IV certification??

[medic417]

Once when the hospital was in serious crisis I was asked to assist in surgery. Since I knew how to spread a chest I did to save time for the surgeon. Thinking about it I think we should start doing it in the ambulance to save time for the surgeon. I mean all we're gonna do is seperate the ribs,not actually touch the heart or anything like that. I mean its so simple a monkey can be trained to do it so why shouldn't we add this skill?

 

[Shishkabob]

Once when the hospital was in serious crisis I was asked to assist in surgery. Since I knew how to spread a chest I did to save time for the surgeon. Thinking about it I think we should start doing it in the ambulance to save time for the surgeon. I mean all we're gonna do is seperate the ribs,not actually touch the heart or anything like that. I mean its so simple a monkey can be trained to do it so why shouldn't we add this skill?

Besides the fact you're being a smartface;

In the state of Texas, if your MC teaches you a skill and puts it in your protocols, you can use it. If your MC teaches you how to do IV's as a basic, you're allowed to do IV's as a basic.



So, if your doctor teaches you how to do that skill, and allowed you to do it and puts it in your protocols, then sure, as it's his prerogative and his license.

 

[vquintessence]

Chest pain. Since we are able to give nitro, in a cardiac event, the nitro may make it difficult for ALS to start an IV. My ability to start the IV gives ALS a medication port, while still enabling the pt to get the pain relief from nitro.

That seems a strange policy? Never personally seen this, but ya can apply nitro ointment to a site to facilitate IV access.

Nitro is a vasodilator, there is no vasoconstriction on a significant level to be aware of. That's why low BP is a contraindication. Do they want you guys getting the IV prior in case the pressure should drastically dump? Is that the difficulty they forsee? Seems like a liability giving the green light to administer someone a dose NTG who isn't on the Rx and BP is borderline. I'm probably looking straight through the pink elephant searching for the answer. What am I missing here guys?

 

[Ridryder911]

Again, people have lost the sensibility affect. If one is depending upon fluids for trauma their wrong. Fluid resuscitation is not avenue for trauma care. An access? Sure. However; the excuse of having to allow a basic to perform such is not warranted.

IV's do not save lives.

It is what assessed, properly diagnosed and then what is administered through such that causes the change.

R/r911

 

[backcountrymedic]

Retracted.

 

[JPINFV]

I did not receive my IV training with my EMT training did anyone else? How do I get it because it seems like everywhere I apply they want it.

Troubles in Denver

IVs are not in the NHTSA National Standard Curriculum and are not normally found in the scope of practice for EMT-Basics.


Let's not get into the entire "Should EMT-Bs start IVs" debate. Here's how that thread will end.

One side says, "We need them, they're helpful, blah blah blah."
Other side says, "You don't have the education to do it nor the education to actually make it useful."
Pro: Yes we do, after out course.
Con: No, you won't. It'll just get watered down and you still can't administer drugs.
Pro: You're just a poopyhead paragod!
Mods: lock.

 

[rmellish]

IVs are not in the NHTSA National Standard Curriculum and are not normally found in the scope of practice for EMT-Basics.


Let's not get into the entire "Should EMT-Bs start IVs" debate. Here's how that thread will end.

One side says, "We need them, they're helpful, blah blah blah."
Other side says, "You don't have the education to do it nor the education to actually make it useful."
Pro: Yes we do, after out course.
Con: No, you won't. It'll just get watered down and you still can't administer drugs.
Pro: You're just a poopyhead paragod!
Mods: lock.

With some states offering an IV supplement, its perfectly reasonable that an area could be hiring EMT-Bs with the IV supplement. Not saying its right or wrong, but without personal knowledge of the area, the OP's issue makes sense.

Especially if he was nationally registered and took his course in a different state.

 

[JPINFV]

I'm not saying that his question doesn't make sense, but he also asked if anyone else didn't receive it. The way he phrased his post makes it look like he is under the impression that IV training is a part of the normal training for EMT-Bs.

 

[Bmelanson]

Here in denver a emt can start iv's, we can give narcan, d50 and saline. base contact for narcan and d50 needed. I think half the iv's started are a waste of time because they weren't needed. I feel that most basics get in trouble with this for not knowing the contradictions for fluid.

 

[ptemt]

I did not receive my IV training with my EMT training did anyone else? How do I get it because it seems like everywhere I apply they want it.

