scope expansion in Washington state?

waaaemt

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I heard from our base station training that Washington is aiming for making the base level scope basically EMT-I? Also medic scope will be expanding to accommodate community paramedic programs to do sutures and prescribe meds etc? Anyone have any info on this? Like when they'll implement these changes and when medic schools will start changing curriculum?
 

NomadicMedic

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Which county is that? I find it VERY hard to believe that King County would allow any changes along those lines.
 

Luno

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Well....

Which county is that? I find it VERY hard to believe that King County would allow any changes along those lines.
You wouldn't think that they would give EMTs, needles and selective spinal immobilization criteria, but the times they are a changing....
 

waaaemt

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Which county is that? I find it VERY hard to believe that King County would allow any changes along those lines.
Haha well King county is kind of it's own thing. Idk of things will change til Coppus is gone but I mean.. the rest of the state... Cause since pretty much every other county outside of sno, king and pierce offers IV and other endorsements, they want to basically add all those endorsements onto the EMT scope . And along with the increased education, looking to increase wages as well. Like I said they are working to change curriculum at emt and medic classes.
 

PotatoMedic

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Haha well King county is kind of it's own thing.
My bet is king county will be forced into things. Heck they are giving us needles and epi! And last year the medical director said never would happen. And it happened.
 

waaaemt

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My bet is king county will be forced into things. Heck they are giving us needles and epi! And last year the medical director said never would happen. And it happened.
My company is transitioning to needle drawn epi too! What county are you in?
 

PotatoMedic

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Mostly king. Also all the fire departments in king county are going to draw up as well. (Though im not sure about Seattle)
 

NomadicMedic

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I taught some of the Epi in service in Jefferson County before I moved. That was a little sketchy. Everyone is transitioning to Epi ampules from Epi-pens. Now the BLS crews can throw away 5 dollars worth of Epi instead of 300 dollars in Epi pens when they expire.

I think advanced EMTs are valuable in areas where ALS is sparse (like eastern Washington) Putting advanced EMTs in Pierce and Snohomish, where there are 3 medics on every fire engine is silly.
 

Angel

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I think continuity of care would be a disaster. unless the AEMT keeps the patient
 

Angel

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yea but usually the EMTs don't do much and they definitely dont (here at least) give meds like epi. pretty much if a non transporting medic (ie fire medic) has to give anything except maybe albuterol/Benadryl ect they are supposed to keep that pt. (if the pt is 'unstable')
I just feel like there a lot of room for error for an emt to be giving medications and the medic has to pick up the pieces if for whatever reason the wrong med/dose was given.
 

unleashedfury

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yea but usually the EMTs don't do much and they definitely dont (here at least) give meds like epi. pretty much if a non transporting medic (ie fire medic) has to give anything except maybe albuterol/Benadryl ect they are supposed to keep that pt. (if the pt is 'unstable')
I just feel like there a lot of room for error for an emt to be giving medications and the medic has to pick up the pieces if for whatever reason the wrong med/dose was given.
Thus if they plan to lay out a AEMT program their is going to be a education standard that these clinicians will have to meet.

Whats the difference in margin of error of a EMTI99 or AEMT administering a medication vs a paramedic administering the same medication?

I understand maybe in your area EMT"s may be reduced to knuckle dragging gurney jockeys. But there are great EMT's out there very knowledgeable ones and there are ones that aren't exactly cream of the crop. Same goes for AEMT and Paramedics
 

Angel

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all things being equal yea sure more education and why not, but why not just have them become medics?

our didactics lasted ~1 year and I felt like that still wasn't enough time! there is so much to know about paramedicine and medicine in general.
If they are so great and knowledgeable they would definitely make good medics so instead of tacking on skills and education why not just go for the whole thing and become a paramedic?

To me that comparison is like comparing a medic to an MD (just a little more training and schooling right?) theres a lot that factors into it IMO.


Take this with a grain of salt because living in CA, especially in metro areas we don't have to worry about ALS units being 20+ minutes out while BLS just twiddles their thumbs on scene.
I am by no means trying to sound arrogant or elitist but at some point I think the lines become blurred.
 

Drax

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I taught some of the Epi in service in Jefferson County before I moved. That was a little sketchy. Everyone is transitioning to Epi ampules from Epi-pens. Now the BLS crews can throw away 5 dollars worth of Epi instead of 300 dollars in Epi pens when they expire.

I think advanced EMTs are valuable in areas where ALS is sparse (like eastern Washington) Putting advanced EMTs in Pierce and Snohomish, where there are 3 medics on every fire engine is silly.
I know Tacoma uses ampules instead of Epi-pens. Shame, auto-injector just looks so much cooler.

And I agree with you about making it a requirement for advanced EMTs in Pierce and Snohomish being unnecessary. Wouldn't mind the training, but yeah, around here, pretty much the only BLS based transports are private ambulance companies it seems.
 

hobozach

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Not sure if I understand the OP correctly, are they planning on expanding the scope of the EMT-B ? by adding endorsements and such? or are they planning on making the AEMT the minimum standard of care?
In response to "Why don't they just become medics?" I can speak for Volly EMS, that not all volunteers want to go through the time and expense to get their medic. We only staff one ALS unit at my service and many surrounding towns are BLS only.
 

waaaemt

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Not sure if I understand the OP correctly, are they planning on expanding the scope of the EMT-B ? by adding endorsements and such? or are they planning on making the AEMT the minimum standard of care?
In response to "Why don't they just become medics?" I can speak for Volly EMS, that not all volunteers want to go through the time and expense to get their medic. We only staff one ALS unit at my service and many surrounding towns are BLS only.
They are aiming towards eliminating endorsements and making AEMT the base level.
 

waaaemt

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all things being equal yea sure more education and why not, but why not just have them become medics?

our didactics lasted ~1 year and I felt like that still wasn't enough time! there is so much to know about paramedicine and medicine in general.
If they are so great and knowledgeable they would definitely make good medics so instead of tacking on skills and education why not just go for the whole thing and become a paramedic?

To me that comparison is like comparing a medic to an MD (just a little more training and schooling right?) theres a lot that factors into it IMO.


Take this with a grain of salt because living in CA, especially in metro areas we don't have to worry about ALS units being 20+ minutes out while BLS just twiddles their thumbs on scene.
I am by no means trying to sound arrogant or elitist but at some point I think the lines become blurred.
Because having every EMS provider be a medic is totally unnecessary... Also your illustration of EMTs compared to medics and medics compared to MDs is totally contradictory. You're saying every medic should just go for the whole thing and become an MD? But then you're saying that's wrong? What?
 

waaaemt

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I know Tacoma uses ampules instead of Epi-pens. Shame, auto-injector just looks so much cooler.

And I agree with you about making it a requirement for advanced EMTs in Pierce and Snohomish being unnecessary. Wouldn't mind the training, but yeah, around here, pretty much the only BLS based transports are private ambulance companies it seems.
How about an epi pen where you can just remove and replace expired epi doses? Who wants to go in on that with me? :p

anyway, I totally disagree with AEMT being unnecessary in sno, king and pierce counties. Especially for the private amb guys who get ridiculous medic dumps all the time. I always hear of medics dumping what looks like a drunk bum who actually has 20 stab wounds and bp of 60/p and stuff like that. I even talked to an AMR guy who had Seattle medics dump a STEMI on him. And personally I've taken in a girl who was pregnant, was punched in the belly, had 10/10 abdominal pain, SVT and 80 something/p bp.

And I'm not saying all medics around here dump patients, 90% are amazing but a few are just lazy
 
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