VentMonkey
BS, FP-C, CCP-C
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In my system—in California—none really either.
Here’s a more important question:
Is there ever a time when we should seek expert consultation?
Why do people hate on LA County protocols?
- Thread starter ParamedicStudent
- Start date
Here’s a more important question:
Is there ever a time when we should seek expert consultation?
RocketMedic
Californian, Lost in Texas
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I think so. Weird cardiac things (weird high-degree blocks, med. interactions, etc), overdoses, and I'm OK with calling in to bounce *elective* RSI off of an MD.
Urgent interventions ought to be treated as standing orders though.
The shame of it is that CA's med-control heavy system has the skeleton of greatness underneath it. Need a weird field intervention like lab interpretation and whole blood? You can bring the MD in on that, maybe even remote-issue an Rx. But it's easier to build floors than ceilings....
Urgent interventions ought to be treated as standing orders though.
The shame of it is that CA's med-control heavy system has the skeleton of greatness underneath it. Need a weird field intervention like lab interpretation and whole blood? You can bring the MD in on that, maybe even remote-issue an Rx. But it's easier to build floors than ceilings....
Jim37F
Forum Deputy Chief
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Can't comment on Paramedic level stuff, but at the EMT level, well...
At my current FD, we're only EMR level medical first response (we're trained to NREMT, but not to state certified EMT), and yet I'm doing almost exactly the same, no loss in skills than when I was an EMT-B in LA Co.
In other words, LA Co protocols leave EMTs so shackled that they're no more than EMR's in the rest of the country based on what they're actually able to do. It's not tough to imagine how similarly restrictive ALS is in LA Co to the rest of the country.
At my current FD, we're only EMR level medical first response (we're trained to NREMT, but not to state certified EMT), and yet I'm doing almost exactly the same, no loss in skills than when I was an EMT-B in LA Co.
In other words, LA Co protocols leave EMTs so shackled that they're no more than EMR's in the rest of the country based on what they're actually able to do. It's not tough to imagine how similarly restrictive ALS is in LA Co to the rest of the country.
I started seeking consult yesterday on a 38wk pregnant lady with a heart rate of 200+ to verify med interactions and if they had any requests since she was maintaining pressures in 140's and I very rarely give meds to people who are pregnant. Converted before I finished my initial report to the comm room folks when my partner stuck her with an IV.
Outside of that, it's been a long time since I have called. I am pretty well equipped to handle most situations and have permission to color outside of my lines a little if needed.
Outside of that, it's been a long time since I have called. I am pretty well equipped to handle most situations and have permission to color outside of my lines a little if needed.
DrParasite
The fire extinguisher is not just for show
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from a practical side, the skills for EMR are pretty much the same as an EMT, at least from the NREMT perspective. If you look at the skill sheets for testing, they are nearly identical.
There are occasionally some drugs that EMTs can give by EMRs can't, but from a "skill" point of view, they are very similar. the difference is in the knowledge and education that an EMT has vs an EMR. I've long said that EMRs are great on the engine for the first time 10 minutes to make sure the patient doesn't die until EMS arrives, but you are going to want someone with a little more knowledge who is going to know what is going on with the patient during transport.
And yes, some states (like Colorado) do give EMTs even more drugs to give and skills to perform. But I wouldn't trust more than a handful of people on my department to do that, much more comfortable waiting for the ambulance to arrive.