# EMT-B administering IV's?



## TX_EMT_RXY (Sep 16, 2010)

I'm in the process of becoming and EMT-B and taking a 6 week cram course thru CINTAS in Houston, TX..

A friend of mine from where I am originally from (Connecticut) asked me if EMT-B's of TX are allowed to administer IV's? We haven't covered anything about it in my class and I don't even know where to begin looking for an answer on the internet.. Can anyone help out? I would appreciate it alot!


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## medic417 (Sep 16, 2010)

There is no statewide policy in TX, but for the most part no.  The services medical director determines what each level can do.  There are some very rural areas where the medical director has approved basics to start IV's.


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## TXMEDIC5317 (Sep 16, 2010)

EMT-B's in Texas can't do IV's, only Intermediates and Paramedics on the streets. Some EMT-B's that work in ER's can, but it depends on the hospital's scope of practice.


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## medic417 (Sep 16, 2010)

TXMEDIC5317 said:


> EMT-B's in Texas can't do IV's, only Intermediates and Paramedics on the streets. Some EMT-B's that work in ER's can, but it depends on the hospital's scope of practice.



Incorrect, the state does not limit them.  Medical director can approve basics to do IV's.  Sadly there are services in Texas that have basics doing IV's.


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## slloth (Sep 16, 2010)

6 week EMT course!  Wow.  Good luck.  Keep us informed on it.  

And yes The Medical Director has the authority to add it to the EMT-B's scope.


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## Shishkabob (Sep 16, 2010)

TXMEDIC5317 said:


> EMT-B's in Texas can't do IV's, only Intermediates and Paramedics on the streets. Some EMT-B's that work in ER's can, but it depends on the hospital's scope of practice.



Wrong.



TX_EMT_RXY;

Texas is what is known as a "Delegated Practice" state, meaning that the limit of the governments overreach in to EMS protocols is "It's up to your medical control".

If your MC wants you to do an IV as an EMT, he has that right as it's his license you're using.  If he wants a Paramedic to open a chest in the field, he has that right, so long as he prudently trains / educates them on the procedure.

Typically, you won't see an EMT starting IVs, however there are a few procedures /drugs that doctors in Texas allow medics to do that are relatively rare elsewhere.


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## medic417 (Sep 16, 2010)

slloth said:


> 6 week EMT course!  Wow.  Good luck.  Keep us informed on it.
> 
> And yes The Medical Director has the authority to add it to the EMT-B's scope.



Yes I agree 6 weeks is to long for a 2 week course.


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## Shishkabob (Sep 16, 2010)

medic417 said:


> Yes I agree 6 weeks is to long for a 2 week course.



Three, medic, three week class.

I don't want to do 60 hour weeks in school... it's bad enough I do it at work!.  We have to keep it to 40 hour weeks and be realistic


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## MrBrown (Sep 16, 2010)

Since when is an IV line "adminstered" 

Refer to Brown's list of things you need to know before cannulation

http://emtlife.com/showpost.php?p=238629&postcount=35


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## bstone (Sep 16, 2010)

Plural of IV is IVs. IV's=IV is, or, belonging to the IV


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## medic417 (Sep 16, 2010)

bstone said:


> Plural of IV is IVs. IV's=IV is, or, belonging to the IV



Darn English Teacher done busted me.  :blush:


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## bstone (Sep 16, 2010)

LOL, sorry, simply a pet peeve of mine.


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## medic417 (Sep 16, 2010)

bstone said:


> LOL, sorry, simply a pet peeve of mine.



Hey I preach being professional and that mistake on my part shows lack of professionalism.


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## bstone (Sep 16, 2010)

medic417 said:


> Hey I preach being professional and that mistake on my part shows lack of professionalism.



I guess we should report this to your state board of ems and have them launch an investigation?


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## Veneficus (Sep 16, 2010)

bstone said:


> I guess we should report this to your state board of ems and have them launch an investigation?



No way!!! Call the medical director at home and have them immediately suspend certification, then give 'em the chair!!!

