RE: Limiting Law of Paramedics

[Guest guest]

Vern,

Have we not learned that when it comes to BNE and nurses, that WE as

EMS give them what they want..i.e. a RN with a pink patch instead of

a red patch because it was not fully earned, but based on

their " LICENSE " we give them what they want! But, when the shoe is

one the other foot, we are not " QUALIFIED " to work outside the pre-

hospital setting, and when we try, they throw up the fact that we

are " not licensed personnel " . Yet, we have a state agency that

issues a license based on a college education and various degrees

from 4 yr colleges, but the BNE want and " REFUSES " to acknowledge the

licensed paramedic as " licensed personnel " .

However, as a state, we bend over backwards to make the nursing

community happy when it comes to EMS. We all deal with some of these

stupid, yes I said STUPID nurses everyday in hospitals and ER's.

Most are too busy grazing to have the pt ready when you get there.

But, yet if they wanted to an EMT or Paramedic, the State of Texas

would hand them a certification. I have always said, until the

nursing community and BNE starts to give us what we want, WE as an

EMS community, SHOULD NOT given them what they want. They should be

made to EARN an EMS certification just like everyone else did, and

that is to place your behind in a chair in a classroom and attend the

ENTIRE program.

What we need to do, is place this same statement in our code to say

that nurses are " UNLICENSED PERSONNEL " in the pre-hospital setting.

I have had more than one nurse escorted off scene by police and

almost had a few arrested for being in the way, and using the " I'm a

nurse " routine. The reply is usually, " that's good, you can leave

now " .

Sorry for the rant, but after today, you caught me in just the right

mood to rant about this.

Fire away....

Wayne

- In , " Verne " <vernew@l...> wrote:

> I am frustrated to find out that we as providers of emergency care

are so

> limited by the wording of this law. '...certified by the

department as

> minimally proficient to provide emergency prehospital or

interfacility

> care...'. Here is a paragraph that was published in the RN Update.

>

> BNE staff confirmed with the Bureau of Emergency Management,

under the

> Texas Department of Health, that the laws governing EMTs and

Paramedics in

> 25 TAC 157.2 are limited to performing duties in the " prehospital

and

> inter-facility transport " settings. Therefore, whether

certified or

> licensed, the BNE delegation rules view EMTs, paramedics, or other

> similarly trained staff as " unlicensed assistive personnel " (UAPs)

when

> working in acute care in-patient settings, such as the

Emergency Room. The

> NPA and Board Rules are available in their entirety on our web site

> www.bne.state.tx.us

>

> Maybe I see this one wrong, however it appears to me that we handed

this one

> to the BNE on a silver platter. How do we work to provide the

skills and

> knowledge to a needed population, regardless of the confinements of

the

> building? How do we as a group of professionals work to change

this law?

> We should not have laws that restrict us to a place or event, but

more

> appropriately within a scope of practice.

>

> Verne

>

>

> TITLE 25 HEALTH SERVICES

> PART 1 TEXAS DEPARTMENT OF HEALTH

> CHAPTER 157 EMERGENCY MEDICAL CARE

> SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

> RULE §157.2 Definitions

>

> (35) Emergency medical technician-paramedic (EMT-P) - An individual

who is

> certified by the department as minimally proficient to provide

emergency

> prehospital or interfacility care by providing advanced life

support that

> includes initiation and maintenance under medical supervision of

certain

> procedures, including intravenous therapy, endotracheal or

esophageal

> intubation or both, electrical cardiac defibrillation or

cardioversion, and

> drug therapy.

[Guest guest]

Verne,

The nurse vs. paramedic issue is a hot topic that causes some to get pretty

worked up, so I won't comment on the bulk of your message, but I do want to

speak briefly on your " scope of practice " comment.

Personally, I like the fact that Texas is without a paramedic scope of

practice rule. Scope of practice regulations are more often a limiting

rather than an enabling factor. The rules generally state something like

" manage patients in accordance with Department approved EMT-paramedic

training curriculum " . In other words, medics are limited to providing care

based upon the most recent curriculum, which may be several years old. In

Texas, because we are not limited by such a rule, we may perform

interventions based upon the most recent medical developments, up to the

level our medical director trains us and feels we are qualified.

As an example, offshore medics with Texas-based medical control are

sometimes ordered to reduce subluxations, insert nasogastric tubes and chest

tubes, perform central line catheterization, or insert Foley catheters. They

routinely remove embedded foreign bodies from eyes and suture minor

lacerations. If Texas were a scope of practice state, this probably would

not be allowed. This is an example of where we are able to do more with

less - regulation that is.

