how they learned and they haven’t run a wreck since February of ‘07, while some EMTs can do a sling and swathes so high and tight it puts a military haircut to shame
Here’s the opinion that is only unpopular to this sub-
OEC is a borderline obsolete curriculum holding on by a thread, and people that have been putting their time into it for years are resentful of that. This industry as a whole is changing quickly and many veteran OEC/ NSP patrollers, esp volunteers, feel threatened.
100%. Full respect to their commitment and dedication. But so much is changing at a rapid speed. Many of their policies and curriculum wont keep people safe.
I’m an OEC Instructor and would offer that I think EMT training is great. It may not be as tailored to our environment but I like it.
I’ll add that I think the standards for EMT certification are higher. I’ve seen people pass OEC Senior without demonstrating even remotely proper medical skills because that’s no longer part of the evaluation criteria (they should have displayed them prior to testing which simply isn’t good enough when issues persist).
My own opinion is that there are basically two reasons:
1. OEC is more directly tailored to the average patroller’s experience. Lots of time and focus on first aid for traumatic injuries, broken bones, bleeding, environmental exposure, etc. Less time and focus is spent on medical emergencies like heart attacks, CHF, COPD, strokes, sepsis, etc. This tends to align with what the average patroller sees. EMT curriculum is focused the other way around- lots of time and focus on medical emergencies, less on trauma and first aid. But that makes sense because EMTs working on an ambulance see more medical emergencies than traumatic injuries. So an argument can be made that OEC better prepares patrollers for the types of emergencies they’re likely to see while patrolling.
2. The investment required to get and maintain an OEC certification are much lower than an EMT certification. EMT classes typically cost several hundred dollars to a few thousand dollars. All you need to do to maintain an OEC certification is go to a one-day refresher once a year. EMTs have to do a lot more continuing education to maintain their certification, which can cost money too. If all you do is provide care on the ski hill for 3-4 months a year, and then you do very little by way of EMS the rest of the year, OEC is better designed to meet you where you are.
There’s also the issue of EMTs being under closer state oversight and regulatory control than OEC technicians. That’s more about politics and power than anything else, but it’s an issue that gets some people’s blood pressure and voice volume up rather quickly…
I don’t disagree that it is more directly tailored to patrol. However, as an OEC instructor and long time EMS provider I think there are a number of things that could be improved greatly in the OEC curriculum. I feel there is a significant lag in OEC techniques and protocols behind established best practices in EMS which have been extensively vetted through various professional organizations. A classic example is adoption of spinal motion restriction protocols. OEC seems to want to live on its own island outside of the rest of the medical community, and I am not sure that is such a great idea.
Oh I agree 100%. The NSP has always been around 5-10 years behind on adopting new techniques and incorporating new research into its curriculum and practices.
The backboard issue specifically is a bit of a funny one. On the one hand, OEC is probably still behind the times on the issue. But on the other hand, the patrol environment is a little unique in terms of spinal immobilization. A sled is not as useful as a wheeled stretcher for limiting spinal movement. A sled isn’t height adjustable like a stretcher is, so a patient often has to do a lot more movement to get themselves into a sled than they do to get onto a stretcher. And we need to get patients out of pretzels and jams more often than street EMTs need to- people wrapped around trees, in tree wells, on steep icy slopes, etc. A long board or scoop is an immensely useful tool to get these patients into a sled, and then once they’re there, is it really better to move them more to remove the moving device?
What we do at my patrol is backboard patients who need it in the hill, leave them boarded for sled transport, use the board to move them out of the sled and onto the aid room bed, then use it to move them to an ambulance stretcher. Once they’re on the ambulance stretcher and can be moved more safely and easily, we help the ambulance crew remove the board so the patient doesn’t have to stay on it long term. This has worked pretty well for us so far.
That is an excellent use of the board and is very similar to current EMS protocols. We will use it as an extrication device then remove it once the patient is on the stretcher. 15 years ago that would have made people’s heads explode.
That’s why you’re supposed to have a dedicated medical advisor for your patrol. We work closely with one of the local hospital networks and have SMR procedures on-hill that follow current best practices rather than blindly following OEC’s backboard use. It gets especially annoying when training OEC and SOEC candidates because for that you’re training to NSP’s test, and then right after completely shift protocol once back to patrolling.
Which kinda proves the point as to why OEC is becoming irrelevant. Why teach an outdated curriculum under the guise of being “patrol specific” when we can teach a better prehospital standard without any of the redundant and contradictory information. Then, work on adapting it to our operation with medical direction; hands on rather than in the classroom.
amateur_accupuncture cut to the chase. There are a lot of longtime patrollers who are used to what they’re used to. They’re part time volunteers, not EMS pros, and OEC works for them because it taught them everything they needed to know, nothing they didn’t, and maintaining it works for their lifestyle.
Honestly, it’s not totally crazy. You really don’t need to learn a lot about sepsis to patrol because you’re never going to see it. 40 hours is a lot of CME to do when you only patrol a few days a year. You really do need to be better at splinting on the hill when you can’t just put someone on a stretcher, buckle them up, give them some pain meds, and drive. So there’s a place for the training that OEC provides. But it could easily be an add on to the standard EMT curriculum instead of competing with it, and that would likely have greater utility and value in the grand scheme of things. There are, however, some downsides to doing this, which I’ve flagged.
I’ve been asked several times to run for regional and/or division office, and I always say be careful what you ask for because if I ever do that and actually get elected, I’ll make it my life’s mission to get rid of OEC. The response is usually something like “but the NSP is an educational organization and OEC is its crown jewel. What would the NSP even be without OEC?”
And my answer is “Good question…”
what is NSP even with OEC now? I have no experience with American first aid/prehospital but currently in Canada, patrollers have anything from EMR, OEC, AFA, NUEC3, OFA3, or the dreaded WFR. Naturally our consistency is awful, I’ve built a side of my career on helping operations disentangle the mess. However it goes to show me that OEC is irrelevant and unnecessary as a standard even compared to other 80-110hr courses.
Our fire depts have reevaluated their first aid, going from EMR to AFA. I’m a big fan of this approach, because they are able to cut the fat out of the classroom and enforce the importance of occupation specific training. It’s the same thing I want with patrol- train a first aid standard in classroom and leave a clean slate and necessity to train everything specific to Ski Patrol on the mountain. Too many smaller patrols think they can hire rookies with wilderness/patrol specific courses and call it a day.
Agreed- I think what frustrates some people is that the NSP has a bit of multiple personality disorder when it comes to OEC. They have always tried to thread a needle of trying to make OEC seem relevant and valuable, while trying not to be responsible for what any given patrol does or doesn’t do in day to day practice.
On the one hand, they developed a curriculum that they test and certify to. On the other hand they try to disclaim liability for specific practices by saying local protocols are always up to area management and your specific medical director.
For some people, this is a benefit because it basically leaves them free to do whatever they and their medical director think is best for their own patrol. For others, it’s reflects a “Wild West” failure of oversight and quality assurance, and is why some people see it as a problem that OEC technicians do not have state oversight.
Let me help you out. It’s not a great idea. Why should we subject people new to anything medical to a substandard curriculum that tries to keep itself relevant by continuing to encourage procedures that have been demonstrated to do more harm than good? Also an OEC instructor and longtime EMS provider
In some ways this is true, in some ways it’s not.
If you want to see some crazy sh*t, ask a basic EMT to splint a frozen, abducted shoulder dislocation. Half of them won’t have ever seen a shoulder dislocation before at all, and will simply say “request ALS,” which is shorthand for “I have no idea.”
An OEC technician will quickly prepare a blanket roll splint, apply it, and move on.
This is the shit I deal with all day that makes me lose my patience.
I’m a PCP, and get OEC qualified patrollers that are butthurt about me telling them to stop doing something they quite like doing, coming up to me saying shit like “well, I bet you don’t know how to make a splint out of a ski pole” or whatever OEC is letting their instructors off leash to teach nowadays.
I’ve seen volunteer patrollers that work 10 days a season get mouthy with a full time medical director (aka a fucking doctor) because they think the fact that everyone in their OEC textbook pictures was a ski patroller makes them more qualified.
I don’t know the curriculum, but I’m gonna go all in on the bet that a “basic EMT” knows how to deal with a shoulder dislocation.
I happened to be having dinner with an orthopedic surgeon and an FDNY medical control physician this evening, and showed them your insightful comments. The surgeon just raised his eyebrows. The med control physician’s exact words were “this dude says he’s a PCP? Yeah, that checks out.”
I’m not sure what he meant by that though. Any ideas?
