question on TEXAS SCope of Practice

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emt junkie

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Just wanted some info regarding some things in Texas. As I have read through many threads here I know there are alot of people with knowledge about Texas.

In Texas I understand there is no Standard Scope of Practice and that Texas is basically a Medical Director driven State. WIth that being said I have a question.

Our Service has instituted new protocols that allow Basics to start IV's if the have been properly trained. This not for bolus or drug admin but mainly for the purpose of have locks in place for drug admin when they get to the ER. The service doesn't always have an I or Medic on board. Our Medical director has signed off on the new protocols.

Now that being said I have been trained and am very comfortable starting lines. I have being doing this as part of my Paramedic CLinicals.

My question is will I be help against in EMS RUles in Texas if I do these being that I am still a Basic and our Medical Director has approved this.

If you could provide a link to the EMS rule in Texas to support your answer would be appreciated.

Thanks in advance to your answers.
 
I'll look for a link when I get back to the station, but yes, you can do whatever your medical director authorizes you to do. Our city PD tac medic team are all Basics and they can start IVs, needle decompression, King and ETI, and I believe surgical cric (though I'd have to double check).
 
emt junkie said:
Just wanted some info regarding some things in Texas. As I have read through many threads here I know there are alot of people with knowledge about Texas.

In Texas I understand there is no Standard Scope of Practice and that Texas is basically a Medical Director driven State. WIth that being said I have a question.

Our Service has instituted new protocols that allow Basics to start IV's if the have been properly trained. This not for bolus or drug admin but mainly for the purpose of have locks in place for drug admin when they get to the ER. The service doesn't always have an I or Medic on board. Our Medical director has signed off on the new protocols.

Now that being said I have been trained and am very comfortable starting lines. I have being doing this as part of my Paramedic CLinicals.

My question is will I be help against in EMS RUles in Texas if I do these being that I am still a Basic and our Medical Director has approved this.

If you could provide a link to the EMS rule in Texas to support your answer would be appreciated.

Thanks in advance to your answers.
Click to expand...

I don't have the ruling handy (I'll look it up if not answered once I get home and off my phone) but I know of one service I've been applying with (City of Beaumont) that their EMS Director told me their EMT-Bs start IVs on a regular basis. So you should be fine as long as it's been written up in your protocols and approved by the medical director

EDIT: For that matter when I worked in far west TX, I heard there was at least one agency in the area that used basics to start IVs and their EMT-Is were pretty much scoped like a medic in some states
 
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Texas is a delegated practice state. If your medical control allows it and teaches you it, there isn't a damn thing the state can do. If he wants EMTs to do IVs, you're golden.



I'm not going to provide the actual statute, but you are more than welcome to email DSHS and ask them, as in reality, that's the smart thing to do if you're worried about the actual legalities.
 
I'm curious why you would go through the hassle and expense of credentialing Basics to perform IVs if they're not going to utilize them for anything though.
 
Recruitment


"Our protocols are aggressive. We allow our EMTs to start IVs in the field!"
 
Linuss said:
Recruitment


"Our protocols are aggressive. We allow our EMTs to start IVs in the field!"
Click to expand...

Yup, I'd sign up :) see it appeals to the lowest common denominator.
 
You are an extension of your Medical Director's medical license. If he/she wants EMT-Bs to start IVs, then it is them who will be held accountable for that, not you. The national standard does not allow EMT-Bs to start IVs but if your state refers to your agency's/city's medical director, then what they say goes (somewhat).

Its really a tricky issue, but I've always been told that we are extensions of the medical director and as long as we contact them or follow standing orders, then its on them.
 
jcalNYC said:
You are an extension of your Medical Director's medical license. If he/she wants EMT-Bs to start IVs, then it is them who will be held accountable for that, not you. The national standard does not allow EMT-Bs to start IVs but if your state refers to your agency's/city's medical director, then what they say goes (somewhat).

Its really a tricky issue, but I've always been told that we are extensions of the medical director and as long as we contact them or follow standing orders, then its on them.
Click to expand...

The way I describe how TX does things to people here in NM is this:
'Other states have a cap and everyone is trained to know everything at this cap and under it. In TX It's a floor. Everyone must be competent in this set of skills and knowledge at each level, and each service can add onto it as they and their medical director see fit'

In TX it's not somewhat, it IS how things are.
 
And it IS how things should be nationally.


No stupid bureaucrats deciding if RSI is good, or what opiods for analgesia, etc etc.
 
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