Hospital Based EMS Protocols

[emtceb]

I work for Cincinnati Children's Hospital as a transport paramedic. The paramedics are a new addition to the facility and have a very confining scope of practice. If anyone can send information, protocols, current transport team set ups etc. I would be very appreciative. I am trying to expand our scope along with the Critical Care Team. Email me at EMTCEB@GMAIL.COM with any help you may have.

[kateyboyer]

You might want to try to get ahold of Children's Hospital in St. Louis MO. They have a ped critical care transport unit they might be able to give you some ideas.

[Just Plain Ruff]

Childrens Mercy hospital in KC MO also has a ambulance service.

I believe that they fall under a lot of the KC MO scope of EMS. But since docs and rt's are on board the protocols may not be the same as KC MO's.

[Kaisu]

Maybe contact Bay Area Medical Center in Marinette Wisconsin. Google 'em - they have a web presence with contact information. They have progressive and aggressive protocols for hospital based EMS and interfacility transport. Good luck.

[VentMedic]

I work for Cincinnati Children's Hospital as a transport paramedic.

Correct me if I'm wrong, but I believe your transport team consists of RNs and RRTs for the critical children that require advanced procedures. These team members have many years of experience working in a PICU and NICU with advanced knowledge and skills.

Are you also working in some compacity inside the ICUs at this facility to gain more experience? Both pedi and neo are very intense specialties which are barely mentioned in Paramedic school. If you are going to expand your scope, you will have to gain lots of knowledge and experience. The pedi transports might be a little easier for you to get more involved. Neonatal medicine is a whole different field.

This is not an easy specialty field to get into. It is one that requires a lot of effort on your part and not a "my scope says so" type of job. It is a little more than just being "allowed" to do a skill per your state. Adult ATVs and a neonatal ventilator are two very different devices. You will have to LEARN (not memorize) all the drips AND be able to titrate them according to ventilation and hemodynamics as easily as you would run through your ACLS protocols. There is NO room for error in this field.

[Richard B the EMT]

You might want to contact the New York Hospital/Cornell Medical Center. They used to have a specialty preemie ambulance, a motor home, actually, that was so well set up, they could, and probably did do, surgery inside the vehicle,

(This was around 1980, they might not have anything like that, now)

[EMS49393]

Good luck with that whole scope thing. We have a Children's Hospital in my city with ground and air transport. They utilize paramedics, however they are VERY limited and function more as an assistant than a practitioner. The team is generally at the physician level. They never have less than a nurse and a registered respiratory therapist on board. As ventmedic said, peds and neonates are a tough patient group. The clinicians charged with their care are educated well beyond the standard paramedic, RN, RRT, and physician. These folks are die-hard about their kids. They are, without a doubt, the most dedicated providers and patient care advocates in my area. Hospice nurses rank second here, but they're a distant second.

[zippyRN]

right pondian perspectve

paeds retrieval uses the ambulance crew primarily as drives and to make sure the kit is kept safe etc ...

a lot of the services don't use paramedics becasue it;s less expensive to use middle tier / ETA / QAT crews for this given that you are carrying nurse/ ODP and Registrar / Nurse paractitioner to actually look after the patient

[Doczilla]

PM sent. Maybe Careflight or Children's Dayton can help.

'zilla

[VentMedic]

PM sent. Maybe Careflight or Children's Dayton can help.

'zilla

http://www.childrensdayton.org/Health/NICU...tml/NICU005.htm

At least they didn't call them "ambulance drivers".

The American Academy of Pediatrics (AAP) sets the guidelines for interfacility transport. It doesn't matter what your "state says" you can or can not do as a Paramedic. You still must meet certain requirements to be a working part of the team with direct patient care. One really should be familiar with the guidelines, regulations and direction they are working under before attempting radical changes without a lot of experience. It's not a matter of they're doing it why can't we as in EMS. It all depends on how the team is designed, availability of experience and the acuity of the babies. We don't let our residents touch the babies either on transport unless they have had specific knowledge and skills checked off by the neonatologists. We rarely let someone "practice" on a baby outside of our own NICU.

If one wants to get more information or has an issue with this, they can contact the AAP. They also have a database of all the transport agencies for children.

http://www.aap.org/sections/transmed/default.cfm