Can first responder units start IV locks?

[Just Plain Ruff]

Chbare, I think that many RN's operating as first responders would find it really hard to relinquish control of the scene to a medic or god forbid an EMT.

It's just a mindset. I think it would be just as hard for a medic to relinquish scene control to an EMT if that medic is acting in a first responder capacity but I think that many of the nurses I know would not be happy handing off care to an emt.

So with that said - an RN if working in a first responder capacity is NOT an RN or she/he would be working as an RN and not a First responder.

[chbare]

Ruffems, I agree with your point.

If you are employed as a first responder and you have the job description as a first responder, than you are a first responder. I would have no problem giving over patient care. Of course, state law and regulations come into play; however, all of that not playing a role in the transition of patient care, I would have to hand over care. It is that simple, my RN license does not come into play unless I am actually working as an RN.

Even then, I transfer care over to EMT's and paramedics all day long. Patient transfers are quite common and I do not see nurses taking up arms because they have to place patient care into the hands of the EMS/transport crew. Usually, we are more than happy to get the patient out of our facility. So, the transition of care "pride" issue may be more situational.

I simply do not see how letting a first responder volly squad have access to placing IV lines is of great benefit to patient care. IMHO, the time, effort, finances, and resources could be used to push for the formation of a paid professional service. I agree with you, pushing for a full time ALS service would be the best choice rather than pushing to allow specific people on specific days to provide one intervention.

Even if we can perform IV therapy, what is the great benefit to patient care and how will this effect outcomes? Having a medlock or IV of NS will not help the cardiac arrest patient. In addition, look at much of the research on trauma, allot of people are no longer emphasizing aggressive fluid resuscitation and in fact fluid resuscitation may cause more harm. Many critical trauma patients seem do better we simply load their butt into the back of our car and drive like hell to the hospital. I think we had a "homeboy" EMS thread on that topic earlier, so I will not digress from the topic on hand.

I know the, "it will help the ALS provider when they show up" argument will be thrown out for discussion. Come on now, how long does it take to place an IV?

So, where is the great payoff?

Vicki Johnson, this is not a personal attack and do not take it as such. I am looking at this as a patient care issue, and I am not finding any significant benefit to letting first responders place peripheral IV lines.

Take care,

chbare.

[ccmedoc]

Chbare, I think that many RN's operating as first responders would find it really hard to relinquish control of the scene to a medic or god forbid an EMT.

I disagree, in fact. Unless an RN is specifically working prehospital, whether medic or PHRN, the scene control is never in their hands to begin with. It is often a detriment to have them onscene unless they have this particular training. I believe that most don't want to be put in that position, as they know the limits to their training and licensure demands.

It is that simple, my RN license does not come into play unless I am actually working as an RN.

Simple and concise..unless an RN is working as an RN..they are simply joe samaritan and can be expected to be treated as such, worse if the trap opens up and arrogance ensues. :shock:

If you need ALS in an area, put ALS in an area..there are a few posts that show it is feasible, both fiscally and logistically..It all comes down to how bad it is wanted or needed. Do away with the volunteers and amazing things happen :twisted:

Another humble opinion...

[spenac]

akroeze wrote the following and it just so fit here I had to paste it.

"FYI:

I worked at a base that only had a call volume in 2006 of 217 calls.

Another base in the same service had a call volume of 120 for the year.

Another base had a call volume of 80 for the year.

The absolute BUSIEST base in the entire service of 14 bases in the service had a call volume of 701 in 2006 and it was near double the next busiest base.

ALL of the bases, from the 80/year to the 701/year had fully paid crews at them. By the way, our wage as a PT employee was $27.16/hr plus 14% in lieu of benefits.

Care to continue saying it is not possible to have a paid staff at all times?"

Thanks akroeze for a great amount of proof that no service is to small to be paid.

Link that statement was made in: http://www.emtcity.com/phpBB2/viewtopic.php?p=147248#147248

See also: http://www.emtcity.com/phpBB2/viewtopic.ph...32&start=30

[Vicki Johnson]

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.

