Can first responder units start IV locks?

[captainstandup]

Of course your state and local medical authority will have the final say in this however, if you are going to offer what amounts to a higher level of care you must, in my opinion, offer that level 24/7 X 365. It will be a political and funding nightmare if you folks offer an inconsistent level of service and with only three or four providers trained to do this it will be very difficult to cover 24/7. Your agency would likely be much better served if the three of you follow the process of upgrading the level of service for the entire organization by being involved in lobbying local and state authorities to allow the increase in service and then by being instrumental in training / educating your folks.

It is very bad form to respond to a call where you offer a higher level of care, then the next day respond to the neighbors house and offer only BLS services. Imagine how this may be perceived by; bystanders that happened to be present at both calls.

[brentoli]

It is very bad form to respond to a call where you offer a higher level of care, then the next day respond to the neighbors house and offer only BLS services. Imagine how this may be perceived by; bystanders that happened to be present at both calls.

If they aren't EMS trained then they won't know the diffrence!!!!

[captainstandup]

Assumption is the mother of all screwups my friend. The public is better educated regarding different aspects of EMS and patient care than ever before. Hollywood and networks like discovery, science and health networks have conditioned people to expect a great deal more than just a ride to the hospital.

[Arkymedic]

Assumption is the mother of all screwups my friend. The public is better educated regarding different aspects of EMS and patient care than ever before. Hollywood and networks like discovery, science and health networks have conditioned people to expect a great deal more than just a ride to the hospital.

I fully agree capt.

[fiznat]

I think this is a terrible idea.

Is our field really this procedure-crazy? Separating skills from the providers capable of utilizing them is a horrible plan, and really serves no purpose other than allowing first responders to "play" before the ALS arrives. This would increase chances of infection, complicate the transfer of medical care, and potentially cause harm to patients through emphasis on the wrong treatments.

I understand you are a RN, but when you are working as a firefighter you are a first responder, and that is it. On a code you should be providing CPR and ventilations, nothing more. I personally believe that - unless there is a special arrangement like in the hospital - the person responsible for the patient's care should be in charge of when/how/where procedures are done. Performing "advanced" skills prior to fully understanding the patient's condition on the ALS level is inappropriate and potentially dangerous.

[JPINFV]

Is our field really this procedure-crazy? Separating skills from the providers capable of utilizing them is a horrible plan, and really serves no purpose other than allowing first responders to "play" before the ALS arrives. This would increase chances of infection, complicate the transfer of medical care, and potentially cause harm to patients through emphasis on the wrong treatments.

[ccmedoc]

I think this is a terrible idea.

Is our field really this procedure-crazy? Separating skills from the providers capable of utilizing them is a horrible plan, and really serves no purpose other than allowing first responders to "play" before the ALS arrives. This would increase chances of infection, complicate the transfer of medical care, and potentially cause harm to patients through emphasis on the wrong treatments.

I understand you are a RN, but when you are working as a firefighter you are a first responder, and that is it. On a code you should be providing CPR and ventilations, nothing more. I personally believe that - unless there is a special arrangement like in the hospital - the person responsible for the patient's care should be in charge of when/how/where procedures are done. Performing "advanced" skills prior to fully understanding the patient's condition on the ALS level is inappropriate and potentially dangerous.

perfect!! :salute: :thumbright:

[Vicki Johnson]

WOW, did I ever submit a productive forum with my one little question! :wink:

Hell, after you've been here a bit you won't feel your post was productive unless someone disagrees with you!

I have learned several things from this experience. One is that the practices and regulations in the Emergency Services System vary greatly from state to state. Another is there is a lack of knowledge regarding rural medicine. Even though I have since received the answer to my question I would to respond to a couple of comments made.

It is very bad form to respond to a call where you offer a higher level of care, then the next day respond to the neighbors house and offer only BLS services. Imagine how this may be perceived by; bystanders that happened to be present at both calls.

Two of our dual responding ambulance services are BLS/ALS providers. These are volunteer services that provide the care pending the staff that are assigned to call. This is not an uncommon practice in rural area. Are you saying that just because a small community can not provide around the clock ALS providers then they should not be allowed to use the ones they can provide?

I understand you are a RN, but when you are working as a firefighter you are a first responder, and that is it. On a code you should be providing CPR and ventilations, nothing more.

Our volunteer fire dept has approximately 28 members. All are BLS certified and about 12 of us are either certified first responders or EMTs. We have no on call time or anyone staffed at the station. When the pager goes off, if you are available you go. I respond to medical runs as a certified EMT. We have a rescue unit that does not transport patients. When we are dispatched the nearest ambulance unit is also dispatched. On a typical code blue we will provide the highest level of care that available from thoses responding. I am not aware of any code blues or MVC/trauma situations where an EMT has not responded. But when it does happen and it will, the level of care will drop to that appropriate to the responders certification. And we do more than chest compressions and ventilation. We use our AED, place a combitube, check blood sugars...just like a certified EMTs on a BLS ambulance unit would do. We average 4-7 medically trained responders to theses runs. We have times when there is more than enough help needed for the situation. This is when we could place a saline lock or even place a lock and start NS for trauma patients, if the qualified personal were available.

Performing "advanced" skills prior to fully understanding the patient's condition on the ALS level is inappropriate and potentially dangerous.

I do not see intravenous cannulation as an advanced skill for an RN or EMT-I. Advanced skills are retrograde intubation, RSI, chest decompression...

[Just Plain Ruff]

even though you don't see an IV as a advanced skill the state of kansas as well as most other states do.

But on to a different point.

I know you want to get this done but maybe you might want to start your RN To medic Bridge program and get that out of the way. Then your service can become bls/als and provide a significantly higher level of care than what you currently provide.

I just think that any service that does not have 24 hour als service does their community a disservice when they can offer ALS only on certain days.

Being that being said, providing more than what you provide now in terms of ALS care is better than nothing.

I do not doubt that having you in play there that this will get done eventually.

[chbare]

"I think this is a terrible idea.

Is our field really this procedure-crazy? Separating skills from the providers capable of utilizing them is a horrible plan, and really serves no purpose other than allowing first responders to "play" before the ALS arrives. This would increase chances of infection, complicate the transfer of medical care, and potentially cause harm to patients through emphasis on the wrong treatments.

I understand you are a RN, but when you are working as a firefighter you are a first responder, and that is it. On a code you should be providing CPR and ventilations, nothing more. I personally believe that - unless there is a special arrangement like in the hospital - the person responsible for the patient's care should be in charge of when/how/where procedures are done. Performing "advanced" skills prior to fully understanding the patient's condition on the ALS level is inappropriate and potentially dangerous."

OWNED

Take care,

chbare.