first aid scope of practice?

[rdkl]

I am trying to find out the scope of practice as far as basic first aid for scrapes and cuts. There is some debate amongst a few EMTs who volunteer to cover first aid for various small events. The question is what kind of treatment can they do on a basic knee scrape or a cut finger.

Anyone have any input?

Specifically if anyone who knows the Santa Clara County scope of practice would be usefull but any input in general is apprecitated.

 

[rescuecpt]

Bandaging is within scope of practice for any EMT. In some areas use of anticeptic liquids and creams is debatable - in my area it is allowable, but we often don't have time to clean and bandage cuts and scrapes on ambulance calls, so we don't - but at "events" where that is our purpose we do.

 

[TTLWHKR]

They don't let your EMT's perform bandaging?

:huh:


So what exactly do they do?

 

[SafetyPro2]

Based on the California EMSA scope (not sure about Santa Clara specifically) and what we're allowed to do in L.A., I'd say bandaging is fine (be it a band-aid or gauze/kerlix/whatever). I wouldn't use any sort of antiseptics or topical medications. If the wound is dirty, just rinse with saline or water.

Basically, California law lets you practice the full BLS scope as an EMT, regardless of whether you're working through an official agency or not. If I was off-duty and came across a person down in the street in full arrest, I could do everything I could do for them if I was on-duty (assuming I had the equipment available, of course.)

Medics are the only ones that have restrictions. In CA, medics can only perform ALS skills while working in an official capacity for an ALS agency. Otherwise, they're restricted to BLS skills. So, in the same example above, a medic coming across the same PT could only perform the same skills I could. They could not intubate, push drugs, etc. unless it was through their agency.

 

[Jon]

I do first aid for Boy scout stuff.

As far as I'm concerned, If it doesn't need sutures, I'll usually just bandage it. If the kid needs a tetnus booster - it is usually a conseting adult, 'cause the first series dosen't wear off until the 20's...

I've boarded and collared twice... Both times BLS was enroute.

I've dealt with mild/ moderate hypothermia... Moron cub scout, camping with boy scouts, didn't have raingear, fighting a stomach bug over the weekend, got wet, threw up over half his dry stuff.... got him into a high school classmates' car (who was visiting his old troop, and happened to be a firefighter and has CPR/AFA). He sat in the car for almost an hour with 4 of us with him, talking outside, checking on him frequently - Scoutmaster, my former classmate, the troop youth leader, and myself. We found the kid a clean, dry sweatsuit and his single-parent mom was out of town, taking the only weekend she had off in ages to spend time with friends out of town. We got the kid into a dry sleeping bag, and the troop checked him a few times during the night. All was good the next morning.

My issue is that I'm dealing with 10-17y/o's as my primary clients.... Usually if it is beyond a large band-aid, I make sure Scoutmaster / onsite parent is notified, and let them know what is going on.

Jon

 

[Jon]

Originally posted by SafetyPro@Jun 1 2005, 08:47 PM

Medics are the only ones that have restrictions. In CA, medics can only perform ALS skills while working in an official capacity for an ALS agency. Otherwise, they're restricted to BLS skills. So, in the same example above, a medic coming across the same PT could only perform the same skills I could. They could not intubate, push drugs, etc. unless it was through their agency.

PA is the same way. I've got a friend who is a medic in "DO" school.... He "Happens to have" a LP12 and full set of gear... He worked a code his first day at school... In the bookstore.... I heard about it later... Aparently he walked in the store to get a last-minute book for a class, sees a group of students and teachers playing "uh-oh squad" as 1 student (an EMT) is doing CPR.... He runs out to his truck, parks out front with the blinkies, and looks at the senior instructor there.... gives the 30 second version of "needing command" and had that doc tell him to do what was needed.....

Fire rescue showed up, and was a little suprised to find the guy tubed and converted..... Given copies of "before and after" and everything.....

When I'm ALS level, I very well might add a few things (sub-q epi and Benadryl) to my Camping gear, and maybe get me a "cric on a keychain" kit.....