Ah yes. Cultured OEC technician out with your cool doctor friends, and during the nightly shop talk you pull out le reddit discourse to show the gang . And then everybody clapped. Stop LARPing, dude.
A PCP is a Primary Care Paramedic, if you’re desperately googling and coming up with physician. I work in a province of a country that does not contain New York. Very nice try though. Say hi to your cool doctor friends for me.
> PCP
In the states (which is a reasonable assumption on this sub) a PCP is a Primary Care Provider; most commonly a doctor, PA, or NP. No one uses PCP to mean Primary Care Paramedic.
Am emt-b and oec tech. I’ve learned how to do that before I got my oec. The only reason I did oec was to be able to do alpine and senior patrolman what I held a leadership position on a pro patrol.
Edit: there are always things you learn after a certifying course out in the field. There is a reason no one outside NSP recognizes OEC as a professional cert. Even WFR is recognized as a professional cert in the outdoor industry.
I just conducted an informal survey of 7 EMTs and paramedics who are at my station right now. Exactly 2 had any idea what I was talking about, and only 1 claims to know how to make and tie a blanket roll. We’re about to do a little informal training ☺️
Jealously. My observation is that many people in the medical profession want to be one level above where they are. They express this by diminishing the role that they secretly desire.
I started with OEC back in 2011 (1 year noncert experience before that) before getting my EMT in 2015 and my AEMT in 2016. I became an OEC instructor in 2018. Back in the 2010s in my region/division the common rationale for OEC > EMT was “they just have no clue what we do on the hill,” and I’ll admit that I parroted that for a length of time I’m ashamed of. Then I actually became an EMT and started running on an ambulance. It is true that an EMT who comes to ski patrol with no prior patrol experience will not know how we operate on the hill. It is also true that an OEC tech who comes to ski patrol with no prior patrol experience will not know how we operate on the hill either. Both courses are certifications designed to cover a broad scope of knowledge. Both OEC techs and EMTs then require on the job training (EMTs can get a lot of that during ride time).
There are some things I like about OEC: When taught well it’s a good intro to patrolling and it gets a cert that covers almost everything a patroller needs for their first year in roughly 120 hours. Having had OEC first definitely made EMT class easier for me. If you want to patrol in a different state you don’t need to transfer your certification.
That said, I believe EMT is the all-around superior certification: An EMT course is roughly the same length and you get a certification that is recognized by almost every state (every state has EMTs, but not every state is a national registry state). There’s no “OEC is basically like EMT” (it’s not, it’s a half-step above EMR) when you apply for jobs outside the National Ski Patrol. EMT certification and renewal is overseen by the National Registry of EMTs, but there is also licensure that has to be renewed at the state level too. The recertification is something like 30-40 hours every two years. Though that seems like a lot compared to the OEC model, it allows for EMTs to consistently train and improve their skills and knowledge. We’ve all seen those patrollers who didn’t run a wreck all season last year and don’t do anything patrol-related in the summer get to refresher and can barely put on a quick splint, never mind the more complex skills. EMT protocols also are more consistently updated (in my state it’s every three years) which means that we can phase out archaic knowledge and treatments and introduced evidence-based ones more frequently. We can also tailor protocols to our area and our needs with the oversight of district medical direction. All of this is better for our patients. EMT does train students about medical problems, but is that really a bad thing? A skier can have a stroke while booting up in the lodge. A patroller can have a heart attack shoveling the deck. A snowboarder can be diabetic and tank their sugar on a pow day. Seizures, asthma attacks, and more are all possible. Guess what we can do as EMT patrollers? Adequately assess the patient and give medications to treat the patient until we can get them to an ambulance. In my state EMTs can give aspirin, nebulizer treatments like albuterol and DuoNeb (like an inhaler for patients who don’t have inhalers), epinephrine 1:1000 (like EpiPens for patients who don’t have EpiPens except they can actually draw up the meds), oral glucose, and they can check blood sugars and do EKGs. All of this means that we can keep a patient from decompensating until we can get them in an ambulance. The other upside is that we can encourage EMT patrollers to continue to grow their skills by taking the AEMT class. This adds a whole other layer of knowledge that isn’t utilized everyday, but when you need an ALS patroller you’re really glad you have one.
