Oxygen in TX

[Sydcomebak]

I was an EMT in PA for a while and now live in TX. I work security downtown and the medical kits at the building include oxygen. The "first responders" are CPR/AED certified. Should I be worried about Scope of Practice issues with these guys (and myself w/ an out of state cert) giving O2 to patients?

 

[Stephanie.]

I was an EMT in PA for a while and now live in TX. I work security downtown and the medical kits at the building include oxygen. The "first responders" are CPR/AED certified. Should I be worried about Scope of Practice issues with these guys (and myself w/ an out of state cert) giving O2 to patients?

O2 is a controlled drug, First responders are administering oxygen on the streets, and yes- it is out of their scope of practice. But no one enforces it. Most companies have their on site first aid personnel identified. If your employer recognizes you as one of their first aid personnel then go for it. If not, then I wouldn't try and be Rickey Rescue just because you hold a cert, especially since it is out of state.

 

[Sydcomebak]

Anyone whose turn it is to sit in the chair next to the bag is the first responder when the medical call comes in. Sometimes it is me, most of the time, no.

 

[Sydcomebak]

Also, I should point out that it's a low-flow pull-ring tank, so no one will be burning anyone with 25L via canula.

 

[Jay]

Also, I should point out that it's a low-flow pull-ring tank, so no one will be burning anyone with 25L via canula.

Just a side point but due to the design of a nasal cannula an entire 25LPM or even 15LPM would not be able to be "pushed" through. Ideal rates of flow are between 2LPM and 6LPM and I don't think that anything much greater than 6LPM would even "push". Think of it like trying to shoot enough water from a faucet into a straw, it's just too small.

Either way I can't really see anyone severally hurting someone with 15LPM if there was a severe medical/trauma necessity. Maybe COPD would be the exception but even while waiting a few minutes for an ambulance or advanced care I don't see there being any harm in it.

 

[Sassafras]

Wait, FR are not O2 permissable in TX? In PA we were trained and it is within our scope of practice to administer O2. Not via cannula just high flow NR but still we tested at the state level with it.

 

[CowboyMedic]

For the record this is how Texas defines scope of practice:
Texas does not have a rigid scope of practice for EMS personnel defined in rule or law as some other states do. That’s because Texas Medical Board rules allow physician-medical directors to delegate medical tasks to EMS personnel as long as they’ve trained and/or verified and documented the training, in the context of the Texas Medical Board language of 22 Texas Administrative Code, Section 197.1. Medical personnel with specific training and competencies may be able to perform skills outside the bounds of traditional practice if their medical director evaluates, provides additional training, authorizes them accordingly and develops protocols to match. For the purpose of this explanation, traditional practice may be defined as the knowledge and competencies described in the DOT National Standard Curriculum at each EMS training level - dshs.state.tx.us

Texas has five levels of certification. The highest is licensed paramedic, followed by EMT-P, EMT-intermediate, EMT-basic and emergency care attendant (ECA). - dshs.state.tx.us

These are the 5 level of certification used to define a person as EMS Personnel. A FR is not certified and last I check when I took my AHA BLS Healthcare Provider for CPR/AED O2 is not included in the course so +1 to Stephanie for the controlled drug.
However since its a lowflow O2 I dont think you have to worry about over oxygenating someone and if your PA State EMT license is still good and you are NREMT just apply for the instate license. Its just a few forms and some green backs. Texas doesnt have a state test.

 

[Shishkabob]

No, cowboy, LP is not above Paramedic. They are essentially, and realistically, the same level.

 

[CowboyMedic]

No, cowboy, LP is not above Paramedic. They are essentially, and realistically, the same level.

Linuss that is straight from the Texas Department of State Health Services website word for word. If you dont like it you can take it up with them. Follow the link its the first paragraph after all the red bullets. I was just using the quote to show that a FR w/ CPR & AED certs is not classified as EMS Personnel in the state of Texas for the argument of what scope of practice they fall under. Realistically yes the only diff from P and LP is a college degree.

 

[Shishkabob]

Yes, I know what DSHS states, but they were also the ones that made the failed level of LP (as far as a non-protocol making body can fail, I guess) , refusing to follow through with their plans and instead just using it as a way to make a bit more $$$ every time someone re-certs, and I was just making sure you didn't really think LP is "higher" than CP.



And FYI, FR (MFR) is the same as ECA, Texas just uses a different name.





(Note: Yes I know it lays more on the agencies not rewarding LP, but still)

 

[CowboyMedic]

Oh I know. Its all a joke. State cert is just a money thing just like everything else that involves the state and EMS. To get state cert you do the same thing to get national cert but it cost more. And people wonder why their ambulance bill is so high. LOL

 

[usalsfyre]

The truly twisted thing is a "Licensed Paramedic" is not really licensed at all, they simply receive a certification that has the word licensed on it.

Chances are the security agency is registered as a First Responder Organization with the local EMS agency. This grants them a medical director under which to work.