Where you taught when you can exceed the legal limits to your practice?

[AnthonyM83]

Is that true in every system?

 

[DesertMedic66]

Thats what i do. Usually when a bgl is needed, an IV is started anyways.

All patients for us that get an IV get a BGL test. Might as well. But not everyone of our patients gets an IV. It's up to the medic if he wants a BGL test.

 

[lampnyter]

Is that true in every system?

The doctor part? yea i believe so.

 

[rwik123]

For us its in our scope to "read" the meter. We can poke their their finger as an EMT. But when the medic starts an IV we can take the "flash" blood to read the BGL.

did you mean to say can't poke the finger?

 

[DesertMedic66]

did you mean to say can't poke the finger?

Yeah. Sorry about that. I had to edit my post because I wasn't able to use a certain word and changed can't to can lol

 

[usalsfyre]

You cant go out of your scope if a doctor says to.

Not true in all cases. Blood, whole pile of meds and certain things like chest tubes I regularly transport on IFTs are technically "out of my scope" as a ground paramedic in my system. However, I am allowed to do so with online orders as i have documented training in those areas.

Texas has no "state scope of practice". There is a service in the DFW area that trains on and authorizes field C-section in the setting of maternal demise.

 

[Chief Complaint]

The only time i can recall witnessing a "breach" of scope of practice is blood glucose levels being checked by Basics. I see it quite often actually, and its just kind of an accepted thing around here. When the :censored::censored::censored::censored: hits the fan and the medics have more important life saving interventions to perform, they'll often ask a Basic to check the BGL.

 

[rmabrey]

Its pretty much accepted around here that the basics are going to do it for the medics. Students do it all the time and dont document it.

 

[HotelCo]

Its pretty much accepted around here that the basics are going to do it for the medics. Students do it all the time and dont document it.

It's within the scope of practice for basics here.... Seems odd that it wouldn't be elsewhere. Where are you located?

 

[rmabrey]

It's within the scope of practice for basics here.... Seems odd that it wouldn't be elsewhere. Where are you located?

Indiana.

 

[Chief Complaint]

Its pretty much accepted around here that the basics are going to do it for the medics. Students do it all the time and dont document it.

Im sure ill catch hell for this, but i dont see a problem with Basics checking BGL. Sure its outside of their scope in most places, so its technically wrong, but its a nearly idiot proof procedure that saves time for the medic.

 

[rmabrey]

Im sure ill catch hell for this, but i dont see a problem with Basics checking BGL. Sure its outside of their scope, so its technically wrong, but its a nearly idiot proof procedure that saves time for the medic.

I dont see why its even out of the scope but I didnt make the rules. :unsure:

 

[usalsfyre]

Im sure ill catch hell for this, but i dont see a problem with Basics checking BGL. Sure its outside of their scope in most places, so its technically wrong, but its a nearly idiot proof procedure that saves time for the medic.

I'm absolutely clueless why a very minimally invasive diagnostic technique is outside of their scope, but the brutality of long spine boards is inside it...

 

[foxfire]

Yeah, I have heard stories but it was always "that guy" who did whatever it was. Our instructor is always drilling into us to stay within local protocol when we are out in the field doing ride time. Not that we are stepping out of bounds that I know of, he just wants us to stay in that mind set and not try to be super hero medics.h34r:
But there is no way I am going to throw my hard earned license away over one pt. Hate to sound cruel but that's the way it is.

 

[Chief Complaint]

I wasnt expecting to be agreed with on that one! This is still the internet right?!?

Seriously though, all it would take is a BRIEF class to train Basics in the fine art of poking patients in the finger. To be honest i never even received training for BGL's at an ALS level, we just started doing it during our clinicals/internships. Once you see it done, its pretty self explanatory.

 

[mycrofft]

Thanks for bringing it back on track Foxfire

Lots and lots of comments, only four use the poll?

I'm surprised also, so many instances of people posting on EMTLIFE about the heroic stuff they have or will do despite limits and now, nada...

And if I hear "BGL" again, I'm gonna have to come back there, kids! You hear?

 

[Anjel]

umm....

BGL isn't out of my scope?

We have it on our rigs. I did it 5 times today.

Now I didn't read the entire thread. So if you are talking about a certain place. then sorry my bad.

 

[Chief Complaint]

Lots and lots of comments, only four use the poll?

I'm surprised also, so many instances of people posting on EMTLIFE about the heroic stuff they have or will do despite limits and now, nada...

And if I hear "BGL" again, I'm gonna have to come back there, kids! You hear?

I think this thread took a wrong turn on my part, my bad.

 

[marineman]

I clicked no because I never exceed my scope of practice but I will (rarely) modify my scope of practice if need be.

I'm a volunteer first responder in a rural area. I work as a paramedic for the service that covers 911 in our area. I have maybe once or twice responded as a first responder and once on scene worked as a medic but anytime I do I will call dispatch and be put on the clock for the call which means I'm no longer a first responder I'm an extra medic on the truck. Like I said it's rare this happens and it's never before the ambulance gets on scene. I have nothing in my first responder jump kit that would allow me to exceed my scope of practice so it's only when the rig full of ALS supplies gets there that I would even be able to go above. The only times I remember doing it are on PNB's, one medic would control airway/intubate, the other would work the monitor and manage the code and I would grab IV and meds.

 

[foxfire]

And if I hear "BGL" again, I'm gonna have to come back there, kids! You hear?

Nobody wants to see that!!