Security staff trained as EMT's

[djones44]

In large building complexes, how practical would it be to require that at least one security staffer each shift have an EMT ticket (and pay)?

I see that as complementary to having an AED PAD in the lobby, until EMS crews can fight their way there. Covers STEMI's as well as SCA's. Look at the modest cost increment of one EMT ticket versus the enormous protection that building is given.

If this was about fire, I don't think I'd have to ask.

Chimpie, you were a security person back in the day?

 

[C.T.E.M.R.]

Sounds like a good idea to me, especially if its a factory or distribution center etc., I dont think it should have to be EMT, i know most states have a level just under EMT and above basic first aid, close enough to EMT just with a few less skills under the scope of practice.

 

[zombiemedic]

Here in las Vegas the larger casinos have security / EMT staff. Great for cardiac arrests since it takes us forever to get in there

 

[djones44]

Sounds like a good idea to me, especially if its a factory or distribution center etc., I dont think it should have to be EMT, i know most states have a level just under EMT and above basic first aid, close enough to EMT just with a few less skills under the scope of practice.

Thanks for making that distinction, Nolan.

Ideally I would want to see the guy with the ticket be allowed to run a LifePak 15, because vital signs monitoring and ePCR etc. connects with d2B procedures and upgrades the basic AED function to cover STEMI's.

Given that requirement, what level of ticket would ordinarily be required? What might the issues be?

 

[Shishkabob]

Covers STEMI's/QUOTE]

How so?

 

[djones44]

Covers STEMI's

How so?

That's what I'm trying nail down. What does it take, training and ticket wise, equipment-wise, infrastructure, etc. to get to the point where cardiac emergencies are dealt with as a whole, not just AEDs being there for SCA's.

 

[TransportJockey]

That's what I'm trying nail down. What does it take, training and ticket wise, equipment-wise, infrastructure, etc. to get to the point where cardiac emergencies are dealt with as a whole, not just AEDs being there for SCA's.

A full hospital with twenty four hour cardiac cath lab.
The closest you will get prehospital is a full paramedic response.

 

[Handsome Robb]

Well, you can't see a STEMI without a 12 lead, and only Medics can use 12 leads, so I don't know how cost effective that would be. The only feasible way to get a leg up on cardiac stuff would be to have an I on staff w/ protocols in place for ASA and Nitro with symptomatic CP. Then Epi, Atropine and antidysrhythmics(sp?) cardiac arrest. But to administer those drugs we need a monitor to actually see the rhythms before you pushed a drug so even then I don't know how feasible it would be.

 

[Chimpie]

Chimpie, you were a security person back in the day?

Yep, worked at an automobile manufacturing plant. We did all the firefighting and EMS response. We were trained at the Medical First Responder level. We had EMT's and Medics on staff but only operated at the MFR level.

There were other plants that practiced at the medic level, however.

 

[djones44]

Yep, worked at an automobile manufacturing plant. We did all the firefighting and EMS response. We were trained at the Medical First Responder level. We had EMT's and Medics on staff but only operated at the MFR level.

There were other plants that practiced at the medic level, however.

I guess there's a key issue of scale - if the facility is big enough then one of the crew on each shift can be a paramedic, and it's justified, especially in dangerous industrial venues.

I'm still trying to rescue the idea here of getting a monitor/defib into very large residential and business complexes. Some are worth half a billion dollars but that $20K machine escapes them, when it can have such an impact.

To my untrained way of thinking, if the electrodes were connected and then put online by the actions of that modestly trained security person, and all the proper parties alerted, is there any way that could work?

How could we do this so that it got more of these machines into play while awaiting EMS crews?

 

[Shishkabob]

Well, you can't see a STEMI without a 12 lead, and only Medics can use 12 leads, so I don't know how cost effective that would be. The only feasible way to get a leg up on cardiac stuff would be to have an I on staff w/ protocols in place for ASA and Nitro with symptomatic CP. Then Epi, Atropine and antidysrhythmics(sp?) cardiac arrest. But to administer those drugs we need a monitor to actually see the rhythms before you pushed a drug so even then I don't know how feasible it would be.

I don't know about you, but I can see ST-elevation on a 3-lead.


Plus, atleast here in Texas (and a couple of other states I know of) EMTs can give ASA and NTG, don't need an I for that.

Plus, you don't need a monitor to push Epi, as (whether wrong or right) it's used for every cardiac arrest event.



And there are a few AEDs that have a basic monitor screen on it so you can see simple rhythms.

 

[Akulahawk]

If you're going to put cross-trained EMT/Security Guards in the facility, probably the easiest way to equip them would be with an AED that can be put in monitor mode OR that has electrodes & pads that can interchange with whatever monitors the 911 folks are using. The next thing to do is ensure that someone is always available to direct incoming crews to the correct location. Basically, the EMTs need to be able to provide the same level of care as the local EMTs.

As I see it, the AED will help with the SCA issues and guiding the responders in will help with transport, which will definitely assist STEMI and non-shockable events... both of which will require transport and evaluation at an appropriate facility, preferably one with a Cath Lab.

 

[JPINFV]

How often do most businesses need ANY EMS response, little less one for STEMI or SCA? An AED is one thing because it sits in it's little box and costs very little to keep up to date. However, how are you going to ensure that the security guard/EMT at an office complex sees enough patients to be comfortable giving care, in addition to maintaining CMEs?

 

[djones44]

If you're going to put cross-trained EMT/Security Guards in the facility, probably the easiest way to equip them would be with an AED that can be put in monitor mode OR that has electrodes & pads that can interchange with whatever monitors the 911 folks are using. The next thing to do is ensure that someone is always available to direct incoming crews to the correct location. Basically, the EMTs need to be able to provide the same level of care as the local EMTs.

As I see it, the AED will help with the SCA issues and guiding the responders in will help with transport, which will definitely assist STEMI and non-shockable events... both of which will require transport and evaluation at an appropriate facility, preferably one with a Cath Lab.

Thank you for these superb comments, Akulahawk.

First - having the security people well versed on guiding in the EMS people is essential. That should be obvious, cheap, and hopefully already basic to their 'training'; but if not it has to be addressed.

Second - putting the AED into monitor mode - you're teaching me that a fully featured pro AED with compatible leads could almost cover the base here. I like that, because it moves things away from the voodoo status of a monitor/defi.

Beefing up the hardware and some heads-up security training could be the solution, especially with the next generation of AEDs with communications functions.

 

[djones44]

JPINF said

How often do most businesses need ANY EMS response, little less one for STEMI or SCA? An AED is one thing because it sits in it's little box and costs very little to keep up to date.

Agreed. The answer seems to lie with the AED and its evolving communications functions.

 

[Handsome Robb]

I don't know about you, but I can see ST-elevation on a 3-lead.


Plus, atleast here in Texas (and a couple of other states I know of) EMTs can give ASA and NTG, don't need an I for that.

Plus, you don't need a monitor to push Epi, as (whether wrong or right) it's used for every cardiac arrest event.



And there are a few AEDs that have a basic monitor screen on it so you can see simple rhythms.

I stand corrected.

You are right about a B with ASA and NTG, but the rest of it you gotta be an I.

I was always taught 3 leads were non-diagnostic even if you can see a STEMI in them.

 

[JPINFV]

From my understanding, it is UNLESS you force the monitor to use the 12 lead filter ("diagnostic mode").