EMT optional scope of practice California

[MedicChuck14]

Hello everyone,

My agency is looking to educate some of our EMT's in the California optional scope of practice; use of EPI pens, Narcan, Mark I kits ect. Question is, are there any EMT's out there that are employed as a EMT-OS and how are you compensated by your employer.

 

[hometownmedic5]

It boggles my mind that there are places where those things aren't in the emt scope without some bs add on class.

Given that I see those as staple basic emt skills, as long as the class is free, I don't see how an increase in compensation is justified. If a member has to pay for the class, then their employer should reimburse 100% for it. Beyond that, I just don't see it.

 

[NomadicMedic]

It boggles my mind that there are places where those things aren't in the emt scope without some bs add on class.

Given that I see those as staple basic emt skills, as long as the class is free, I don't see how an increase in compensation is justified. If a member has to pay for the class, then their employer should reimburse 100% for it. Beyond that, I just don't see it.

You also don't live in California.

You know one system. It's not like any other system.

 

[MedicChuck14]

I agree California has a very unique EMS system and Labor system.

With the optional scope being taught at no expense to the employees and with a skill set advanced from the EMT-Basic we want to offer some type of financial incentive to our EMT's just wanted a basis if anyone else is using the optional scope.

 

[DesertMedic66]

I would say no for an increase in pay. We got TXA for ALS not to long ago. Does that mean I should get a pay raise as a medic?

 

[luke_31]

I agree California has a very unique EMS system and Labor system.

With the optional scope being taught at no expense to the employees and with a skill set advanced from the EMT-Basic we want to offer some type of financial incentive to our EMT's just wanted a basis if anyone else is using the optional scope.

It's noble that you want to offer more money to your EMTs, but realistically the additional optional scope training isn't worth more money. Any other state and some counties in California do that optional scope with no additional compensation.

 

[Tigger]

You also don't live in California.

You know one system. It's not like any other system.

Still, BLS in California is a mess.

 

[NomadicMedic]

Still, BLS in California is a mess.

But it's a mess in other places as well. How about those places that let basics intubate? How about those places that make AEMT the entry point for 911 trucks? How about NJ and their "first aid squads" with no real requirements at all? How about Boston where they hire medics to work as basics because they only have so many medic spots? How about South King County washington where private EMTs are basically uber drivers with a stretcher? How about ... ?

It's all different. None of it is perfect. And until you spend time there, you have no idea. And if that's the only place you know, you're just as clueless as to the rest of the world.

Most of the people who work in EMS are not as plugged in as us (the users if this forum) are. They have NO IDEA about any system other than where they work. I had an argument with a guy I work with about RSI. He told me that only flight medics could RSI patients. I said, "yeah. In Georgia". He said, "no, in the whole country." When I told him that RSI is in the scope of practice for many ground medics, and is standing orders for many, he didn't believe me. I had to show him protocols.

Due to the lack of standardization, each EMS system is uniquely different. And despite what you may think about your particular system, it's not a good thing.

 

[GMCmedic]

I wish I got a raise when we got Zosyn.

Sent from my SAMSUNG-SM-G920A using Tapatalk

 

[EpiEMS]

You know one system. It's not like any other system.

This, x100.

If you've seen one system, you've seen...one system.

 

[hometownmedic5]

How about Boston where they hire medics to work as basics because they only have so many medic spots?

While I think you made some great points, I think this one falls flat. BEMS runs a tiered system heavily weighted towards the BLS side. They pay well enough at the BLS level to make it worth it to medics who would otherwise work for a private to work for BEMS as a basic until they either promote, or much more likely burn out and go somewhere else. They aren't actively recruiting medics for BLS jobs.

You and Epi are also correct in that every system is unique and its unfair to judge one by another. That being said, I dont think its unfair to judge a system by the national scope of practice. Until five minutes ago, I was mistakenly under the impression that glucometry, Epi auto injectors, inhaled bronchodialators and such were BLS skills in the national scope. They are not. So, while it still cooks my noodle to think there are BLS ambulances rolling around in this country without AED's and EpiPens; evidently by my own standards its unfair to judge California EMS so harshly.

 

[VentMonkey]

Yet how does any of this make a provider regardless of the state they are in, and the amount of "tricks in their bag" more, or less, competent?

It doesn't. I could have restricted protocols in a "mother may I" system, or work somewhere where I "bring the ED to the patient", but what is ANY of it worth without an individuals proper clinical insights? It's useless.

 

[Tigger]

But it's a mess in other places as well. How about those places that let basics intubate? How about those places that make AEMT the entry point for 911 trucks? How about NJ and their "first aid squads" with no real requirements at all? How about Boston where they hire medics to work as basics because they only have so many medic spots? How about South King County washington where private EMTs are basically uber drivers with a stretcher? How about ... ?

It's all different. None of it is perfect. And until you spend time there, you have no idea. And if that's the only place you know, you're just as clueless as to the rest of the world.

Most of the people who work in EMS are not as plugged in as us (the users if this forum) are. They have NO IDEA about any system other than where they work. I had an argument with a guy I work with about RSI. He told me that only flight medics could RSI patients. I said, "yeah. In Georgia". He said, "no, in the whole country." When I told him that RSI is in the scope of practice for many ground medics, and is standing orders for many, he didn't believe me. I had to show him protocols.

Due to the lack of standardization, each EMS system is uniquely different. And despite what you may think about your particular system, it's not a good thing.

These are all good points and I've said the same thing many times. I just don't think it's necessarily out of bounds to say (without direct experience) that generally speaking California is behind the times when it comes to how EMTs (and EMS) is used.

 

[RocketMedic]

Flipside: CA EMS, when it eventually does modernize, is going to have an easier time dragging everyone forward.

 

[Summit]

I remember when I was trained on those things as an EMT... 14 years ago... will CA get pulse ox and glucometers next?

 

[Jim37F]

I remember when I was trained on those things as an EMT... 14 years ago... will CA get pulse ox and glucometers next?

Halfway there, have the pulse ox, but still not trusted with the drugstore over the counter test.