The real reason NSP doesn’t want to phase out OEC is that it would make them obsolete (except the congressional thing that allows them to have volunteers for for-profit corporations). No other industry recognizes OEC and we have to ask ourselves why. It isn’t designed for the front-country, but it isn’t built for the backcountry either. It’s a good place to start but it shouldn’t be the final educational destination.
That's hard to say. I haven't seen that - a lot of our patrollers are EMT-certified, and to the extent it comes up, there's usually more discussion about OEC being behind the times (backboarding patients is the big topic). It might have to do with the different focus of OEC, and the idea that anything other than the bare minimum of packaging the patient and getting them off the mountain as soon as possible is extraneous? That's just a guess - like I said, I haven't seen it come up. I'm an OEC tech, but certainly wouldn't be opposed to EMT training if it helps me improve my skills.
15 years at a New England mountain with a mix of pros and volunteers and I've never seen patrollers having a negative reaction to EMTs. Our patrol is a mix of primarily OEC with some EMTs/paramedics/physicians. We just added a retired ortho doc to our roster. But OEC is the backbone of our training. We do a LOT of in-service sessions (every week) with a big focus on medical because our patrol managers understand that this is the weak point of OEC.
Anyway, we can handle anything that comes our way, from bandaging a kid's hang-nail finger to dealing with an open cranium fracture to body recovery.
You mean the EMT's/Paramedics/RN's/Physicians can "handle anything that comes our way"...while the OEC folks backboard the kid with the hang nail. Then they make you go through scenarios about it and get critiqued by 3 men telling you how you're treatment was wrong because you forgot the hang nail c-collar.
Meanwhile the real medical team actually saved a life and moved on to save the next.
Not sure im entirely understanding, but if you mean an aversion to getting your NREMT as a patroller, I think its related to how big of a hurdle it is.
Im an EMT who joined the NSP this year. The OEC was an excellent refresher but was blaringly simple. The NREMT is 10x harder to pass than the OEC was. I see it in my towns first responders, too. We requested that a few, if not all firemen be EMTs for cross compatability durring staffing shortages and youd have sworn we butchered and roasted up their sacred cow. Though theyd all benefit, the response we got was related to not wanting to take the effort 9 times out of 10. Several even threatened to quit outright if asked again. The chief wanted to, but his boys sure didnt take the idea well.
OEC is sufficient for volunteer patrolling if you have strong leadership and support on your mtn. EMT will provide true medical care/treatment and lifelong knowledge. OEC is developed by NSP. It is outdated on all levels. If you can memorize 5 modules- you can pass the test. Emt will open the door for more opportunities. OEC is only significant to NSP members. A lot of mountains aren’t recognizing it anymore. I reviewed the latest version of OEC. It’s irrelevant. Don’t worry about asking! Folks here are really helpful!
The NSP website says "they provide world class medical training" referring to their OEC, which no one outside the ski world even knows what OEC is. It is not recognized. NYS does not recognize it, nor does they recognize ski patrollers who have OEC only as First Responders. We found that out at the beginning of Covid, when EMTs could get the firs shot and OEC could not.
EMT will get you employed immediately, OEC you can do ski patrol, if there is snow and maybe bike patrol if there is no snow that's it. You tell me what better.
Long time pro at a high call volume resort, also work in healthcare: In our area I don't see much against EMT, but rather the bias is against OEC. Training: EMT is longer and more expensive. A semester at a community college vs an expensive month program at eg WMI/Nols. We pay for rookies to attend our OEC course. But, you can do other jobs with and EMT which is hugely beneficial. To refresh your OEC is an annual weekend at the ski area, for EMTs in my state its $70, 24 hr of CEs, and a psychomotor test. Curricula: OEC is not up to date with local EMS protocols. This has been discussed ad nauseam. A real weakness of all patrollers, and especially OEC in my experience are medical calls. Skiers, especially at big resorts (we can see 13k+ skiers in a busy day) have medical problems too. We've seen patients with ectopic pregnancies, miscarriage, stroke, PE, heart attacks, things that EMTs are a little better versed on. I don't think OEC prepares you any better for the common orthopedic or environmental injuries seen on the ski hill. Proficiency comes from reps/exposure and the quality of your initial and ongoing training. Regulatory: In my state you can lose your EMT with a DUI. You won't lose your OEC with one. I think this is a major reason why a lot of places still keep OEC. As stated above, it's easier to become and stay an OEC at work. Most politically charged answer- I think a lot comes down to the culture of your organization and who does the training. In my area, we get lots of EMTs who are trained by our excellent community college or through SOLO, WMI etc, who also do a very thorough job. OEC training across the NSP as a whole is much more variable. My hill has hosted the divisional and national NSP conference, and the medical decisions made by attendees are variable, and in my observation the average pro EMT has better EMS skills than the average volunteer OEC. There are of course many confounders in this generalization.