Regarding paramedics working in-hospital, this may be prevented by hospital

regulations, but not by TDH regulation, regardless of what the BNE says.

Best regards,

Donn

D.E. . LP, REMT-P

Make plans now to attend the 2nd annual

Gene Weatherall Memorial EMS Reunion & Chili Cook-off

Commonly known as " EMStock 2003 "

May 9 - 10 - 11, 2003

Midlothian, Texas

All public health and public safety workers welcome!

http://www.emstock.com

Limiting Law of Paramedics

I am frustrated to find out that we as providers of emergency care are so

limited by the wording of this law. '...certified by the department as

minimally proficient to provide emergency prehospital or interfacility

care...'. Here is a paragraph that was published in the RN Update.

BNE staff confirmed with the Bureau of Emergency Management, under

the

Texas Department of Health, that the laws governing EMTs and

Paramedics in

25 TAC 157.2 are limited to performing duties in the " prehospital and

inter-facility transport " settings. Therefore, whether certified or

licensed, the BNE delegation rules view EMTs, paramedics, or other

similarly trained staff as " unlicensed assistive personnel " (UAPs) when

working in acute care in-patient settings, such as the Emergency

Room. The

NPA and Board Rules are available in their entirety on our web site

www.bne.state.tx.us

Maybe I see this one wrong, however it appears to me that we handed this one

to the BNE on a silver platter. How do we work to provide the skills and

knowledge to a needed population, regardless of the confinements of the

building? How do we as a group of professionals work to change this law?

We should not have laws that restrict us to a place or event, but more

appropriately within a scope of practice.

Verne

TITLE 25 HEALTH SERVICES

PART 1 TEXAS DEPARTMENT OF HEALTH

CHAPTER 157 EMERGENCY MEDICAL CARE

SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

RULE §157.2 Definitions

(35) Emergency medical technician-paramedic (EMT-P) - An individual who is

certified by the department as minimally proficient to provide emergency

prehospital or interfacility care by providing advanced life support that

includes initiation and maintenance under medical supervision of certain

procedures, including intravenous therapy, endotracheal or esophageal

intubation or both, electrical cardiac defibrillation or cardioversion, and

drug therapy.

[Guest guest]

Verne,

The nurse vs. paramedic issue is a hot topic that causes some to get pretty

worked up, so I won't comment on the bulk of your message, but I do want to

speak briefly on your " scope of practice " comment.

Personally, I like the fact that Texas is without a paramedic scope of

practice rule. Scope of practice regulations are more often a limiting

rather than an enabling factor. The rules generally state something like

" manage patients in accordance with Department approved EMT-paramedic

training curriculum " . In other words, medics are limited to providing care

based upon the most recent curriculum, which may be several years old. In

Texas, because we are not limited by such a rule, we may perform

interventions based upon the most recent medical developments, up to the

level our medical director trains us and feels we are qualified.

As an example, offshore medics with Texas-based medical control are

sometimes ordered to reduce subluxations, insert nasogastric tubes and chest

tubes, perform central line catheterization, or insert Foley catheters. They

routinely remove embedded foreign bodies from eyes and suture minor

lacerations. If Texas were a scope of practice state, this probably would

not be allowed. This is an example of where we are able to do more with

less - regulation that is.

Regarding paramedics working in-hospital, this may be prevented by hospital

regulations, but not by TDH regulation, regardless of what the BNE says.

Best regards,

Donn

D.E. . LP, REMT-P

Make plans now to attend the 2nd annual

Gene Weatherall Memorial EMS Reunion & Chili Cook-off

Commonly known as " EMStock 2003 "

May 9 - 10 - 11, 2003

Midlothian, Texas

All public health and public safety workers welcome!

http://www.emstock.com

Limiting Law of Paramedics

I am frustrated to find out that we as providers of emergency care are so

limited by the wording of this law. '...certified by the department as

minimally proficient to provide emergency prehospital or interfacility

care...'. Here is a paragraph that was published in the RN Update.

BNE staff confirmed with the Bureau of Emergency Management, under

the

Texas Department of Health, that the laws governing EMTs and

Paramedics in

25 TAC 157.2 are limited to performing duties in the " prehospital and

inter-facility transport " settings. Therefore, whether certified or

licensed, the BNE delegation rules view EMTs, paramedics, or other

similarly trained staff as " unlicensed assistive personnel " (UAPs) when

working in acute care in-patient settings, such as the Emergency

Room. The

NPA and Board Rules are available in their entirety on our web site

www.bne.state.tx.us

Maybe I see this one wrong, however it appears to me that we handed this one

to the BNE on a silver platter. How do we work to provide the skills and

knowledge to a needed population, regardless of the confinements of the

building? How do we as a group of professionals work to change this law?

