RT's in EMS

I've had a RT in the back with me a few times now, every time they were eager to share their knowledge.
 
akflightmedic said:
Does doing little mean the knowledge is little?
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No, but giving breathing treatments and setting up the biPAP doesn't seem like a good prereq experience for HEMS
 
LanceCorpsman said:
No, but giving breathing treatments and setting up the biPAP doesn't seem like a good prereq experience for HEMS
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And how do you think they got to the point to just give nebs and set up biPAP? Do you think they received a simple step by step instruction manual or do you think they had an education followed by clinicals? I mean, you know a real education...one which which requires everything becoming a EMT or Paramedic does not? An education which just about every medical profession requires (exception being EMTs and Medics).
 
We did clinicals with RT in medic school. While they couldn't do a lot the two that I worked with we're both incredibly knowledgable. I learned more about respiratory physiology, paths and vent management from them than I did in class.


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Their level of education is quite high: Not only is the minimum degree for an entry level practitioner an associate's degree, many (most?) RCPs move up to a bachelors degree and beyond...
That doesn't really exist in EMS, at least, not nearly to the same extent.
 
It would make a lot of sense to have one in HEMS. From what I hear, a lot of flight is critical care type transports. I would imagine a lot of intubated patients make up those flights. Having someone who has a strong knowledge in vent management would be a good thing. My vent training was just a portion of one day of class and an occasional patient already on a vent or that we put on one after intubating. They do it every day.
 
LanceCorpsman said:
No, but giving breathing treatments and setting up the biPAP doesn't seem like a good prereq experience for HEMS
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Op, again, think of it this way, it is way more than breathing treatments, and BiPap (pretty standard paramedic skills, FWIW).

It is their clinical expertise that these programs seek as others have mentioned, and are attempting to point out.

These folks generally know the ins and out of airway management top to bottom as this is their primary role, and what they focus on is school, hence the name.

Are paramedics more skilled than RT's at prehospital intubation? Well, yeah. Are they more skilled than them in other facets of airway management up to, and including ventilator management, which again, is a big part of prehospital critical care medicine? Hardly.

While again, there are some great critical care paramedics out there, (I strive to be a strong one myself, and have lots to learn), most of what paramedics do doesn't focus on one particular aspect of medicine, they (RT's/ RCP's) do.

Paramedics are often seen as a "jack of all trades, but master of none", which includes airway management (not to say one cannot seek mastery). We are trained providers in a prehospital setting; trained to treat, stabilize, and transport to a higher level of care, where higher level of care providers including respiratory therapists await our arrival, and work under a physicians orders directly to provide long term airway management until said patient can be weaned off of the ventilator.

Guess what many in-house docs do at hospitals, particularly with well known and respected RT's? They run stuff by them, and consult with them regarding their patients to see what it is that their goals should be for that particular patient. Why? Well because not every intubated patient doesn't fit one shoe.

A good clinician, whether prehospital, or in hospital realizes where there are great clinicians, and when to feed of, or run things through them for feedback and input.

How else is improvement achieved?

Together a strong critical care team regardless of the configuration could probably suffice in regards to figuring what it is a patient on a ventilator needs for transport, but RT's, IMO, often don't get the recognition that they deserve for the service that they actually provide, nor do they get recognition for their clinical knowledge.

I once had a pretty good RT friend I enjoyed working with. This lady could run circles around most of the CCT nurses at the company I was at back then, and often the hospital staff. She could have easily made it through PA school with her level of knowledge, perhaps even med school, and most definitely would have put any paramedics then, and even now that "I" know (including myself) to shame.
 
I was at work talking with an RT very briefly about this topic. I guess RT's are more geared towards CCT, and taking care of neonates since my go to HEMS agency specialzes in neonatal transports to tertiary care facilities. The RT's here told me that RT's arent trained to provide ALS, the only meds they can give even with physician orders are breathing treatments. I just had a narrow minded view of HEMS being...well picking pt's up from wrecks and picking up other medical emergencies from a rural setting not CCT.
 
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LanceCorpsman said:
I just had a narrow minded view of HEMS being...well picking pt's up from wrecks and picking up other medical emergencies from a rural setting not CCT.
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Again, we're about ~60/40 scene to IFT (CCT) calls, which seems to flip flop back and forth in favor of one another.

All 3 of our calls last shift were IFT/ CCT, 2 of which were on ventilators.
 
Nova1300 said:
What a great gig that must be. I would take that job tomorrow.
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Agreed. To leach off of an anesthesiologists' knowledge alone sounds enticing?
 
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