# N.J.A.C. 8:40A Regulations



## TheAfterAffect (Jul 9, 2008)

So, Some other NJ EMT's may have noticed the following in their inbox today, I thought this was rather interesting.




> New Jersey Department of Health & Senior Services                                                          Heather Howard
> P.O. Box 360                                                                                                                         Commissioner
> 
> For Release:                                                                                               For Further Information Contact:
> ...





The bolded part I found rather interesting. Do any other states do this?


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## KEVD18 (Jul 9, 2008)

you guys dont have epi-pens????

mk1 kits are a good step on paper.

basics tubing, here we go again.


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## VentMedic (Jul 9, 2008)

> *The authorized but not required use of esophageal or multilumen airway management devices on adult patients suffering from cardiac arrest, *



At least it clarifies "cardiac arrest" as to when they can be used.   

I had asked that question to some of the EMT-Bs on the other threads and no one bothered to clarify their statutes or protocols.


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## Jon (Jul 9, 2008)

I read it as combitube/KingLT.... not endotracheal intubation with a blade and tube.

One of them is somewhat idiot resistant... the other can be messed up REALLY easily.

As for epi... I think they already have a temporary policy in place for that... and the Mark I injectors are already solider-proof... but not paramedic proof (remember the FDNY medic instructor who put a Mark-1 kit needle through his thumb?)


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## Fire292Rescue (Jul 10, 2008)

I got this email yesterday as well but I'm not an EMT. Just took my test last Thursday. B)


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## Epi-do (Jul 10, 2008)

Jon said:


> I read it as combitube/KingLT.... not endotracheal intubation with a blade and tube.



Me too.  It does say _esophageal_ airways, not endotracheal.  If someone is placing, leaving, and leaving an ETT in the esophagus, they have no business intubating in the first place.


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## reaper (Jul 10, 2008)

All of that has been in a lot of EMT-B SOP's for a long time. NJ is just getting around to it?


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## TheAfterAffect (Jul 10, 2008)

yes....


As my partner from my current job tells me, NJ Is far far far behind the times.


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## Hopper (Jul 12, 2008)

To TheAfterAffect,I'll start working at LifeStar on the 18th.
I'm located in north Jersey and being a volunteer our squad does carry  adult and child epi-pens.I had to take a class to be certified to use them.Just like the AED,there is a form to be filled out noting your patient assessment,the patient vitals(before/after) and patient care that was given.A copy of the form goes to the hospital.


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## MMiz (Jul 12, 2008)

Michigan has all three at the EMT-Basic level.  All three were instituted around 2005.


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## EMTSteve (Jul 12, 2008)

Jon said:


> As for epi... I think they already have a temporary policy in place for that... and the Mark I injectors are already solider-proof... but not paramedic proof (remember the FDNY medic instructor who put a Mark-1 kit needle through his thumb?)



Funny you should say that....
About 2 semesters before my class during anaphylaxis and epi training, the teacher sent a live epi pen around the class. AFTER warning everyone it was live and not to hit the button.
A 19 y/o student hit the button and plunged the needle into his thumb :blink: a little while later he fell off his chair sweating like crazy and a pounding heart rate.

Needless to say, they dont hand around live epi pens lol


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## volff21 (Jul 12, 2008)

wow three steps ahead of Pa & NY


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## Jon (Jul 12, 2008)

PA has the EXACT same rules with Epi Pens... ALL the staff of the service must be trained, and the Medical Director must approve the service... but PA EMT's can use EpiPens too.

PA restricts 2-Pam and Atropine to EMT-P and above.
PA restricts any advanced airway skills to medics and above.

So we are only 2 steps behind


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## fma08 (Jul 13, 2008)

Sounds like you guys just got caught up to ND and MN.


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## BLSBoy (Jul 13, 2008)

Hooooly crap......:blink:

Now, if they can just get the First Grade Council dissolved, all BLS ambulances on par with each other, eg same equipment, same inspection process, and oh yea, 2 EMTs on it at all times!
No more of this one EMT and one driver crap. :angry:


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## NJN (Jul 13, 2008)

BLSBoy said:


> Now, if they can just get the First Grade Council dissolved, all BLS ambulances on par with each other, eg same equipment, same inspection process, and oh yea, 2 EMTs on it at all times!
> No more of this one EMT and one driver crap.



