States and EMT-B Morphine Administration

[RocketMedic]

Can do.

Back on topic, I'd agree with one of the other replies. If you want to be given the ability to provide medication, earn that ability with knowledge and education. Don't be a Basic wanting loose protocols without education.

 

[RipCity]

Adverse conditions are not an acceptable excuse for poor education and shouldn't be an excuse for poor care. Besides, even in an infantry role, those situations are uncommon, and the interventions are CLS-level.

I have new medics who can't tell me what an IV IS, much less how/why it works, when or where to start one, and what can be done with it. Theuly literally only know for volume replacement and dehydration, and can't even explain how fluids correct those.

I never said they were an excuse. I dont know what to tell you brother it sounds like Ft Sam is pumping out crap medics or your in a crap unit does doesnt put a big emphasis on the "why?" of medicine. Our PA held classes 2 or 3 times a week and made tests for us about A&P, pharmacology etc. they even had EMT-B refreshers with mock scenarios just so we stayed current on the knowelage. He would never just hand us random drugs to give.

 

[RocketMedic]

I never said they were an excuse. I dont know what to tell you brother it sounds like Ft Sam is pumping out crap medics or your in a crap unit does doesnt put a big emphasis on the "why?" of medicine. Our PA held classes 2 or 3 times a week and made tests for us about A&P, pharmacology etc. they even had EMT-B refreshers with mock scenarios just so we stayed current on the knowelage. He would never just hand us random drugs to give.

Nailed it on both counts I think. New 68w is pretty much untrained.

 

[ffemt8978]

Last warning...stop the threadjacking and stay on topic.

 

[DHFD402]

Morphine is in no way, shape, or form able to be administered by an EMT Basic...

 

[Basermedic159]

I hope this is not too off topic, but I think the drug formulary/skills of an EMT and an Intermediate should be combined. OEMS has been talking about consolidating them for about 5 years now. Instead of EMT-B, EMT-I, EMT-P It would just be Advanced EMT and EMT-Paramedic. I think its a great idea. Of course the basics would need to have additional training, but I think this is what needs to happen.

 

[Tigger]

Morphine is in no way, shape, or form able to be administered by an EMT Basic...

Not sure about now, but I have read on this forum of basics in Montana (I think) administering morphine via autoinjector following OLMC approval.

I hope this is not too off topic, but I think the drug formulary/skills of an EMT and an Intermediate should be combined. OEMS has been talking about consolidating them for about 5 years now. Instead of EMT-B, EMT-I, EMT-P It would just be Advanced EMT and EMT-Paramedic. I think its a great idea. Of course the basics would need to have additional training, but I think this is what needs to happen.

I would support such an idea, the death of the BLS emergency ambulance needs to be hastened in many areas.

 

[JPINFV]

I would support such an idea, the death of the BLS emergency ambulance needs to be hastened in many areas.

Not according to a Facebook EMS group discussion. Those poor brave heroic EMTs are the only thing racing the reaper, armed only with an oxygen tank and compassion.


Ever write something that almost makes you vomit because you have to actually think about the words as you write it? Yea, that just happened to me.

 

[Handsome Robb]

I hope this is not too off topic, but I think the drug formulary/skills of an EMT and an Intermediate should be combined. OEMS has been talking about consolidating them for about 5 years now. Instead of EMT-B, EMT-I, EMT-P It would just be Advanced EMT and EMT-Paramedic. I think its a great idea. Of course the basics would need to have additional training, but I think this is what needs to happen.

The thing I don't understand is if there are only two levels why it has to be "Advanced EMT"? Why not just EMT and Paramedic? ILS and ALS. Maybe a BLS designation in certain rural areas but limit it to that.

But that's another argument all together.

I still stand by my stance that BLS providers and even some ILS providers have no business dealing with and administering narcotics until the education standard increases.

The autoinjector idea is cool but then you are pretty limited on your decision for dosing. Especially in weight based pediatric dosages.

 

[JPINFV]

Why not "Basic Paramedic" and "Advanced Paramedic" or something similar. After all, until we can provide a single unified name do we really have a foot to stand on when a news article calls us "ambulance drivers"?

