Taking CEs Before NR Goes Through

EpiEMS

EpiEMS

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So, I've completed my course (EMT-B + WEMT), passed my NREMT cognitive exam, and passed my NREMT-approved state practical. I'm now waiting on the practical results to post to my NREMT site. After that, I'm going to be applying for a state license. Any idea if it is possible to take some CEs now and then use them later? Or do I have to take them only once NREMT finishes certifying me? I'm essentially done, it's just a matter of time until it all posts.
 
2 years cycle. Mar 31 to Mar 31 for medics, not sure on date for EMTs but anything outside of those will not count
 
Darn! I was hoping to take BDLS online soon — that seems like an interesting course.

Thanks!
 
According to NREMT website EMT is Mar 31 to Mar 31 also
 
BDLS?

Disaster?
Dope?
Diesel?
 
bstone said:
BDLS?

Disaster?
Dope?
Diesel?
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Disaster, in this case.

A Basic Dope Life Support upgrade class to allow EMT-Bs to consider Narcan couldn't hurt...
 
EpiEMS said:
Disaster, in this case.

A Basic Dope Life Support upgrade class to allow EMT-Bs to consider Narcan couldn't hurt...
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Do you have an NPA and BVM? See, no need to put a dangerous medication in undereducated hands...
 
usalsfyre said:
Do you have an NPA and BVM? See, no need to put a dangerous medication in undereducated hands...
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Valid point. I did hear somewhere in Massachusetts gave intranasal narcan to basics, though.
 
Also a service option in Colorado.
 
Oh, where's that one guy from Montana when you need him. Last I looked, with an endorsment class, basic's can interpret 12 leads, intubate, and give a decent list of meds.
 
emt11 said:
Oh, where's that one guy from Montana when you need him. Last I looked, with an endorsment class, basic's can interpret 12 leads, intubate, and give a decent list of meds.
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Can't Ohio Basics intubate cardiac arrests?

Basics do not need more "toys" to play with. Especially those that could potentially mess with the ER's treatment path.
 
You guys know I'm all for more treatment across the board, but basics need to stick with the "basics" as it were. Totally agree that putting new stuff in undertrained hands is going to lead to problems.
 
emt11 said:
Oh, where's that one guy from Montana when you need him. Last I looked, with an endorsment class, basic's can interpret 12 leads, intubate, and give a decent list of meds.
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I just looked on Montana's EMS site and the licensure site for Montana (http://bsd.dli.mt.gov/license/bsd_boards/med_board/emt.asp#b), and it seems that EMT-Bs,with endorsements, can do almost everything an Intermediate can do — and in some cases, more! With a certain endorsement, a Basic in Montana can give IM morphine.
No lie, I'm kinda scared by this, actually. Although if transport time is long, I suppose it could be defensible?
 
EpiEMS said:
I just looked on Montana's EMS site and the licensure site for Montana (http://bsd.dli.mt.gov/license/bsd_boards/med_board/emt.asp#b), and it seems that EMT-Bs,with endorsements, can do almost everything an Intermediate can do — and in some cases, more! With a certain endorsement, a Basic in Montana can give IM morphine.
No lie, I'm kinda scared by this, actually. Although if transport time is long, I suppose it could be defensible?
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It has nothing to do with transport times. If it's that big of a deal stop off at the local urgent care ER ordeal and get some pain management then transfer them out.

When it comes down to it pain medications are relatively benign compared to some of the other meds we use. That's just my opinion though. It seems like Nitronox would be a good candidate for basics but that also has very limited applications (read: isolated extremity trauma) and questionable effects.
 
NVRob said:
When it comes down to it pain medications are relatively benign compared to some of the other meds we use. That's just my opinion though. It seems like Nitronox would be a good candidate for basics but that also has very limited applications (read: isolated extremity trauma) and questionable effects.
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Just spitballing here, but if you're allowing basics to give narcotics, then it'd make sense for them to have narcan in case there's respiratory depression, no?
Is Nitronox relatively safe/have few contraindications (also, if you've got somebody who's a bit shock-y or likely to become shock-y, wouldn't pure O2 be better)?

