N.J.A.C. 8:40A Regulations

[TheAfterAffect]

So, Some other NJ EMT's may have noticed the following in their inbox today, I thought this was rather interesting.

New Jersey Department of Health & Senior Services Heather Howard
P.O. Box 360 Commissioner

For Release: For Further Information Contact:
July 7, 2008 609-984-7160

Department of Health and Senior Services Proposes to Amend
N.J.A.C. 8:40A, Emergency Medical Technician—Basic: Training and Certification

The Office of Emergency Medical Services in the Division of Health Infrastructure Preparedness and Emergency Response of the Department of Health and Senior Services is proposing amendments, a repeal, and new rules at N.J.A.C. 8:40A, which establishes standards for the training and certification of Emergency Medical Technician—Basics (EMT—Basics). The notice of proposal appears in the July 7, 2008, issue of the New Jersey Register.

The proposed amendments, repeal, and new rules would implement technical changes throughout the chapter, and would implement the following substantive changes:

* Require additional emergency preparedness training for EMT-Basics, to implement the recommendations of the New Jersey Domestic Security Task Force that EMT-Basics receive training in Hazardous Materials Level 1 Awareness, Weapons of Mass Destruction Awareness, and Incident Command System 100 Procedures. In addition, the proposed amendments would implement Executive Order No. 50 (Governor Codey, August 5, 2005), which requires EMT-Basics to complete ICS-700, an introductory course to the National Incident Management System (NIMS);
* Restate in a proposed new rule the criminal history record review procedure; continue to require applicants to pay the cost of obtaining criminal history records from law enforcement agencies; and expand the breadth of criminal history record reviews of EMT-Basics and EMT-Basic Instructors to authorize the Department to examine the criminal history records of EMT-Basics and EMT-Basic Instructors in states and jurisdictions outside of New Jersey;
* Expand the scope of practice of EMT—Basics to include the following “physician-directed protocols,” that is, EMT—Basics would be authorized to perform these procedures only under the supervision of a physician medical director:
o The administration of epinephrine auto injector devices, pursuant to N.J.S.A. 26:2K-47.1 et seq., which requires the Department to develop protocols for this procedure; and
o The administration of nerve agent antidote kits (NAAKs) to themselves and to fellow EMS crewmembers; and
o The authorized but not required use of esophageal or multilumen airway management devices on adult patients suffering from cardiac arrest, in accordance with recommendations of the Emergency Medical Services Advisory Council and the Mobile Intensive Care Unit Advisory Council that the Department develop protocols for these procedures;
* Authorize the Department to use an alternate EMT-Basic testing service provider, and establish requirements applicable to students and providers with respect to testing procedures, recordkeeping, and other matters;
* Establish procedures for EMT-Basics to establish a publicly accessible “address of record” in addition to an actual physical address with the Department;
* Establish reporting requirements for EMT-Basics who are first responders to the scene of unexpected infant and child deaths, developed in cooperation with the State Medical Examiner and consistent with recommendations of the Sudden Child Death Autopsy Protocol Committee established pursuant to N.J.S.A. 52:17B-88.10; and
* Promulgate forms to be used to comply with chapter reporting requirements.
The public has until September 7, 2008, to comment on the proposal. Persons wishing to comment on the proposal must submit their comments in writing via the United States Postal System to Ruth Charbonneau, Director, Office of Legal and Regulatory Affairs, New Jersey Department of Health and Senior Services, PO Box 360, Trenton, NJ 08625-0360. Written comments on the proposal must be postmarked on or before September 7, 2008, which is the close of the 60-day public comment period.

A copy of the proposed rules may be found in the New Jersey Register at 40 N.J.R. 3869(a), available at most law libraries. The Department will post an unofficial copy of the rule proposal on the OEMS website at http://nj.gov/health/ems/index.shtml as soon as it is available. The OEMS estimates that an unofficial copy will be posted on the OEMS website in 10-15 business days.

The bolded part I found rather interesting. Do any other states do this?

 

[KEVD18]

you guys dont have epi-pens????

mk1 kits are a good step on paper.

basics tubing, here we go again.

 

[VentMedic]

The authorized but not required use of esophageal or multilumen airway management devices on adult patients suffering from cardiac arrest,

At least it clarifies "cardiac arrest" as to when they can be used.

I had asked that question to some of the EMT-Bs on the other threads and no one bothered to clarify their statutes or protocols.

 

[Jon]

I read it as combitube/KingLT.... not endotracheal intubation with a blade and tube.

One of them is somewhat idiot resistant... the other can be messed up REALLY easily.

As for epi... I think they already have a temporary policy in place for that... and the Mark I injectors are already solider-proof... but not paramedic proof (remember the FDNY medic instructor who put a Mark-1 kit needle through his thumb?)

 

[Fire292Rescue]

I got this email yesterday as well but I'm not an EMT. Just took my test last Thursday. B)

 

[Epi-do]

I read it as combitube/KingLT.... not endotracheal intubation with a blade and tube.

Me too. It does say esophageal airways, not endotracheal. If someone is placing, leaving, and leaving an ETT in the esophagus, they have no business intubating in the first place.