We should not have laws that restrict us to a place or event, but more

appropriately within a scope of practice.

Verne

TITLE 25 HEALTH SERVICES

PART 1 TEXAS DEPARTMENT OF HEALTH

CHAPTER 157 EMERGENCY MEDICAL CARE

SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

RULE §157.2 Definitions

(35) Emergency medical technician-paramedic (EMT-P) - An individual who is

certified by the department as minimally proficient to provide emergency

prehospital or interfacility care by providing advanced life support that

includes initiation and maintenance under medical supervision of certain

procedures, including intravenous therapy, endotracheal or esophageal

intubation or both, electrical cardiac defibrillation or cardioversion, and

drug therapy.

[Guest guest]

Verne-

We perform those duties assigned us by our Medical Directors - Regardless of the

roof over our heads.

EMT's exist as technical adjuncts of a Physician. We perform only those skills

and administer only those medications that Physician authorizes. The Physician

shoulders the responsibility for the actions of those persons under his

direction.

If you need to use your skills in a clinical setting, your Medical Director

needs to provide the necessary coordination with the clinical staff.

In my own case, since my Medical Director works in the ER and ICU at our base

hospital, I frequently continue treatments within the confines of the ER during

peak load times without repercussion.

Regards-

Terry Dinerman EMTP

Limiting Law of Paramedics

I am frustrated to find out that we as providers of emergency care are so

limited by the wording of this law. '...certified by the department as

minimally proficient to provide emergency prehospital or interfacility

care...'. Here is a paragraph that was published in the RN Update.

BNE staff confirmed with the Bureau of Emergency Management, under the

Texas Department of Health, that the laws governing EMTs and Paramedics in

25 TAC 157.2 are limited to performing duties in the " prehospital and

inter-facility transport " settings. Therefore, whether certified or

licensed, the BNE delegation rules view EMTs, paramedics, or other

similarly trained staff as " unlicensed assistive personnel " (UAPs) when

working in acute care in-patient settings, such as the Emergency Room. The

NPA and Board Rules are available in their entirety on our web site

www.bne.state.tx.us

Maybe I see this one wrong, however it appears to me that we handed this one

to the BNE on a silver platter. How do we work to provide the skills and

knowledge to a needed population, regardless of the confinements of the

building? How do we as a group of professionals work to change this law?

We should not have laws that restrict us to a place or event, but more

appropriately within a scope of practice.

Verne

TITLE 25 HEALTH SERVICES

PART 1 TEXAS DEPARTMENT OF HEALTH

CHAPTER 157 EMERGENCY MEDICAL CARE

SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

RULE §157.2 Definitions

(35) Emergency medical technician-paramedic (EMT-P) - An individual who is

certified by the department as minimally proficient to provide emergency

prehospital or interfacility care by providing advanced life support that

includes initiation and maintenance under medical supervision of certain

procedures, including intravenous therapy, endotracheal or esophageal

intubation or both, electrical cardiac defibrillation or cardioversion, and

drug therapy.

[Guest guest]

Wayne-

When did you ever allow a nurse or a MD who just wanders up, to control a scene?

Sorry you run into even one poor performer in the nursing community.........it

is frustrating, but your only defense is to be extra crisp and professional in

your approach and demeanor.

It scares the crap out of the poor performers and endears you to the REAL nurses

and MD's.

And always smile.......they wonder if you know something they don't.

Regards-

Terry Dinerman EMTP

Re: Limiting Law of Paramedics

Vern,

Have we not learned that when it comes to BNE and nurses, that WE as

EMS give them what they want..i.e. a RN with a pink patch instead of

a red patch because it was not fully earned, but based on

their " LICENSE " we give them what they want! But, when the shoe is

one the other foot, we are not " QUALIFIED " to work outside the pre-

hospital setting, and when we try, they throw up the fact that we

are " not licensed personnel " . Yet, we have a state agency that

issues a license based on a college education and various degrees

from 4 yr colleges, but the BNE want and " REFUSES " to acknowledge the

licensed paramedic as " licensed personnel " .

However, as a state, we bend over backwards to make the nursing

community happy when it comes to EMS. We all deal with some of these

stupid, yes I said STUPID nurses everyday in hospitals and ER's.

