dealing with differences
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mikie
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Well I am moving states and I know the Basic protocol in each area is very different. It is a little 'aggravating' that I could do some procedures in one place that I can no longer do, but you gotta learn to adapt to the protocols.
KEVD18
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this is something that frequently comes up in a variety of way. while working in a hospital, a basic emt can do many things they could never do in the field. that same is true in the camp/athletic setting.
my biggest problem adjusting when i stated doing details of that sort was realizing where the line was. in the field, upon making patient contact with a minor, they have to go to the hospital regardless of whether or not they want to unless a parent or guardian is present. theres no way around this, at least in ma. so if a third party calls and ambulance for the kid that fell off his bike but didnt hurt himself(or did so in a minor way9no pun intended)), i have to take him unless i can get the parent down to sign the form. but, in the athletic event setting, im required to use my judgement. you cant send every football player your called to evaluate to the hospital. the coach will kill you, the parents will cook your corpse and the fire dept/ambulance company will eat you. you really have to be able to accurately assess your patient and determine whether or not they are actually sick/injured.
also, i have worked at scout camps where the medical director has written protocols for the dispensing of medications that are outside of my protocols. in the field, i can give you asa for your chest pain, but i cant give it to you for a headache. at camp, i can. add to that laxatives, antihistamines, and everything else i cant think of right now. the protocols are much more relaxed due to the situation. i cant send every camper who presents to the medical tent with a belly ache to the hospital. its just not logistically possible. i feel this makes me a better emt and that this sort of thing should be used int he prehospital environment.
onscene treat and release makes sense in so many ways. less money spent on useless transports; less time taken up by family practice cases in the er, emts/medics that are actually taught how to think and not just to react. the bottom line is a lot of people dont need to go to the er. if we had the capability to say " hey buddy, this is a case for your gp. call him monday for an appt", the system would be far less strained and much more efficient.
[/off soapbox]
my biggest problem adjusting when i stated doing details of that sort was realizing where the line was. in the field, upon making patient contact with a minor, they have to go to the hospital regardless of whether or not they want to unless a parent or guardian is present. theres no way around this, at least in ma. so if a third party calls and ambulance for the kid that fell off his bike but didnt hurt himself(or did so in a minor way9no pun intended)), i have to take him unless i can get the parent down to sign the form. but, in the athletic event setting, im required to use my judgement. you cant send every football player your called to evaluate to the hospital. the coach will kill you, the parents will cook your corpse and the fire dept/ambulance company will eat you. you really have to be able to accurately assess your patient and determine whether or not they are actually sick/injured.
also, i have worked at scout camps where the medical director has written protocols for the dispensing of medications that are outside of my protocols. in the field, i can give you asa for your chest pain, but i cant give it to you for a headache. at camp, i can. add to that laxatives, antihistamines, and everything else i cant think of right now. the protocols are much more relaxed due to the situation. i cant send every camper who presents to the medical tent with a belly ache to the hospital. its just not logistically possible. i feel this makes me a better emt and that this sort of thing should be used int he prehospital environment.
onscene treat and release makes sense in so many ways. less money spent on useless transports; less time taken up by family practice cases in the er, emts/medics that are actually taught how to think and not just to react. the bottom line is a lot of people dont need to go to the er. if we had the capability to say " hey buddy, this is a case for your gp. call him monday for an appt", the system would be far less strained and much more efficient.
[/off soapbox]
rhan101277
Forum Deputy Chief
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Well they need to come up with something across the board. Like the military has done with its field medics. Everything needs to be the same for everyone in every area.
akflightmedic
Forum Deputy Chief
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You mean like a standardized national curriculum???
Hmmm....geez I do not think anyone else has ever mentioned that before.
Wait a minute, I do believe there is one out there, but it seems the IAFF, volunteers and people opposed to education keep shooting it down.
Just a thought....
Hmmm....geez I do not think anyone else has ever mentioned that before.
Wait a minute, I do believe there is one out there, but it seems the IAFF, volunteers and people opposed to education keep shooting it down.
Just a thought....
Ridryder911
EMS Guru
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Really? So you say that those that are 2 minutes from a trauma center needs to do the same as one for say .... 50 minutes away or be required to have the same education? Or those that to maintain EMT's are actually health care providers?
As Flight described, these issues have been attempted numerous times before. As Flight pointed out.... the biggest opponent is ..whom? Fire Departments and Volunteers. All going back to the issue if everyone was on the same page, then it would require standardized education (NOT training) thus it would increase the requirements of becoming an EMT to Paramedic, as well a true standardized test (similar to other health care providers... oops! That's right many that oppose do not believe we are such).
Standardized Scope of Practice .. comes with a large responsibility... in which most states EMS programs and services unfortunately are not yet prepared for.
R/r 911
mycrofft
Still crazy but elsewhere
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KEVD18 I've had a similar experience but I turned it around.
I was tagged to be nurse at a girl scout and their moms' retreat for two days (my wife and daughter were there), told I had to be "in charge:" of the meds anyone brought, and then told they were customarily kept in the unlocked, uncontrolled first aid cabinet.
Uh-uh! I insisted on getting a signed count of the tabs or caps in the bottles with the owners, then emptied out my Duluth Trading map case and carried them on my shoulder or sitting on my foot the rest of the time. Included narcs, and the mom who brought those did not surrender her fentanyl lollipop I found out later. One kid's mom had a barrage of meds (OTC and Rx) for asthma, and insisted upon her kid being given PRN doses when there was no sign of asthma (had her sign a release with promise to keep the meds to herself then gave them back).
I wrote a letter to the local Council about their practice being unsafe and probably illegal. Last time I ever went there, coincidentally, and probably to their liking.
I was tagged to be nurse at a girl scout and their moms' retreat for two days (my wife and daughter were there), told I had to be "in charge:" of the meds anyone brought, and then told they were customarily kept in the unlocked, uncontrolled first aid cabinet.
Uh-uh! I insisted on getting a signed count of the tabs or caps in the bottles with the owners, then emptied out my Duluth Trading map case and carried them on my shoulder or sitting on my foot the rest of the time. Included narcs, and the mom who brought those did not surrender her fentanyl lollipop I found out later. One kid's mom had a barrage of meds (OTC and Rx) for asthma, and insisted upon her kid being given PRN doses when there was no sign of asthma (had her sign a release with promise to keep the meds to herself then gave them back).
I wrote a letter to the local Council about their practice being unsafe and probably illegal. Last time I ever went there, coincidentally, and probably to their liking.
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