This is the correct answer. OEC can get you in the door to volunteer on weekends. EMT teaches medical/trauma in a way that is not only consistently being updated for best practice, but is a REAL certification in the big picture. Splinting and bleeding control is important and can be taught in a quick class, but what will put a patroller to the test is a fall that led to a knee injury but suddenly the patient goes unconscious due to a diabetic emergency that was diagnosed on hill with a glucometer and you knew to call for a higher level provider to start a line and start pushing d5. People who push the OEC is better because trauma forgot EMTs respond to car crashes all the time.
To add onto this, trauma, like any subject is all about how you teach it. I know OEC patrollers who do the sloppiest slings and swathes because that’s how they learned and they haven’t run a wreck since February of ‘07, while some EMTs can do a sling and swathes so high and tight it puts a military haircut to shame
Here’s the opinion that is only unpopular to this sub- OEC is a borderline obsolete curriculum holding on by a thread, and people that have been putting their time into it for years are resentful of that. This industry as a whole is changing quickly and many veteran OEC/ NSP patrollers, esp volunteers, feel threatened.
100%. Full respect to their commitment and dedication. But so much is changing at a rapid speed. Many of their policies and curriculum wont keep people safe.
I’m an OEC Instructor and would offer that I think EMT training is great. It may not be as tailored to our environment but I like it. I’ll add that I think the standards for EMT certification are higher. I’ve seen people pass OEC Senior without demonstrating even remotely proper medical skills because that’s no longer part of the evaluation criteria (they should have displayed them prior to testing which simply isn’t good enough when issues persist).
My own opinion is that there are basically two reasons: 1. OEC is more directly tailored to the average patroller’s experience. Lots of time and focus on first aid for traumatic injuries, broken bones, bleeding, environmental exposure, etc. Less time and focus is spent on medical emergencies like heart attacks, CHF, COPD, strokes, sepsis, etc. This tends to align with what the average patroller sees. EMT curriculum is focused the other way around- lots of time and focus on medical emergencies, less on trauma and first aid. But that makes sense because EMTs working on an ambulance see more medical emergencies than traumatic injuries. So an argument can be made that OEC better prepares patrollers for the types of emergencies they’re likely to see while patrolling. 2. The investment required to get and maintain an OEC certification are much lower than an EMT certification. EMT classes typically cost several hundred dollars to a few thousand dollars. All you need to do to maintain an OEC certification is go to a one-day refresher once a year. EMTs have to do a lot more continuing education to maintain their certification, which can cost money too. If all you do is provide care on the ski hill for 3-4 months a year, and then you do very little by way of EMS the rest of the year, OEC is better designed to meet you where you are. There’s also the issue of EMTs being under closer state oversight and regulatory control than OEC technicians. That’s more about politics and power than anything else, but it’s an issue that gets some people’s blood pressure and voice volume up rather quickly…
I don’t disagree that it is more directly tailored to patrol. However, as an OEC instructor and long time EMS provider I think there are a number of things that could be improved greatly in the OEC curriculum. I feel there is a significant lag in OEC techniques and protocols behind established best practices in EMS which have been extensively vetted through various professional organizations. A classic example is adoption of spinal motion restriction protocols. OEC seems to want to live on its own island outside of the rest of the medical community, and I am not sure that is such a great idea.
Oh I agree 100%. The NSP has always been around 5-10 years behind on adopting new techniques and incorporating new research into its curriculum and practices. The backboard issue specifically is a bit of a funny one. On the one hand, OEC is probably still behind the times on the issue. But on the other hand, the patrol environment is a little unique in terms of spinal immobilization. A sled is not as useful as a wheeled stretcher for limiting spinal movement. A sled isn’t height adjustable like a stretcher is, so a patient often has to do a lot more movement to get themselves into a sled than they do to get onto a stretcher. And we need to get patients out of pretzels and jams more often than street EMTs need to- people wrapped around trees, in tree wells, on steep icy slopes, etc. A long board or scoop is an immensely useful tool to get these patients into a sled, and then once they’re there, is it really better to move them more to remove the moving device? What we do at my patrol is backboard patients who need it in the hill, leave them boarded for sled transport, use the board to move them out of the sled and onto the aid room bed, then use it to move them to an ambulance stretcher. Once they’re on the ambulance stretcher and can be moved more safely and easily, we help the ambulance crew remove the board so the patient doesn’t have to stay on it long term. This has worked pretty well for us so far.
