AEMTs

[DrParasite]

Think of how frustrating it would be if we didn't have Fire dispatch on every one of our calls. The Paramedic would pretty much need to do everything all the time.

OMG, the paramedic and ambulance crew would have to actually work? you wouldn't be spending how much on a 2-4 person crew who is spending driving a million dollar truck to the scene only to stand there and wait for an under staffed EMS system to finally arrive? and the ambulance crew would be able to function on their own, stand up for themselves as an equal and not always have to take the scraps from what the FD and PD don't want?

I'm not saying there isn't a time and a place for additional manpower or muscle, but I'll take a competent, well funded EMS system that can handle it's call volume (without needing the FD to "stop the clock") over an FD dependent system that doesn't know how to do its job without the FD there to tell them what to do any day of the week.

BTW, I dream for the day when IM zofran is a BLS skill, or at least an Intermediate one. It's still a beautiful drug, can do wonders to a sick person in terms of making them feel better, and, while there are risks just like with any drug, the benefits out-way the slim chance of complications. But that's a different story for another thread.

A strong training coordinator can certainly elevate their company’s delivery model and see to it that the paramedic is utilized appropriately, as would the EMT’s and/ or AEMT’s.

have you been sneaking into my dreams again? because that sounds very much like paradise......

 

[Bullets]

AEMT should be the minimum standard of EMS. And i think of it as Enhanced BLS more than Light ALS.

But in a system with dual AEMT trucks and regional MICU cars, everyone will get good exposure to the patients who need it.

I would love to have FD not come to calls. I can count on one hand how many times ive needed those 4 guys to actually do something on a call. Usually its just a gopher for menial stuff i could have the cop do. If me and my partner + 2 other providers cant handle it, then we should hang up our scopes and find a new job.

 

[EpiEMS]

BTW, I dream for the day when IM zofran is a BLS skill,

IM epi already is, why not IM zofran? Some places have PO Zofran ODT for their EMTs, btw.

AEMT should be the minimum standard of EMS. And i think of it as Enhanced BLS more than Light ALS.

Our AEMT is basically Canada's PCP, FWIW. I

 

[Tigger]

IM epi already is, why not IM zofran? Some places have PO Zofran ODT for their EMTs, btw.

Colorado EMTs with IV authorization can give IV and IM Zofran on standing orders. EMTs can give ODT Zofran on standing orders. I'm not sure why we are so lonely with allowing EMTs to provide one of the most commonly administered medications.

I am much more comfortable with using AEMTs in a tiered system than the "national standard" EMTs. It's an additional semester (in this state) and I'll admit I am not entirely familiar with the curriculum (we don't use them locally) but my understanding this is that there is some improved physiology provided along with some additional and important skills. AEMTs can start some truly life-sustaining treatments prior to the flycar's arrival. Hopefully the system can still get a paramedic to a scene in which the AEMT is going far down their guidelines provided that the hospital is not closer. To me if there's a strong QA process for the AEMT's use or non-use of paramedics, you can avoid a lot of the issues of a tiered system.

 

[DrParasite]

Some places have PO Zofran ODT for their EMTs, btw

The last time I had a kidney stone, the ER gave me a script for PO zofran (might have been SL not PO)..... lets just say it came up just as quick as it went down.

the one time I got IM zofran, it felt immensely better afterwards. and it wasn't from an autoinjector, the medic just stuck me in the shoulder with a tiny needle. and I felt soooooo much better.

Can you PM me some of the places you know that allows EMTs to give PO zofran? I'd like to pass that onto my medical director (off thread to not cause a major derailment).

EMTs can give ODT Zofran on standing orders. I'm not sure why we are so lonely with allowing EMTs to provide one of the most commonly administered medications.

I just looked, and it wasn't listed in the approved EMT meds (found at https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=1929 under appendix B). It is listed as VO here, which I think means it's voluntary, and even then, only AEMTs can administer it IT, not even EMT-IV,

 

[DrParasite]

double post

 

[Tigger]

Can you PM me some of the places you know that allows EMTs to give PO zofran? I'd like to pass that onto my medical director (off thread to not cause a major derailment).

I just looked, and it wasn't listed in the approved EMT meds (found at https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=1929 under appendix B). It is listed as VO here, which I think means it's voluntary, and even then, only AEMTs can administer it IT, not even EMT-IV,

While I am not very smart, I am generally pretty up on my state's Acts Allowed. The attached guidelines are from 2007. Rule 500 no longer exists, it is now called Chapter 2 and was updated this in January of this year. Also VO means verbal order, either via medical director call in or under the supervision of a higher licensed EMS provider.

Chapter 2 can be found here. Then click the "effective 01/01/18" link.

Before 2018 EMT-IVs could give ODT Zofran via verbal order. We don't really do the AEMT thing in this state since the majority (there is no data as your certification continues to say EMT on it), take the IV authorization class. Those EMTs were providing fluids, Narcan, and D50 for a long time. Through the waiver process, many were also doing IOs, draw and give 1:1k epi, and albuterol nebulizers. Some also had IV Zofran on standing orders via waiver. As so many departments had these waivers over the last few years, these were added to the standard state Acts Allowed and waivers are no longer needed and it was decided that EMT-IVs can give IM Zofran as well. This is nice, but it is unfortunate that we could not just promote the idea of AEMTs and provide them with vetted education instead of the "recommended" 24-30 hour course.