But that would require EMT training fund for the volly squads, it would also require effort from them and their members, and last time i checked effort is a big no no. (I'm on a 1/2 paid 1/2 volly squad so we have to adhere to the paid service regulations even tho we don't have the money for it)


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## BLSBoy (Jul 13, 2008)

NJNewbie196 said:


> But that would require EMT training fund for the volly squads, it would also require effort from them and their members, and last time i checked effort is a big no no. (I'm on a 1/2 paid 1/2 volly squad so we have to adhere to the paid service regulations even tho we don't have the money for it)



Do you bill for services?
The issue of no money to do things is a sad, pathetic arguement. 
Do you have paid trashmen?
Even better, is your community a part of a regionalized service?
There is a way to bring in funding, argue for career staffing, and reduce overhead costs. 

And I won't even charge you a consultants fee. h34r:


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## BLSBoy (Jul 13, 2008)

If you are on the agency displayed on you shirt, then y'all have NO excuse for going fully career. 
Average of just under 5 calls a day, and they are still volunteer?
And they don't bill for services. 
Figure you get an average return of 150 dollars per trip. 
That is assuming that more then half don't pay. Average billing for BLS in many areas is 400 dollars, plus mileage, and interventions.
Some people have excellent insurance. Some just don't pay. 
Either way, billlng for services, and assuming the statistics posted on the squad website, and the city website are correct, then you could be bringing in over $270,000 a year. 
Now, if you want to go career, figure 35,000 a year for an EMT, x2 EMTs per shift, x3 shifts (24/48)
Salary comes out to $210.000 a year. Now I know, with benefits, and retirement, it will increase, probably to almost 400,000 a year. 
Implement an EMS assessment on the community. 
Charge each household 25 dollars per year, you get another aprox $200,000.
Now, you charge the "hundreds of businesses" in the community, it brings down the cost for each household. 
And you can even make it a combo dept to put up a second rig, standbys, and for that Heavy Rescue. 

You combine with neighboring areas, and you can have a career Chief, faster response times, and the more communities you get together, then you can get a "special ops" team together. Paid one at that. 

Once again, you can skip paying me the fee, and just send me a t shirt. -_-


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## NJN (Jul 13, 2008)

Yes we bill for services, the majority doesn't pay, we have around 10-14 calls per 12 hours. I don't know what website your talking about, we don't have one and the city doesn't want to acknowledge that we exist, meaning we get no money from them. 80% of shifts are paid shifts. In addition to that we spend most of any return we get on maintaining our fleet and building. We can only afford to pay for one crew on at any time, and trust me if we could run a second we would, and you mentioned Heavy Rescue, we don't have anything of the sort.


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## BLSBoy (Jul 13, 2008)

OK, my apologies, I googled, and ended up with SOUTH Plainfield. 
You should look into consolidating with local agencies to reduce overhead costs, as well as combining dispatch centers, to reduce dispatch costs. 
A good PR presentation to the City Fathers could help wake them up. 

Also, combining collection agencies could result in more revenue...

Good luck man.


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## NJN (Jul 13, 2008)

BLSBoy said:


> OK, my apologies, I googled, and ended up with SOUTH Plainfield.
> You should look into consolidating with local agencies to reduce overhead costs, as well as combining dispatch centers, to reduce dispatch costs.
> A good PR presentation to the City Fathers could help wake them up.
> 
> ...



With the elections coming up in November we hope to change the trend and the stronghold one certain assembly person has on the offices in our city. Dispatch is through PD so we don't have to handle it. In addition to that we have trouble recruiting due to the violent and "dangerous" environment we serve. Also you read the S. Plainfield page, they're a much more affluent community that we are.


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## BLSBoy (Jul 13, 2008)

NJNewbie196 said:


> With the elections coming up in November we hope to change the trend and the stronghold one certain assembly person has on the offices in our city. Dispatch is through PD so we don't have to handle it. In addition to that we have trouble recruiting due to the violent and "dangerous" environment we serve. Also you read the S. Plainfield page, they're a much more affluent community that we are.



Why not combine North, South, and you guys?
Plainfield Regional EMS....