Most are too busy grazing to have the pt ready when you get there.

But, yet if they wanted to an EMT or Paramedic, the State of Texas

would hand them a certification. I have always said, until the

nursing community and BNE starts to give us what we want, WE as an

EMS community, SHOULD NOT given them what they want. They should be

made to EARN an EMS certification just like everyone else did, and

that is to place your behind in a chair in a classroom and attend the

ENTIRE program.

What we need to do, is place this same statement in our code to say

that nurses are " UNLICENSED PERSONNEL " in the pre-hospital setting.

I have had more than one nurse escorted off scene by police and

almost had a few arrested for being in the way, and using the " I'm a

nurse " routine. The reply is usually, " that's good, you can leave

now " .

Sorry for the rant, but after today, you caught me in just the right

mood to rant about this.

Fire away....

Wayne

- In , " Verne " <vernew@l...> wrote:

> I am frustrated to find out that we as providers of emergency care

are so

> limited by the wording of this law. '...certified by the

department as

> minimally proficient to provide emergency prehospital or

interfacility

> care...'. Here is a paragraph that was published in the RN Update.

>

> BNE staff confirmed with the Bureau of Emergency Management,

under the

> Texas Department of Health, that the laws governing EMTs and

Paramedics in

> 25 TAC 157.2 are limited to performing duties in the " prehospital

and

> inter-facility transport " settings. Therefore, whether

certified or

> licensed, the BNE delegation rules view EMTs, paramedics, or other

> similarly trained staff as " unlicensed assistive personnel " (UAPs)

when

> working in acute care in-patient settings, such as the

Emergency Room. The

> NPA and Board Rules are available in their entirety on our web site

> www.bne.state.tx.us

>

> Maybe I see this one wrong, however it appears to me that we handed

this one

> to the BNE on a silver platter. How do we work to provide the

skills and

> knowledge to a needed population, regardless of the confinements of

the

> building? How do we as a group of professionals work to change

this law?

> We should not have laws that restrict us to a place or event, but

more

> appropriately within a scope of practice.

>

> Verne

>

>

> TITLE 25 HEALTH SERVICES

> PART 1 TEXAS DEPARTMENT OF HEALTH

> CHAPTER 157 EMERGENCY MEDICAL CARE

> SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

> RULE §157.2 Definitions

>

> (35) Emergency medical technician-paramedic (EMT-P) - An individual

who is

> certified by the department as minimally proficient to provide

emergency

> prehospital or interfacility care by providing advanced life

support that

> includes initiation and maintenance under medical supervision of

certain

> procedures, including intravenous therapy, endotracheal or

esophageal

> intubation or both, electrical cardiac defibrillation or

cardioversion, and

> drug therapy.

[Guest guest]

Wayne-

When did you ever allow a nurse or a MD who just wanders up, to control a scene?

Sorry you run into even one poor performer in the nursing community.........it

is frustrating, but your only defense is to be extra crisp and professional in

your approach and demeanor.

It scares the crap out of the poor performers and endears you to the REAL nurses

and MD's.

And always smile.......they wonder if you know something they don't.

Regards-

Terry Dinerman EMTP

Re: Limiting Law of Paramedics

Vern,

Have we not learned that when it comes to BNE and nurses, that WE as

EMS give them what they want..i.e. a RN with a pink patch instead of

a red patch because it was not fully earned, but based on

their " LICENSE " we give them what they want! But, when the shoe is

one the other foot, we are not " QUALIFIED " to work outside the pre-

hospital setting, and when we try, they throw up the fact that we

are " not licensed personnel " . Yet, we have a state agency that

issues a license based on a college education and various degrees

from 4 yr colleges, but the BNE want and " REFUSES " to acknowledge the

licensed paramedic as " licensed personnel " .

However, as a state, we bend over backwards to make the nursing

community happy when it comes to EMS. We all deal with some of these

stupid, yes I said STUPID nurses everyday in hospitals and ER's.

Most are too busy grazing to have the pt ready when you get there.

But, yet if they wanted to an EMT or Paramedic, the State of Texas

would hand them a certification. I have always said, until the

nursing community and BNE starts to give us what we want, WE as an

EMS community, SHOULD NOT given them what they want. They should be

made to EARN an EMS certification just like everyone else did, and

that is to place your behind in a chair in a classroom and attend the

ENTIRE program.

What we need to do, is place this same statement in our code to say

that nurses are " UNLICENSED PERSONNEL " in the pre-hospital setting.

