What advice would you give to a newly certified EMT?

[FDJohn]

Well, volunteering is a great way to get experience. Otherwise it's just like getting any other job. Put an application in. And, fyi you should check your local and/or state laws about having lights in your POV. Where I live volunteers are allowed to have lights in their cars but can only use them with sirens on the way to a cardiac event or structure fire.

[Dearing]

I was kidding about the lights. I don't think anyone would take a medical honda seriously anyway.

Thanks for the advice about the volunteering I'll try that while sending out resumes.

[supermoto69]

use your base hospital!! if you and your partner dont know its better to ask base for advise dont think of it as a pride thing think of it in a patient care aspect. radios are there for a reason

[Robb]

Originally Posted by supermoto69

use your base hospital!! if you and your partner dont know its better to ask base for advise dont think of it as a pride thing think of it in a patient care aspect. radios are there for a reason

Not trying to pick a fight but at the BLS level what exactly are you contacting a base physician for? I'm truly curious, we don't use BLS providers in my system at all.

[Tigger]

Originally Posted by NVRob

Not trying to pick a fight but at the BLS level what exactly are you contacting a base physician for? I'm truly curious, we don't use BLS providers in my system at all.

We have a "high-risk refusal policy" that mandates that medical control be contacted for a refusal if the patient is:

• Any patient under the age of 18 (where parental consent has not been obtained) or over the age of 70.
• Any patient who is a type 2 diabetic (taking oral medications for control of their diabetic condition) who is having a condition that may be diabetes related.
• Any patient who is under the influence of alcohol or drugs.
• Any patient with a head injury or altered mental status.
• Any patient who has attempted suicide or has verbalized intent to harm themselves or others.
• Any patient who was administered medications or reversal agents prior to or in the presence of the EMS personnel.
• Any patient whom the providers feel has a potentially serious medical condition that is in need of further medical attention yet refuses care (medical control may be able to help persuade the patient).

We are also supposed to call med control to administer repeat dosing of the patient's own NTG and if using activated charcoal.

[supermoto69]

Originally Posted by NVRob

Not trying to pick a fight but at the BLS level what exactly are you contacting a base physician for? I'm truly curious, we don't use BLS providers in my system at all.

In san diego emts cannot do a lot and my bls company has contracts with many SNFs who like to call us for emergent calls so if there is something that looks too advanced for me or there is something out of my scope that can be done to help the patient ill contact base hospital to see what they need me to do that way if something happens it helps cover me and it can potentially help the patient if I upgrade to als

[supermoto69]

Originally Posted by NVRob

Not trying to pick a fight but at the BLS level what exactly are you contacting a base physician for? I'm truly curious, we don't use BLS providers in my system at all.

I didn't mean a physician all the time either the MICNs can tell us to upgrade or drive code or we can handle it till we get to the hospital

[DEmedic]

Wait a second… You can contact the base hospital to see if there is "something out of your scope" that you can do to help the patient? Are you serious?

I would think the best thing you could do to help the patient would be to get a paramedic en route. And the best thing you could do to help yourself would be, not perform any skills outside your scope.

I understand contacting medical control for high-risk refusals. We have to do it too, simply as a CYA move. I've always been curious as to what's going to happen when the refusal doesn't go as planned. The guy who's had two or three drinks, sitting at home, doesn't want to go to the hospital… I call medical control and the doc says, "no way, bring him in." Yeah okay Doc. He doesn't want to go, he's at his house, he's not hurting anybody… I know you don't want to let them refuse but, sorry.

Anyway… I can see a paramedic calling for medical control when there is some question of performing something that might be off the page… But for BLS? If it's a BLS call, put them 'em the ambulance and drive 'em to the hospital. If it's not a BLS call, call a paramedic.

[leoemt]

Originally Posted by NVRob

Not trying to pick a fight but at the BLS level what exactly are you contacting a base physician for? I'm truly curious, we don't use BLS providers in my system at all.

At the BLS we need to contact Medical Control if we are to give NTG, ASA, or MDI's. We also need to call them if we have a high risk refusal or if we have questions concerning treatment.

If Basics in WA have IV Therapy endorsement, then they will need to obtain MPD authorization prior to administering drugs (ALS should be enroute)

[JPINFV]

Originally Posted by n7lxi

I understand contacting medical control for high-risk refusals. We have to do it too, simply as a CYA move. I've always been curious as to what's going to happen when the refusal doesn't go as planned. The guy who's had two or three drinks, sitting at home, doesn't want to go to the hospital… I call medical control and the doc says, "no way, bring him in." Yeah okay Doc. He doesn't want to go, he's at his house, he's not hurting anybody… I know you don't want to let them refuse but, sorry.

...and that's why I disagree with contacting medical control for refusals unless you think that the physician can talk the patient into going because, well... "the doctor said so."

Anyway… I can see a paramedic calling for medical control when there is some question of performing something that might be off the page… But for BLS? If it's a BLS call, put them 'em the ambulance and drive 'em to the hospital. If it's not a BLS call, call a paramedic.

I can see the need for med control for some funky DNR situations.