 

[Handsome Robb]

Why not "Basic Paramedic" and "Advanced Paramedic" or something similar. After all, until we can provide a single unified name do we really have a foot to stand on when a news article calls us "ambulance drivers"?

You make a very good point sir.

Here even though we ride I/P all the firefighters always tell people "Sir/Ma'am the Paramedics are here."

 

[JPINFV]

You make a very good point sir.

Here even though we ride I/P all the firefighters always tell people "Sir/Ma'am the Paramedics are here."

To be fair, it was my very first blog post...

http://emtmedicalstudent.wordpress.com/2010/10/31/whatarewe/

 

[RocketMedic]

As ling as I'm not "Jeeves"...

 

[Medic Tim]

Why not "Basic Paramedic" and "Advanced Paramedic" or something similar. After all, until we can provide a single unified name do we really have a foot to stand on when a news article calls us "ambulance drivers"?

Most of Canada switched to Paramedic levels years ago. It is a much more understood term to the public. Primary Care Paramedic- PCP is in line with an Intermediate, Advanced Cara Paramedic- ACP is in line with the paramedic, and Critical Care Paramedic -CCP is mostly hospital based. very few of them skill set closer to a PA than anything else. In alot of areas the PCP is the minimum to run on a truck.

 

[R99]

Why not "Basic Paramedic" and "Advanced Paramedic" or something similar. After all, until we can provide a single unified name do we really have a foot to stand on when a news article calls us "ambulance drivers"?

We've changed titles a bunch of times

1972 paramedic trial in auckland
1975 ambulance officer level formally established
early 1980s intermediate care officers introduced
mid 1980s advanced care officer (paramedic) established

1980s to 2002 ambulance officer, intermediate care officer, paramedic

2002 to 2009 ambulance officer, paramedic, advanced paramedic

2009 onward emergency medical technician, paramedic, intensive care paramedic

in US you use EMT and Paramedic no?

 

[JPINFV]

Most of Canada switched to Paramedic levels years ago. It is a much more understood term to the public. Primary Care Paramedic- PCP is in line with an Intermediate, Advanced Cara Paramedic- ACP is in line with the paramedic, and Critical Care Paramedic -CCP is mostly hospital based. very few of them skill set closer to a PA than anything else. In alot of areas the PCP is the minimum to run on a truck.

That's basically where I got [stole] the idea from...

 

[triemal04]

Most of Canada switched to Paramedic levels years ago. It is a much more understood term to the public. Primary Care Paramedic- PCP is in line with an Intermediate, Advanced Cara Paramedic- ACP is in line with the paramedic, and Critical Care Paramedic -CCP is mostly hospital based. very few of them skill set closer to a PA than anything else. In alot of areas the PCP is the minimum to run on a truck.

How has that worked out as far as public perception goes? I'm guessing the difference in healthcare systems and how EMS is run will make a difference, don't know about any difference in media coverage/accuracy, but I've been curious for awhile.

The problem I can see with any designator that is designed as either XXX-paramedic or EMT-XXX is that, even though there are different level's, they still sound very much alike. And in the US at least, it is much more common for people to assume that everyone is an EMT with the same skillset; either guessing that to much or to little will be done. My guess would be it's the same in Canada; most people assume that every PCP, ACP and maybe CCP are all going to do/know the same things because they can't see the difference. But you can answer that better than me.

The NREMT seems to have caught on to this; EMT, Advanced EMT (still could be a problem) and Paramedic. Makes sense.

 

[Tigger]

You make a very good point sir.

Here even though we ride I/P all the firefighters always tell people "Sir/Ma'am the Paramedics are here."

Where I work at school the AMR crews made up "Colorado Springs Paramedics" hoodies and hats. They work P/B, yet you can be sure that the basics are all wearing the same stuff. I don't like it.

 

[docmoods]

in US you use EMT and Paramedic no?

Yea, depending on what state your in depends on the level of care, for instance in New Jersey there's only EMT-B (Basic only first aid with very little difference to first responder) and Paramedic. In most other states they recognize EMT-I (Intermediate) and they can perform higher medical treatment (IV, Combitube, Narcan ect.).

 

[MontanaEMT]

Montana EMT B's can do Morphine injecotr if they have the Medication endorsment