I have had more than one nurse escorted off scene by police and

almost had a few arrested for being in the way, and using the " I'm a

nurse " routine. The reply is usually, " that's good, you can leave

now " .

Sorry for the rant, but after today, you caught me in just the right

mood to rant about this.

Fire away....

Wayne

- In , " Verne " <vernew@l...> wrote:

> I am frustrated to find out that we as providers of emergency care

are so

> limited by the wording of this law. '...certified by the

department as

> minimally proficient to provide emergency prehospital or

interfacility

> care...'. Here is a paragraph that was published in the RN Update.

>

> BNE staff confirmed with the Bureau of Emergency Management,

under the

> Texas Department of Health, that the laws governing EMTs and

Paramedics in

> 25 TAC 157.2 are limited to performing duties in the " prehospital

and

> inter-facility transport " settings. Therefore, whether

certified or

> licensed, the BNE delegation rules view EMTs, paramedics, or other

> similarly trained staff as " unlicensed assistive personnel " (UAPs)

when

> working in acute care in-patient settings, such as the

Emergency Room. The

> NPA and Board Rules are available in their entirety on our web site

> www.bne.state.tx.us

>

> Maybe I see this one wrong, however it appears to me that we handed

this one

> to the BNE on a silver platter. How do we work to provide the

skills and

> knowledge to a needed population, regardless of the confinements of

the

> building? How do we as a group of professionals work to change

this law?

> We should not have laws that restrict us to a place or event, but

more

> appropriately within a scope of practice.

>

> Verne

>

>

> TITLE 25 HEALTH SERVICES

> PART 1 TEXAS DEPARTMENT OF HEALTH

> CHAPTER 157 EMERGENCY MEDICAL CARE

> SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

> RULE §157.2 Definitions

>

> (35) Emergency medical technician-paramedic (EMT-P) - An individual

who is

> certified by the department as minimally proficient to provide

emergency

> prehospital or interfacility care by providing advanced life

support that

> includes initiation and maintenance under medical supervision of

certain

> procedures, including intravenous therapy, endotracheal or

esophageal

> intubation or both, electrical cardiac defibrillation or

cardioversion, and

> drug therapy.

[Guest guest]

Wayne,

I believe you need to seriously consider the ramifications of the items you post

here. A lot of name calling will do nothing to promote this profession. Your

immature comments about " stupid nurses " and " grazing " can serve no positive

purpose and I take offense to these statements. You obviously raise some

issues that should be addressed but that should be done in a professional

manner. Many people read this listserv and statements such as these only shows

a lack of professionalism to the community.

I have been a medic for 14 years and this subject has been beaten to death many

times over. The EMT/Paramedic profession was designed to operate outside of a

hospital setting. The nursing profession was not designed to operate within the

EMS system. They are distinct and separate jobs utilizing some of the same

skills. Mechanisms should be in place that allow these professions to cross

paths without prejudice. However, until we move past attitudes such as this

that may never happen.

Jack Sosebee, LP

>>> rxmd911@... 01/29/03 01:56AM >>>

Vern,

Have we not learned that when it comes to BNE and nurses, that WE as

EMS give them what they want..i.e. a RN with a pink patch instead of

a red patch because it was not fully earned, but based on

their " LICENSE " we give them what they want! But, when the shoe is

one the other foot, we are not " QUALIFIED " to work outside the pre-

hospital setting, and when we try, they throw up the fact that we

are " not licensed personnel " . Yet, we have a state agency that

issues a license based on a college education and various degrees

from 4 yr colleges, but the BNE want and " REFUSES " to acknowledge the

licensed paramedic as " licensed personnel " .

However, as a state, we bend over backwards to make the nursing

community happy when it comes to EMS. We all deal with some of these

stupid, yes I said STUPID nurses everyday in hospitals and ER's.

Most are too busy grazing to have the pt ready when you get there.

But, yet if they wanted to an EMT or Paramedic, the State of Texas

would hand them a certification. I have always said, until the

nursing community and BNE starts to give us what we want, WE as an

EMS community, SHOULD NOT given them what they want. They should be

made to EARN an EMS certification just like everyone else did, and

that is to place your behind in a chair in a classroom and attend the

ENTIRE program.

What we need to do, is place this same statement in our code to say

that nurses are " UNLICENSED PERSONNEL " in the pre-hospital setting.

I have had more than one nurse escorted off scene by police and

almost had a few arrested for being in the way, and using the " I'm a

nurse " routine. The reply is usually, " that's good, you can leave

now " .

