Epi-Pens: Discussion

[mobey]

Ok, but why do you disagree? If an EMT and/or Paramedic is working under a Physician's licensure acting as the eyes & ears of the Physician in the field & assess a patient & relays that information to the Medical Command Physician and the Physician issues a Verbal Medication Order to the EMT and/or Paramedic based upon the assessment is that not the same thing as a prescription?

First off, we are talking about EMT-B, NOT Paramedics.... please do not derail.

To answer your question, NO. The ass-umption that you are making is the EMT-B's are educated in how to properly assess and interpret and communicate thier findings. They are not.

Paramedics assess and prescribe one time doses under thier own assessment, and a physicians licence.

[1EMT-P]

First off, we are talking about EMT-B, NOT Paramedics.... please do not derail.

To answer your question, NO. The ass-umption that you are making is the EMT-B's are educated in how to properly assess and interpret and communicate thier findings. They are not.

Paramedics assess and prescribe one time doses under thier own assessment, and a physicians licence

First off, 1) We are all Emergency Medical Technicians ( Basic, Intermediate & Paramedic ). 2) If you read the EMT- Basic scope of practice & you review EMT-Basic texts you will see that EMT-Basics are taught to assess their patients & they are also taught to treat what they find & to relay that information. 3) EMT-Basics are an important link in the EMS System & it is counter productive for you to degrade them! 4. FYI Paramedics do not prescribe, that is a function that is reserved for mid level providers such as ( CNM, NP & PA's ) & Physicians!

[Kiwiology]

First off, 1) We are all Emergency Medical Technicians ( Basic, Intermediate & Paramedic ). 2) If you read the EMT- Basic scope of practice & you review EMT-Basic texts you will see that EMT-Basics are taught to assess their patients & they are also taught to treat what they find & to relay that information. 3) EMT-Basics are an important link in the EMS System & it is counter productive for you to degrade them! 4. FYI Paramedics do not prescribe, that is a function that is reserved for mid level providers such as ( CNM, NP & PA's ) & Physicians!

1. That's like me saying oh "all Kiwi ambo's are 'Ambulance Officers'" it doesn't really mean anything

2. I've read a few EMT-Basic textbooks and yes, they are taught to assess but a. minimally and b. do minimal things with that information which really amounts to jack

3. Arguable

4. Won't argue there

Edited March 21, 2010 by kiwimedic

[mobey]

First off, 1) We are all Emergency Medical Technicians ( Basic, Intermediate & Paramedic ). 2) If you read the EMT- Basic scope of practice & you review EMT-Basic texts you will see that EMT-Basics are taught to assess their patients & they are also taught to treat what they find & to relay that information. 3) EMT-Basics are an important link in the EMS System & it is counter productive for you to degrade them! 4. FYI Paramedics do not prescribe, that is a function that is reserved for mid level providers such as ( CNM, NP & PA's ) & Physicians!

Ya, I am not going to play semantics with you, if you are not willing to put effort into this debate, then neither will I.

/discussion

[1EMT-P]

1. That's like me saying oh "all Kiwi ambo's are 'Ambulance Officers'" it doesn't really mean anything

2. I've read a few EMT-Basic textbooks and yes, they are taught to assess but a. minimally and b. do minimal things with that information which really amounts to jack

3. Arguable

4. Won't argue there

With all do respect there are different levels of Emergency Medical Technicians, just like there are different levels of Nurses & they have different levels of education & skill. All Emergency Medical Technicians assess their patients & then treat what they find accordingly & then relay that information to the hospitals. The real question we should be asking is which interventions make a difference & what do we need to do to make EMS care better....

[Kiwiology]

With all do respect there are different levels of Emergency Medical Technicians, just like there are different levels of Nurses & they have different levels of education & skill. All Emergency Medical Technicians assess their patients & then treat what they find accordingly & then relay that information to the hospitals. The real question we should be asking is which interventions make a difference & what do we need to do to make EMS care better....

Good point. I certianly think GTN is one and that your Technicians should be able to administer it, as in not "help the patient to take his own after asking the doctor" but do a proper assessment and some critical thinking, whip out the ubiquidos little red squirty bottle and use it themselves.

[CBEMT]

Here's a thought, why dont you actually educate the EMTs to use nitro and remove the need to run off and ask "doctor may i?"

I appreciate that you feel there should be more education and less direct oversight. It's a line the state has chosen to walk. Admittedly, the EMT-B providers don't get a comprehensive A+P/pharmacological background that we find necessary- which is WHY they aren't allowed to make the decision on their own. Its why they can't even THINK of giving nitro to a patient that doesn't have an existing prescription. Should they be able to? maybe, but it doesn't seem like the Basic curriculum will be getting any longer anytime soon, for reasons that have been discussed here over and over again.

With that in consideration, it becomes a matter of how far those in charge are willing to let such providers go, and how the patient could benefit from their scope of practice.

I think that the compromise that has been chosen is a reasonable one. It takes into consideration both the limits of the BLS curriculum and the reality that two doctors (patient's primary who wrote the script, and the OLMC physician giving the order) are weighing into the decision. And in areas where ALS is not immediately available, a basic provider with the ability to provide pain/symptom relief in this way is, as people with much more education and experience than I have decided, a good thing.

Edited March 21, 2010 by CBEMT

[Kiwiology]

...but it doesn't seem like the Basic curriculum will be getting any longer anytime soon...]

Have you looked at the new 2009 EMS Education Standards?. Looks like the move is being made away from "hours" of education to scope of education which is pleasing to see, the content however remains grossly inadequte although it is an improvement on the 1994 update.

I think that the compromise that has been chosen is a reasonable one. It takes into consideration both the limits of the BLS curriculum and the reality that two doctors (patient's primary who wrote the script, and the OLMC physician giving the order) are weighing into the decision. And in areas where ALS is not immediately available, a basic provider with the ability to provide pain/symptom relief in this way is, as people with much more education and experience than I have decided, a good thing.

I do agree it's a reasonable compromise given the medicolegal issues involved however as we can both agree, that needs to fall by the wayside in favour of increased education and autonomy.

Now I think we're straying from the orginal topic ..... but thats what makes this place so fun right?

[CBEMT]

Have you looked at the new 2009 EMS Education Standards?. Looks like the move is being made away from "hours" of education to scope of education which is pleasing to see, the content however remains grossly inadequte although it is an improvement on the 1994 update.

My state still requires MAST and EOA- I'll believe in the new BLS standards when I see them on a syllabus.