EMT without medical direction

[FFmed]

You got it! Just like if I give you 800mg of ibuprofen it is a recordable, but if I give you 400mg and tell you to take 1 pill every 4 hours, it is a non-recordable.

And the "other duties as assigned" allows me to have you sit at a desk and stack papers or twiddle pens instead of getting a "lost time" on record.

If I sutured someone, recordable. If I used butterfly strips, non recordable. If I used dermabond, recordable. If I instruct patient how to use dermabond on their own, non-recordable. All the rules exist for one reason or another, yet every single one of them has a complete workaround.

Geez..did you go straight from EMS into this job? How long did it take to really settle in and become comfortable? Did you ever have to provide more than first aid?

 

[akflightmedic]

I was a govt contractor for many years, prior to my own medical business. I deployed as a medic, then took all the OSHA classes through the employer, then transitioned into a newly created "Safety Medic" role which meant they now rolled up two high paying jobs into one and gave me a fractional increase in wages that while ok at the time, in hindsight was an insult. Especially once deployed to remote FOBs and being the only medic/safety guy on site, and being expected to control recordables with the care I give or do not give....and also to turn a blind eye to many of the very unsafe operations taking place under the Camp Manager's direction who is responding to the US Gov daily demands and pressures.

'Twas a huge conflict of interest all the time...so I stuck to working out and being a hermit in my clinic/living container. Required inspections were announced way in advance at the morning meeting for all to plan for. See me walking, you best be doing the right thing.

 

[BillEMTP]

I worked for a nationwide company that did mostly clinics at job sites. We were in a convention center doing first responder type calls. We also handed out OTC meds.

I got nervous about doing this with no medical direction. Their protocols were geared for clinics and didn't address the type of calls we were running. I asked the manager about needing a first responder permit. I was told it wasn't necessary. Needless to say I don't work there anymore.

 

[HardKnocks]

As long as the LEMSA says it can be done, it’s a basic skill.

Some of us practice in Multi-State Jurisdictions.

EMS Rules under the following State(s), (TX, FL, ID, AZ.), made no references made to the term LEMSA.

You have to remember that there are a large number of visitors to the forums that are just beginning in this career.

 

[DrParasite]

As for the meds, these are all OTC meds. If these people were at home, what would they do? They get a headache, they go to their medicine cabinet and they chug some pills. They are adults and at work. They get a headache, oops they do not regularly carry tylenol, and they do not want to go home. They just want a pill and to keep working. Give them a dang pill. They do not need physical exam, vitals, etc. They are not "patients" in the context we normally see patients in. They ate a sausage biscuit from a questionable gas station on the way in to wok, now they got the poops...give them some Imodium. Back to work. One standby company I worked for many moons ago (for anyone who wants to argue the above about this being "prescribing meds"), we simply had a large tackle box filled with OTC meds. We pointed at the box, said help yourself and left it at that. You know, treat people like adults.

The problem is, OTC meds are still meds that need approval, at least from the prehospital guidelines. Your standby company did what we used to do: we won't give them the meds, but if they want to get it from the cabinet, they can get what they want. it's stupid, that some places don't let EMTs give benedryl for an allergic rxn, or tylenol for a headache, but mom and dad could give it to their kids or each other with no issues.

As for the original question, I interviewed for a job as an OMT (occupational medical technician), which sounds like what OP is describing. they required you to have an EMT cert to get hired, but once hired, you followed the employers SOPs (which, in theory, were signed off on by a doctor, somewhere in the US). Some of the procedures were beyond the scope of your basic EMT, but, as it was explained to me, you weren't functioning as an EMT, so you had a wider scope of what you can do. The whole idea was the prevent recordable incidents, and to prevent 911 and OSHA from seeing any elevated numbers. Suffice it to say, I said thanks but no thanks.