Troubles in Denver

Here is a link to HealthONE, class starts tomorrow.


http://healthoneems.com/course_pdf/2009/2009_IV_Approval.pdf

 

[medic417]

Besides the fact you're being a smartface;

In the state of Texas, if your MC teaches you a skill and puts it in your protocols, you can use it. If your MC teaches you how to do IV's as a basic, you're allowed to do IV's as a basic.



So, if your doctor teaches you how to do that skill, and allowed you to do it and puts it in your protocols, then sure, as it's his prerogative and his license.

You are right I am smart. And your prize youngster is a :wacko:

Thank you for playing.

But seriously good medical directors do properly educate their people and with that proper education expand scope of practice. You are telling me nothing knew as I work with some of the most aggressive protocols, but those were earned by education. Not all in our service are given the extra protocols, sadly often as they just want the skill but are not willing to workfor it.

 

[BossyCow]

That seems a strange policy? Never personally seen this, but ya can apply nitro ointment to a site to facilitate IV access.

Nitro is a vasodilator, there is no vasoconstriction on a significant level to be aware of. That's why low BP is a contraindication. Do they want you guys getting the IV prior in case the pressure should drastically dump? Is that the difficulty they forsee? Seems like a liability giving the green light to administer someone a dose NTG who isn't on the Rx and BP is borderline. I'm probably looking straight through the pink elephant searching for the answer. What am I missing here guys?

You are missing that we don't issue the NTG unless they are on the Rx and the BP warrants it. The only exception for us is under the direct orders of our MPD who has on a few occasions directed us to issue NTG to a pt who didn't have a script for it. All of those cases are ALS pts and we are enroute to meet with ALS. But in my neighborhood that can be up to a half hour away.

I have seen veins just disappear after NTG administration especially in those big round fat arms of extremely white women. We are always told to start the IV prior to the administration of NTG regardless of whether or not its their prescription or ours at the orders of Med Control.

 

[Veneficus]

You are missing that we don't issue the NTG unless they are on the Rx and the BP warrants it. The only exception for us is under the direct orders of our MPD who has on a few occasions directed us to issue NTG to a pt who didn't have a script for it. All of those cases are ALS pts and we are enroute to meet with ALS. But in my neighborhood that can be up to a half hour away.

I have seen veins just disappear after NTG administration especially in those big round fat arms of extremely white women. We are always told to start the IV prior to the administration of NTG regardless of whether or not its their prescription or ours at the orders of Med Control.

I have noticed that in larger patients cannulating the cephalic or basilic vein is usually the best bet. Even if you cannot see them they are quite easy to approximate.

use such info as you will.

 

[mikeylikesit]

it would be great for you to start the IV but then what? put on a lock and wait till the hospital. like most said what is the point of starting one if you don't know where to go from there?

 

[BossyCow]

it would be great for you to start the IV but then what? put on a lock and wait till the hospital. like most said what is the point of starting one if you don't know where to go from there?

The point for us is with the extreme transport times, the patient may not have IV access by the time we meet up with ALS. We quarantee a med port and a patent IV for a pt that will need one. It's not that I don't know where to go from there, its that my cert is only for a specific level and it requires the monitoring of the IV by ALS.

 

[Shishkabob]

What people seem to be missing is something that was stated early on;

No, B's wont be starting IV's and just sitting there twittling their thumbs, and no, B's won't be administering a crap load of drugs.

What the reason would be for a M/B combo, where the medic can intubate and the basic can IV. or the medic can do any number of things and the basic can IV. Or any number of different scenarios.


Do I need to phrase this differently? Apparently many people aren't grasping the concept of "starting" and not administering.

 

[JPINFV]

Just to make sure I'm reading your posts correctly, you think that basics should start IVs only under direct observation from a paramedic? Of course the proper follow up question is why not just have 2 paramedics?

 

[TomT]

IV Certification

I believe that the ability to start IV.. draw labs, and intubation should be taught...if it is only under the orders or observation of and I or CC.

 

[JPINFV]

Why should basics be intubating if a paramedic is on scene?

 

[BossyCow]

Just to make sure I'm reading your posts correctly, you think that basics should start IVs only under direct observation from a paramedic? Of course the proper follow up question is why not just have 2 paramedics?

Because our under 200 calls a year and many of them BLS doesn't justify changing our agency classification to ALS which requires 24/7 response. That means at least 3 full time medics and their toys. We are too geographically isolated to get that coverage from adjoining areas and have lost 2 of our go-to agencies for ALS support in the past year.