Diary of the NREMT

[DrParasite]

To Dr Parasite and Hometownmedic:
1: Where I was working before we had to be NR; and then the state would give us their certification as long as we had a letter from the supervisor of the company that we were going to work from and our new medical director (although a phone call for the MD would work too).

yeah, that's called reciprocity, it's very common. It's how I got my NYS EMT. and NC EMT. but the big difference is you were given a state cert from that state, with a state number; you weren't operating under NR, you had the state approval with a state card.

2: When we would get flagged down we would ask the trooper, who had a car in the ditch, who he thought the driver had a seizure; (turned out the driver had an MI) to ask his dispatcher how far out their EMS was (it was during a bad ice storm) and the trooper's dispatch said that it was up to 2 hours before they could get an ambulance there, they were backed up with runs do to the storm and she asked if we would take the patient to the hospital. We asked the trooper if he would lead us, since we didn't know where the local hospital was. He did, we followed. When we got to the hospital, my partner/medic explained to the ED Doc what happened where we were from, who our Medical Director was and his phone number, and the doc took our names and cert numbers. Our MD gave us nice comments at the next Audit and Review for it.

I have no problem with anything you did; in fact, I'd probably do the same thing. Actually, I know I would. It's a lot easier to defend taking someone to the hospital in an ambulance than not, however if someone wanted to make a big deal about it, I'm pretty sure my former management would back me. But I still know the rules, which is why I would be ok with breaking them and dealing with any consequences. I'm actually surprised the doc took your names and cert numbers; most don't care, because once you are out of the ER, they forget about you, unless you do something that makes you super memorable. But has nothing to do with national registry.

3: Prior to a long distant transport, our company would check with the State EMS offices of the states we were transports to or from and through to see if they had problems and none of the states had a problem with it. A few EMS offices would ask if any of our people were nationally registered. Sometimes when I was in Dispatch and I would make those calls (which was fun when I was setting up long distance transports for me to take) I would ask the State EMS offices what they thought if during a return we got waved down for help: usually the answer was "help people, just like we expect our people to do".

I'm a little fuzzy on the rules, but typically as long as the ambulance is registered by either the source or destination hospital, no one cared. I've transported to NY from NJ several times, as well as into PA. Never had a PA card, and my NY card is long expired. And I have never asked a state EMS office that question, but I'm not surprised by the response; when in doubt, err on the side of the patient. But none of this has anything to do with national registry.

Every time we got waved down to help we would call 911 on cell phone mainly to say this is who we are, and were we are and what we got, are you going to send an ambulance to take the patient? If they asked us to transport, We would have to ask for directions to the closest hospitals. Probably only had local EMS come out 3 out of 5 or 6 times other times we would transport.
I did probably 50 plus out of state transports. 100's of long distance in state transports.

So when I was in the 911 center, on a few occasions, I had BLS ambulances calling in stuff. Maybe it was an MVA. maybe it was that they needed ALS from our agency. If they have an ambulance, why would I not tell them to take them to the hospital? I'm not that territorial. We had one of our ambulances going to an address, that somehow ended up being in the next town over. like several blocks into the next town. they asked what they should do. our supervisors response: "go inside, treat them appropriately, and take them to the hospital if needed. They take one of ours, we will take one of theirs, it all balances out in the end." But it has nothing to do with national registry, and should someone make an issue out of it, there are the potential for consequences.

With the Tornado it wasn't a border call we were on the way back from Missouri and were close to the MO/IL border at 2am and went through an area that was just nailed by a tornado; it took 20 minutes to get a cell call out; in fact I had to send my partner in the ambulance on a 10 minute drive before she got cell service to call 911 and report it, and then come back. Myself and the 3rd on the truck stayed with the trauma gear, and continue searching and treating who we could. 3 died, nothing we could do; We didn't transport any on that one; we did triage and treatment. 45 or so serious injuries.

Good for you, I probably wouldn't have sent my partner away with the ambulance and no way to reach them, but that's jsut me.. Has nothing to do with national registry.

Let me try to explain this whole thing: everything you said is great, but has absolutely nothing to do with your national registry card. the exception is having an NR card helps with reciprocity (sometimes). But even then, you still need state approval to be an EMT; NR alone doesn't cut it, unless your state uses NR as their state card.

If you are in a marked vehicle, and you get flagged down, and you take someone to the hospital, and there are no negative consequences to your actions, good for you. bonus points if you ask the AHJ if they are ok with it, and they say yes. Same applies if you drive up on an MCI. You might have to do some paperwork afterwards, maybe even call your state office of EMS to report the unusual activity, but most of the time, they will say "thanks for letting us know, good job, a shiny gold star for all involved." Has nothing to do if you are NR certified or not.

It's when you are doing it when you aren't supposed to, or when someone does complain, or you aren't following the regulations like you are supposed to, that is when there can be consequences. But that has nothing to do with NREMT at all.

for the TLR crowd: everything you said was great, your a hero in my book, but the only thing that had any relevance to NREMT was the first line, which says that NREMT makes it reciprocity easier.

 

[Alan L Serve]

NREMT, "Where our ConEd requirements change as often as the seasons and we rejected your ConEd despite state and CBCEMSBENMS approval because our people can't be bothered to read that the approvals are there in big bold blue letters."

 

[toreishi]

Biggest money scam in the US.

YES !!!!! They created a need and filled it (with themselves) !