Originally posted by TTLWHKR@May 3 2005, 09:14 AM
I didn't think anyone was talking poorly about them (FR's). No matter what you call any of our certifications, the simple fact is that the "Scope of Practice" is different for every level of cert, in every state. What you can do in NY, may not be legal in PA. And knowing how to do more is great, but it's a big no-no to go out of your scope of practice. Good way to get the service your running with in hot water. I don't care if your willing to lose your certification to save someones life; we all think about that every now and then. But my career depends on my certifications.
My "beef" with FR's stems from a couple we had on a substation QRS team. They were provided with basic first aid equipment, that came from looking in the only "First Responder" guide we could find, from 1980, and that was American Red Cross FR's. We operated fine for about six years, had a Class 1 Medical Call, arrived; the squad was doing everything that we would have done. But not with our equipment. They went out and bought their own, a lot of equipment; outside of their scope.. Out side of MY scope. They wiped that QR service out with one call, that was all it took. The first person on the scene was an off duty Paramedic, also the regional director. :angry: They removed the "First Responder" patches from their uniforms and put on simple "EMS" patches. The person was boarded for a medevac (ER is 60 miles away), Nasal Airway, Bagging him and someone had cut the lock off the EPI box on the rescue and given it to him w/ out calling medical command. The law then was EMS could carry EPI but only give it w/ Med Command Orders.
It is a fact that their actions saved the patients life. But it is also a fact that FR's (at the time) were not permitted to carry backboard, EPI, Oxygen, Nasal Airways or Bag Valve Resuscitators. All of them were stripped of their certs, and we lost the license for operating a QRS. Now, they were so proud that they lost their certs and the license; but saved someones life. What happens when someone drops in Cardiac Arrest, and there is a chance that CPR or AED can save their life now that FR's can use AED's? We can't go for a QRS license because it was permanently revoked. They weren't seeing the big picture, they have to be there for everyone, not just to satisfy themselves. Their little ego trip cost us 5,500.00 in Fines; and near loss of all EMS vehicle certifications.
ANYHOO. After this happened, I contacted the PA EMS Director and asked for "Protocols" for First Responders. They said "use the BLS protocols". They were using the BLS protocols-except EPI-when they broke all the FR Protocols. How can they accuse them of breaking protocol, when they do not have a written protocol for just first responders?
I still have never gotten an answer, somewhere there is a list of what people can do under scope of practice. But it lists certifications they have not existed since the early 80's. Which shows again how far behind PA is.
Following that incident, we no longer all personnel to be active as First Responders; because we are still glad the guy didn't die b/c the lawsuits would have been horrible when they found out what happened.
I can't wait till they come up w/ a national scope of practice and hopefully take over so PA can't keep holding us back.
