# What can YOU do?



## BloodNGlory02 (May 1, 2005)

I was reading an older topic and some basics were amazed that other basics around the country are allowed to do a lot more then they can. I almost feel paramedic like being a basic in Wisconsin. What are you allowed to do as a basic in your state/area?

combitube
AED
ASA
SQ Epi
Albuterol
Glucagon
Glucose
Glucometer checks
apply MAST pants
nasal/oral airways
tranport pts with trachs/vent dependant

Im probably missing some stuff but ill remember once someone posts their list if I forgot anything.


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## Luno (May 1, 2005)

In the field, anything we can get our hands on, including experimental stuff, as well as chest tubes, field crics, closed bone reductions, etc...  Back at home, pretty much the same as you, except no combi in King Co.


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## TTLWHKR (May 1, 2005)

It really all depends on who is on the bus. I went completely through the NREMT-P program, I just "walked away" before I took my final exam. So usually the medic will let me do just about anything that needs to be done. We just don't write it down that I helped out side of my Scope of Practice.

In PA; EMT-Basics can:

AED
Give EPI w/out orders and carry it on a BLS unit
Glucose
Assist w/ Inhaled B/D
Assist w/ Ntg
apply MAST pants
nasal/oral airways

As a W-EMT-Advanced, and in a wilderness setting I can:
Administer IV of NS
SubQ Epi
BGL
IV Dextrose


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## ffemt8978 (May 1, 2005)

As an EMT-B, we're allowed to do the following:

Administer Epi-Pens to any age patient
Administer ASA
Apply MAST Pants
AED
Combitube (with special certification)
Oral/Nasal Airway
Administer Oral Glucose
Administer Activated Charcoal
Assist with Pt. NTG
Assist with Pt. MDI
Assist with Pt. Nebulizer
Glucometer checks


As an EMT-IV, I'm allowed to do the following:

IV of NS (EJ included if MD gives permission)
IO of NS
Titrate O2 to keep sats above 90%


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## Summit (May 2, 2005)

Basic (all standing):
Combitube
ASA
Albuterol (assist rx)
NTG
SQ Epi (currently assist with Rx, very soon we will have standing for our own pens)
Oral Glucose
NPA/OPA

BIV  (all standing):
Glucometer
IV starts (peripheral only)
D50
NS

Future:
NO

WEMT
In theory if more than 2 hours from definitive care in the wilderness there are protocols to: clear spine in the field, reduce indirect dislocations of shoulder/patella/digits dislocations, assist albuterol, SQ Epi for anaphylxsis and severe asthma, PO benadryl for anaphylaxis, ASA


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## rescuemedic7306 (May 2, 2005)

Quote: As an EMT-B, we're allowed to do the following:

Administer Epi-Pens to any age patient
Administer ASA
Apply MAST Pants
AED
Combitube (with special certification)
Oral/Nasal Airway
Administer Oral Glucose
Administer Activated Charcoal
Assist with Pt. NTG
Assist with Pt. MDI
Assist with Pt. Nebulizer
Glucometer checks


As an EMT-IV, I'm allowed to do the following:

IV of NS (EJ included if MD gives permission)
IO of NS
Titrate O2 to keep sats above 90%

In MN, all the above, plus: Glucagon, 'no-haul' patients without MD authority (but that's just a local protocol), call codes in the field (with MD agreement) and apply and transmit, but not read, 12 lead EKG.


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## Jon (May 2, 2005)

> _Originally posted by TTLWHKR_@May 1 2005, 10:00 PM
> * It really all depends on who is on the bus. I went completely through the NREMT-P program, I just "walked away" before I took my final exam. So usually the medic will let me do just about anything that needs to be done. We just don't write it down that I helped out side of my Scope of Practice.
> 
> In PA; EMT-Basics can:
> ...