Really!? So what are your suggestions for rural America? I just talked with a MICT friend who volunteers for a rural BLS/ALS ambulance service. He is the only MICT on the service and gets $1.00/hr to be on call and said the average person gets $10.00 a run. Keep in mind that run could be a simple run to the hospital that may last one hour or a fire standby

that may last several hours. You know better than I do the time and money that is involved in running an ambulance service. After he puts in the hours at his full time ALS service he gets to spend his spare time "going to meetings." for the volunteer service. It consumes his life. So lets hear it. Any of you have any ideas on how to draw MICTs to rural areas to volunteer for this lifestyle? As for my local fire department providing an ALS (or even BLS)ambulance, I just don't see it happening. We have two paid ALS ambulance services within 15 minutes, one volunteer BLS/ALS seven miles away and another 15 miles. We watch the volunteers struggle to keep enough staff around to provide their service. Some volunteer ambulance services have to have fund raisers just to keep their department going. We have a good thing going at our department and will continue to keep that going. In the meantime we will continue to look for ways to improve our care.

[Vicki Johnson]

Vicki Johnson, this is not a personal attack and do not take it as such. I am looking at this as a patient care issue, and I am not finding any significant benefit to letting first responders place peripheral IV lines.

Hey, this is about patient care! I was challenged to look into what it would take for our department to start IVs and that is what I did. If you all think the idea is"procedure crazy"and "terrible" then what would the ALS providers that we respond with think. I have been on the fire dept for 15 years and worked in ER for eight years. These ALS providers are my friends. We have a good working relationship with them through the EMS system also. The way I see it, the risk of interferring with that relationship may outweigh the benifit of starting a saline lock.

Oh by the way, we had a total of 118 runs last year. We usually average about 50 fire calls so the rest would have been medical related. We have probably been debating over the possiblity of starting 10 IVs per year! :roll: Thanks for all your input!

[flight-lp]

Really!? So what are your suggestions for rural America? I just talked with a MICT friend who volunteers for a rural BLS/ALS ambulance service. He is the only MICT on the service and gets $1.00/hr to be on call and said the average person gets $10.00 a run. Keep in mind that run could be a simple run to the hospital that may last one hour or a fire standby

that may last several hours. You know better than I do the time and money that is involved in running an ambulance service. After he puts in the hours at his full time ALS service he gets to spend his spare time "going to meetings." for the volunteer service. It consumes his life. So lets hear it. Any of you have any ideas on how to draw MICTs to rural areas to volunteer for this lifestyle? As for my local fire department providing an ALS (or even BLS)ambulance, I just don't see it happening. We have two paid ALS ambulance services within 15 minutes, one volunteer BLS/ALS seven miles away and another 15 miles. We watch the volunteers struggle to keep enough staff around to provide their service. Some volunteer ambulance services have to have fund raisers just to keep their department going. We have a good thing going at our department and will continue to keep that going. In the meantime we will continue to look for ways to improve our care.

1. Taxation

2. Effective Billing

3. Consider contracting with a private for profit service

All can enable a paid ALS staff

I would also recommend separation from any VFD. Or at least separate the budgets........

[akroeze]

Really!? So what are your suggestions for rural America? I just talked with a MICT friend who volunteers for a rural BLS/ALS ambulance service. He is the only MICT on the service and gets $1.00/hr to be on call and said the average person gets $10.00 a run. Keep in mind that run could be a simple run to the hospital that may last one hour or a fire standby

that may last several hours. You know better than I do the time and money that is involved in running an ambulance service. After he puts in the hours at his full time ALS service he gets to spend his spare time "going to meetings." for the volunteer service. It consumes his life. So lets hear it. Any of you have any ideas on how to draw MICTs to rural areas to volunteer for this lifestyle? As for my local fire department providing an ALS (or even BLS)ambulance, I just don't see it happening. We have two paid ALS ambulance services within 15 minutes, one volunteer BLS/ALS seven miles away and another 15 miles. We watch the volunteers struggle to keep enough staff around to provide their service. Some volunteer ambulance services have to have fund raisers just to keep their department going. We have a good thing going at our department and will continue to keep that going. In the meantime we will continue to look for ways to improve our care.

Did you read the post directly above yours?

PAID staff will attract staff.