 

[reaper]

All of that has been in a lot of EMT-B SOP's for a long time. NJ is just getting around to it?

 

[TheAfterAffect]

yes....


As my partner from my current job tells me, NJ Is far far far behind the times.

 

[Hopper]

To TheAfterAffect,I'll start working at LifeStar on the 18th.
I'm located in north Jersey and being a volunteer our squad does carry adult and child epi-pens.I had to take a class to be certified to use them.Just like the AED,there is a form to be filled out noting your patient assessment,the patient vitals(before/after) and patient care that was given.A copy of the form goes to the hospital.

 

[MMiz]

Michigan has all three at the EMT-Basic level. All three were instituted around 2005.

 

[EMTSteve]

As for epi... I think they already have a temporary policy in place for that... and the Mark I injectors are already solider-proof... but not paramedic proof (remember the FDNY medic instructor who put a Mark-1 kit needle through his thumb?)

Funny you should say that....
About 2 semesters before my class during anaphylaxis and epi training, the teacher sent a live epi pen around the class. AFTER warning everyone it was live and not to hit the button.
A 19 y/o student hit the button and plunged the needle into his thumb :blink: a little while later he fell off his chair sweating like crazy and a pounding heart rate.

Needless to say, they dont hand around live epi pens lol

 

[volff21]

wow three steps ahead of Pa & NY

 

[Jon]

PA has the EXACT same rules with Epi Pens... ALL the staff of the service must be trained, and the Medical Director must approve the service... but PA EMT's can use EpiPens too.

PA restricts 2-Pam and Atropine to EMT-P and above.
PA restricts any advanced airway skills to medics and above.

So we are only 2 steps behind

 

[fma08]

Sounds like you guys just got caught up to ND and MN.

 

[BLSBoy]

Hooooly crap......:blink:

Now, if they can just get the First Grade Council dissolved, all BLS ambulances on par with each other, eg same equipment, same inspection process, and oh yea, 2 EMTs on it at all times!
No more of this one EMT and one driver crap. :angry:

 

[NJN]

Now, if they can just get the First Grade Council dissolved, all BLS ambulances on par with each other, eg same equipment, same inspection process, and oh yea, 2 EMTs on it at all times!
No more of this one EMT and one driver crap.

But that would require EMT training fund for the volly squads, it would also require effort from them and their members, and last time i checked effort is a big no no. (I'm on a 1/2 paid 1/2 volly squad so we have to adhere to the paid service regulations even tho we don't have the money for it)

 

[BLSBoy]

But that would require EMT training fund for the volly squads, it would also require effort from them and their members, and last time i checked effort is a big no no. (I'm on a 1/2 paid 1/2 volly squad so we have to adhere to the paid service regulations even tho we don't have the money for it)

Do you bill for services?
The issue of no money to do things is a sad, pathetic arguement.
Do you have paid trashmen?
Even better, is your community a part of a regionalized service?
There is a way to bring in funding, argue for career staffing, and reduce overhead costs.

And I won't even charge you a consultants fee. h34r:

 

[BLSBoy]

If you are on the agency displayed on you shirt, then y'all have NO excuse for going fully career.
Average of just under 5 calls a day, and they are still volunteer?
And they don't bill for services.
Figure you get an average return of 150 dollars per trip.
That is assuming that more then half don't pay. Average billing for BLS in many areas is 400 dollars, plus mileage, and interventions.
Some people have excellent insurance. Some just don't pay.
Either way, billlng for services, and assuming the statistics posted on the squad website, and the city website are correct, then you could be bringing in over $270,000 a year.
Now, if you want to go career, figure 35,000 a year for an EMT, x2 EMTs per shift, x3 shifts (24/48)
Salary comes out to $210.000 a year. Now I know, with benefits, and retirement, it will increase, probably to almost 400,000 a year.
Implement an EMS assessment on the community.
Charge each household 25 dollars per year, you get another aprox $200,000.
Now, you charge the "hundreds of businesses" in the community, it brings down the cost for each household.
And you can even make it a combo dept to put up a second rig, standbys, and for that Heavy Rescue.

You combine with neighboring areas, and you can have a career Chief, faster response times, and the more communities you get together, then you can get a "special ops" team together. Paid one at that.

Once again, you can skip paying me the fee, and just send me a t shirt. -_-

 

[NJN]

Yes we bill for services, the majority doesn't pay, we have around 10-14 calls per 12 hours. I don't know what website your talking about, we don't have one and the city doesn't want to acknowledge that we exist, meaning we get no money from them. 80% of shifts are paid shifts. In addition to that we spend most of any return we get on maintaining our fleet and building. We can only afford to pay for one crew on at any time, and trust me if we could run a second we would, and you mentioned Heavy Rescue, we don't have anything of the sort.

 

[BLSBoy]

OK, my apologies, I googled, and ended up with SOUTH Plainfield.
You should look into consolidating with local agencies to reduce overhead costs, as well as combining dispatch centers, to reduce dispatch costs.
A good PR presentation to the City Fathers could help wake them up.

Also, combining collection agencies could result in more revenue...

Good luck man.