How "Basic" is BLS in your area

[MedicDelta]

Oh and assisting with an Epi-Pen auto injector

 

[drjekyl75]

My company runs in multiple counties and each have slightly different protocols.

For the most part EMT-B's can:

Combi-Tube / King Airway
Aspirin
Nitro (patient assist)
C-Pap has come and gone a couple of times
Epi-Pen autoinjector
Albuterol (patient assist)
Glucose (oral)
Pulse Oximetry
Glucometry
AED
OPA / NPA
Bleeding control, also have combat application tourniquets

and there's probably a few main one's I'm missing!

 

[Tigger]

In my old system in Colorado, EMTs are able to start IVs, administer saline boluses, give D50, albuterol, NTG assist, ASA, Narcan, King tubes, plus everything else you mentioned in the first part of your post. As far as I know, they still can't do CPAP, Epi for asthma, Venturi masks (kind of surprised you guys carry these), or vents of any kind.

Not much has changed.

Our new medical direction has gotten us a countywide waiver for IOs and dislocation reductions (patella, anterior shoulder, and digits).

 

[JDEMT18]

(Start note I have provided only examples there is more that i did not say in our scope) Where I am from our BLS I believe the most basic in the U.S. and possibly the world. (not and exaggeration the truth EMTs are not common anywhere outside NA or UK which means...) We have no scope nor do our medics. Other states EMRs can do as much as our EMTs and EMT-Is in other states can do as much as our medics with a course that is half the length. EMS agencies in my area are so excited because we are aloud to carry EPI Pens on the rig now. The same item a 5yo has in his pocket everyday is a big deal to have on an ambulance!!! We might be soon able to assist in 1 nebulizer dose of the patients own nebulizer. These are major steps which is very depressing. We can't use glucometers, can't give pain relief or NSAIDs, no endotrachel suctioning, can't confirm a intubation, spinal assessments or even realign bones in some situations. We can only carry 3 meds on our trucks namely oral glucose, IN narcan and epi. (side note to use narcan you have to take a whole separate course and get approval through your Med director to use it which means most but not all can use it even though its on the truck and EMRs got Narcan before EMTs did as well) We cannot use rescue airways even though they are proven to be very easy place and have good outcomes. EMTs in my area cannot even setup, acquire or interpret EKGs or help prepare an intubation. Most other places this is aloud but sometimes is considered a skill in their scope of just an accepted and trust base thing or common knowledge. Our medics can't do much either. For example only can do needle crics not surgical which is proven to be quicker and provide better outcomes. Our medics have to also call most things through a MD at the ER before doing it. They cannot close wounds yet other EMT-Bs who take EMT-T courses can. Also our medics never do procedures in their scope because the distance to the hospital or if the MD in the ER says not to. The OEMS in my area is slow to change and will stay that way for some time. The system is so regulated yet so unregulated. My instructor a few months back had a whole rant on this topic. His example was that the rules to setup a BLS unit in my area is all you need is an ambulance with an AED, o2, first aid kit and some people trained in CPR thats it. I read up and he is right the regulations for a ambulance only have recommended equipment to carry nothing is required. It says BLS ambulance SHOULD (don't have to) be staffed with 2 EMTs. Our system is very bad. Another instructor who was a medic said he worked in 2 neighboring states for a short experience and was required to operate under our areas scope not the locations he was working and said he felt really useless on calls and could not do anything compared to the other medics. There are states which large scopes of practice and where 16yos can be EMTs and are doing more than an 30yo EMT with 10 years under their belt from my area. I love medicine and want to do more and also this scope of practice does effect patient outcomes which means it should be changed.

 

[LMEMT]

We actually have almost the same protocol, vc85. The things that you have coming on the way are things that we have right now, though. And we can't use the epi-pen for asthmatics.

 

[coffeegal]

I work in North and South Carolina. Pretty much the same, with SC being a little more...
MEDS:
Narcan-up to 10 mg in NC-even for pediatrics, more if needed with med-control....I hope we wouldn't ever need this much!
Oxygen
Albuterol (if patient has a prescription, can give from our meds though)
Aspirin
Acetaminophen
Nitro tablets (if patient has a prescription, can give from our meds though)
Oral glucose
Epi-pens, adult and jr.
We don't carry atropine, 2-pam or activated charcoal, but are able to administer.

OTHER:
Vitals
CPR
AED
Pulse Oximetry
Glucometry
OPA
NPA
3 attempts to reduce a fx if distal pulse is missing
All of the splinting, backboarding, bandaging, etc
Nasal Narcan-up to 10 mg in NC even for peds
CPAP-SC Only
Tourniquet application
King/rescue airways
Anything related to paramedic assist, (12-lead placement, IV prep, medication prep, etc.)
Birth Babies
In some counties of SC I've heard BLS trucks can run a 12-lead to go ahead and send to the doc at the hospital so that they get a look at it before arrival.

I've posted the links to the state protocols, however some counties vary from the state, just an FYI
Here is SC Protocols: http://www.scdhec.gov/Health/FHPF/EMS_TrainingProtocolsRequirements/ProtocolsForms/
Here is NC Protocols: http://www.ncems.org/nccepstandards.html