Finding scope of care for a first responder?

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musicislife

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Should I go by whatever I learned in my book or is there some state/ local thing i can look at? If so, where do I find information for scope of care?
 
You should go by department policy... acting a a first responder does not require a medical director, state protocol or medical control-- merely supplies and a good head on your shoulders. Where are you located-- I can try to pull your EMT Scope of Practice as a baseline...
 
New Jersey, Bergen County
 
Are you with an actual agency of some sort? Where I live First Responders have protocols they must follow just like everyone else and you cant just be out there doing it on your own.

I volunteer with a fire department/first responder unit, and we have a protocol book that sets out the scope of practice and protocols for every level of responder. Most of us are EMTs but we also have some MFRs. One of the MFRs is an RN, and even she isnt allowed to go beyond the scope of an MFR, which means no checking BGL.

I live in an extremely rural area where first responders can be an important part of EMS, since it can be 1/2 hour to 45 minutes before ALS gets on scene. Maybe its different in urban areas.
 
EFR or MFR is like teenage, that awkward in-between stage.

Check your local EMSA, but generally if you want to do more than basic first aid you have to be working under some sort of medical control.

EMSA and state laws trump company rules and trying to freelance under the Good Sam laws.
 
disregard dupe
 
Holding C-spine, CPR, and bleeding control. That's about it.
 
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mycrofft said:
EFR or MFR is like teenage, that awkward in-between stage.

Check your local EMSA, but generally if you want to do more than basic first aid you have to be working under some sort of medical control.

EMSA and state laws trump company rules and trying to freelance under the Good Sam laws.
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The one thing about the Good Sam laws is that they can protect you from civil suit for trying to do the "right thing" and may protect you from prosecution as well.

Sacramento County explicitly authorizes affiliated but off-duty Paramedics to use their full scope of practice. Individual agencies and companies may restrict their employees from using that scope... under penalty of some kind of internal discipline.

As a general rule, I'd expect that a First Responder (MFR) would have a scope similar to that of an EMT, minus a few things. Here's NorCal EMS's scope of practice for all levels of provider: http://www.norcalems.org/pnp-manual...mergency_Care_Personnel_Scope_of_Practice.pdf

Note that the 1st level is EMR, then it adds EMT, AEMT, Paramedic, and then MICN. At least they have a formal EMR scope...
 
Emergency First Responders in Sacramento County

As a matter of fact, last autumn I dug into the Sacramento Calif EFR scope through the local EMSA. It does not recognize (not for, not against) EFR's. Many agencies (FD's, CERT's, CHP) brian to EFR but just try tom keep it reasonable by copying Sierra Sacramento Valley's EMSA rules, which are just slightly conservative-ized versions of the national suggestions.

I was astonished to get a reply from SacCounty EMSA within a month, and unsurprised when they did not reply to my followup queries.
 
hogwiley said:
Are you with an actual agency of some sort? Where I live First Responders have protocols they must follow just like everyone else and you cant just be out there doing it on your own.
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This is the important part, a scope of practice is fairly useless you are affiliated with some sort of agency. If you're not then you're then always off duty limiting you to basic first aid. Obviously most of the MFR scope is basic first aid anyway (not a knock at them), but giving say oral glucose while unaffiliated is not probably a wise idea.
 
Oral glucose is basic first aid per Am Red Cross. Taking blood glucose is not.
 
mycrofft said:
Oral glucose is basic first aid per Am Red Cross. Taking blood glucose is not.
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I did not know that. I guess I considered it a medication and basic first aid does not generally allow for medication administration?
 
Tigger said:
I did not know that. I guess I considered it a medication and basic first aid does not generally allow for medication administration?
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Maybe they changed it but asa for chest pain is a first aider skill. At least it was years ago when I first took a class.

Back on topic
As previously stated it depends where you are and or where you work
 
ARC says give juice if not obtunded.
ASA (aspirin) : ARC says may assist the pt in taking it. Ditto MDI inhalers, epinephrine injector pens, and nitro, somehow "assist" the pt to take it.
 
By assist, do they mean that you can have the aspirin on you and say, "here, take this?"
 
I think it's more like you stick it in their hand then pinch the fingers shut then guide the arm and hand to where it's supposed to go....
 
mycrofft said:
I think it's more like you stick it in their hand then pinch the fingers shut then guide the arm and hand to where it's supposed to go....
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I like to make airplane noises and say "Here comes the plane, open up!!" then I finish with, "Landing successful" and do a little victory dance.
 
You obviously know small children. Or geri pts.
OP, did you get your answer?
 
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