Emt advance?

[rescu]

EMt advance

I don't really agree with every Medical Director making protocols based on their own opinion. Statewide protocols offer uniformity and are usually based on a committee consensus. As an ALS provider state-wide protocols allow mobility and continuity of care since you will be operating under the same protocols.

I feel this subject got carried away to many different direction, which I never intended to happen. I evidently did not explain myself fully. I will try one last time to clarify based on all the responses.

I know all the protocols in my county at the advanced level we are under a hospital protocols and under a med director like all are. There are 2 hospitals in the area one has advance level protocols the other does not. We are under the one that has them. In the protocol book 95% of the operations we will do say bls skills then IV, Monitor for doumentation and accu-check. That with a few other small add ons is the extent of our scope in indiana.

However the thing that confused me was area's not fully explained. For example a basic in indiana can not transport a patient with various fluids, IE: antibiotics, nutrition that is running, potassium over the 20 level and so on. Those things even in most emt-b classes are not fully taught until you reach the field and understand them in depth. So my question was directed toward those areas, are we allowed to transport different types of fluids than the basic, "did we expand that part of our scope?". I did not ask you guys on this forum to give me an answer and I was going to run with it as 100 percent right, but I wanted to get other inputs while I was waiting on an answer from the state office.

On the website it considers advance level a basic-advance. My cert says EMT advance. The NREMT considers is an Advance EMT. As far as insurance goes IV's, cardiac montioring and accu-checks are not considered als if its by a bls person, obviously. So my original question was just to shed some light on this level and see if any body else had trouble getting a black and white answer on this level. As far as emergency care for the patient I do not have any trouble deciphering my scope it is with patients that are stable who are hooked up to a fluid that i'm not sure if I can transport, and also the confusion between is an advance a bls that can do 3 or 4 als skills or considered an als provider.

Thanks for the input never intended this to be a name throwing game.

 

[usafmedic45]

Pathophysiology doesn't change from town to town.

No, but unfortunately the skill levels of the providers (mostly due to differing call volumes) often do and what is a good idea in downtown Philly ("Pick up, haul ***" because you're 10 minutes from a variety of excellent hospitals) isn't going to be the best approach in East Bum****, PA where you are 40 miles from the nearest hospital and you have to stabilize the patient for the much longer prehospital interval. The reverse also applies because you could harm patient outcomes by increasing the prehospital interval on close-in calls by having excessively aggressive protocols which would make providers more tempted to "stay and play".

There should be an accepted statewide minimum but moving above that should always be allowed.

 

[usafmedic45]

i feel this subject got carried away to many different direction, which i never intended to happen. I evidently did not explain myself fully. I will try one last time to clarify based on all the responses.

I know all the protocols in my county at the advanced level we are under a hospital protocols and under a med director like all are. There are 2 hospitals in the area one has advance level protocols the other does not. We are under the one that has them. In the protocol book 95% of the operations we will do say bls skills then iv, monitor for doumentation and accu-check. That with a few other small add ons is the extent of our scope in indiana.

However the thing that confused me was area's not fully explained. For example a basic in indiana can not transport a patient with various fluids, ie: Antibiotics, nutrition that is running, potassium over the 20 level and so on. Those things even in most emt-b classes are not fully taught until you reach the field and understand them in depth. So my question was directed toward those areas, are we allowed to transport different types of fluids than the basic, "did we expand that part of our scope?". I did not ask you guys on this forum to give me an answer and i was going to run with it as 100 percent right, but i wanted to get other inputs while i was waiting on an answer from the state office.

On the website it considers advance level a basic-advance. My cert says emt advance. The nremt considers is an advance emt. As far as insurance goes iv's, cardiac montioring and accu-checks are not considered als if its by a bls person, obviously. So my original question was just to shed some light on this level and see if any body else had trouble getting a black and white answer on this level. As far as emergency care for the patient i do not have any trouble deciphering my scope it is with patients that are stable who are hooked up to a fluid that i'm not sure if i can transport, and also the confusion between is an advance a bls that can do 3 or 4 als skills or considered an als provider.

Thanks for the input never intended this to be a name throwing game.

Ask your medical director. Why is that so difficult? Some state level paper pusher isn't the person to ask which is why they keep blowing you off. Ask the person who would actually know.