Nevermind, thats a smart idea..

haha


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## NJN (Jul 13, 2008)

BLSBoy said:


> Why not combine North, South, and you guys?
> Plainfield Regional EMS....
> 
> Nevermind, thats a smart idea..
> ...



We were allready planning on taking over North through slowly taking over their officer positions (we have a few who hold dual membership) And we just don't like SPRS so we decided against taking them over.

And as you said that would be a smart idea.

P.S. you should go to the chatroom (on the menu bar second from left) now that you have enough posts


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## BLSBoy (Jul 13, 2008)

Ya may not like em, but if thats where the tax base is....:wub:


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## NJN (Jul 13, 2008)

BLSBoy said:


> Ya may not like em, but if thats where the tax base is....:wub:



Ha ha, I hear that.


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## BLSBoy (Jul 13, 2008)

If I remember correct, then good ol Jon Corzine should be offering incentives for combining services. Perhaps your Ossifers should look into that. 
Combine Fire, PD, and EMS services, as well as dispatch, you will save the tax payers some money.


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## NJN (Jul 13, 2008)

We wouldn't mind, except that would give the city govt. more control. It would be a difficult process since we're an independent org.


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## Turner (Jul 13, 2008)

You won't get volunteer services to mix together. They like there pride.


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## BLSBoy (Jul 13, 2008)

50 years of tradition, unimpeded by progress...


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## NJN (Jul 13, 2008)

BLSBoy said:


> 50 years of tradition, unimpeded by progress...



:beerchug: Here Here :beerchug:


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## jordanfstop (Jul 14, 2008)

TheAfterAffect said:


> So, Some other NJ EMT's may have noticed the following in their inbox today, I thought this was rather interesting.
> 
> 
> 
> ...




NYS you're allowed to carry EpiPens and Atropine.


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## Jon (Jul 15, 2008)

BLSBoy said:


> Hooooly crap......:blink:
> 
> Now, if they can just get the First Grade Council dissolved, all BLS ambulances on par with each other, eg same equipment, same inspection process, and oh yea, 2 EMTs on it at all times!
> No more of this one EMT and one driver crap. :angry:



BLS - I've only worked transport in NJ (and special events) I was flabbergasted when I found out about the First Aid Council and the double standard.



BLSBoy said:


> 50 years of tradition, unimpeded by progress...


Not JUST in NJ... but they do tend to have a lot of that. Heck...volunteer co's in general have a lot of that.


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## snaketooth10k (Jul 20, 2008)

*Don't Be a Hater Now...*

Why is every ALS user getting all fussy over BLS crews being able to place esophageal tubes and multilumen tubes in *dead* patients. While it is true that it is possible to wind up doing an ETI with a combitube, it is NOT possible with an LMA. And it's hard to say that we aren't trained well enough to do it, since EMT-I's are allowed to do it and they are pretty far from paramedic level. I admit that there are some incompetent EMT's, more at the basic level than the paramedic level. But in my neck of the woods, paramedics are few and far between. My neighbor died last week and when the paramedics arrived it was WAY too late (god bless them though they were rushing like hell). I just think that if BLS was not skilled enough to put a tube in, it would not be allowed in all of the states that it is. I guess within the next year we will see whether this legislation will have positive or negative gains.


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## ffemt8978 (Jul 20, 2008)

snaketooth10k said:


> Why is every ALS user getting all fussy over BLS crews being able to place esophageal tubes and multilumen tubes in *dead* patients. While it is true that it is possible to wind up doing an ETI with a combitube, it is NOT possible with an LMA. And it's hard to say that we aren't trained well enough to do it, since EMT-I's are allowed to do it and they are pretty far from paramedic level. I admit that there are some incompetent EMT's, more at the basic level than the paramedic level. But in my neck of the woods, paramedics are few and far between. My neighbor died last week and when the paramedics arrived it was WAY too late (god bless them though they were rushing like hell). I just think that if BLS was not skilled enough to put a tube in, it would not be allowed in all of the states that it is. I guess within the next year we will see whether this legislation will have positive or negative gains.



Let's not turn this into another ALS vs BLS thread.  Please do a search for basics intubating, as this topic has been discussed here previously (and to death).


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