Crossing State Lines

[mikie]

I don't think this has been discussed in length (that I could find), so I'd like to ask!

For services that are close to state borders, how does that work?

If you're crossing state lines, are you now obligated to follow that states protocols?

Anyone have experience with this?

I guess this same question would apply to flight crews as well.

Thanks!

 

[KEVD18]

i know this was just done, but oddly i dont feel like looking it up for you, so i'll just repeat myself(whats this world coming too)

you always follow to protocols of the state in which you, your company and in turn your vehicle are licensed. it would be somewhat problematic to expect us to memorize the protocols for every state.

the last time this was discussed, the angle of what to do in the event of stumbling across another call(onsighting an mva etc). remember, you may currently hold a license/cert in your home state and you may very well carry a ticket in an adjoining state but unless you, your partner, your company and the vehicle are all properly licensed in a state, you cant work their. you are then limited to the first responder level only, regardless of your level.

i used to work for a service that did very frequent interstate transports. the va almost always chooses to transport by ground, sometimes two or three or more states away.

 

[KEVD18]

well imagine that, back to my old ways in less than 10 minutes:

http://www.emtlife.com/showthread.php?t=9175

if i relapsed that quick in other areas of my life, id have real problems.

 

[medic258]

Much like KevD stated, you always follow your state or local protocols. The only difference is if you and your service are dual licensed. There are a few services in Mass that are. The 2 that come to mind are Alert (some trucks) and Blackstone FD. Both are dual licensed in RI. I think AMR might have some dual licensed trucks in NH as well.

It is always fun intercepting with out of state services. The is usually some discussion between the medics and basics about what to do. For example in one area of Connecticut, BLS must go to the closest facility period, unless medcon tells them otherwise. When we arrive, under Mass protocol, we can transport to the closest "appropriate" facility. This is usually only an issue with trauma patients. The crews never have an issue with it. They just get concerned for their ticket and who can blame them in todays "screw everyone" world.

 

[mikie]

wow, Now I feel stupid!

I remember that thread now. I even posed the same question..

doh!

well, i'm going to cry in the corner. :blush:

[thanks for the response though!]

 

[KEVD18]

Much like KevD stated, you always follow your state or local protocols. The only difference is if you and your service are dual licensed. There are a few services in Mass that are. The 2 that come to mind are Alert (some trucks) and Blackstone FD. Both are dual licensed in RI. I think AMR might have some dual licensed trucks in NH as well.

It is always fun intercepting with out of state services. The is usually some discussion between the medics and basics about what to do. For example in one area of Connecticut, BLS must go to the closest facility period, unless medcon tells them otherwise. When we arrive, under Mass protocol, we can transport to the closest "appropriate" facility. This is usually only an issue with trauma patients. The crews never have an issue with it. They just get concerned for their ticket and who can blame them in todays "screw everyone" world.

i used to work for alert. one thing you missed is both emts have to be dual licensed. i never got my ri ticket, so i could do call from ma to ri but not the reverse.

 

[medic258]

i used to work for alert. one thing you missed is both emts have to be dual licensed. i never got my ri ticket, so i could do call from ma to ri but not the reverse.

You are right about both EMT's. That must have slipped my mind. Thanks.

According to the regs, I don't have the specific number off the top of my head, you can transport a patient from another state to MA. The caveat being the call must begin or end in MA. I have taken both ALS and BLS patients from other states. When I was a basic I took someone from Delaware to MGH.

 

[KEVD18]

According to the regs, I don't have the specific number off the top of my head, you can transport a patient from another state to MA. The caveat being the call must begin or end in MA. I have taken both ALS and BLS patients from other states. When I was a basic I took someone from Delaware to MGH.

ive been all though this with ma and ri oems. it was a whole big hoopla when i was at alert. i cant speak to any other state, but it was expressly prohibited for a mass only emt to go into ri, pick up a pt and come back to ma. i cant remember exactly how the rules were written though. it boiled down to it was ok with one state as long as the other state said it was ok and that state said no. i just cant remember who the dissident was.

 

[medic258]

ive been all though this with ma and ri oems. it was a whole big hoopla when i was at alert. i cant speak to any other state, but it was expressly prohibited for a mass only emt to go into ri, pick up a pt and come back to ma. i cant remember exactly how the rules were written though. it boiled down to it was ok with one state as long as the other state said it was ok and that state said no. i just cant remember who the dissident was.

Makes sense. Too bad we can't have the same protocols for all states. Got to go, Sox are on.

 

[KEVD18]

Makes sense. Too bad we can't have the same protocols for all states. Got to go, Sox are on.

nope. that would make too much sense. all states operating under the same rules and regulations. one cert for the whole country. nope, thats crazy talk.

 

[medicdan]

I know AMR has a whole bunch of dual certified MA/NH trucks-- with corresponding crews-- that are stationed in NH, but come down for transfers/city coverage often. I understood they they have a waiver with both OEMSs that they can do non-emergency transfers if one crew member is dually certified--the caviat being that they have to tech the call-- as long as the other crew member is EMT-B in the other state. I understand this is only true for BLS transfers.
In terms of responses across state lines-- that's different. There are a few fire departments in western MA that respond to CT/NY often, and I dont believe they need the cross certification, as long as it comes through as Mutual Aid and they transport back into MA.

 

[JPINFV]

Makes sense. Too bad we can't have the same protocols for all states. Got to go, Angels are on.

Fixed:excl:

 

[KEVD18]

Fixed:excl:

you should be ashamed of yourself.

 

[JPINFV]

At least my team isn't named after a piece of clothing.

 

[flhtci01]

Makes sense. Too bad we can't have the same protocols for all states. Got to go, Sox are on.

That would make it way too easy. Currently licensed and respond in three states. That does not include the state of insanity.:wacko:

 

[JPINFV]

The problem with national protocols is that it assumes that every location has the exact same needs.

 

[KEVD18]

The problem with national protocols is that it assumes that every location has the exact same needs.

i disagree.

national uniformity in the certification and licensing of emts would makes the basic rules and procedures the same for the entire country. a specific jurisdiction could modify the protocols for that area by limiting certain skills if deemed unnecessary for a particular area. but everybody would be initially trained and certified at the same level, from the same book, taking the same tests.

the theory that an emt needs to know less or more because they live in a particular area is what has destroyed the foundation that could have served as the platform for the best ems system in the world.

 

[JPINFV]

National protocol!=national certification/licensing?

Furthermore, whose protocol do we follow? The watered down paint by numbers method favored in places like Los Angeles or the places that are on the front lines of advanced care with good CPAP, RSI, etc procedures and QA/QI (i.e. places where RSI isn't killing patients)? Are we going to say that someone with an average 30 minute transport doesn't need RSI because the people with the 5 minute transports do not preform it enough to remain competent? Alternatively, are we going to force people to remain competent for skills that they'll never preform because the risk to reward ratio is so skewed to risk so somewhere else needs it? Furthermore, if everyone adds or subtracts interventions, what good is a national standard?

Furthermore, who decides the protocols? It's arguable that it's not really constitutional for the federal government to control it (it's a hard case to use interstate commerce as constitutional justification and I highly doubt that there will be enough support to use the 'power of the purse' a la minimum drinking age legislation.). Hence there's a reason why each state maintains their own boards for nursing and medicine.