Paramedic practicing in ED

[scmedic85]

I am looking for information about Paramedics working in emergency departments and what skills they are allowed to perform.

I am a Paramedic and work in an ED in order to earn some extra money as my service isn't playing nice with the schedule. I have approached the ED leadership about allowing techs that are certified as paramedics to perform advanced skills such as starting IVs, fluid administration, tele transport from the ED to floor when admitted, etc (I'm currently bored out of my mind).

I am looking for information on other hospitals allowing their techs to perform any or all of these skills in the ED. If you respond and let me know that your ED allows tech IV starts please let me know if this is allowed by all techs or just a limited group (ie EMT-I/P).

 

[Pittsburgh77]

Where I'm from [Pittsburgh lol] we have ALS Techs in our EDs as well as basic PT. Care Techs.

Each perform within standard scope of practice. I know some Basic-Techs that take the phelebotomy (spelling?) course, and are then allowed to do IVs as well as the 12-lead class.

 

[lightsandsirens5]

As far as I know, WA does not allow that kind of stuff anywhere in the state. I have heard that might change sometime in the next few (read 25) years to allow EMS personnel to operate under their protocols in hospital. (With minor modifications obviously. Ie. medics can admin all medic drugs, but only after ordered to. And so on.)

 

[scmedic85]

As far as I know, WA does not allow that kind of stuff anywhere in the state. I have heard that might change sometime in the next few (read 25) years to allow EMS personnel to operate under their protocols in hospital. (With minor modifications obviously. Ie. medics can admin all medic drugs, but only after ordered to. And so on.)

I am in SC and DHEC (our EMS regulating body) does not allow it either. What we are looking at is creating an advanced emergency department tech position of which holding a current P card (and maybe I) would be a qualification.

My nurse manager is looking for information about what other hospitals are doing and I thought this would be a great place to gather some information. We actually have several hospitals in the general area that allow their techs to start IVs but they allow it for all techs regardless of prior certification.

I am interested in seeing just how far we can take this. I know many nursing organizations are opposed as they don't want to give up any control/skills to outside groups but most EDs are so overworked and under budgeted right now that this helps the nursing staff and almost everyone in my ED is in favor.

 

[lightsandsirens5]

That is pretty cool. Keep us updated if you would.

 

[LonghornMedic]

Our ER's use EMT-B, EMT-I and Paramedic as ER Techs. On occasion a Paramedic ER Tech might do a 12 lead. But all IV's and meds are done my RN's. ER Techs are nothing more than glorified CNA's. They go around collecting vitals, cleaning up homeless patients, fetching pillows and blankets and moving stable patients to the floor.

 

[scmedic85]

On occasion a Paramedic ER Tech might do a 12 lead.

Interesting, in our ED techs (medic or not) do practically all ECGs. The med surg floors are a whole different situation though, nurses dont even do them there... They have an ECG tech come do them.

 

[Mike Honcho]

I think it depends on what hospital you're at. When I did my EMT-B rotations in E.R., the paramedics were running I.V.'s and drawing blood. I was told by the same paramedics that another nearby hospital would'nt allow them to do either.

 

[TransportJockey]

As a tech in an ED in ABQ, I could run twelve leads, start lines, and do blood draws.
At university hospital in ABQ they hire medics with a limited drug scope, ivs and io insertion, suturing, and of course splinting and basic wound care like I did in my ed

 

[Shishkabob]

Really depends on the hospital.


Some hospitals hire only Paramedics as techs, and allow them to do alot. Some hire EMTs, Medics, CNAs, and MAs, and they all have scaled back skills.

Some hire all levels, but seperate Paramedics from the rest, and give medics more leeway.



Some allow all to start IVs and flush them. Some only allow techs to start IVs, but not even flush the line with 5cc of saline.


Some allow techs to give many drugs, some do not.

 

[Emtpbill]

I was working at a local ER in Philly, I am not sure of the legality but it was probably mre of a trust issue with the nurses. Many a times they would be busy and hand me IV Ativan to push on a patient and even would have me give morphine. Now obviously they are in my scope of practice but once you cross into the ER you are no longer the top doggy.