 Just to clarify - PA BLS epi is 0.3mg and 0.15mg IM epi-Pens

Jon


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## Summit (May 2, 2005)

That would be a don't cut and paste and post when drunk after working a 72 and then an all day MRA avalanche field training at 12,000ft.
In my post above. All "SQ" should have been "IM"
NTG should be assist rx only for above 100sys and must at least attempt to contact MC.
My head hurts... back to studying.


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## Jon (May 2, 2005)

> _Originally posted by Summit_@May 2 2005, 12:51 PM
> * My head hurts... *


 Should ease off helping with the nitro


Jon


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## TTLWHKR (May 2, 2005)

> _Originally posted by MedicStudentJon+May 2 2005, 04:26 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ May 2 2005, 04:26 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Summit_@May 2 2005, 12:51 PM
> * My head hurts... *


Should ease off helping with the nitro


Jon [/b][/quote]
 We used to have a medic who sprayed the nitrostat into the air three times before giving a dose to a patient. I hated to ride out w/ him b/c he was just the biggest idiot in the world. Bad medic, and made poor decisions. He was fired for leaving IV needles (we the the kind w/ retractable needles) on the bench seat *or in the bench seat* w/ out retracting the needle.


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## Jon (May 2, 2005)

> _Originally posted by TTLWHKR+May 2 2005, 07:49 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ May 2 2005, 07:49 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


We used to have a medic who sprayed the nitrostat into the air three times before giving a dose to a patient. I hated to ride out w/ him b/c he was just the biggest idiot in the world. Bad medic, and made poor decisions. He was fired for leaving IV needles (we the the kind w/ retractable needles) on the bench seat *or in the bench seat* w/ out retracting the needle. [/b][/quote]
 We have one Old-school PHRN who did that. He is the Chief of one of the local squads. The reason his squad went needleless on him way back when... Jelco's causing holes in the bench seat, and being left around.


And isn't "one for you, one for me" common prehospital practice? if it is good for ativan, why not nitro?    :lol: 

Jon


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## runindash05 (May 4, 2005)

rescuemedic7306~

  Where in MN?


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## emtbuff (May 4, 2005)

Okay lets see here.  

combi
Oral/nasal airways
Defib
collar
backboard
splint with pillow
Can us a traction splint for femur
glucose
activated Charcoal
Assist with Nitro

I belive we can Give 
ASA
Pt prescribed inhalers


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## SafetyPro2 (May 5, 2005)

Let's see. This is in LA County, but it can vary county-to-county (in Orange, for example, they can't assist with Epi pens).

OPA
NPA
BVM
AED (if your agency is approved and has one...can't use a public access one)
O2 admin (via cannula or NRB mask, or the above BVM)
traction splint for suspected isolated mid-shaft femur FX
spinal immobilization
oral glucose for diabetic PTs
assist with:
- sublingual nitro pill or spray
- Epi pen
- asthma inhalers
monitor peripheral lines (can't insert/change, but can transport PT with existing)
prep IVs (for medics)
position/inflate MAST pants (under direction of medic...rarely if ever used)

We used to have ET intubation as an optional skill, but that was removed as of the first of the year. CombiTube has never been approved. 

For the three "drug assists" we can only use them if they're prescribed to the PT and they PT meets protocol. 

We can "determine" death in a few cases, namely obvious signs (decap, decomp, massive crush, incineration, etc.) and pulsless/apneic with lividity or rigor (after auscultating apical pulse, breath sounds, and determining lack of neuro response). We can also honor DNRs and advanced directives.


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## rescuemedic7306 (May 5, 2005)

> _Originally posted by runindash05_@May 4 2005, 01:14 PM
> * rescuemedic7306~
> 
> Where in MN? *


 SW MN, near Pipestone


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## emtbuff (May 5, 2005)

Thanks to SafetyPro I thought of a few others things that we can do;

Suctioning
Changing IV bags if they run out/or are low
DCing an IV if it goes bad in route.
Monitor the IV if there are no added drugs.

