Christopher
Forum Deputy Chief
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But we're in EMS. we've been trying to stuff that round peg in the square hole since the 70s.
And then hyperinflate a cuff to hold it there...
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But we're in EMS. we've been trying to stuff that round peg in the square hole since the 70s.
- SQ Epinephrine, i.e. EpiPens (carried on ambulance -- not just prescribed)
What I do find objectionable is bureaucrats trying to convince their public constituents that EMT basics who can use CPAP and SGA and stick a 12 lead on somebody are just as good as paramedics. And if you think that doesn't happen, think again.
We continue to dilute the educational process giving basics more skills to do without education to back them up. I notice how nobody complains about giving basics more to do… But if a paramedic started to step into the nursing realm, the fur would fly.
Either let's just realize that EMT B is simply that, a basic entry-level point... Or let's revamp the training and make the entry-level point closer to EMTI 99 and increase the paramedic training to be more community minded and focused on social service and preventative care along with advanced procedures.
EMT's that gives drugs and uses a monitor? Oh wait- thats a paramedic. If you want more responsibility you need to continue your education.
I mostly agree, however, on an ALS truck the EMT is just the assistant right? Why not allow your assistant to do more to help.
I discussed this with my partner the other day. As a basic I am not allowed to check a BGL, place the monitor leads or give nitro. So on a typical chest pain call.
EMT: VS, ASA, Oxygen
Medic: Assesment, Monitor, 12-lead, IV, Nitro, BGL
I would be much more helpful if I were allowed to place the leads and give nitro, while my partner does other things. Or I can just be a good EMT and shut up and drive(which is the direction it is slowly moving at my service)
I mostly agree, however, on an ALS truck the EMT is just the assistant right? Why not allow your assistant to do more to help.
I discussed this with my partner the other day. As a basic I am not allowed to check a BGL, place the monitor leads or give nitro. So on a typical chest pain call.
EMT: VS, ASA, Oxygen
Medic: Assesment, Monitor, 12-lead, IV, Nitro, BGL
I would be much more helpful if I were allowed to place the leads and give nitro, while my partner does other things. Or I can just be a good EMT and shut up and drive(which is the direction it is slowly moving at my service)
Sounds more like a case of a partner who wants to do everything or does not trust you to do it in conjunction with him. (Not implying the latter, just a statement)
No reason you can't help. Technically is it in your scope, no. But if it isn't invasive it's a little ridiculius to exclude you.
I mostly agree, however, on an ALS truck the EMT is just the assistant right? Why not allow your assistant to do more to help.
I discussed this with my partner the other day. As a basic I am not allowed to check a BGL, place the monitor leads or give nitro. So on a typical chest pain call.
EMT: VS, ASA, Oxygen
Medic: Assesment, Monitor, 12-lead, IV, Nitro, BGL
I would be much more helpful if I were allowed to place the leads and give nitro, while my partner does other things. Or I can just be a good EMT and shut up and drive(which is the direction it is slowly moving at my service)
This is essentially the argument for doing away with basic all together and make the entry level cert AEMT. This would cover everything you covered minus ECG/12-lead interp.
If you can't check a BGL as a basic...you're not an EMT. (No offense to you)
BGL is a layperson skill and must be available at all levels of EMS in order to have practitioners be taken seriously.
Tell that to the state of Indiana
please mention that to the state of NJ... they don't seem to understand that, despite you being correct about the skill involved. While you are in the area, mention it to New York too.If you can't check a BGL as a basic...you're not an EMT. (No offense to you)
BGL is a layperson skill and must be available at all levels of EMS in order to have practitioners be taken seriously.
please mention that to the state of NJ... they don't seem to understand that, despite you being correct about the skill involved. While you are in the area, mention it to New York too.
NY has nasal narcan, albuterol, asa, epi pens and glucometry... Narcan literally started in september and the others have been for a few years.
Bringing up these skills and how Narcan is a recent addition, I'm curious if anybody has a good reason why these sorts of skills and equipment shouldn't be BLS skills. Is there, say, a reasonable reason why an EMT shouldn't be allowed to administer albuterol from an inhaler or nebulizer?
Honestly, its a simple skill as can be. In practice inserting an NPA is more invasive. As long as medical control contact is required for administration it should be a BLS skill. Once you start permitting it to be done without authorization you are crossing the line between BLS and ALS. There should be distinct boundaries either you have the necessary training (which is still not enough) or you don't.
While I agree that there should be somewhat distinct limits in regards to what is appropriate given the minimum training, I think there's a significant logistical issue with requiring med control for life saving treatments. If an EMT thinks that he needs to be administering Albuterol, I'd rather have them make the phone call for paramedics and administer it, than waste time with medical control. Calling medical control is not going to activate medics, and I don't think medical control is going to deny all but the most stupid requests for Albuterol.
BLS units carry glucometers? I knew epipens and albuterol were in place (or coming into place) when I left in 2004, they didn't have narcan or asa or glucometry on the trucks. I guess I need to double check my outdated facts :blush:NY has nasal narcan, albuterol, asa, epi pens and glucometry... Narcan literally started in september and the others have been for a few years.