 

[MrBrown]

99% of ED staff here are either MDs or RNs we do not have "Techs"

 

[46Young]

I am looking for information about Paramedics working in emergency departments and what skills they are allowed to perform.

I am a Paramedic and work in an ED in order to earn some extra money as my service isn't playing nice with the schedule. I have approached the ED leadership about allowing techs that are certified as paramedics to perform advanced skills such as starting IVs, fluid administration, tele transport from the ED to floor when admitted, etc (I'm currently bored out of my mind).

I am looking for information on other hospitals allowing their techs to perform any or all of these skills in the ED. If you respond and let me know that your ED allows tech IV starts please let me know if this is allowed by all techs or just a limited group (ie EMT-I/P).

The Inova Health System has their techs start IV's, do blood draws (not arterial) and cultures, and also run 12's, but that's about it regarding paramedic capable skills.

 

[46Young]

We actually have several hospitals in the general area that allow their techs to start IVs but they allow it for all techs regardless of prior certification.

Hospitals hire phlebotomists to do their blood draws. Having a certified paramedic start lines when ordered shouldn't be an issue. It's my understanding that each particular hospital will train a new RN to do lines and such the way they want it. Training a medic to do the same would be a similar process, with similar results.

BTW, where do you work? I used to work for Charleston County EMS I was hired by them three years ago, but I only stayed for five months.

 

[FrostbiteMedic]

As far as I know, any ER tech here can start IVs...That being said, there are only two levels of EMT in this state, EMT-IV (read that 85 standard intermediate with a few things thrown in) and EMT-P (We also have CCEMT-P, but I am lumping that with regular EMT-P). So, starting IVs is a basic part of EMS here, and can be done on BLS rigs.....

 

[scmedic85]

Hospitals hire phlebotomists to do their blood draws. Having a certified paramedic start lines when ordered shouldn't be an issue. It's my understanding that each particular hospital will train a new RN to do lines and such the way they want it. Training a medic to do the same would be a similar process, with similar results.

BTW, where do you work? I used to work for Charleston County EMS I was hired by them three years ago, but I only stayed for five months.

Phlebotimists don't come to the ED, we are pretty much self sufficient for all skills with the exception of "rapid response" for CVA pts and respiratory to setup vents (but we don't let them intubate).

The interesting thing at the hospital I work at is that ED (not floor) techs can straight stick for blood but can't start IV as that would be administering medication with the flush.

I've been here for somewhere around 3-3.5 years so it sounds like we may have been hired at the same time.

 

[jjesusfreak01]

Techs can't do anything here, but techs are all CNAs too, so that's expected.

 

[scmedic85]

Phlebotimists don't come to the ED

young46 I apologize I think I misread your post earlier (on my phone). I thought you were saying they wouldn't need medics because phlebotomy could come if more help would be needed.

A little more background I should have provided up front as well:
We have already determined that we cannot just let Paramedics practice in the ED while working as ED Techs as the job description currently stands. I will likely be putting a proposal together to create a second modified tech position that we could call "Advanced ED Tech", "Critical Care Tech" (or some other way over complicated name that is not just Paramedic). I am trying to determine what skill sets these type of positions cover when Paramedic certification/licensure is a qualification for the position. At a minimum I hope to add IV starts, fluid administration, and the use of the cardiac monitor/defibrillator. ACLS drugs wouldn't be a bad addition but I won't be holding my breath for that. Hopefully by adding these skills I will be able to cure my boredome while helping the nurses out.

 

[RUGBY66X]

when I was in the ED the other day working on clinicals for medic a nurse tech was there complaining all she can do is ECG and vitals and then chart them because she wasn't a nursing assistant which are allowed to do those things and was even more pissed because I could do everything that the nurses could. The nurses just showed me the orders and i did just about everything for our section of ten beds while they just kept charting everything i brought back to them.

 

[Akulahawk]

when I was in the ED the other day working on clinicals for medic a nurse tech was there complaining all she can do is ECG and vitals and then chart them because she wasn't a nursing assistant which are allowed to do those things and was even more pissed because I could do everything that the nurses could. The nurses just showed me the orders and i did just about everything for our section of ten beds while they just kept charting everything i brought back to them.

Just wait until you get your cert and start working... something tells me that you won't have the same privileges if you were to work as a Tech there.