Oh sorry, we are talking about a grammar error, thought we were in another thread about the moral turpitude of EMS


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## bstone (Sep 16, 2010)

veneficus said:


> then give 'em the chair!!!



the chair! Give em the chair!


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## Medicus (Sep 16, 2010)

I think the level of ridicule for someone asking an innocent question on this board is unnecessary and detracts from the purpose of an EMS discussion board. I particularly love how medics mock EMTs- it's as puerile as seniors making fun of freshmen. Every medic was an EMT at one point.



medic417 said:


> Incorrect, the state does not limit them.  Medical director can approve basics to do IV's.  Sadly there are services in Texas that have basics doing IV's.



I don't see the problem with it. The amount of damage you can do with them is relatively limited and they free up hands on a call.



> Yes I agree 6 weeks is to long for a 2 week course.



By the same turn, just imagine what an MD could say about EMT-I or P.

-Medicus


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## medic417 (Sep 16, 2010)

Medicus said:


> 1.I don't see the problem with it. The amount of damage you can do with them is relatively limited and they free up hands on a call.
> 
> 2.By the same turn, just imagine what an MD could say about EMT-I or P.
> 
> -Medicus



1. That shows you do not know what you think you know.  There is much harm we can do with IVs up to costing a person their life.

2. I agree Paramedics in the USA do not have nearly enough education for the treatments they are responsible to provide.


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## Medicus (Sep 16, 2010)

medic417 said:


> 1. That shows you do not know what you think you know.  There is much harm we can do with IVs up to costing a person their life.
> 
> 2. I agree Paramedics in the USA do not have nearly enough education for the treatments they are responsible to provide.



EMTs (I am using this now to refer to medics, since that is what they are- EMTs) seem to have a vastly inflated sense of self-importance. Deaths from IVs are incredibly rare. Do you know what Medicus means?

I would again like to understand your hostility toward the OP for his attempt to understand more about his field. I am going to frame this conversation in the same manner you responded to the OP- if you went to medical school, you would immediately have a DDx for why you respond this way from a psych clerkship.

Yours,
Medicus


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## medic417 (Sep 16, 2010)

Medicus said:


> EMTs (I am using this now to refer to medics, since that is what they are- EMTs) seem to have a vastly inflated sense of self-importance. Deaths from IVs are incredibly rare. Do you know what Medicus means?
> 
> I would again like to understand your hostility toward the OP for his attempt to understand more about his field. I am going to frame this conversation in the same manner you responded to the OP- if you went to medical school, you would immediately have a DDx for why you respond this way from a psych clerkship.
> 
> ...



Number one I showed no hostility to the OP so drop that crap.  

Actually under the new levels no Paramedics are not emts they are Paramedics.  

Medicus is the maker of a darn good golf club.   Or by definition can be as high as a doctor or just be a hospital orderly.   In your case your remarks are leading me to come up with another definition but I will leave that alone.


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## bstone (Sep 16, 2010)

Don't worry, Medicus. We gave him the chair!


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## medic417 (Sep 16, 2010)

bstone said:


> Don't worry, Medicus. We gave him the chair!



I knew I would eventually win the chair.  Now as Chairman of emtlife my first action is........


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## CAOX3 (Sep 16, 2010)

Is there a logical reason to allowing an emt to start an iv? I have worked as an emt for close to fifteen years and never once have I thought I wish I could put an iv in this patient.

In my experience a patient that requires an iv is probably going to require a paramedic at some point.

Please save all your comments about every patient needing a paramedic it simply isn't true, the toe pain with the underlying inferior wall MI going on is getting a little old.

Maybe in a PB system.

Other then that I really don't see the point, I agree it would be up to your medical director.

Really six weeks, wow.

Good luck.


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## Veneficus (Sep 16, 2010)

CAOX3 said:


> Is there a logical reason to allowing an emt to start an iv? I have worked as an emt for close to fifteen years and never once have I thought I wish I could put an iv in this patient.



Depends on the environment.

Wilderness, disaster, long transport/evac times, etc.