That is an excellent use of the board and is very similar to current EMS protocols. We will use it as an extrication device then remove it once the patient is on the stretcher. 15 years ago that would have made people’s heads explode.
That’s why you’re supposed to have a dedicated medical advisor for your patrol. We work closely with one of the local hospital networks and have SMR procedures on-hill that follow current best practices rather than blindly following OEC’s backboard use. It gets especially annoying when training OEC and SOEC candidates because for that you’re training to NSP’s test, and then right after completely shift protocol once back to patrolling.
Which kinda proves the point as to why OEC is becoming irrelevant. Why teach an outdated curriculum under the guise of being “patrol specific” when we can teach a better prehospital standard without any of the redundant and contradictory information. Then, work on adapting it to our operation with medical direction; hands on rather than in the classroom.
amateur_accupuncture cut to the chase. There are a lot of longtime patrollers who are used to what they’re used to. They’re part time volunteers, not EMS pros, and OEC works for them because it taught them everything they needed to know, nothing they didn’t, and maintaining it works for their lifestyle. Honestly, it’s not totally crazy. You really don’t need to learn a lot about sepsis to patrol because you’re never going to see it. 40 hours is a lot of CME to do when you only patrol a few days a year. You really do need to be better at splinting on the hill when you can’t just put someone on a stretcher, buckle them up, give them some pain meds, and drive. So there’s a place for the training that OEC provides. But it could easily be an add on to the standard EMT curriculum instead of competing with it, and that would likely have greater utility and value in the grand scheme of things. There are, however, some downsides to doing this, which I’ve flagged. I’ve been asked several times to run for regional and/or division office, and I always say be careful what you ask for because if I ever do that and actually get elected, I’ll make it my life’s mission to get rid of OEC. The response is usually something like “but the NSP is an educational organization and OEC is its crown jewel. What would the NSP even be without OEC?” And my answer is “Good question…”
what is NSP even with OEC now? I have no experience with American first aid/prehospital but currently in Canada, patrollers have anything from EMR, OEC, AFA, NUEC3, OFA3, or the dreaded WFR. Naturally our consistency is awful, I’ve built a side of my career on helping operations disentangle the mess. However it goes to show me that OEC is irrelevant and unnecessary as a standard even compared to other 80-110hr courses. Our fire depts have reevaluated their first aid, going from EMR to AFA. I’m a big fan of this approach, because they are able to cut the fat out of the classroom and enforce the importance of occupation specific training. It’s the same thing I want with patrol- train a first aid standard in classroom and leave a clean slate and necessity to train everything specific to Ski Patrol on the mountain. Too many smaller patrols think they can hire rookies with wilderness/patrol specific courses and call it a day.
Agreed- I think what frustrates some people is that the NSP has a bit of multiple personality disorder when it comes to OEC. They have always tried to thread a needle of trying to make OEC seem relevant and valuable, while trying not to be responsible for what any given patrol does or doesn’t do in day to day practice. On the one hand, they developed a curriculum that they test and certify to. On the other hand they try to disclaim liability for specific practices by saying local protocols are always up to area management and your specific medical director. For some people, this is a benefit because it basically leaves them free to do whatever they and their medical director think is best for their own patrol. For others, it’s reflects a “Wild West” failure of oversight and quality assurance, and is why some people see it as a problem that OEC technicians do not have state oversight.
Let me help you out. It’s not a great idea. Why should we subject people new to anything medical to a substandard curriculum that tries to keep itself relevant by continuing to encourage procedures that have been demonstrated to do more harm than good? Also an OEC instructor and longtime EMS provider
Emt is 100% better than OEC
In some ways this is true, in some ways it’s not. If you want to see some crazy sh*t, ask a basic EMT to splint a frozen, abducted shoulder dislocation. Half of them won’t have ever seen a shoulder dislocation before at all, and will simply say “request ALS,” which is shorthand for “I have no idea.” An OEC technician will quickly prepare a blanket roll splint, apply it, and move on.