Sorry for the rant, but after today, you caught me in just the right

mood to rant about this.

Fire away....

Wayne

- In , " Verne " <vernew@l...> wrote:

> I am frustrated to find out that we as providers of emergency care

are so

> limited by the wording of this law. '...certified by the

department as

> minimally proficient to provide emergency prehospital or

interfacility

> care...'. Here is a paragraph that was published in the RN Update.

>

> BNE staff confirmed with the Bureau of Emergency Management,

under the

> Texas Department of Health, that the laws governing EMTs and

Paramedics in

> 25 TAC 157.2 are limited to performing duties in the " prehospital

and

> inter-facility transport " settings. Therefore, whether

certified or

> licensed, the BNE delegation rules view EMTs, paramedics, or other

> similarly trained staff as " unlicensed assistive personnel " (UAPs)

when

> working in acute care in-patient settings, such as the

Emergency Room. The

> NPA and Board Rules are available in their entirety on our web site

> www.bne.state.tx.us

>

> Maybe I see this one wrong, however it appears to me that we handed

this one

> to the BNE on a silver platter. How do we work to provide the

skills and

> knowledge to a needed population, regardless of the confinements of

the

> building? How do we as a group of professionals work to change

this law?

> We should not have laws that restrict us to a place or event, but

more

> appropriately within a scope of practice.

>

> Verne

>

>

> TITLE 25 HEALTH SERVICES

> PART 1 TEXAS DEPARTMENT OF HEALTH

> CHAPTER 157 EMERGENCY MEDICAL CARE

> SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

> RULE §157.2 Definitions

>

> (35) Emergency medical technician-paramedic (EMT-P) - An individual

who is

> certified by the department as minimally proficient to provide

emergency

> prehospital or interfacility care by providing advanced life

support that

> includes initiation and maintenance under medical supervision of

certain

> procedures, including intravenous therapy, endotracheal or

esophageal

> intubation or both, electrical cardiac defibrillation or

cardioversion, and

> drug therapy.

[Guest guest]

I work in a hospital-based 911 system. While the BNE might not much care

for it, we are a respected, integral part of the hospital staff, and are

authorized by both our protocol and the medical executive committee to

perform any and all skills in-hospital, just as we would pre-hospital. When

the ER gets slammed, the floors have a tough stick, or worse, a code, the

whole turf battle thing goes away.

This didn't happen by chance. Those that preceded my proved both their

competence and their value to the doctors and nurses alike. To everyone I

have spoken to at the hospital, we are hospital staff, no more or less than

anyone else (except that the RN's make better money).

Close interaction with our fellow healthcare providers in which we act like

competent professionals gets us treated like competent professionals. I

believe that this can develop anywhere. It happened in Del Rio, TX where I

am.

Steve Pike

Limiting Law of Paramedics

I am frustrated to find out that we as providers of emergency care are so

limited by the wording of this law. '...certified by the department as

minimally proficient to provide emergency prehospital or interfacility

care...'. Here is a paragraph that was published in the RN Update.

BNE staff confirmed with the Bureau of Emergency Management, under the

Texas Department of Health, that the laws governing EMTs and Paramedics in

25 TAC 157.2 are limited to performing duties in the " prehospital and

inter-facility transport " settings. Therefore, whether certified or

licensed, the BNE delegation rules view EMTs, paramedics, or other

similarly trained staff as " unlicensed assistive personnel " (UAPs) when

working in acute care in-patient settings, such as the Emergency Room. The

NPA and Board Rules are available in their entirety on our web site

www.bne.state.tx.us

Maybe I see this one wrong, however it appears to me that we handed this one

to the BNE on a silver platter. How do we work to provide the skills and

knowledge to a needed population, regardless of the confinements of the

building? How do we as a group of professionals work to change this law?

We should not have laws that restrict us to a place or event, but more

appropriately within a scope of practice.

Verne

TITLE 25 HEALTH SERVICES

PART 1 TEXAS DEPARTMENT OF HEALTH

CHAPTER 157 EMERGENCY MEDICAL CARE

SUBCHAPTER A EMERGENCY MEDICAL SERVICES - PART A

RULE §157.2 Definitions

(35) Emergency medical technician-paramedic (EMT-P) - An individual who is

certified by the department as minimally proficient to provide emergency

prehospital or interfacility care by providing advanced life support that

includes initiation and maintenance under medical supervision of certain

procedures, including intravenous therapy, endotracheal or esophageal

intubation or both, electrical cardiac defibrillation or cardioversion, and

drug therapy.