# California Paramedic Regulations



## DrankTheKoolaid (May 11, 2012)

Just a quick heads up to all the Paramedics in California.  The second round of draft regulations have come up for public review.  If you can please given them a read and have your discussion with your Medical Directors if you have any concerns.  Remember, if you don't try to fix something, don't complain about it later when the changes affect you.


http://www.emsa.ca.gov/paramedic/default.asp


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## socalmedic (May 11, 2012)

1797.195 (1)D - looks like pediatric intubation is officially being removed from the paramedic scope of practice.


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## DrankTheKoolaid (May 11, 2012)

*re*

Yeah my medical director is fighting that tooth and nail.  That is definitely not a skill we need to lose up here in far northern remote California.  At least Fentanyl is finally coming in.  My biggest issue (not mine personally, just company wise as I am already working on CCT-P / FP-C) Is the minimum requirement of BCCTCP CCT-P certification for transfers we have been trained on and have been doing for 15 years.  I am absolutely for more education, but how does a rural service recruit and maintain employees with this as a minimum standard when the pay is akin to a burger flipper? 

I would venture a guess quite a few medics will simply be out of a job when they cant obtain the certification


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## socalmedic (May 11, 2012)

I love that they are finally recognizing that paramedics are qualified to do CCT, as I did in other states before CA. I like that they are using BCCTPC however there are no current programs ANYWHERE that meet the requirements for clinical education. I do see this as a plus though, for once California is not settling for the bare minimum. this new section of Title 22 should not affect you as your "Local Optional Scope of Practice" will not change, this only creates a more fluid and standardized way for paramedic services to offer CCT. on a side note, prior to this change it was forbidden for paramedics to utilize IV pumps or mechanical ventilators, if your service has paramedics using these it is against statute regardless of the LOSOP.


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## DrankTheKoolaid (May 11, 2012)

Yup been using vents/ IV pumps for years through expanded local scope.   Love my LTV 1200!

Should qualify that.  Only for Xfer's atm.  Not medic initiated unfortunately


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## socalmedic (May 11, 2012)

that may be how you are sliding under the radar. I think cal-emsa would poop two bricks if they knew a medic had a vent on a 911 call.


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## Handsome Robb (May 11, 2012)

socalmedic said:


> that may be how you are sliding under the radar. I think cal-emsa would poop two bricks if they knew a medic had a vent on a 911 call.



That's insane. 

Every one of our units have a vent on board, a very basic vent but it's a vent. Pumps are only for CC-Ps though.


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## TRSpeed (May 11, 2012)

socalmedic said:


> that may be how you are sliding under the radar. I think cal-emsa would poop two bricks if they knew a medic had a vent on a 911 call.



Actually medics in ICEMA are always using vents. Especially in the rural areas


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## chc1993 (May 12, 2012)

TRSpeed said:


> Actually medics in ICEMA are always using vents. Especially in the rural areas



Sure do. Use them all the time out here in the desert. Carried them for years. I know for a fact they are ICEMA approved. If the state doesn't like it they need to take it up with ICEMA. Sure beats bagging somebody for an hour or longer.


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## TRSpeed (May 12, 2012)

chc1993 said:


> Sure do. Use them all the time out here in the desert. Carried them for years. I know for a fact they are ICEMA approved. If the state doesn't like it they need to take it up with ICEMA. Sure beats bagging somebody for an hour or longer.



MBA is a great company from what I hear from friends that work there. 

LA folks have no idea how different Icema is. They are in for a surprise.


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## Akulahawk (May 12, 2012)

I think pediatric intubation shouldn't be removed from the basic scope. If a LEMSA doesn't want it done, they just remove it from their local scope like some do now... Now if the basic scope was authorized for ALL and no LEMSA could subtract from that, then I could support removal of pediatric intubation from the basic scope and just let the LEMSA determine if it's appropriate for their system. 

I just think that the state basic scope should be the same wherever you go so that each paramedic only has to learn what the local optional scope is instead of having to remember what part of the basic scope is or isn't done in that local system too.


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## mycrofft (May 14, 2012)

Agreed. Local exemptions should be evidence and science based. BUT, have more frequent opportunities for the Feds to fine tune the standards, and make all local exceptions be proven by statistics/studies by the end of the first year after inception.


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## socalmedic (May 16, 2012)

mycrofft said:


> Agreed. Local exemptions should be evidence and science based. BUT, have more frequent opportunities for the Feds to fine tune the standards, and make all local exceptions be proven by statistics/studies by the end of the first year after inception.



I only know how to quote one post... as for your post about the CCT and becoming a RN. what if I dont want to be an RN? I could never/will never do that job, I am perfectly happy being a Paramedic. I am just glad they are going to finealy allow us to use our potential for Critical Care Transports. as I have witnessed many "MICNs" over the years who will only sit in the front seat and give orders through the window because they get car sick... sorry but the ambulance is no place to have a RN who isnt used to being in the back or without a MD behind them.

as for the above quoted post, ALL treatments should be evidence based not just the local optional treatments. as for statistics in the first year, you do know pacing took 5 years to get approval and 10 years later is just now being added to the basic scope... by placing time constraints you arent allowing for a large enough sample group and enough time for all the checks and balances to work out. the current three year time frame for trials seams to work just fine.


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## JakeEMTP (May 16, 2012)

I don't think it is just because they are an RN that they get motion sickness. It happens to a lot of us also and probably everyone will experience it at least once in their career.  Several new EMTs have left before they even get started when they find out they get motion sickness. EMT programs with only 10 or 12 hours of ambulance time during their class with maybe only one short transport during that time don't give them an opportunity to know what it is like. 

RNs do bring critical care ICU experience to the table. For California we will have a problem since most of that stuff on the list is done in other states but is totally foreign to the California Paramedic. RSI and paralytics are not used  nor are most of the meds.  I dont' think it is a good  idea to take CCT RNs totally out of the equation just yet.

Found this on the search

http://www.emtlife.com/showthread.php?t=22962&highlight=motion+sickness


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