And also any obvious deaths that we come along we can call for the corner.  No pulse, Breathing, signs of rigor, and any obviouse death by decap.


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## Jon (May 5, 2005)

> _Originally posted by emtbuff_@May 5 2005, 11:20 AM
> *
> And also any obvious deaths that we come along we can call for the corner.  No pulse, Breathing, signs of rigor, and any obviouse death by decap. *


 Corner?

is this the new thing with stiffs... leave them at nearest corner?


(I know this is the pot calling the kettle black, but...)


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## TTLWHKR (May 5, 2005)

> _Originally posted by MedicStudentJon+May 5 2005, 12:02 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ May 5 2005, 12:02 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-emtbuff_@May 5 2005, 11:20 AM
> *
> And also any obvious deaths that we come along we can call for the corner. No pulse, Breathing, signs of rigor, and any obviouse death by decap. *


Corner?

is this the new thing with stiffs... leave them at nearest corner?


(I know this is the pot calling the kettle black, but...) [/b][/quote]
 And what do you do with the deceased?

When I lived back home, the funeral director was a firefighter, so if there was an ambulance run w/ the possibility of deceased persons; he brought the hearse to pick them up. He was also the county coroner, not just out looking for business. Of course if the call was for arrest, he didn't come.. Just the "confirmed dead". 

At least we could bury our mistakes. lol


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## Phridae (May 5, 2005)

Alright, lets see here....

as a basic....

o2
ASA
Pt. assisted Nirto
Pt. assisted MDI
Blood sugar checks
AED.
pt. assisted epi pen.
neb with albuterol.
LP 300
combitube
nasal/oral airways
glucagon
glutose

as an IV tech

all the above plus....
IV with NS.
Narcan
Atrovent
d-50 (d-23, d-10)
epi (not pt's)

Thats all I can think of at the moment. I'm sure theres more.


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## xems (May 13, 2005)

im a student from nj n im pretty sure we dont use combitubes so jus wonderin what r they??


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## emtbuff (May 14, 2005)

> _Originally posted by TTLWHKR+May 5 2005, 03:07 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ May 5 2005, 03:07 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


And what do you do with the deceased?

When I lived back home, the funeral director was a firefighter, so if there was an ambulance run w/ the possibility of deceased persons; he brought the hearse to pick them up. He was also the county coroner, not just out looking for business. Of course if the call was for arrest, he didn't come.. Just the "confirmed dead". 

At least we could bury our mistakes. lol [/b][/quote]
 Sorry must have been a late night.  

With the deceased we leave them lay until the coroner (there better?)  And then when he comes we have usually already called the local funeral director and when he arrives we help remove the body and load into the hearse.  However we have also loaded the deceased into the rig and took the body to the funeral home.


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## emtbuff (May 14, 2005)

> _Originally posted by xems_@May 13 2005, 09:45 PM
> * im a student from nj n im pretty sure we dont use combitubes so jus wonderin what r they?? *


 A combitube is similar to an ET tube.  The only thing is that combi is done via blind insertion.  It has two tubes up on the top one of the tubes puts air straight on through the tube and the second lets the air out of little holes down on the bottom portion of the tube.  There are two balloon cuffs on the tube one is almost all the way to the bottom of the tube and the secound one is about half way up the tube.  The reason for the two tubes to ventilate is that if you miss the trach with the main tube (the one the air goes straight through) the air ends up in the stomach (not a good thing) so then you switch it over to the secound tube and ventilate it should go in to the lungs because the holes on the side are between the two balloons. so it forces the air into the trach.  So I am sure someone with a little more time on their hands will be able to find a pic and post it.


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## xems (May 14, 2005)

oo we just get a BVM i think i know what they look like thanks


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## CodeSurfer (May 15, 2005)

Thar it be... I just got certified to use one.  Pretty simple.  B)


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## TTLWHKR (May 16, 2005)

Now if only every patient had a clear, see through body!


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