15 or less minutes to the hospital, no real reason.


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## bstone (Sep 16, 2010)

CAOX3 said:


> Is there a logical reason to allowing an emt to start an iv? I have worked as an emt for close to fifteen years and never once have I thought I wish I could put an iv in this patient.
> 
> In my experience a patient that requires an iv is probably going to require a paramedic at some point.



And a doctor probably.


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## Medicus (Sep 16, 2010)

CAOX3 said:


> Is there a logical reason to allowing an emt to start an iv? I have worked as an emt for close to fifteen years and never once have I thought I wish I could put an iv in this patient.
> 
> In my experience a patient that requires an iv is probably going to require a paramedic at some point.



I can particularly see its value from more of a support standpoint. Lets say you have a code, the EMT with the ability to start an IV can do so, freeing the medic up to do the higher level tasks such as analyzing the situation and deciding on an appropriate course of action. When he has done so, the IV is in place and good to go. 

If it is a simple case of hypovolemic shock, the EMT can begin fluid resuscitation independently. 

-Medicus


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## Medicus (Sep 16, 2010)

medic417 said:


> Number one I showed no hostility to the OP so drop that crap.
> 
> Actually under the new levels no Paramedics are not emts they are Paramedics.
> 
> Medicus is the maker of a darn good golf club.   Or by definition can be as high as a doctor or just be a hospital orderly.   In your case your remarks are leading me to come up with another definition but I will leave that alone.



Medicus is Latin for physician. I took five years of it. Vesalius, for example, was a medicus.

Glad to know they changed the word play for NREMT-P, that really changes what it is.

Your comments are indicative of a well-developed inferiority complex. You feel threatened by the OP and felt the need to comment because you know they could have the same license in nine months to a year.


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## CAOX3 (Sep 16, 2010)

Vene: I don't have any experience with wilderness ems, I saw a tree the other day it was nice, we should get more of those.

Bstone:  My point was an ALS complaint will usually get an ALS response here.

Medicus:  I agree in some areas which work PB this could be valuable, here when Als arrives it will be two medics.  The emts will then concentrate on effective compressions while the medics address medications, monitoring and airway.


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## Medicus (Sep 16, 2010)

CAOX3 said:


> Vene: I don't have any experience with wilderness ems, I saw a tree the other day it was nice, we should get more of those.
> 
> Bstone:  My point was an ALS complaint will usually get an ALS response here.
> 
> Medicus:  I agree in some areas which work PB this could be valuable, here when Als arrives it will be two medics.  The emts will then concentrate on effective compressions while the medics address medications, monitoring and airway.



Always depends on the environment. I didn't know what PB stood for (I assumed it meant pay-based). From an operations standpoint, it makes more sense to me to have one medic on an ambulance and one basic so you could run two ALS units instead of just a BLS and ALS.


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## medic417 (Sep 16, 2010)

Medicus said:


> Your comments are indicative of a well-developed inferiority complex. You feel threatened by the OP and felt the need to comment because you know they could have the same license in nine months to a year.



Pull your head out of your butt, wipe the excrement off the glasses, and read my post.  I never downgraded or attacked the OP.  And again I have already stated that Paramedics don't have enough education.  I hope the OP goes forth and gets more education. I feel no threat from the OP.  

Why do you feel threatened by me?   You are actually trying to do what you falsely accuse me of doing so thus you feel threatened by me based on your own comments.


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## JPINFV (Sep 16, 2010)

Medicus said:


> If it is a simple case of hypovolemic shock, the EMT can begin fluid resuscitation independently.
> 
> -Medicus


Would you trust the ER tech or CNA with determining that a patient is in hypovolemic shock and initiating fluids?


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## rwik123 (Sep 16, 2010)

with the training that I have received, i think it would be irresponsible to me or other basics to start IVs... theres no physiology involved in the emt-b curriculum that would carry over the IV's


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## medic417 (Sep 16, 2010)

JPINFV said:


> Would you trust the ER tech or CNA with determining that a patient is in hypovolemic shock and initiating fluids?



