EMT basic scope of practice

[utjsh83]

I am a brand new EMT-IV in Tennessee. I am an EMT basic and in Tennessee we offer a special license for EMT basics to start IVs and give certain meds via IV. I was also trained to give shots IM and SC.

I was wondering if anyone knew if EMT basics are allowed to give any medications via IM with a doctor's orders and under a doctor's supervision.

thank you,
Jason

 

[medic417]

Search of the site will show a heated debate on that very subject last week.

 

[utjsh83]

Thank you. I am new to the site. Do you mind pointing me in the direction of that debate?

 

[Shishkabob]

Look for the locked one



http://emtlife.com/showthread.php?t=10871

 

[medic417]

Look for the locked one



http://emtlife.com/showthread.php?t=10871

Did we get that one locked with our varied opinions?

 

[Shishkabob]

Did we get that one locked with our varied opinions?

I believe we did.... funny considering we kept saying the same things over and over just using different words

 

[medic417]

I believe we did.... funny considering we kept saying the same things over and over just using different words

No we didn't. We never said the same thing over and over.:blush:

 

[Shishkabob]

No we didn't. We never said the same thing over and over.:blush:

I mean, I said my view, and you said yours, and I said mine, and you said yours, and I spelled a word wrong in mine, and you made fun of it and said yours.

 

[medic417]

I mean, I said my view, and you said yours, and I said mine, and you said yours, and I spelled a word wrong in mine, and you made fun of it and said yours.

Your view is wrong mine is right. Or was it we were both wrong and someone else was right? Or was it I was wrong? :wacko:

 

[Shishkabob]

Your view is wrong mine is right. Or was it we were both wrong and someone else was right? Or was it I was wrong? :wacko:

D. None of the above.

 

[medic417]

D. None of the above.

Or was it E. Can not even agree to disagree. B)

 

[daedalus]

As KEVD would say; (face palm)

The debate over EMT use of medications is the stuff of legends. I think we all know where each of us is on the polarized spectrum between increased scope of practice vs. complete elimination of EMTs.

I think its fair to say we all want to do what is best for our communities and patients; and therein lies the answer. The best thing you can do for your patients is to educate yourself; not take a 10 hour EMT add-on class; but really truly understand the human organism.

When you do, you will see that IM medications and IVs make little overall difference in the outcome of your patient.

I know the argument because I used to argue with the EMTs that begged for little gives, I mean, come one, why can't we use a glucometer. Its so simple that patients do it to themselves at home! Its embarrassing that I have to ask a patient to check it themselves when I am supposed to be the professional here to help them. Perhaps it is, but it serves as a mechanism to demonstrate that you, as an EMT, cannot provide comprehensive prehospital care to your patients, and perhaps the patient deserves the best form of prehospital care modern society can give, better yet, we are a capitalistic society so perhaps the public deserves the level of EMS they want to pay for. If we let the public know that the ambulance responding to their daughter's difficulty breathing episode that the crew cannot give medications to terminate the episode like albuterol or epinephrine, cannot preform advanced airway procedures if she stops breathing, and does not even understand the physiology of her disease, what do you think the public is going to do? Its going to demand and insist ALS care. Not EMT-Add-on/IV/Airway/etc/ABCDEFG

ALS care. We never delineate medicine anywhere else. Medical care is just that, and without mindless "levels" like BLS or ILS or ALS. I think its time we show the public what has been pulled over their heads.

 

[Shishkabob]

Well, in Texas, B's are allowed Epi/Albuterol/Glucometer/Intubation/NTG and other "ALS"-esque procedures.


So does that make Texas wrong for having been educated on them and doing them when the majority of the country has/is not?




EDIT: hehe, here we go again. Shall we just stop before it goes any further?

 

[daedalus]

Well, in Texas, B's are allowed Epi/Albuterol/Glucometer/Intubation/NTG and other "ALS"-esque procedures.


So does that make Texas wrong for having been educated on them and doing them when the majority of the country has/is not?





EDIT: hehe, here we go again. Shall we just stop before it goes any further?

No it does not make Texas "wrong" (besides, I am not about to argue with a Texan ). I am only kidding. You do what you think is best for your community, and like I said, that is what we all want.

Just because we have good intentions, does not make a practice correct. Perhaps using these medications is a practice that you have had for a while, and therefore see it as your own truth. All I can say is, do you know the pharmacokinetics, potential interactions, dosages, indications, and mechanisms of all the drugs you list above? Does any of that even matter in the prehospital world?

 

[medic417]

Well, in Texas, B's are allowed Epi/Albuterol/Glucometer/Intubation/NTG and other "ALS"-esque procedures.


So does that make Texas wrong for having been educated on them and doing them when the majority of the country has/is not?




EDIT: hehe, here we go again. Shall we just stop before it goes any further?

Actually its the medical director not the states call in Texas. If the medical director says first responders can do open heart surgery they can. Does not make it right, but they can do it.

 

[Veneficus]

Actually its the medical director not the states call in Texas. If the medical director says first responders can do open heart surgery they can. Does not make it right, but they can do it.

it's like a whole nother country

 

[Shishkabob]

No it does not make Texas "wrong" (besides, I am not about to argue with a Texan ).

HEY NOW, don't be insulting me like that. I am NOT a Texan, I just live here. I'm a Michigander.

All I can say is, do you know the pharmacokinetics, potential interactions, dosages, indications, and mechanisms of all the drugs you list above?

To the extent we're required, and then some, yes.


I know each school is different, but mine spent 3 weeks on just the 7 drugs that Basics can use in Texas. Some might think 3 weeks is nothing, and that's their opinion. We were taught indications, contraindications, side effects, dosage, actions, form of medications, and route.

The 7 drugs were Albuterol, oral glucose, Nitro, charcoal, Epi, ASA, and O2. Now, as to why we're allowed albuterol instead of Xoponex, no one knows.

Does this mean I know everything about every drug? Nope. And I don't pretend to.

Texas' scope of practice for B's is assist PTs with their own meds, or use on other PT's who meet the criteria, whether or not they have been prescribed it.

Actually its the medical director not the states call in Texas.

Actually, if the state didn't want us to do it, it doesn't matter what the MD said or not. Texas allows it, not all MD's put it in protocols. Heck, my Basic class didn't teach intubation because most MD's only allow I's and P's to do it.

 

[daedalus]

The Board of Medicine might not be to please with one of their physicians extending his surgical abilities to field providers....

But I know what you mean. My company used to run 911 in Texas, and three Texas BLS 911 rigs still with their plates and everything sit in the back of my station's parking lot. I have gone through them before for supplies, and I find combi-tubes, glucometers, tackle boxes full of IV equipment, and ET tubes.

 

[Shishkabob]

The Board of Medicine might not be to please with one of their physicians extending his surgical abilities to field providers....

But I know what you mean. My company used to run 911 in Texas, and three Texas BLS 911 rigs still with their plates and everything sit in the back of my station's parking lot. I have gone through them before for supplies, and I find combi-tubes, glucometers, tackle boxes full of IV equipment, and ET tubes.

Heh, I remember on my first clinical on a truck, the medic asked me to get a BG reading on a PT. I was like "Umm... huh?"

I've never had a family member with diabetes and I had never done it before. Learned fast though, and did it dozens more times in the next 100 hours. Not that it required much training, but it was still new.

 

[medic417]

I'm a Michigander.

I knew there was a reason I didn't like you.:glare: