Taking Blood Glucose - Scope of Practice

gamma6 said:
i could see that with the hospitals being close by..

can you guys take saline bags during a transfer from a hospital?
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We can... It has to be less than %10 dextrose nor may it be mixed with any IV medications.
 
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guardian528 said:
Talking to our Clinical Education Specialist, he says its already through, and that we are going to be training and implementing it next year. possibly this is just for our company (amr), but one of the fire departments(it was either lompoc or guadalupe fire) already has expanded scope for EMT's so it is already somewhere in SB county.
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That'd be guadalupe fire, I asked my EMT bud about expanded scope last night and he said that because guadalupe fire is BLS and about 10-15 out of ALS range... that they have expanded scope for basics (what is included in that scope... im not sure)
 
emt1972 said:
We can... It has to be less than %10 dextrose nor may it be mixed with any IV medications.
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rock on, we have an employee with us out here from cali. when she first got on the trucks, most of the medics were mad cause she was used to the cali SOP and not ours where we are. she wouldn't do much at first cause she wasn't sure what she could and couldn't do. she's much better now...nice person too
 
gamma6 said:
rock on, we have an employee with us out here from cali. when she first got on the trucks, most of the medics were mad cause she was used to the cali SOP and not ours where we are. she wouldn't do much at first cause she wasn't sure what she could and couldn't do. she's much better now...nice person too
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In LA county... you can transport any pt with an IV provided that they're on a pump that has been already set by a nurse. (there may be certain restrictions the the prior statement)
 
DV_EMT said:
In LA county... you can transport any pt with an IV provided that they're on a pump that has been already set by a nurse. (there may be certain restrictions the the prior statement)
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Interesting how things change county to county, we can't take a pump (unless it is CCT)... It has to be gravity fed...

^_^
 
emt1972 said:
Interesting how things change county to county, we can't take a pump (unless it is CCT)... It has to be gravity fed...

^_^
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down here... basic scope is O2, defib, PO glucose (but no glucose needle stick) and vitals. pretty thin scope..... which is why i'm planning for medic school!
 
DV_EMT said:
down here... basic scope is O2, defib, PO glucose (but no glucose needle stick) and vitals. pretty thin scope..... which is why i'm planning for medic school!
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That's not far off from the National Standard Curriculum. Maybe you're missing activated charcoal, but that's not common anymore anyway.
 
emt1972 said:
It is because of the abundance of hospitals in close proximity. In the more desolate counties of California, the scope of practice is expanded.

It would be nice to be able to do finger sticks... because is it hypoglycemia or something else? Oh well...
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No. No, that has nothing to do with it. The reason Texas has a more liberal scope than Cali is that there IS no state scope in Texas. Texas is something called a "delagated practice" state, meaning we can do anything and everything our med control teaches us and allows us to do, from chest thoracostomies to surgical chricotomies to neuro surgery if they so choose.

I am actually surprised more states don't follow this model aside from the 2 or 3 that do. Let a companies MD decide what he wants his medics to do, as in tge end it's his license.
 
Linuss said:
No. No, that has nothing to do with it. The reason Texas has a more liberal scope than Cali is that there IS no state scope in Texas. Texas is something called a "delagated practice" state, meaning we can do anything and everything our med control teaches us and allows us to do, from chest thoracostomies to surgical chricotomies to neuro surgery if they so choose.

I am actually surprised more states don't follow this model aside from the 2 or 3 that do. Let a companies MD decide what he wants his medics to do, as in tge end it's his license.
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that would be great in a big state like california (even though texas is bigger ;) )
 
emt1972 said:
Interesting how things change county to county, we can't take a pump (unless it is CCT)... It has to be gravity fed...

^_^
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Same in Orange County. Basics can transport a handful of different fluids (saline, TPN, etc) provided that a nurse sets the rate to TKO. Also, we can transport any patient operated pump.
 
JPINFV said:
(TPN, etc) provided that a nurse sets the rate to TKO. Also, we can transport any patient operated pump.
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TPN are so much fun to make!
 
Yes, but I can't remember actually transporting a patient on a locked PCA. I vaguely remember a few transports with patients on patient controled medication pumps (I don't remember if it was analgesia or other medications), but these were definately a different style than the hospital style PCAs that I'm familiar with.
 
transporting with a PCA..... thats not a good idea... just legally speaking.
 
What extra legality is there if it's a PCA that the patient is cleared to take home for home care? It's like saying EMT-Bs shouldn't transport patients that have fentanyl despite the patch being something that is prescribed and self administered, despite being a schedule 2 narc.
 
JPINFV said:
What extra legality is there if it's a PCA that the patient is cleared to take home for home care? It's like saying EMT-Bs shouldn't transport patients that have fentanyl despite the patch being something that is prescribed and self administered, despite being a schedule 2 narc.
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for IFT's... it creates discrepancies for Narcotics... which in turn could require that the DEA becomes involved... which is no fun.

take for instance... the fentanyl is a transdermal SR medication... but a PCA is usually 50mL of straight Fentanyl, Dilaudid, or other medications. Thats 1mg/mL x50 mL's. Can you imagine the potential lawsuits and legal actions happen if a Basic decides that he wants to take that PCA? Perhaps he/she manages to get a hold of the PCA Pump Key (which isn't that hard to do) and while the PT is... let say asleep for a long transport... decides to swap the 60mL syringe with 60mL of NS or SW?

It's just a bad idea. I'm not saying that most basics will do the above... but not everyone is a good apple.

that's my 2 cents on that
 
Couldn't the same be said for any schedule 2 perscription that a patient fills on their own though? People aren't only on pumps in the hospital/nursing home. Similarly, what's stopping a paramedic or RN from swapping out narc with saline during a transport?
 
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JPINFV said:
Couldn't the same be said for any schedule 2 perscription that a patient fills on their own though? People aren't only on pumps in the hospital/nursing home. Similarly, what's stopping a paramedic or RN from swapping out narc with saline during a transport?
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That has already happened, in my own neighborhood.

http://www.vcstar.com/news/2008/oct/07/nxxfcwilsonfolo08/

I agree with JP, and would like to add the following. EMTs can transport patients on PCA. Just because you have a RN, or Paramedic, or Pharmacist, or Physician, does not make you anymore honest than an EMT. There is not problem with EMTs taking patients on PCA, there is only a problem with dishonest drug abusers.
 
DV_EMT said:
for IFT's... it creates discrepancies for Narcotics... which in turn could require that the DEA becomes involved... which is no fun.

take for instance... the fentanyl is a transdermal SR medication... but a PCA is usually 50mL of straight Fentanyl, Dilaudid, or other medications. Thats 1mg/mL x50 mL's. Can you imagine the potential lawsuits and legal actions happen if a Basic decides that he wants to take that PCA? Perhaps he/she manages to get a hold of the PCA Pump Key (which isn't that hard to do) and while the PT is... let say asleep for a long transport... decides to swap the 60mL syringe with 60mL of NS or SW?

It's just a bad idea. I'm not saying that most basics will do the above... but not everyone is a good apple.

that's my 2 cents on that
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As stated what stops a paramedic or RN from doing the same?
 
Yea, have to say that it makes no sense?
 
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