Gypsy Posted October 8, 2009 Posted October 8, 2009 Ok as many of you know I currently teach in a preschool. We also have kids that come in at like 3pm and stays until 6pm. These kids come in from the local middle schools so that they aren't "lach key kids". Now I am only an EMT-Basic. In school I was told the only medications I could give where: charcol, epi-pens ( after checking the 5 Rs), and Nitro ( after checking the 5 Rs). Ok I understand this. Not a problem. I was just ( and I mean 3 seconds ago) handed a box with 2 doses of rectal diazepam and told that if our new aftercare kid has a seizure I am ordered to give it. Isn't this an ALS drug? Wouldn't I get into a whole mess of trouble if I were to administer this? Um... help!!!!!!
mobey Posted October 8, 2009 Posted October 8, 2009 Ok as many of you know I currently teach in a preschool. We also have kids that come in at like 3pm and stays until 6pm. These kids come in from the local middle schools so that they aren't "lach key kids". Now I am only an EMT-Basic. In school I was told the only medications I could give where: charcol, epi-pens ( after checking the 5 Rs), and Nitro ( after checking the 5 Rs). Ok I understand this. Not a problem. I was just ( and I mean 3 seconds ago) handed a box with 2 doses of rectal diazepam and told that if our new aftercare kid has a seizure I am ordered to give it. Isn't this an ALS drug? Wouldn't I get into a whole mess of trouble if I were to administer this? Um... help!!!!!! are you administering a prescription to a child as a caregiver? Or as a responding EMT? Technically it is "out of scope" for me to give my 8mon old his antibiotics.
P_Instructor Posted October 8, 2009 Posted October 8, 2009 This would be for the school nurse to administer per parental and medical authorization. If as EMT - NO, not within your scope. As caregiver, and authorized, I am not sure; this falls under other state legalities.
VentMedic Posted October 8, 2009 Posted October 8, 2009 (edited) This has nothing to do with you being an EMT if you are working as a teacher in Florida. This falls under the guidelines of the position you hold in the school system. Unless you are specifically hired to be an EMT with the school system and that is the title you are working under, don't confuse that cert with the job you are hired to do and the responsibilities that accompany it. If you are uncertain about your job description and responsibilities to the children, you can contact the education board in your county or FLDOE. You can also review the P&P for your school and that medication with the School RN. I also know it is unfortunate that the School RN is often covering several schools at one time and is not immediately available. http://www.fldoe.org/default.asp?flsh=false Example of Manatee county: Manatee County Good article this month in Pediatrics: http://pediatrics.aappublications.org/cgi/reprint/124/4/1244 Edited October 8, 2009 by VentMedic 1
Gypsy Posted October 8, 2009 Author Posted October 8, 2009 I'm a PVK teacher's aid who is also the school EMT. Which is very confusing. As a preschool we're not required to have any medical staff at all. If something did happen my boss would flip my title from teacher's aid to EMT. See why I started to freak out a bit? I just spoke to my boss and told her it was out of my scope. She wasn't aware of exactly what is was. She thought it was like an epi-pen. It's being sent home today and removed from the building. Which means I can breath alot easier. Thanks for your replies guys. :: takes a deep breath and goes back under my rock::
VentMedic Posted October 8, 2009 Posted October 8, 2009 (edited) I'm a PVK teacher's aid who is also the school EMT. Which is very confusing. As a preschool we're not required to have any medical staff at all. If something did happen my boss would flip my title from teacher's aid to EMT. See why I started to freak out a bit? I just spoke to my boss and told her it was out of my scope. She wasn't aware of exactly what is was. She thought it was like an epi-pen. It's being sent home today and removed from the building. Which means I can breath alot easier. Thanks for your replies guys. :: takes a deep breath and goes back under my rock:: Whose medical direction are you working under as an EMT? Is there a School RN covering your area? Is there paperwork the family has filled out? In Florida, several associations fought long and hard to allow medications in the school system after we had 5 children die in school from not having their asthma medication available to them. I would really hate to see the EMT scope of practice limit the effort that has been put forth into the legislation for the school systems. There needs to be a clarification of the guidelines as it is possible the teachers may have a larger "scope of practice" than an EMT in the state when it comes to giving medication as a designated caregiver working under the supervision of an RN. I would definitely clarify your job description and medical direction since this situation will occur again as more medical needs children enter the school system. Suctioning a trach may not be an EMT procedure either but you may also be doing that as a teacher or aide. Edited October 8, 2009 by VentMedic
P_Instructor Posted October 8, 2009 Posted October 8, 2009 Whose medical direction are you working under as an EMT? Ditto, you need medical direction to practice as an EMT.
fireflymedic Posted October 8, 2009 Posted October 8, 2009 (edited) Gypsy - in most states (I know here) that anyone who has been trained in the administration of rectal diazepam is allowed to give it. This may include teachers, nurses, principals, etc. If you have a student there which requires it then you are required to have at least one person for each "shift" the child may be there trained in its administration. Most schools do this as a teacher and the principal as if one is absent then the other can administer it in an episode of status as many school systems don't have a full time nurse for each school, but rather one that floats through the whole school system. It much be kept in a cool place (preferably locked if you can as it is a controlled substance). My guess is due to your experience in EMS you are one of the people chosen and there should be one other. If you do administer it, you do need to contact EMS as that was an episode of status and have them evaluated though that gives you a way of stopping the seizure prior to their arrival. It is no different than giving the other children medication that is prescribed to them. You are not functioning under specific medical direction at the time, but within the confines of a teacher and specific medical guidelines of when to give it. I would have no concerns. In this case it is essentially the same as an epi pen and if I were a parent of a child that required it in status, I would be frustrated to know you could have given it and didn't. The epilepsy foundations are really good at providing information on this type of stuff and they come around and do free trainings to schools, police depts, even EMS services if you request it and can clarify this for you. But you are perfectly legal to administer it. It is prescribed to the child, for a specific amount, under specific conditions. It is not a med which you can give at your discretion which is what is the difference. I'm sure there are other children which require medication throughout the day for certain conditions (ie hyperactivity, whatever). Would be no different than if you had a diabetic child which couldn't give themselves insulin but required it several times a day you would be able to give it due to the things I stated above. Take care. Edited October 8, 2009 by fireflymedic
Gypsy Posted October 8, 2009 Author Posted October 8, 2009 Ditto, you need medical direction to practice as an EMT. Ya I know my school director keeps flinging the fact I went to school for it around. I'm trying to get out of here fast.
VentMedic Posted October 8, 2009 Posted October 8, 2009 (edited) Ya I know my school director keeps flinging the fact I went to school for it around. I'm trying to get out of here fast. Clarify what school staff can do under the Florida legislative guidelines and those for your county/school district. You may just want to go with the title of Teacher's Aide with "some first aid training" rather than EMT. Fireflymedic's post summed it up nicely. The epilepsy foundations are really good at providing information on this type of stuff and they come around and do free trainings to schools, police depts, even EMS services if you request it and can clarify this for you. But you are perfectly legal to administer it. It is prescribed to the child, for a specific amount, under specific conditions. It is not a med which you can give at your discretion which is what is the difference. I'm sure there are other children which require medication throughout the day for certain conditions (ie hyperactivity, whatever). Would be no different than if you had a diabetic child which couldn't give themselves insulin but required it several times a day you would be able to give it due to the things I stated above. Take care. The asthma, allergy and respiratory therapy associations have been doing the same for breathing medicatons and epipens. However there are still a couple of states that have been reluctant to allow children to carry their inhalers or have them even easily accessible. Edited October 8, 2009 by VentMedic
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