I am not saying lets just give everyone a wider scope with no additional training, I am saying we should be getting this training to begin with.
Good luck cramming that into the semester long course to begin with.
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I am not saying lets just give everyone a wider scope with no additional training, I am saying we should be getting this training to begin with.
Just wondering what the biggest problems my fellow EMTs feel affect the EMT level of care.
Personally I feel that EMT-Basic has too basic of a scope.
Shouldn't we be able to use CPAP, pull 12 leads, give Narcan, have our own supply of NTG and ASA, drop Kings/LMAs, amongst other things? I honestly think we should also be able to hang a bag of NS and grab peripheral IV access for certain C/Cs? With that, if we had the above, along with glucose testing, and d50... We would keep ALS free for the serious crap.
Just wondering what the biggest problems my fellow EMTs feel affect the EMT level of care.
Personally I feel that EMT-Basic has too basic of a scope.
Shouldn't we be able to use CPAP, pull 12 leads, give Narcan, have our own supply of NTG and ASA, drop Kings/LMAs, amongst other things? I honestly think we should also be able to hang a bag of NS and grab peripheral IV access for certain C/Cs? With that, if we had the above, along with glucose testing, and d50... We would keep ALS free for the serious crap.
Good luck cramming that into the semester long course to begin with.
Well, it is called EMT-BasicPersonally I feel that EMT-Basic has too basic of a scope.
Shouldn't we be able to use CPAP, pull 12 leads, give Narcan, have our own supply of NTG and ASA, drop Kings/LMAs, amongst other things? I honestly think we should also be able to hang a bag of NS and grab peripheral IV access for certain C/Cs? With that, if we had the above, along with glucose testing, and d50... We would keep ALS free for the serious crap.
the original 220, plus at least an additional 100-150. However long is needed in order to teach these skills effectively.
My EMT hours are 252...not under 200.
I'm currently in rural Montana and am able to do many of these skills as an EMT-Bl all the way up to and including ET intubation and administering morphine for some patients. My scope is quite advanced. I believe that basics should be allowed to do these skills withe proper training. Take your class, get your practice, do your competency skills test and have a certain number of patients in which you performed these tasks and I would think you should be cleared to perform the tasks without supervision.
I'm currently in rural Montana and am able to do many of these skills as an EMT-Bl all the way up to and including ET intubation and administering morphine for some patients. My scope is quite advanced. I believe that basics should be allowed to do these skills withe proper training. Take your class, get your practice, do your competency skills test and have a certain number of patients in which you performed these tasks and I would think you should be cleared to perform the tasks without supervision.
You have to remember that Montana is different than almost all other states. There are still large areas that are truly "frontier" areas, and, as in Alaska, there are places that, weather dependent, may be days away from a hospital, not just minutes or hours. While I don't neccasarily agree with how this type of thing usually get's done, I can see the reasoning behind it. And let's be honest...giving someone morphine (or a fentanyl lozenge, or narcotic patch, or any of the multitude of ways to give a pain reliever other than an injection), especially if you have access to narcan, is relatively benign.
Intubation is a bit different, and probably just a throw back to a time when there weren't as many supraglottic airways available as there are now; to be honest I'm surprised it hasn't been removed in favor of one of those.
If people are going to do/give something they absolutely need to be properly taught how to do it, I'm not saying anything at all against that. What I am suggesting it that, in certain very specific situations, there may be exceptions to that.
Now, if this guy lives in any type of population center with even somewhat easy access to advanced care, then all bets are off.
I know. I have no clue how widely all the little extra certs are used, but it wouldn't surprise me at all if they were misused, even to the point of places that should have paramedics not having them in favor of an EMT with XYZ extra tacked on.Having some of my wife's family living in Montana, and looking at possibly moving there one day. From my understanding, the classes are recognized state wide and the only thing stopping you at that point is the medical director.
If people are going to do/give something they absolutely need to be properly taught how to do it, I'm not saying anything at all against that. What I am suggesting it that, in certain very specific situations, there may be exceptions to that.
I was actually thinking more along the lines of narcotics, not airway management. As I said that's probably a throwback to when there weren't any good SGA's around and the thinking was along the lines of "well, the patient's already dead, so where's the harm?" Ignoring that even in dead people improper intubation attempts can be harmful. Best intentions don't always work out for the best..."First, do no harm".
When it comes to invasive airway management, the threat of harm from someone not knowing what they are doing is very high. Probably always higher than just sticking to skilled BLS airway management. Frontier or not, there is never a justification for handing a complete layperson (which is exactly what an EMT-B is after a 3-hour intubation course) an ETT and blade and telling them to go to work.
Paramedics get at least 30 hours of airway training in the classroom alone - plus manikin time, OR clinical, and ride time - and there are still a lot of people who think as a group paramedics suck at airway management because they don't get nearly enough education in it.
I would love to see the statewide QI data on EMT-B intubation.