I guess my whole line of questioning regarding pain management is that, as a Basic, I feel like I really can't do much for somebody who's really hurting –:censored:especially kids.
 
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EpiEMS said:
Just spitballing here, but if you're allowing basics to give narcotics, then it'd make sense for them to have narcan in case there's respiratory depression, no?
Is Nitronox relatively safe/have few contraindications (also, if you've got somebody who's a bit shock-y or likely to become shock-y, wouldn't pure O2 be better)?

I guess my whole line of questioning regarding pain management is that, as a Basic, I feel like I really can't do much for somebody who's really hurting –:censored:especially kids.
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You just pointed out the problem with it. I'm not advocating giving basics narcotics at all.

In all honesty unless you are rural I don't know any medics personally that would chase their tails like that with giving pain meds then narcan if the patient had respiratory depression, they'd bag them, but most I know would also be using fentanyl rather than morphine so they wouldn't have to wait as long for the effects to wear off.

The problem with nitronox is there are quite a few contraindications to it which is why you can only really use it in isolated extremity trauma. If the injury fits in that category there really isn't any contraindications that I can think of off the top of my head besides altered mental status but then it wouldn't be isolated to the extremity ;)

O2 isn't the end all solution to "shock". N2O is contraindicated with hypotension so if they are to that point you shouldn't be giving it and if they have an injury that leads to hypotension it's probably been contraindicated in some other way.

Unfortunately you're right. As a basic you're basically stuck up :censored::censored::censored::censored: creek without a paddle when it comes to a patient who's in pain.

The only reason I said anything about nitronox is I could see it as possibly something a basic could use in very limited applications. The biggest thing with it is that no one really uses it anymore in the U.S. that I'm aware of. We have it for our special events Intermediates but 9 times out of 10 there's a paramedic working with them or within a couple minute response after a quick radio call to dispatch.


Sorry if none of this post makes sense. I'm pretty beat from today, I should probably be sleeping :lol:
 
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NVRob said:
It has nothing to do with transport times. If it's that big of a deal stop off at the local urgent care ER ordeal and get some pain management then transfer them out.

When it comes down to it pain medications are relatively benign compared to some of the other meds we use. That's just my opinion though. It seems like Nitronox would be a good candidate for basics but that also has very limited applications (read: isolated extremity trauma) and questionable effects.
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I imagine it probably does have to do with transport times though. I can think of more than a couple of places in Colorado (which is less rural generally speaking) where it would be a half hour minimum to a daytime urgent care clinic. Plus a lot of these places are staffed with only a PA half the time and I'm not sure they'd be willing to give pain meds and allow then send a BLS crew on their way. You can't leave a patient at some of these places and have them wait for ALS (might take an hour) since they have no beds. If they have to wait on your stretcher, maybe it would be better to just drive them with no meds?

Obviously giving basics narcotics is an imperfect solution, but in extremely rural areas it's tough to come up with other ideas. Calling the helicopter for everything is another option, which brings other pitfalls.
 
This is my opionion as far as basic's giving narcotics(in the state of Montana). I understand why the state has given basics the ability to do so. If you look up healthcare for the state. Their's only 3 level II trauma centers in the entire state, and get this, NO level I trauma centers. They have to lifelight out patients to Seattle for patients needing level I care. Plus you have the fact that alot of Montana is rural aswell.
 
NVRob said:
You just pointed out the problem with it. I'm not advocating giving basics narcotics at all.
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The more I think about it, the less sense giving us basics narcotics makes. Other than the obvious folks, i.e. a 68W or hospital corpsman on active duty.

NVRob said:
Unfortunately you're right. As a basic you're basically stuck up :censored::censored::censored::censored: creek without a paddle when it comes to a patient who's in pain.
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Oy vey, that's comforting...:(

Your post makes good sense and was very informative, thanks!
 
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