Certificates beyond the EMT-B license.

[mycrofft]

EXAMPLE: in California, an employer, using proper training and documentation, can elevate the technical tasks which an employee at a certain level of licensure or certification by the state cannot normally do, as long as there is medical control and SOP, Standardized Procedure, etc. which eliminates critical decision making.

Are there such things for EMT-B's (i.e., doing EKG's, fingerstick glucometry), and would you be "comfortable" woring above and beyond like that?
(Ths might vary state by state, look it up)

 

[Afflixion]

As far as my understanding in the state of Texas if your medical director states in writing a basic can perform that task. I may be wrong but that was my understanding of how Texas EMS works.

 

[8jimi8]

LOL I know I can't save the world singlehandedly! But if I can save just one... I will, isn't that why we train? Only thinking about it, isn't preparation. I'm no scanner chaser, but I do also go remote on climbing trips very often and my new job carries me over the most dangerous stretch of I-35 and if you have ever driven in Austin or San antonio, you know these people don't understand the aftermath of roadrage-redbull-texting + 80 mph.

 

[8jimi8]

Yes, in Texas, basics can perform duties above scope per MD. Yes I'm completely comfortable practicing above the scope of a basic as long as it is authorized.

 

[TraumaJunkie]

From my understanding after approval from OEMS a service can be permitted to participate in a "special project" (ie nasal narcan, dual luman airway)
With this comes very close observation by the company and the state, with 100% CQI .

As far as SpO2 monitoring, Glucometry, micro nebz treatments goes. Those are in our standard protocols.

 

[VCEMT]

EMT-Ds can read EKGs and assist medics. Your employer would have to train you on that. Usually, after you've had some experience beyond just being the attendant.

 

[JPINFV]

For California the scope of practice for EMT-Basics (EMT-I/EMT-One) is regulated by statute whereas paramedics have an "unlimited scope of practice" by statute. The maximum scope of practice for EMT-Basics can be found here:

http://www.emsa.ca.gov/laws/files/reg2.pdf

with the normal scope listed starting at the bottom of page 6 and the "optional skill" packages begining on page 11. For the optional skills packages, the training is all or none for each package, so for example subsection "f" (not to be confused with the subsubsections "F") covers the use of glucometers and symptom relief medications (asa, narcan, bronchodilators, sub-q epi, nitro, glucagon, and charcoal). Even if the medical director only wants ASA, glucometry, and glucagon, for example, the training and QA monitoring has to cover all drugs in that section.

As a note about paramedics, just because the scope is unlimited by statute doesn't mean that paramedics can do anything and everything. They are still constrained by California Emergency Medical Authority regulations (EMSA) (i.e. state OEMS) and local EMSA medical control guidelines/protocol (local EMSA are counties or groups of counties). Yes, that means that scope of practice and protocols will be different in each county.

 

[BillB]

Here in Illinois I am able to and have acquired a basic level PEPP,GEMS and ITLS.Being hospital based,we function as ER techs and can perform EKGs,blood draws and use the glucometer.In the field we are allowed "limited" drugs consisting of epi-pens,oral glucose and baby aspirin,as long as we call med control.Not much in the grand scheme of things but,a little extra.

 

[medic89]

Here in Illinois I am able to and have acquired a basic level PEPP,GEMS and ITLS.Being hospital based,we function as ER techs and can perform EKGs,blood draws and use the glucometer.In the field we are allowed "limited" drugs consisting of epi-pens,oral glucose and baby aspirin,as long as we call med control.Not much in the grand scheme of things but,a little extra.

I'm also in Illinois, and we're allowed Glucose Monitoring, Baby ASA, Epi-Pens, Oral glucose, and Albuterol Nebs, along with assisting with a patient's own prescribed Nitro.

 

[BillB]

We're allowed to assist with nitro.No albuterol though.One nice thing about being hospital based is,I get to sit in on more advanced classes pretty regularly.Ceu's are fairly easy to keep up with.

 

[SemiMedic]

As far as my understanding in the state of Texas if your medical director states in writing a basic can perform that task. I may be wrong but that was my understanding of how Texas EMS works.

It depends as far as I know, all on the Midical Doctor who's license is at stake due to your abilities lol.