BLS pushing ALS drugs in a "pinch"

[Thunderchild145]

^

Isn't it generally held that a student working with a preceptor has the same scope as the preceptor? I know that according to California law, if I have an EMT-Basic student with me during a shift then the basic can utilize the full basic scope while supervised.

Technically, the school at which the EMT-B/I/P student is attending should have a medical director and the student is practicing skills under the medical director's license. Least, that's how it works here.

[swn919]

Yeah I started thinking about that last-night. But what if the medical director at your service allows basics to push meds under the supervision of the medic?

[Lone Star]

I dont know why people are dancing around this topic when it has already been stated that there are clearly defined laws involved the unequivicably show that under no circumstances does the US basic push that med?

It black and white folks, there no other angle or spin. It is what it is. Follow the law.

Well said!

In MY protocols, I'm not allowed to push any drugs. I can assist with epi pens, I can assist with nitro, but I cannot push meds! It's plain and simple...I cannot push meds!

I don't care if the medic implies that I should, or outright orders me to.... I can't push drugs!

[JakeEMTP]

Yeah I started thinking about that last-night. But what if the medical director at your service allows basics to push meds under the supervision of the medic?

If your Medical Director allows Basics to administer medications, then they have lost their mind. Also, I wouldn't allow Basics under my supervision to push meds regardless of what the Medical director said in the protocols. It would be MY certification on the line if the patient took a turn for the worse. If the basic wants to administer medications, then they should continue their education and become medics.

This is so black and white, as stated above, that it borders on ridiculous that this thread continues.

[CBEMT]

Ok, different scenario. Not to be an @$$, I'm genuinely curious given the responses so far.

Nitro. Allowed for our Basics, of the patient's own med and with medical control. ASA. Allowed for our Basics with the usual precautions, other than that it's completely theirs.

Basic Bob is my partner. I'm an ALS provider. We get a chest pain call. I'm, say, setting up for a 12-lead, and I ask Bob to administer ASA. He does, and I think everybody would agree that this is no problem (unless you're the type threatened by Basics with asprin, in which case feel free to stop reading).

Now I'm looking for an IV, and I want the patient to get a nitro. Patient does not have a script. Can I tell Bob to give the patient a Nitro without incurring the wrath of the board?

[Lone Star]

Ok, different scenario. Not to be an @$$, I'm genuinely curious given the responses so far.

Nitro. Allowed for our Basics, of the patient's own med and with medical control. ASA. Allowed for our Basics with the usual precautions, other than that it's completely theirs.

Basic Bob is my partner. I'm an ALS provider. We get a chest pain call. I'm, say, setting up for a 12-lead, and I ask Bob to administer ASA. He does, and I think everybody would agree that this is no problem (unless you're the type threatened by Basics with asprin, in which case feel free to stop reading).

Now I'm looking for an IV, and I want the patient to get a nitro. Patient does not have a script. Can I tell Bob to give the patient a Nitro without incurring the wrath of the board?

In My protocols, the Basic cannot administer nitro that is not speciffically prescribed for the pt.

[Thunderchild145]

Now I'm looking for an IV, and I want the patient to get a nitro. Patient does not have a script. Can I tell Bob to give the patient a Nitro without incurring the wrath of the board?

That happens here. All the time.

More commonly though I'll ask the basic to set up a 12-lead while I start my IV, and as soon as I have a line in place I'll give the nitro. (If I tell the basic to give nitro and then I cant get a line in, I'll really be in for it; so I like to only give it to pts with lines established. Not partially, but all the way.)

[CBEMT]

In My protocols, the Basic cannot administer nitro that is not speciffically prescribed for the pt.

*headdesk*

[Lone Star]

Since you are NOT the pts physician, I fail to see what authority you have for writing prescriptions. You stated that the pt does not have a prescription for it. Falls back under the part of My protocols that says BASICS CANNOT ADMINISTER MEDS (outside of the previously mentioned exemptions).

This is the part where you should actually feel relieved that I'm not going to violate my protocols, and therefore risk your license for ordering me to work outside the scope of my licensure.

I worked too hard and it cost me alot of sacrifices to obtain my license, and keep it for the last 11 years with NO complaints or actions against it. I for one would like to see that record continue....

[CBEMT]

Since you are NOT the pts physician, I fail to see what authority you have for writing prescriptions.

What planet are you on? I said I'm an ALS provider, and if I decide the patient needs a nitro I'm going to give him one.

Reading comprehension- it does a poster good!

This is the part where you should actually feel relieved that I'm not going to violate my protocols, and therefore risk your license for ordering me to work outside the scope of my licensure.

Actually I'm not, I'm more worried about the fact that you can't pull yourself out of the textbook long enough to work in the real world, where sometimes I can only do 5 things at once and need my partner to be an extension of my hands.

I'm not even asking you to do something you don't know how to do! (IE push Morphine, which is what this topic was originally about.)

I worked too hard and it cost me alot of sacrifices to obtain my license, and keep it for the last 11 years with NO complaints or actions against it. I for one would like to see that record continue....

I can't wait for your 500 what-ifs that would somehow lead to you losing your license.