What can your EMT-B's do??

[LeeAnnMedic]

I am curious about the training that Basics receive in other areas. Here in Mississippi, Basic are limited on the care or "procedures" that they can perform (legally that is). I think if companies are going to continue to team 2 Basics per rig in stead of Para/Basic teams, the scope of practice for EMT-B should atleast include Intibation and IV(saline), Re: Rural EMS.

All of you know, time is precious, and ALS is not always close enough to pick up the slack, alot of times they are not available at all. Some body please tell me that its not like this everywhere.

[Ridryder 911]

First, intubation or starting an I.V. is not a skill.. so just being able to "start or perform" is not the problem. Intubation & establishing an I.V. are procedures. Procedures have implications, risks, & side effects ( some potentially lethal or fatal).

Although I would like every trauma & medical patient be to intubated & have an lifeline established when needed, I also rather have them have it performed by a professional that is educated & trained in-depth on those procedures. Short cuts or temporary fixing the problem is never a solution when dealing with peoples lives. This has always been one of EMS pitfalls.

Proper assessment, basic airways, and intervention with ALS crews works very well. Although basic airway is not the "ideal" choice, it is very efficient when performed properly.

So if the problem is not having an advanced crew member on the rig.. Let us focus on that problem. Address the problem accurately, not substitute or fix the problem with placing inadequate or poorly trained individuals who only know the skill or technical aspect of a procedure.

Having the knowledge of the etiology of the disease and injury as well as the mechanism of your treatment modality is crucial. Understanding that even treating the patient you are disrupting the homeostasis of the body.

Be safe,

Ridryder 911

[noahmedic]

They already have a level that includes only intubation (why can no one seem to spell that word correctly!), and I.V. skills. In most states its called EMT-Intermediate, National Registry calls it EMT-I88.

[supasta.]

Now it is called EMT-Intermediate 99 which is the new standard.

EMT-I includes a lot more than just IV and intubation - It includes ACLS, cardiology, medication (no longer just assisting), and a much better understanding of EMS, events, traumas, etc. IMO Intermediate was very helpful to me, even though I am not recignised as an I.

Here in CO, Intermediates are not recognised by any services to my knowledge anymore, mabye a few VERY rural services. I know thatmany rural services rid of that, and no services in the city do.

Around here, being a basic without an IV certification, you won't find a job. Most if not all services require Basics to be IV certified.

All of the schools still offer the Intermediate courses (I-99) of which the first 2 weeks is the IV course. Thats how I got my IV certification. Or, many local schools offer a simple 2 week course for IV certification.

I do not agree that Basics should be able to intubate, however starting IVs is a crucial skill that all EMTs should have.

[LeeAnnMedic]

I do not, by any means think that proper patient care should be sustituted with an alternative type of care. What I am bascially concerned with, is that in areas such as mine, there are way too many people needing a Paramedics care and not getting it. A lot of problems here are "political" and not geared toward the actual care of patients. EMT-I is not recognized nor are they trained in my state. I completely understand your point, Ridryder, and I do mostly agree with you. But, if things continue to go the way they are going now (like in my area) these type of problems are going to have to be addressed somehow. But I dont think it will include forking out more $$ for employing more Paramedics which would solve the problem. Some insite:: My county,which has 3 towns in it, has a population of about 4,000 people(on record). 85% of the area is "backwoods" and some calls involve actually accessing your patient on foot, on an ATV or crossing a creek b/c the ambulance cannot reach their location and we have very few First responders.It is way too common for people in need of emergency care/transport that have to wait b/c the only ambulance we have is on another call. Thats right, we have only ONE ambulance. The company that runs our county is well established in other counties in Ms and in Al, but we are the only one that has only 1 ambulance. Why? more trucks would mean paying more paramedics.

So, I hope you now can understand my concerns and why I wont even work here myself.

[Ridryder 911]

I do understand the problem. A roving Paramedic unit may be able to increase response time for ALS. This Supervisor/ALS unit could rendezvous with the BLS unit. Cost would be decreased, since the call the volume of 4000 people would be less than a increased population area.

Good luck,

Ridryder 911

[Capman]

Northern Maine.

EMT-B = Very limited

This would include Vitals, splinting, BLS-CPR, Driving, and fetching supplies. Of course the operation of an AED is included in the BLS-Provider course.

In Maine we utilize the Intermediate provider level of EMS

This is a nice level if you like to play but don't want that huge responsibility. In this level you may Intubate, Recognize and defibrillate VFib and Pulseless VTach, start IVs, administer a small selection of medication with doctors orders which include Nitro, ASA, Albuterol and D50. (however protocol states if the Paramedic is present, he/she must administer the Meds).

I think these advanced skills should be left to this level. All Basics who want to play more should go back to school.

[FireMedicChick164]

in NY state EMT-B's can do BLS work, splinting, assist with nitro and epi pens, give O2, use a defibrillator, board and collar...all that stuff...

we have a level called EMT-CC (critical care) who can administer meds, start IV's, EKG's and intubate as well as BLS stuff

and then at the top is Paramedic..they do everything...

[Alcomedicism]

Here EMTBs are restricted greatly in what they can and cannot do. They however can start IVs as an ALS assist skill, Im very iffy on that decision I am not so sure if the Medical Director understands the possible consequneces of allowing this into the BLS SoP at this time w/o any professional training, the EMTs are being taught this skill/procedure by their medic partners as per directors orders.

-Alco

[GEMSEMT]

Here in the great state of IN we have few procedures available to EMT-B's. We can do basic first aid, Duel-Lumen Airways, ASA and Inhaler assists, AED Cardiac arrest management. We recognize the I99, and NREMT-P, and we have an additional level available to us, EMT-Advanced. It is a cert that allows Saline IV's and Cardiac Monitoring of basic rhythm management. In my county though we don't have medics available to us... 2 units are EMT-A. The rest of us have to fly by the seat of our pants and hope for the best. If the patient is gonna be a multi-system trauma that will involve extended scene time we use the Cincinnati Air Care flight team... Otherwise we load and haul tail. :twisted: