Whatz yer skillz?

[TKO]

Just wondering wat yer skillz as an EMS personelle are?

I am a Primary Care Paramedic in Saskatchewan, Canada.

We are trained in oxygen therapy, OPA's, ECG interpretation, AED use, we can administer Nitroglycerin, ASA and oral glucose, assist with Epi-pens and inhalers etc. We are also trained in IM/ Sub Q /NPA's but are currently not allowed to practice it ..hopefully in the next little while that will change. We are taught IV monitoring/discontinuation. Drug calcs and pharmacology is also required training. We use KED's, traction splits and full imbolilization procedure.
With the new programs beginning to take affect throughout Canada our BLS training isn't only limited to BLS. We learn alot of ALS physiology and skills to better prepare us in the future and help out in the field.

I am interested in learning about all other countries since one day I would like to travel and possibly work all over..

Second part of this post:

Every state has their own standards and everyone has different skills and levels. I am wondering if their has been any talk amongst American EMS that you will be following in Canadas footsteps and possibly adopting our new systems where it is a national standard of training throughout the provinces...the levels being Primary Care Paramedic, Advanced Care Paramedic and Critical Care Paramedic.

Looking forward to your responses. B)

 

[ResTech]

In Pennsylvania (not to far from your border) we have four levels of EMS providers.

1) First Responder
2) EMT-Basic
3) Paramedic
4) PHRN (Pre-hospital Registered Nurse)

Primarily our EMS system is run by EMT-B's and Paramedics in a two-tiered system where ambulances respond as BLS and ALS comes as a "chase" unit from the hospital.

EMT-B's are trained in all of the basic modalities such as O2 delivery, assessments, splinting, AED (adult & pediatric), NPA/OPA's, patient-assisted medications - NTG, beta-2 inhalers, and Epi-Pen's. Just recently protocol was approved for "primary use of Epinephrine" where BLS services are permitted to carry the Epi-Pen onboard the ambulance. We are not permitted to perform any type of advanced airway or give any drugs other then Epi-Pen.

Paramedics are trained in peripheral IV's, external jugular cannulation, SC/IM injections, chest decompression, cricothyrotomy, EKG (12-lead), RSI (usually limited to air medical services).

Paramedics give a good many drugs here: epi, atropine, lidocaine (bolus/drip), narcan, glucagon, dextrose, cardizem, verapamil, dopamine, SL/paste NTG, albuterol, brethine (terbutaline), phenergan, diphenhydramine, morphine, valium, versed, calcium chloride, sodium bicarb, and a few more that I am sure I forgot because I have way to many drug sheets to learn. In Maryland where I am going to school we administer Duo-Neb's over plain albuterol and are permitted to perform adult IO's in critical patients when IV access can't be obtained.

 

[rescuecpt]

In New York State we are similar to Pennsylvania (here's what we can do - as far as I can remember!):

1. First Responder: Bag-Valve Mask breathing, O2 therapy, splinting, bandaging, immobilization, CPR.

2. EMT-Basic: Same as above plus AED, albuterol nebulizer treatment, epi-pen, nitroglycerine, glucose, OPA, NPA.

3. EMT-Intermediate: Same as above plus direct laryngoscopy and Magill forceps to remove foreign body, Endotracheal Intubation, endotracheal intubation, up to two large bore IV NS.

4. EMT-Critical Care: Same as above plus manual defibrillation, ECG monitoring, IV drug push, SubQ, IM, IO, Epinephrine 1:1,000, Epinephrine 1:10,000, Atropine, Lidocaine, Magnesium Sulfate, Sodium Bicarbonate, Dopamine, Morpine, Diazepam (Valium), Atrovent, Adenosine, Aspirine, Thiamine, Furosemide (Lasix), Methylprednisolone (Solumedrol), Diphenhydramine (Benadryl), Dextrose, Naloxone (Narcan), Glucagon, Nitrous Oxide, Transcutaneous pacing, synchronized cardioversion, fluid challenge, blood glucose determination. Hopefully soon we will be able to use the Combi-Tube and perform Needle Chest Decompression.

5. EMT-Paramedic: Same as above, including needle cricothorotomy (spelling???) and 12 lead. CC's have the option of learning the 12 lead if they want to, but most use 6.

6. Transport Nurses - these usually only run out of the State hospital for critical transports performed by State EMS from other facilities.

(Yes, I had to look this up so I could remember everything, and I probably still forgot some!).

 

[ffemt8978]

This is gonna take a while. (Washington state has so many different levels)

AFA (Advanced First Aid) Basically, this is a first aid class and Health Care Provider CPR.

FR (First Responder) More than AFA, but less than EMT. Basically, they can't transport a patient unless they're with an EMT.

EMT-B (EMT Basic) Not quite to NREMT standards. The EMT-B can administer O2, ASA, Charcoal, Oral Glucose, and Epi-Pens (in certain circumstances. I'll post a seperate thread on this). EMT-B's are allowed to assist with metered-dose inhalers and nitroglycerin. They can use OPA's and NPA's, but not the Combitube. The only cardiac rythyms they are taught is "Good" and "Bad".

EMT-B Combitube Tech: Same as EMT-B, but can use a Combitube.

EMT-IV: Same as EMT-B, but able to start IV's in the arms and external jugular. They are also allowed to start IV's in the legs, but must get permission first. EMT-IV's are also allowed to perform blood draws on scene for Law Enforcement and hospital use.

EMT-Airway: Same as an EMT-B, but is allowed to perform ET intubations.

EMT-IV/Airway: Combination of EMT-IV and EMT-Airway.

EMT-ILS (Intermediate Life Support): Closer to the NREMT standards, but different. EMT-ILS is allowed to administer some drugs, such as albuterol, nitroglycerin, ASA, and epinephrine. First line cardiac drugs are generally off limits, though, unless the medical director approves.

EMT-ILS/Airway: Same as EMT-ILS but allowed to perform ET intubation.

EMT-Paramedic: Same as NREMT Paramedic.

Oh yeah, almost forgot. EMT-IV is only valid for the county that you practice in. If you cross county lines, you are an EMT-Basic.

 

[colafdp]

Originally posted by TKO@Jun 24 2004, 09:12 PM
the levels being Primary Care Paramedic, Advanced Care Paramedic and Critical Care Paramedic.

I do believe that you forgot about the lonely ICP's here in Saskatchewan

 

[TKO]

I do believe that you forgot about the lonely ICP's here in Saskatchewan

No I didnt forget about the ICP course....ICP training is really only recognized in Saskatchewan.

 

[colafdp]

true, i guess they had to replace the advanced's with something.