Scopes of Practice

[Kiwiology]

Howdy;

I am interested in finding out about your scopes of practice by jurisdiction (be it national or at state level). Its unfortunate but New Zealand's EMS system is currently in bad need of an overhaul in terms of qualifications and funding. Our qualifications are standardized by the Government but the SoP is not, and as such, we're looking to develop a national standard with three levels (BLS, ILS & ALS). We currently have five (CFR+D, BLS, 2 x ILS & ALS) any one of which can crew a rig.

Ours are below, any international comparison would be appreciated.

1. CFR+D (Pre Hospital Emergency Care or "Please Help, Educaton must Continue")

- Advanced first aiid & splinting

- AED

- O2 & OPA

- Entonox/methoxyflurane

2. BLS (Ambulance Officer or "Blast! limited skills, so only able to offer some care")

- IM Glucagon

- LMA

- NPA

- Allbuterol (salbutamol)

- GTN

3. Paramedic

- Manual defib

- IV NaCI & D50W

- 12 lead EKG

4. ILS Paramedic (or "I am likely to save people")

- Morphine

- Metaclopramide (maloxon)

- Epi

- Naloxine (naloxone)

5. Advanced Paramedic (or ALS Paramedic -- "auctually likely to save people")

- ETT (incl RSI)

- Thoracostomy

- Cricothyriodotomy

- IO

- Pacing

- Frusemide (frusomide)

- Ketamine

- Atropine

- Amiodarone

- Midazolam

Thanks for reading!

[Trauma612]

takin the easy road 8)

http://www.mass.gov/Eeohhs2/docs/dph/emerg...prehospital.pdf

[dahlio]

Sounds like your CFR-D is an NJ EMT-B. No Entonox though. In NYC and other places, EMT-B's can administer Albuterol, but not a national standard. An EMT-B in the states can also stick in an OPA as well as a NPA. Also, Glucose orally only, no glucagon. It differs from state to state, as said before. Seems like we're the ones in need of an overhaul. :roll:

[Dustdevil]

Seems like we're the ones in need of an overhaul. :roll:

You can make that judgement not knowing anything about the education involved?

[dahlio]

You can make that judgement not knowing anything about the education involved?

Sorry, I'm not following you..what judgement?

[Dustdevil]

Sorry, I'm not following you..what judgement?

About the adequacy of your protocols as compared to theirs.

[dahlio]

About the adequacy of your protocols as compared to theirs.

I don't have the education, and that's exactly my point. Sorry if it sounded like I wanted to do more advanced things, but without the education, it shouldn't happen. More and more you see the US EMT-B scope of practice continue to expand, yet we're still getting the same amount of training and education then we were before, even though it wasn't enough to begin with. You're Correct.

[Dustdevil]

Sorry for the misunderstanding. I don't know about your education or theirs. I didn't figure you did either. That's why I was surprised that you could conclude that one was ahead of or behind the other with so little information. I wasn't meaning to comment on you, your education, or your system.

[dahlio]

I don't know about your education or theirs.

For the responsibility given to me, not even close to enough.

[Dustdevil]

For the responsibility given to me, not even close to enough.

Welcome to the club. :wink: