What can your EMT-B's do??

[Dustdevil]

If your agency does not have Paramedics, then there is only one skill I recommend be added to your BLS protocols: Pronouncing full arrests on the scene. If you can't do anything for them, then at least don't jeopardise other lives with a bunch of pointless, siren screaming, bat out of hell runs to the hospital with a dead body.

IV's and airways aren't going to bring those people back. And if somebody needs ALS, they need a Paramedic, not a wannabe.

[PRPGfirerescuetech]

If your agency does not have Paramedics, then there is only one skill I recommend be added to your BLS protocols: Pronouncing full arrests on the scene. If you can't do anything for them, then at least don't jeopardise other lives with a bunch of pointless, siren screaming, bat out of hell runs to the hospital with a dead body.

IV's and airways aren't going to bring those people back. And if somebody needs ALS, they need a Paramedic, not a wannabe.

We have that skill here, it works.

[hfdff422]

Indiana's EMT-A is the most pointless cert there is. You barely have anymore definitively life saving procedures than a B has available. The I cert has merit. While you should probably just finish it off, you at least have real cardiac and respiratory management drugs and equipment available. One of the area fire departments (all area departments are transporting EMS providers) is requiring all new personnel to become certified as at least EMT-I's within their first year on the department, and is looking at requiring all personnel to become certified to the intermmediate level. This is a wonderful move and will ikely result in more paramedics as they get no pay increase for the I level but get a nice boost at the P level.

In Indiana, B's are limited like most places. The only thing we have working in our favor is the use of dual lumen airways. I am not a big fan of these, but it is better than not protecting the airway (depending on the EMT- but I won't go into that story).

[DCMed124]

EMT-B in PA? we can drive... IF we have EVOC.

oh.. we can lift heavy things. occasionally.

of course, my favorite... I get to play with the lights and the air horn. weeeee!

ok, seriously... administer 02, assist with oral glucose, epi pen, inhaler and nitro (charcoal after med command / poison control says so).

most of the standard BLS stuff. package, transport, etc. can't check glucose levels, can't take a pulse ox. we can assist a medic with a combi-tube (read as take it out of the packaging).

oh wait.. yeah... we can take vitals!

there are some fairly active BLS squads around here, albeit normally covered / assisted by an ALS crew. PA doesn't recognize the EMT-I cert. you're a B, a P, a PHRN or a Doc.

[PRPGfirerescuetech]

DC-

Correct in all but 2 things.

Pulse ox is BLS, yes. Allowable with update training if service carries it.

PA will be recognizing EMT-I by the end of the year...

Glucometer use varies by region

[GEMSEMT]

Pulse ox is BLS, yes.

I agree with this statement to a degree... apparently there are some EMT's out there who are using this device and not their skills when assessing a patient. Indiana (or at least my part of it) took these off of our units for about 4 months. We just got them back. Apparently the Docs in charge of the state EMS protocols feel that since they don't actually teach how to properly use one in EMT-B class then no one can figure it out on their own. Then they changed it so that local Docs can approve use if they feel unit won't abuse them.

[The Hook]

I find this hard to say without sounding condescending. If you can't figure out how to use a Pulse Ox you may find yourself in the wrong field of work. There are only 2 numbers. As an EMT-B if you count out a pulse and match it up to one of the numbers; the other has to be the percentage of O2 the blood is carrying. These devices are usually fairly well marked.

Here is GA we actually didn't have EMT-B's until the spring of 05'. Their scope of practice is so limited here they wind up, quite literally, as drivers and vital sign takers. Which is a shame, though since we have had I's and P's for so long taking a step down was almost an awkward moment.

For all who do not know how to use these devices feel free to read the manual or ask someone who knows. You will find it a useful tool in assisting your diagnosis of a hypoxic patient. Again, please treat the PT and not the machine.

Kevin

[vs-eh?]

I find this hard to say without sounding condescending. If you can't figure out how to use a Pulse Ox you may find yourself in the wrong field of work. There are only 2 numbers. As an EMT-B if you count out a pulse and match it up to one of the numbers; the other has to be the percentage of O2 the blood is carrying. These devices are usually fairly well marked.

I find this hard to say without sounding condescending, that is not necessarily true. It is the ratio of bound to unbound hemoglobin.

There are various factors to also consider i.e. oxyhemoglobin disociation curve, CRAP, etc...

FYI CRAP =

C - Colour i.e. nail polish, ambient light, etc...

R - Reduced perfusion

A - Anemia

P - Poisoning

Remember the Fick Principal, etc...

PS - Yes, I'm in a bad mood...

[Dustdevil]

Again I agree with VS. Figuring out how to "use" the device is not the issue. It is figuring out how to utilise the information you get from the device that requires education. And that education involves a lot more than a crash course in a specific device. It requires a thorough foundation in physiology. If your personnel do not have that foundation, then save your money because they have no business with the Pulse Ox.

[Ridryder 911]

Again, another point for rationale of knowing what you are measuring, and what it means, more than "using the equipment. I would estimate >90% of EMS personal, does not know much about pulse oximetry, EtC02 capnography and the fundamentals of what, how and the significance of the device.

If one was to really study outcome base criteria on use of equipment, very few medics (over-all) would pass the grade.

R/r 911