Nightwatch comes to Tampa, Florida!

[NysEms2117]

define ALS. We are not medics, but we do have AEMTs, and considering our extended transport times and rural nature, our EMTs have a slightly expanded scope of meds from the national registry, but I wouldn't consider it ALS. And by meds I mean EMTs can give albuteral, ASA, narcan, epi, glucagon, oral glucose, etc... and AEMTs by IV/IO can give D50, LR, NS, etc...

But no, no RSI, no intubation only combi/king/igel, no cricothyrotomy, I can place, acquire, and transmit a 12-lead to the hospital, but no interpretation. No pacing, no manual defib, no EtCO2 (I guess we can obtain, but not interpret), no thrombolytics, no pain meds. Which makes transporting that dislocated shoulder 30min on a bumpy road a long LONG trip for both us and them. It also means that if you go into anaphalaxis and epi doesn't stop it, you probably are going to die before you get to the hospital, since we can't cric.

ALS is any invasive procedures in my personal opinion

 

[EpiEMS]

Though it's odd seeing one person in the back of an ambulance. Being an all volunteer rig, it's not out of the ordinary to have 3-4 people in the back treating the PT at the same time. I actually think 3 and a driver. One on the PT's right, doing questioning/IV/Meds/etc, one on their left doing vitals, and one in the air chair either managing airway, or as with most calls, documenting times and filling out the run sheet.

That's beyond excessive - how many BLS calls (for a person of average or lesser weight) require anything more than two personnel? Even most ALS calls don't really need more than one provider and a driver/lifting aide.

volly with ALS capabilities????

Not so uncommon - even in NYS, there are many volunteer ALS services, especially in Long Island and rural areas upstate. Most of these seem to run at the risk-loving AEMT-CC level.

ALS is any invasive procedures in my personal opinion

Invasive is subjective, my good sir - a BGL is "invasive" in some places because there's a needle involved). I tend to agree with your statement, but it needs to be qualified - ALS procedures are any invasive procedure not also performed by a layperson (e.g. EpiPen administration, BGL), but ALS doesn't just mean a procedure - for billing purposes, it's an "ALS assessment".

 

[medichopeful]

View attachment 3502

Someone might want to check the electrolytes of the person with that EKG. Doesn't look healthy

 

[NysEms2117]

That's beyond excessive - how many BLS calls (for a person of average or lesser weight) require anything more than two personnel? Even most ALS calls don't really need more than one provider and a driver/lifting aide.



Not so uncommon - even in NYS, there are many volunteer ALS services, especially in Long Island and rural areas upstate. Most of these seem to run at the risk-loving AEMT-CC level.



Invasive is subjective, my good sir - a BGL is "invasive" in some places because there's a needle involved). I tend to agree with your statement, but it needs to be qualified - ALS procedures are any invasive procedure not also performed by a layperson (e.g. EpiPen administration, BGL), but ALS doesn't just mean a procedure - for billing purposes, it's an "ALS assessment".

In my personal opinion aemt-CC isn't a healthcare provider role to sneeze at. They are pretty advanced. Higher then aemt-I.. Which is what the rest of the country is at if I'm correct? An epi pen is specifically stated in protocols, nationwide if I'm correct too?


Sent from my iPhone using Tapatalk

 

[cruiseforever]

Though it's odd seeing one person in the back of an ambulance. Being an all volunteer rig, it's not out of the ordinary to have 3-4 people in the back treating the PT at the same time. I actually think 3 and a driver. One on the PT's right, doing questioning/IV/Meds/etc, one on their left doing vitals, and one in the air chair either managing airway, or as with most calls, documenting times and filling out the run sheet.[/QUOTE]

Sounds like St. Paul Fire.

 

[VentMonkey]

Should be paragod

It should be neither.

 

[EpiEMS]

In my personal opinion aemt-CC isn't a healthcare provider role to sneeze at. They are pretty advanced. Higher then aemt-I.. Which is what the rest of the country is at if I'm correct? An epi pen is specifically stated in protocols, nationwide if I'm correct too?

It's not so much the skills, but the training - NYS generally expects 300-400 hours of training, but the collaborative protocols provide for quite a range of skills that seem (ETI, transcutatneous pacing, electrical cardioversion, etc.) pretty advanced for such low educational requirements above the EMT level. Not to mention that the national scope has removed this EMT-I99 level (by giving AEMT more than EMT-I85, namely, and allowing folks from I99 to bridge to NRP).

As far as EpiPen, I would agree that assisting self-administration is in national scope. However, while EpiPen administration is considered an invasive practice, by definition, it is not "invasive" in the sense that a layperson "cannot" do it.

 

[NysEms2117]

so much the skills, but the training - NYS generally expects 300-400 hours of training, but the collaborative protocols provide for quite a range of skills that seem (ETI, transcutatneous pacing, electrical cardioversion, etc.) pretty advanced for such low educational requirements above the EMT level.

I can't figure out how to quote on tapatalk lol. However are those standard protocols or online medical direction?? I'm not familiar with CC emt. Only CC medic

 

[DrParasite]

I can't figure out how to quote on tapatalk lol. However are those standard protocols or online medical direction?? I'm not familiar with CC emt. Only CC medic

that is what he is referring to, CC EMT is CC medic.

 

[VentMonkey]

It's not so much the skills, but the training - NYS generally expects 300-400 hours of training, but the collaborative protocols provide for quite a range of skills that seem (ETI, transcutatneous pacing, electrical cardioversion, etc.) pretty advanced for such low educational requirements above the EMT level. Not to mention that the national scope has removed this EMT-I99 level (by giving AEMT more than EMT-I85, namely, and allowing folks from I99 to bridge to NRP).

As far as EpiPen, I would agree that assisting self-administration is in national scope. However, while EpiPen administration is considered an invasive practice, by definition, it is not "invasive" in the sense that a layperson "cannot" do it.

I can't figure out how to quote on tapatalk lol. However are those standard protocols or online medical direction?? I'm not familiar with CC emt. Only CC medic

that is what he is referring to, CC EMT is CC medic.

http://www.upstate.edu/emergency/education/emstat/courses/emt_cc.php

This cert? Hmm, is this specific to NYS, or east coast states? And how does this differ from that "cardiac tech" cert?

waiver: total west coaster here, boys; bear with me...

 

[NysEms2117]

that is what he is referring to, CC EMT is CC medic.

there's a difference, NYS has EMT-B-> EMT-I -> CC-EMT-> paramedic-> CC-Medic. If im not mistaken. (https://www.health.ny.gov/professionals/ems/training.htm)
Then the CC-P certifications that go with FP-C and all that alphabet soup.

 

[NysEms2117]

This cert? Hmm, is this specific to NYS, or east coast states? And how does this differ from that "cardiac tech" cert?

This cert is NYS specific i think??? One of the wikipedia pages has a huge list of all the types of EMT's, Now Dr.P correct me if im wrong, but NJ has EMT-B or MICP(mobile intensive care paramedic) as the only 2 ems providers for the state. Again thats just what i think, and generally im wrong . However from what I can gather, they are a paramedic, with less hours of training. Much much less hours of training

Edit: https://en.wikipedia.org/wiki/Emergency_medical_responder_levels_by_U.S._state
Found it

 

[DrParasite]

It's a completely NYS cert... sort of like Paramedic-light. They can do almost as much as a medic, but they need to call medical control more frequently. And there are some clinical difference. The CC Medic is a con ed class, but not a state level of training

No one else has a cert like this, although IIRC, VA has an EMT-cardiac who can do similar stuff.

 

[EpiEMS]

So NYS Part 800 delineates it this way:

CFR (basically NREMR)

EMT (basically NREMT)

AEMT (basically NRAEMT, plus ETI for apneic and pulseless adults), which used to be called AEMT-I

EMT-CC (i.e. the former EMT-I '99, similar to RI's EMT-C, among others), also called AEMT-CC

EMT-P (i.e. Paramedic), also called AEMT-P

That's all they've got.

EMT-CC is essentially the same as EMT-I '99, which is "Medic-lite". In NYS, as far as I am aware, many areas require more on-line consultations for EMT-CCs to perform procedures than a paramedic would require.

 

[VentMonkey]

It's a completely NYS cert... sort of like Paramedic-light. They can do almost as much as a medic, but they need to call medical control more frequently. And there are some clinical difference.

Again, this mirrors the average LA County fire paramedic, and their scope. While I can certainly see and understand the seemingly unfortunate gap in education, this is exactly, to a tee, how they function.

Is it right? IMO, no. They're fooling the average layperson by calling themselves paramedics when clearly it's evolved outside of this bubble since the 70's. Obviously, not every fire department in California operates this way, nor do they hold their paramedics to this model, but it's just so sad the politics often involved "behind the scenes" with things of this nature.

Why not make a TV documentary about that?

 

[NysEms2117]

So NYS Part 800 delineates it this way:

CFR (basically NREMR)

EMT (basically NREMT)

AEMT (basically NRAEMT, plus ETI for apneic and pulseless adults), which used to be called AEMT-I

EMT-CC (i.e. the former EMT-I '99, similar to RI's EMT-C, among others), also called AEMT-CC

EMT-P (i.e. Paramedic), also called AEMT-P

That's all they've got.

EMT-CC is essentially the same as EMT-I '99, which is "Medic-lite". In NYS, as far as I am aware, many areas require more on-line consultations for EMT-CCs to perform procedures than a paramedic would require.

If i was smart in the EMS field this is how i would've worded it

 

[pogoemt]

Y'all I just wanted to bring exposure to a show in my city. :O

 

[StCEMT]

Three people in the back just sounds like more trouble. I had two other medics in the back on Saturday and I wish I had told one to just stay out. It was more cramped and I didn't need more than one as a "just in case" set of hands.

 

[Giant81]

I think it also comes down to the size of the rig and who is doing what. I've run with groups where you really did feel like the third wheel. While the other two AEMT's were tending to the PT, I (EMT) just sat in the air chair and documented everything. Helps us get back into the shed faster so we can go home. With volunteer we don't turn and burn on our next call, it's run, do paperwork, go home, wait a couple days/week for some other call to show up. So every call is probably both your first and last of the day.

With size, we have a big enough rig we have bench seats on both sides of the PT, and an air chair. Means we have seatbelts enough for 5 providers in the back plus PT and driver make a total of 7 bodies in the truck with room for a passenger up front. While 5 people in the back would be chaos, I think 3 can be well managed if you have the room. During the day when there are less volunteers in town (everyone's at work) it's not unusual to run 2 in the back and a driver.

I've also been on a CPR call where our autopulse was not working, and we did manual CPR the whole way to the hospital, a 20min ride. We had 4 of us swapping off and I was still exhausted when we got there.

 

[EpiEMS]

Y'all I just wanted to bring exposure to a show in my city. :O