It's hard to believe that they allow Paramedics with their limited education to do it.  Many Paramedics can not explain the whats and whys.


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## Medicus (Sep 16, 2010)

JPINFV said:


> Would you trust the ER tech or CNA with determining that a patient is in hypovolemic shock and initiating fluids?



:blink: What a terrifying thought! That post really did startle me.

I guess the reason, I am not against EMTs starting IVs is that I forget everyone else doesn't really have the same working knowledge.

I'm still cringing from your post. I'm going to have nightmares tonight. Thanks a lot.


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## Veneficus (Sep 16, 2010)

Medicus said:


> :blink: What a terrifying thought! That post really did startle me.
> 
> I guess the reason, I am not against EMTs starting IVs is that I forget everyone else doesn't really have the same working knowledge.
> 
> I'm still cringing from your post. I'm going to have nightmares tonight. Thanks a lot.



If it makes you feel any better, in the 70s and early 80s prior to nursing moving into the EDs, the ED techs, who had less formal education and a lot of OTJ often started lines and fluids.


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## Shishkabob (Sep 16, 2010)

JPINFV said:


> Would you trust the ER tech or CNA with determining that a patient is in hypovolemic shock and initiating fluids?



Eh, depends.


Cook Childrens hires ONLY Paramedics as ER techs.


So yes, I would trust some ER techs with that.


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## JPINFV (Sep 16, 2010)

Linuss said:


> Eh, depends.
> 
> 
> Cook Childrens hires ONLY Paramedics as ER techs.
> ...



...and what about the majority of other places that either uses CNAs and/or EMTs for techs?


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## Shishkabob (Sep 16, 2010)

JPINFV said:


> ...and what about the majority of other places that either uses CNAs and/or EMTs for techs?



Ah, but you said ER techs, you didn't qualify it was a cert level, and as such was a null and void blanket statement 




But, just to indulge...


I don't know.. should I trust you?


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## JPINFV (Sep 16, 2010)

Linuss said:


> Ah, but you said ER techs, you didn't qualify it was a cert level, and as such was a null and void blanket statement
> 
> 
> 
> ...



Touche at this point...


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## TraprMike (Sep 16, 2010)

I just put their hand in a water bowl, and rehydrate themselves by absorbtioin. unless they p on the cot first, then plan B.


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## TX_EMT_RXY (Sep 17, 2010)

Thanks to everyone who responded to my post, and just to make everyone understand...I was only posting this because I was curious nothing more! And for those that judge my grammer or punctuation, get real..this is a forum for EMT, paramedic, and emergency personel. Not for your free time you have available because you have no life..

As for the 6 week course I am taking, its a cram course, 4 days a week, 8 hours a day..the only other classes that were available last for 3 months to a year..it's a lot of information to take in, in a short period of time, but if you're as interested and dedicated to a career in emergency medical response as I am you learn just as much as you would during the longer courses.. as far as furthering my education, this is my plan. I am 21 years young and have a lot of life in front of me and plan to become a paramedic..

Thanks again to all who answered and helped clear up my curiousity!!!!


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## Medicus (Sep 17, 2010)

I couldn't agree more with you. If you're dedicated to it and passionate about it, you retain the information quickly. Best of luck and welcome aboard.

-Medicus



TX_EMT_RXY said:


> Thanks to everyone who responded to my post, and just to make everyone understand...I was only posting this because I was curious nothing more! And for those that judge my grammer or punctuation, get real..this is a forum for EMT, paramedic, and emergency personel. Not for your free time you have available because you have no life..
> 
> As for the 6 week course I am taking, its a cram course, 4 days a week, 8 hours a day..the only other classes that were available last for 3 months to a year..it's a lot of information to take in, in a short period of time, but if you're as interested and dedicated to a career in emergency medical response as I am you learn just as much as you would during the longer courses.. as far as furthering my education, this is my plan. I am 21 years young and have a lot of life in front of me and plan to become a paramedic..
> 
> Thanks again to all who answered and helped clear up my curiousity!!!!


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