First call in which i was lead tech!

[STXmedic]

Where I am you can't perform an advanced intervention and then leave the patient in the hands of a lesser-certified EMT. If you push MS, you bought the ride in the back.

Exactly. The thought behind that over here is either a) you can monitor the patient for any adverse reactions and treat accordingly, b) if the patient needs more, you will have an easier time pushing it if you aren't trying to drive at the same time... or c) if the patient actually needs an ALS intervention, they are sick enough to warrant an ALS provider, too. Remember, though our ALS may be considerably lacking when compared to you guys over there in Australia/NZ, they are still considerably more trained than a 120hr basic class.

No but she let him take the lead with the pt assessment and work up to the point of his protocols, instead of just doing everything since it was an ALS call

I realize that's what was going on, and have already congratulated the OP on a job well done Keep it up, guy!

 

[Elk Oil]

The fact that people take or are administered narcotics all the time without the constant presence of a HCP aside, you're not leaving. The paramedic is still there. He/she just isn't in the attendant's chair. What's the big deal?

I'm just saying what our rules are. How inconvenient would it be for the medic to have pull the truck over, jump in the back and apply some other intervention if required! The most advanced EMT who provides interventions at their level of certification must attend the patient during transport or transfer care to an equally certified EMT. Period.

It's the same as First Responders. Certified FRs can man our trucks as long there is one EMT at any certification level. They may only drive to the hospital, however -- they may not attend the patient during transport if there's a two-person crew.

These are the rules and I'm not of the mind to go breaking them.

Oh, and by the way, as far as my protocols are concerned, if you get out of the back of the truck, you have indeed left. And patient abandonment is frowned upon in my neck of the woods.

 

[rmabrey]

There was a paramedic there the whole time. What's the difference.

What so special about morphine that it needs a paramedic to watch them not be in pain, rather than an emt?

Feel free to correct me if Im wrong but if the Medic hands off care after performing ALS treatment, to a Basic, that constitutes abandonment.

 

[AmeriMedic21]

So your medic also gave nitro without having a line established? :s Scary..

Edit: And all chest pain is ALS until it is determined otherwise.

lol. no. sorry, i must be doing a horrible job explaining this.

I ASSISTED the patient with her OWN nitro. When we got in the back of the truck our medic ran an IV and administered Morphine. Our transport time to the hospital was about 3 minutes.

good lord, im sorry to everyone, i didnt mean to start a damn firestorm on here, i was just proud of being able to do my first lead. on a technical aspect, she was lead, but she let me play. its not like i didnt know what i was doing, she told me she would stop me before i did anything stupid. i now know how to be cautious on this forum.

for everybody else, thanks for the support.

 

[jjesusfreak01]

Feel free to correct me if Im wrong but if the Medic hands off care after performing ALS treatment, to a Basic, that constitutes abandonment.

Depends. The medic will still be closeby if they are driving, and it would need to be a call where you could reasonably believe no further ALS interventions would be needed, and nothing currently being used on the patient was above the scope of the EMT-Basic (ie, no running IVs, nitro paste). How about a diabetic who was given D50 onscene and still wanted to go to the hospital. They could have an IV lock, but be perfectly stable with no expectation of going downhill during transport. A fracture patient with a little bit of morphine onboard wouldn't be unreasonable for an EMT to attend on if the transport was short (no need to re-administer narcs).

I think (ie, this is not a legal opinion and IANAL) abandonment is more along the lines of transferring care to a provider who lacks the scope or training to appropriately care for the patient. Transferring a post-rosc cardiac arrest patient to a radiologist could be just as much abandonment as handing them over to a CNA.

 

[Strap]

It sounds like you did a great job AmeriMedic!

 

[Addicted2Narcan]

After I tech'ed my first call, my lieutenant told me to wipe the smile off my face and wash the trucks. Don't get cocky, young Skywalker.