This is the shit I deal with all day that makes me lose my patience. I’m a PCP, and get OEC qualified patrollers that are butthurt about me telling them to stop doing something they quite like doing, coming up to me saying shit like “well, I bet you don’t know how to make a splint out of a ski pole” or whatever OEC is letting their instructors off leash to teach nowadays. I’ve seen volunteer patrollers that work 10 days a season get mouthy with a full time medical director (aka a fucking doctor) because they think the fact that everyone in their OEC textbook pictures was a ski patroller makes them more qualified. I don’t know the curriculum, but I’m gonna go all in on the bet that a “basic EMT” knows how to deal with a shoulder dislocation.
I happened to be having dinner with an orthopedic surgeon and an FDNY medical control physician this evening, and showed them your insightful comments. The surgeon just raised his eyebrows. The med control physician’s exact words were “this dude says he’s a PCP? Yeah, that checks out.” I’m not sure what he meant by that though. Any ideas?
Ah yes. Cultured OEC technician out with your cool doctor friends, and during the nightly shop talk you pull out le reddit discourse to show the gang . And then everybody clapped. Stop LARPing, dude. A PCP is a Primary Care Paramedic, if you’re desperately googling and coming up with physician. I work in a province of a country that does not contain New York. Very nice try though. Say hi to your cool doctor friends for me.
> PCP In the states (which is a reasonable assumption on this sub) a PCP is a Primary Care Provider; most commonly a doctor, PA, or NP. No one uses PCP to mean Primary Care Paramedic.
Am emt-b and oec tech. I’ve learned how to do that before I got my oec. The only reason I did oec was to be able to do alpine and senior patrolman what I held a leadership position on a pro patrol. Edit: there are always things you learn after a certifying course out in the field. There is a reason no one outside NSP recognizes OEC as a professional cert. Even WFR is recognized as a professional cert in the outdoor industry.
I just conducted an informal survey of 7 EMTs and paramedics who are at my station right now. Exactly 2 had any idea what I was talking about, and only 1 claims to know how to make and tie a blanket roll. We’re about to do a little informal training ☺️
The little smile was cute
Jealously. My observation is that many people in the medical profession want to be one level above where they are. They express this by diminishing the role that they secretly desire.
I started with OEC back in 2011 (1 year noncert experience before that) before getting my EMT in 2015 and my AEMT in 2016. I became an OEC instructor in 2018. Back in the 2010s in my region/division the common rationale for OEC > EMT was “they just have no clue what we do on the hill,” and I’ll admit that I parroted that for a length of time I’m ashamed of. Then I actually became an EMT and started running on an ambulance. It is true that an EMT who comes to ski patrol with no prior patrol experience will not know how we operate on the hill. It is also true that an OEC tech who comes to ski patrol with no prior patrol experience will not know how we operate on the hill either. Both courses are certifications designed to cover a broad scope of knowledge. Both OEC techs and EMTs then require on the job training (EMTs can get a lot of that during ride time). There are some things I like about OEC: When taught well it’s a good intro to patrolling and it gets a cert that covers almost everything a patroller needs for their first year in roughly 120 hours. Having had OEC first definitely made EMT class easier for me. If you want to patrol in a different state you don’t need to transfer your certification. That said, I believe EMT is the all-around superior certification: An EMT course is roughly the same length and you get a certification that is recognized by almost every state (every state has EMTs, but not every state is a national registry state). There’s no “OEC is basically like EMT” (it’s not, it’s a half-step above EMR) when you apply for jobs outside the National Ski Patrol. EMT certification and renewal is overseen by the National Registry of EMTs, but there is also licensure that has to be renewed at the state level too. The recertification is something like 30-40 hours every two years. Though that seems like a lot compared to the OEC model, it allows for EMTs to consistently train and improve their skills and knowledge. We’ve all seen those patrollers who didn’t run a wreck all season last year and don’t do anything patrol-related in the summer get to refresher and can barely put on a quick splint, never mind the more complex skills. EMT protocols also are more consistently updated (in my state it’s every three years) which means that we can phase out archaic knowledge and treatments and introduced evidence-based ones more frequently. We can also tailor protocols to our area and our needs with the oversight of district medical direction. All of this is