 

[ECC]

Originally posted by SafetyPro@Jun 1 2005, 07:47 PM
Medics are the only ones that have restrictions. In CA, medics can only perform ALS skills while working in an official capacity for an ALS agency. Otherwise, they're restricted to BLS skills. So, in the same example above, a medic coming across the same PT could only perform the same skills I could. They could not intubate, push drugs, etc. unless it was through their agency.

In NY and Colorado Intubation is condisered a BLS Skill for Medics.

Thank God!

 

[rdkl]

Ok, in re-reading my post I guess I wasnt too clear. I guess I wasnt fully awake when I posted. The debate was on wound cleaning/care before bandaging and if we could apply any kind of antiseptics or topical medications. For now the policy has always been rinse if necessary and bandage but I just thought I'd see if I could get a more solid answer. A call to the EMS agency in the next few days will hopefully end their debate

Thanks for all the replies. I've been reading this board for quite a while, just never really had anything to post.

 

[rescuecpt]

Yep, on ALS items... CC's are only allowed to perform ALS skills under the authority of their department, or another department at their request. If I stop at a car accident out of my district, I can only perform BLS skills. When their Chiefs get there, I can tell them I'm ALS and I'm willing to perform ALS if they'd like me to.

 

[Jon]

I've used triple antiseptic cream before. I do it at home. If I'm dealing with skinned knees, I'll probably do it again.

As for Advil and other pain meds - I've seperated all that from my bags... mine is for me, and occasionally my partner(s), from MY personal backpack.

Jon

 

[PArescueEMT]

Originally posted by MedicStudentJon@Jun 2 2005, 09:09 PM
I've used triple antiseptic cream before. I do it at home. If I'm dealing with skinned knees, I'll probably do it again.

As for Advil and other pain meds - I've seperated all that from my bags... mine is for me, and occasionally my partner(s), from MY personal backpack.

Jon

and if i'm not mistaken, the separation thng was at the strong urging of multiple parties...

 

[Jon]

Originally posted by PArescueEMT+Jun 14 2005, 08:44 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (PArescueEMT @ Jun 14 2005, 08:44 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Jun 2 2005, 09:09 PM
I've used triple antiseptic cream before. I do it at home. If I'm dealing with skinned knees, I'll probably do it again.

As for Advil and other pain meds - I've seperated all that from my bags... mine is for me, and occasionally my partner(s), from MY personal backpack.

Jon

and if i'm not mistaken, the separation thng was at the strong urging of multiple parties... [/b][/quote]
Zak.....


I need to find my taser....

 

[TTLWHKR]

Originally posted by MedicStudentJon+Jun 14 2005, 07:51 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Jun 14 2005, 07:51 PM)</td></tr><tr><td id='QUOTE'>

Originally posted by PArescueEMT@Jun 14 2005, 08:44 PM
<!--QuoteBegin-MedicStudentJon

@Jun 2 2005, 09:09 PM
I've used triple antiseptic cream before. I do it at home. If I'm dealing with skinned knees, I'll probably do it again.

As for Advil and other pain meds - I've seperated all that from my bags... mine is for me, and occasionally my partner(s), from MY personal backpack.

Jon

and if i'm not mistaken, the separation thng was at the strong urging of multiple parties...

Zak.....


I need to find my taser.... [/b][/quote]
great. a baby medic with a taser.

I'll get the bandaids.

 

[MedicPrincess]

Originally posted by TTLWHKR+Jun 15 2005, 05:18 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (TTLWHKR @ Jun 15 2005, 05:18 AM)</td></tr><tr><td id='QUOTE'> [<!--QuoteBegin-MedicStudentJon@Jun 2 2005, 09:09 PM

Zak.....


I need to find my taser....

great. a baby medic with a taser.

I'll get the bandaids. [/b][/quote]
I'll bring the antiseptic wash....


Anybody want to bring the needles?

 

[emtbuff]

Sure I will bring the needles.