# EMT-B volunteer/work in ER?



## EpiEMS (Jan 31, 2012)

Can an EMT-B volunteer or work in an ER or urgent care center or clinic in a capacity that equals or exceeds his/her scope of practice as an EMT-B? For example, say I'm an EMT-B and the MD or PA or NP in the ER/ambulatory care place/clinic teaches me how to give IVs or, say, vaccinations. Is that legal? Is it realistic to suggest that I could be trained to do simple procedures like giving vaccinations, taking strep cultures, etc.?


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## emt6207 (Jan 31, 2012)

From my understanding of the ems in east central illinois, it could be quite different other places, the all-around answer is no. 

The only EMT-B's that work in the er's here can only work if they also have extra training in EKG's, and their role for the most part in said ER is to just run the ekg's, and then assist nurses when needed. They are not allowed to train/learn/give IV's or other medications other then their EMT-B allowed, and even then they can't unless a doctor asks them too, and even then most emt-B allowed medications aren't going to be used in an ER where they have access to better more potent stuff.

You have to move on to a paramedic to even do most of what you had posted there. At least here in illinois.


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## EpiEMS (Jan 31, 2012)

I suppose it makes sense. But isn't your practice effectively a function of the controlling physician? And if the controlling physician says explicitly (or is right there) you can do something, then shouldn't you be able to?


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## emt6207 (Jan 31, 2012)

Only if the medical director has a written directive approved by the state you are in that gives you permission to do it. You would have to be careful about having people let you "do things" and then something happening, because of a family or whatever decided to sue and you were found doing something out of scope of your licensed training/directives your then liable. Someone might correct me on that if I'm wrong but thats my understanding.

Just as a disclaimer I've only been an NREMT for about a month and still on a waiting list to get onto an EMS, all this is based off of curriculum and talks with the EMS/hospitals I clinical'd at.


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## JDub (Jan 31, 2012)

Most ER's do not hire "EMT-Bs" to work there. However they do hire people who have their EMT-Bs to fill other positions. My friend (who actually isn't even an EMT-B yet) got hired on as Phlebotomist at the local ER. He had never started an IV before but now he starts IVs and does blood draws all day, even though he has no certs. It is just that what he does is within his positions scope of practice and was trained at the hospital in it. 

So ultimately it really depends on what position you get hired on as and what that hospital allows you to do.


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## JPINFV (Jan 31, 2012)

In general, you are not working under an EMT license when working as a tech in an emergency department, and as such the state EMS department/office/what have you does not have a say in your scope of practice.


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## emt6207 (Jan 31, 2012)

JPINFV said:


> In general, you are not working under an EMT license when working as a tech in an emergency department, and as such the state EMS department/office/what have you does not have a say in your scope of practice.



ah thank you


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## Maine iac (Jan 31, 2012)

I think you got your answer, but in short No. If you are hired as an EMT (B,I,P) you have to work under that scope. Even if in the field I have a doctor talk me through a C-section I can not preform one; the same would be the case in the hospital. 

I also have never heard of a hospital having volunteers actually doing anything medical.


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## JPINFV (Jan 31, 2012)

Just to throw this out there. There's a difference between hiring someone _*AS*_ an EMT, and hiring an ED tech where a requirement is being trained as an EMT.


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## Maine iac (Jan 31, 2012)

JPINFV said:


> Just to throw this out there. There's a difference between hiring someone _*AS*_ an EMT, and hiring an ED tech where a requirement is being trained as an EMT.



Exactly.

In many areas for example, paramedics that are hospital based often work in the ER then when they get a call go out into the streets.


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## JPINFV (Jan 31, 2012)

...and in most areas the hospitals own no ambulances and, while the ED techs might hold an EMT license, the techs are not governed in any fashion by the rules and laws governing EMS providers, including those regarding scope of practice. Hence why an EMT might not be able to take a blood glucose level on an ambulance, the ED tech, who is also an EMT, could be trained and allowed to do so without any input or approval of the EMS authority or EMS medical director.


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