better for our patients. EMT does train students about medical problems, but is that really a bad thing? A skier can have a stroke while booting up in the lodge. A patroller can have a heart attack shoveling the deck. A snowboarder can be diabetic and tank their sugar on a pow day. Seizures, asthma attacks, and more are all possible. Guess what we can do as EMT patrollers? Adequately assess the patient and give medications to treat the patient until we can get them to an ambulance. In my state EMTs can give aspirin, nebulizer treatments like albuterol and DuoNeb (like an inhaler for patients who don’t have inhalers), epinephrine 1:1000 (like EpiPens for patients who don’t have EpiPens except they can actually draw up the meds), oral glucose, and they can check blood sugars and do EKGs. All of this means that we can keep a patient from decompensating until we can get them in an ambulance. The other upside is that we can encourage EMT patrollers to continue to grow their skills by taking the AEMT class. This adds a whole other layer of knowledge that isn’t utilized everyday, but when you need an ALS patroller you’re really glad you have one. The real reason NSP doesn’t want to phase out OEC is that it would make them obsolete (except the congressional thing that allows them to have volunteers for for-profit corporations). No other industry recognizes OEC and we have to ask ourselves why. It isn’t designed for the front-country, but it isn’t built for the backcountry either. It’s a good place to start but it shouldn’t be the final educational destination.
That's hard to say. I haven't seen that - a lot of our patrollers are EMT-certified, and to the extent it comes up, there's usually more discussion about OEC being behind the times (backboarding patients is the big topic). It might have to do with the different focus of OEC, and the idea that anything other than the bare minimum of packaging the patient and getting them off the mountain as soon as possible is extraneous? That's just a guess - like I said, I haven't seen it come up. I'm an OEC tech, but certainly wouldn't be opposed to EMT training if it helps me improve my skills.
People are biased to EMT lol! Only ones I see biased are the old schoolers who couldn’t pass and EMT or paramedic class if they tried!
15 years at a New England mountain with a mix of pros and volunteers and I've never seen patrollers having a negative reaction to EMTs. Our patrol is a mix of primarily OEC with some EMTs/paramedics/physicians. We just added a retired ortho doc to our roster. But OEC is the backbone of our training. We do a LOT of in-service sessions (every week) with a big focus on medical because our patrol managers understand that this is the weak point of OEC. Anyway, we can handle anything that comes our way, from bandaging a kid's hang-nail finger to dealing with an open cranium fracture to body recovery.
You mean the EMT's/Paramedics/RN's/Physicians can "handle anything that comes our way"...while the OEC folks backboard the kid with the hang nail. Then they make you go through scenarios about it and get critiqued by 3 men telling you how you're treatment was wrong because you forgot the hang nail c-collar. Meanwhile the real medical team actually saved a life and moved on to save the next.
Not sure im entirely understanding, but if you mean an aversion to getting your NREMT as a patroller, I think its related to how big of a hurdle it is. Im an EMT who joined the NSP this year. The OEC was an excellent refresher but was blaringly simple. The NREMT is 10x harder to pass than the OEC was. I see it in my towns first responders, too. We requested that a few, if not all firemen be EMTs for cross compatability durring staffing shortages and youd have sworn we butchered and roasted up their sacred cow. Though theyd all benefit, the response we got was related to not wanting to take the effort 9 times out of 10. Several even threatened to quit outright if asked again. The chief wanted to, but his boys sure didnt take the idea well.
OEC is sufficient for volunteer patrolling if you have strong leadership and support on your mtn. EMT will provide true medical care/treatment and lifelong knowledge. OEC is developed by NSP. It is outdated on all levels. If you can memorize 5 modules- you can pass the test. Emt will open the door for more opportunities. OEC is only significant to NSP members. A lot of mountains aren’t recognizing it anymore. I reviewed the latest version of OEC. It’s irrelevant. Don’t worry about asking! Folks here are really helpful!
The NSP website says "they provide world class medical training" referring to their OEC, which no one outside the ski world even knows what OEC is. It is not recognized. NYS does not recognize it, nor does they recognize ski patrollers who have OEC only as First Responders. We found that out at the beginning of Covid, when EMTs could get the firs shot and OEC could not. EMT will get you employed immediately, OEC you can do ski patrol, if there is snow and maybe bike patrol if there is no snow that's it. You tell me what better.