Basics Doing Advanced Patient Care - Good Or Bad?

[Christopher.Collins]

Im going to aknowlege your quote with the upmost ammount of sarcasm I believe is possible for one person to dish out. Only because it hurts to think of it as truely being meant.

As time goes on I wish my finances were straight. I dont think that EMT-Basics are useless at all... but I am beging to feel useless and like I could do so much more.

Now to answer the question. If anything I think that the most advanced thing EMT-Bs should be allowed to do is cardiac monitoring. I dont mean interpriting rhythms (maybe basic ones if anything)... but I mean if you have a chest pain call and all the medics are tied up... get an initial rhythm for the doc. I know some rural services do this. I also know with added responsabilities comes the need for more knowledge... why does this do that, what causes this etc. My only response for this is that there is no reason we shouldnt continue to educate ourselves.

Maybe combitube also. Connecticut for a short time allowed basics to drop combitubes, I was certified to do it also but never got the chance. They pulled it because it wasnt actually in the state standards when implimented. Supposedly since its "not used often" people will forget how to do it properly.

Anything involving IVs... well we have an inbetween solution. The EMT-Intermediate. Mostly they only practice in commercial transport services. If your going to transport a patient whos on maybe 1000 bag of saline and nothing else then just have an EMT-I do it and spare your medic. They are considered ALS and can do more than just transport and start IVs but they arnt very common anymore so I dont know their standards well.

~~~~~

Overally my one big beef with implimenting anything at the basic level, hell at any level is the whole, "we dont use it enough and people forget" argument. I smite anyone who thinks like that for epic laziness. TRAIN TRAIN TRAIN.... and damn it TRAIN some more. Oh but we are volunteer... tough luck, if you cant commit some time then dont do it.

[VentMedic]

My comment from that forum:

Why do EMT-Bs put so much time and effort into getting so many "certs" for individual "skills"? It is this type of piece mill stuff that has gotten EMS to the point of 50+ different levels.

It seems that some just want to say they can do the skills of a Paramedic but without the extra responsility the comes with knowing why.

[Eydawn]

No, I certainly shouldn't be doing IV's as a basic, nor should I be able to give Narcan and D-50. I hate that all of those are in my protocols as a basic where I work.

I need to go to paramedic school. That's all there is to it...

Wendy

CO EMT-B

[Christopher.Collins]

Vent, that would deffinatley be a good thing to ask the State of Connecticut. Around here while its not required, generally you have to have almost 30 (exagerating for dramatics) different certifications to do a damn thing. Even though we are taught all of this as EMTs and have to keep up with CME's you generally need to be seperatley certified in AED, Bloodborne Pathogeons, epi-pen... etc. Its more a money making thing though than it is a, "Im certified to do all of this" thing.

One particular hospital (whom shall be un-named) is notorious for requiring seperate additional certifications to use equipment. Of course these training courses must only be taught by their own personel and the certifications issued with their seal of approvale. Yea as an EMT I am trained and certified to administer epi with med control and use an AED... but Im not allowed to unless I re-learn it by them and pay like $30.

[VentMedic]

One particular hospital (whom shall be un-named) is notorious for requiring seperate additional certifications to use equipment. Of course these training courses must only be taught by their own personel and the certifications issued with their seal of approvale.

Is this you own equipment or their equipment. If it is their equipment, that may not be a "cert" but a competency requirement for state and Federal agencies. That can also go for the bloodborne pathogens and infectious disease certs which are part of an OSHA standard and will be reviewed during accreditation inspections.

Our hospital will not longer "loan" equipment to any ambulance (BLS, ALS or CCT) unless a member of the hospital staff going with it. At no time will they be touching the equipment. This definitely includes IV pumps.

[Christopher.Collins]

Is this you own equipment or their equipment. If it is their equipment, that may not be a "cert" but a competency requirement for state and Federal agencies. That can also go for the bloodborne pathogens and infectious disease certs which are part of an OSHA standard and will be reviewed during accreditation inspections.

Our hospital will not longer "loan" equipment to any ambulance (BLS, ALS or CCT) unless a member of the hospital staff going with it. At no time will they be touching the equipment. This definitely includes IV pumps.

No, it was all our own equipment. I understand your point though, under thoes circumstances I would be in full agreement. And yes while I understand that they have medcontrol and want people under that to be compitent... they do nothing but demonstrate it as a money making scheme rather than a competancy test.

[iMac]

That's a thread that answered itself with the original post. I would hope I wouldn't get a doc come out and surgical procedure if they had never been trained in surgery. I wouldn't want an EMT to treat me if they had no been trained specifically for that situation. Can you imagine the kind of insurance you would now require? It makes no sense.

[WolfmanHarris]

I already wonder if some ALS EMS providers should be doing some of their skills with the education they currently have, why the heck would I support more skills with less education? Let's be clear folks, as tempting as it is as a BLS provider to be able to do more without going through the education, do NOT consider it a plus for you as a provider. You are being done a disservice and are being insulted (whether you realize it or not), but the administration (hypothetical as it may be) pushing for this. They are not saying "you're such a great basic we think you can intubate." They're saying "we don't care to send you for a proper education or to pay for Paramedic's, so we're going to toss you a one day CME and have you do these ALS skills without being an ALS provider. This isn't worth our time, effort or money to do right."

I wonder how common this is in the United States? Here as a PCP I have to take a seperate base hospital certification in SAED and Symptom Relief, despite the fact that I have an entire semester devoted just to this component of my scope. This is a hold over from when PCP was a much shorter program and SAED and SR were add-on's to our scope requiring a separate certification. As a result we need to be tested by our base hospital on these skills and be certified by them (as these are our delegated medical acts) when we start at a service and whenever we work under a different base hospital. It seems redundant, but like a lot of things in government, the rules have not caught up to reality yet.

[mobey]

I already wonder if some ALS EMS providers should be doing some of their skills with the education they currently have,

You would not be speaking of EMT's Alberta would you??

Bwahahahaha

[WolfmanHarris]

My concerns aren't province specific. They're provider specific. Though sometimes I wonder about this guy named Mobey...