[akulahawk]

Originally posted by DaleGribble
If you have any type of proof you need to take it to whatever state office is over EMS in your state!

I absolutely agree. A FR administering NTG/ASA from the drug box is a huge no-no. That is even with a properly certified person overseeing the administration. This way out of the scope of practice of any first responder and most EMT-B's.

About the only time a FR trainee MIGHT be able to work as a "Lead Tech" would be during training AND the preceptor was present at all times during delivery of patient care. Even then the care given may not exceed (in this case) FR level. Once the level of care required exceeds the FR level, then the FR may assist but the EMT (or higher) functions as lead. Otherwise, the FR is practicing w/o a license and the preceptor is responsible for any bad outcome that the FR trainee does.

When I was actively working as an EMT-P, I allowed my BLS partner to assist me in setting up for ALS procedures, but I refused to allow my partner to DO any ALS as it was out of their scope and if they goofed, would put me in legal jeopardy.

If you have ANY concrete proof of this happening, most definitely report it to the appropriate medical authority at the state or county level.

 

[akulahawk]

I used to work in Santa Clara County as an EMT. When I left that county, there was talk of adding to the EMT Local Optional Scope of Practice. Effectively you'd have 2 types of EMT-1's: the garden variety and those certified in specific ALS meds and procedures. Above them you'd have Paramedics.

I just rechecked that county's protocols. There is now a mechanism by which an EMT-1 can be certified by the county in certain ALS procedures. Effectively the county is raising the EMT-1 to something just short of an EMT-2 (intermediate). The added stuff for that county's EMT's now CAN include:
-Albuterol Nebulizer
-AED
-Laryngoscopy w/ use of forceps
-OTI Adult/Peds
-Combitube
-ASA/NTG for chest pain
-Glucometry & Glucagon use for Hypoglycemia/ALOC
-Epi for anaphylaxis
-Naloxone for suspected Opiate OD/ALOC

Note: Nothing is allowed to go via IV as these EMT's are NOT allowed to start IV's. ASA is given PO, NTG is given SL, and injectables are given deep IM.

Just before I left, I was trying to get my company to go ALS so I wouldn't have to deal with those restrictions... and just be able to DO full bore ALS. We had to give away many contract/private emergency calls, (we weren't a primary 911 provider) because we didn't have a county accredited EMT-P, due to scene/transport time protocol limitations that applied ONLY to BLS providers.:frown: