Re: Scope of Practice Questions

[Guest guest]

According to my interpretation of the SoP, both of the services that I am

over will suffer greatly, at any time (on both services) we could go out 30

miles on highway, not to mention ranch roads or oilfield roads. Our Medical

Director has given us standing orders for RSI, we have a Vent, and we can

also do IO's as most MICU services can. My interpretation is that we will

not be able to work a code past the first line, intubate the head injured

and oxygenate him, without have a BS. There is so much that we will not be

able to do, that we can do now, without the fear of DPS coming to pick us up

just for taking care of our pt.

Another issue is communication, we are on our own 10 miles south or east of

Fort Stockton, no cell phone or radio service, so even if the SoP were to

let the lowly EMT-P do something with on-line medical control?????????

There are 3 LP's in the county and only one is one the truck. The other

ones are in the hospital making twice what we make on the truck. The way I

look at the LP is " where will it get me in EMS at this time? "

There is no way that I can go to school, work full time, vol full time and

still have a family.

Scope of Practice Questions

>

>

> Ok, I know that everyone is talking about the Scope of Practice

> issue. I too have some issues with the model, but I have a

> questions for everyone especially administrators and chiefs.

>

> I am in the process of writing a paper for a college course in

> concern to the Scope of Practice model. What I was wondering is how

> will the changes in allowable skills affect your service?

>

> Those who choose to help I appreciate it and want to let you know

> that the information may be used in a paper for the course.

>

> Thank you,

> Mike Shown, EMT-P/FP-C

> Student UTHSCSA

>

>

>

>

>

>

>

>

[Guest guest]

According to my interpretation of the SoP, both of the services that I am

over will suffer greatly, at any time (on both services) we could go out 30

miles on highway, not to mention ranch roads or oilfield roads. Our Medical

Director has given us standing orders for RSI, we have a Vent, and we can

also do IO's as most MICU services can. My interpretation is that we will

not be able to work a code past the first line, intubate the head injured

and oxygenate him, without have a BS. There is so much that we will not be

able to do, that we can do now, without the fear of DPS coming to pick us up

just for taking care of our pt.

Another issue is communication, we are on our own 10 miles south or east of

Fort Stockton, no cell phone or radio service, so even if the SoP were to

let the lowly EMT-P do something with on-line medical control?????????

There are 3 LP's in the county and only one is one the truck. The other

ones are in the hospital making twice what we make on the truck. The way I

look at the LP is " where will it get me in EMS at this time? "

There is no way that I can go to school, work full time, vol full time and

still have a family.

Scope of Practice Questions

>

>

> Ok, I know that everyone is talking about the Scope of Practice

> issue. I too have some issues with the model, but I have a

> questions for everyone especially administrators and chiefs.

>

> I am in the process of writing a paper for a college course in

> concern to the Scope of Practice model. What I was wondering is how

> will the changes in allowable skills affect your service?

>

> Those who choose to help I appreciate it and want to let you know

> that the information may be used in a paper for the course.

>

> Thank you,

> Mike Shown, EMT-P/FP-C

> Student UTHSCSA

>

>

>

>

>

>

>

>

[Guest guest]

According to my interpretation of the SoP, both of the services that I am

over will suffer greatly, at any time (on both services) we could go out 30

miles on highway, not to mention ranch roads or oilfield roads. Our Medical

Director has given us standing orders for RSI, we have a Vent, and we can

also do IO's as most MICU services can. My interpretation is that we will

not be able to work a code past the first line, intubate the head injured

and oxygenate him, without have a BS. There is so much that we will not be

able to do, that we can do now, without the fear of DPS coming to pick us up

just for taking care of our pt.

Another issue is communication, we are on our own 10 miles south or east of

Fort Stockton, no cell phone or radio service, so even if the SoP were to

let the lowly EMT-P do something with on-line medical control?????????

There are 3 LP's in the county and only one is one the truck. The other

ones are in the hospital making twice what we make on the truck. The way I

look at the LP is " where will it get me in EMS at this time? "

There is no way that I can go to school, work full time, vol full time and

still have a family.

Scope of Practice Questions

>

>

> Ok, I know that everyone is talking about the Scope of Practice

> issue. I too have some issues with the model, but I have a

> questions for everyone especially administrators and chiefs.

>

> I am in the process of writing a paper for a college course in

> concern to the Scope of Practice model. What I was wondering is how

> will the changes in allowable skills affect your service?

>

> Those who choose to help I appreciate it and want to let you know

> that the information may be used in a paper for the course.

>

> Thank you,

> Mike Shown, EMT-P/FP-C

> Student UTHSCSA

>

>

>

>

>

>

>

>

[Guest guest]

also another point is that we transport very critical pts as some have

already pointed out,Fort Stockton EMS has a mimimum on 85 miles to go from

Pecos Co. Memorial Hosp Level IV to Odessa Medical Center Level III, I

myself have transported numerous vent pts Pts receiving TpA, chest tubes and

multiple drips, luckly now we have Carestar Helicopter but when they are not

flying because of the weather, scheduled down time or they are busy

somewhere else in the region what will we do with that pt?

Scope of Practice Questions

>

>

> Ok, I know that everyone is talking about the Scope of Practice

> issue. I too have some issues with the model, but I have a

> questions for everyone especially administrators and chiefs.

>

> I am in the process of writing a paper for a college course in

> concern to the Scope of Practice model. What I was wondering is how

> will the changes in allowable skills affect your service?

>

> Those who choose to help I appreciate it and want to let you know

> that the information may be used in a paper for the course.

>

> Thank you,

> Mike Shown, EMT-P/FP-C

> Student UTHSCSA

>

>

>

>

>

>

>

>

[Guest guest]

My name is , and just retired from Nacogdoches County EMS as the

Education Officer. In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree to be able

to preform them would put our service back to a basic level service. The only

remaining skills would be some drugs, and not all of those would be allowed.

For those services with RSI and pre-hospital Thromboletics would be limited even

more. This is just the short version.

, EMT-P

EMS Coordinator/Educator

Board Member EMSAT

Mike wrote:

Ok, I know that everyone is talking about the Scope of Practice

issue. I too have some issues with the model, but I have a

questions for everyone especially administrators and chiefs.

I am in the process of writing a paper for a college course in

concern to the Scope of Practice model. What I was wondering is how

will the changes in allowable skills affect your service?

Those who choose to help I appreciate it and want to let you know

that the information may be used in a paper for the course.

Thank you,

Mike Shown, EMT-P/FP-C

Student UTHSCSA

[Guest guest]

My name is , and just retired from Nacogdoches County EMS as the

Education Officer. In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree to be able

to preform them would put our service back to a basic level service. The only

remaining skills would be some drugs, and not all of those would be allowed.

For those services with RSI and pre-hospital Thromboletics would be limited even

more. This is just the short version.

, EMT-P

EMS Coordinator/Educator

Board Member EMSAT

Mike wrote:

Ok, I know that everyone is talking about the Scope of Practice

issue. I too have some issues with the model, but I have a

questions for everyone especially administrators and chiefs.

I am in the process of writing a paper for a college course in

concern to the Scope of Practice model. What I was wondering is how

will the changes in allowable skills affect your service?

Those who choose to help I appreciate it and want to let you know

that the information may be used in a paper for the course.

Thank you,

Mike Shown, EMT-P/FP-C

Student UTHSCSA

[Guest guest]

My name is , and just retired from Nacogdoches County EMS as the

Education Officer. In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree to be able

to preform them would put our service back to a basic level service. The only

remaining skills would be some drugs, and not all of those would be allowed.

For those services with RSI and pre-hospital Thromboletics would be limited even

more. This is just the short version.

, EMT-P

EMS Coordinator/Educator

Board Member EMSAT

Mike wrote:

Ok, I know that everyone is talking about the Scope of Practice

issue. I too have some issues with the model, but I have a

questions for everyone especially administrators and chiefs.

I am in the process of writing a paper for a college course in

concern to the Scope of Practice model. What I was wondering is how

will the changes in allowable skills affect your service?

Those who choose to help I appreciate it and want to let you know

that the information may be used in a paper for the course.

Thank you,

Mike Shown, EMT-P/FP-C

Student UTHSCSA

[Guest guest]

Certificate Paramedics under the proposed SoP will still be able to

perform chest decompression and percutaneous cricothyrotomy. Now,

you might argue that you won't be able to perform a surgical airway,

but wouldn't a properly performed percutaneous airway be just as

efficient (from the dying patient's perspective) as a surgical

airway?

Kenny Navarro

>> In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree

to be able to preform them would put our service back to a basic

level service. <<

[Guest guest]

Certificate Paramedics under the proposed SoP will still be able to

perform chest decompression and percutaneous cricothyrotomy. Now,

you might argue that you won't be able to perform a surgical airway,

but wouldn't a properly performed percutaneous airway be just as

efficient (from the dying patient's perspective) as a surgical

airway?

Kenny Navarro

>> In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree

to be able to preform them would put our service back to a basic

level service. <<

[Guest guest]

Certificate Paramedics under the proposed SoP will still be able to

perform chest decompression and percutaneous cricothyrotomy. Now,

you might argue that you won't be able to perform a surgical airway,

but wouldn't a properly performed percutaneous airway be just as

efficient (from the dying patient's perspective) as a surgical

airway?

Kenny Navarro

>> In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree

to be able to preform them would put our service back to a basic

level service. <<

[Guest guest]

Kenny - There are differing views on the use of needle crics. One is

that it does sustain a pt. for a short period of time and until they

receive a surgical airway. The other extreme is that needle crics are a

joke, useless, and a cause for negligence. There are Medical Directors

on both sides of the view and many do have needle crics in their

protocols (including our company). Subsequently, paramedics &

instructors too will differ in their opinion. It might be safe to

believe that a 10, 12, or 14 gauge catheter (as long as it has enough

oxygen pressure behind it) beats the heck out of no airway.

Don Elbert, Tyler

>>> kenneth.navarro@... 12/6/2004 12:41:43 PM >>>

Certificate Paramedics under the proposed SoP will still be able to

perform chest decompression and percutaneous cricothyrotomy. Now,

you might argue that you won't be able to perform a surgical airway,

but wouldn't a properly performed percutaneous airway be just as

efficient (from the dying patient's perspective) as a surgical

airway?

Kenny Navarro

>> In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree

to be able to preform them would put our service back to a basic

level service. <<

[Guest guest]

Kenny - There are differing views on the use of needle crics. One is

that it does sustain a pt. for a short period of time and until they

receive a surgical airway. The other extreme is that needle crics are a

joke, useless, and a cause for negligence. There are Medical Directors

on both sides of the view and many do have needle crics in their

protocols (including our company). Subsequently, paramedics &

instructors too will differ in their opinion. It might be safe to

believe that a 10, 12, or 14 gauge catheter (as long as it has enough

oxygen pressure behind it) beats the heck out of no airway.

Don Elbert, Tyler

>>> kenneth.navarro@... 12/6/2004 12:41:43 PM >>>

Certificate Paramedics under the proposed SoP will still be able to

perform chest decompression and percutaneous cricothyrotomy. Now,

you might argue that you won't be able to perform a surgical airway,

but wouldn't a properly performed percutaneous airway be just as

efficient (from the dying patient's perspective) as a surgical

airway?

Kenny Navarro

>> In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree

to be able to preform them would put our service back to a basic

level service. <<

[Guest guest]

Kenny - There are differing views on the use of needle crics. One is

that it does sustain a pt. for a short period of time and until they

receive a surgical airway. The other extreme is that needle crics are a

joke, useless, and a cause for negligence. There are Medical Directors

on both sides of the view and many do have needle crics in their

protocols (including our company). Subsequently, paramedics &

instructors too will differ in their opinion. It might be safe to

believe that a 10, 12, or 14 gauge catheter (as long as it has enough

oxygen pressure behind it) beats the heck out of no airway.

Don Elbert, Tyler

>>> kenneth.navarro@... 12/6/2004 12:41:43 PM >>>

Certificate Paramedics under the proposed SoP will still be able to

perform chest decompression and percutaneous cricothyrotomy. Now,

you might argue that you won't be able to perform a surgical airway,

but wouldn't a properly performed percutaneous airway be just as

efficient (from the dying patient's perspective) as a surgical

airway?

Kenny Navarro

>> In my Opinion there are skills such as surgical airway

technequics, Chest decompression and the addition of a 4 year degree

to be able to preform them would put our service back to a basic

level service. <<

[Guest guest]

Don, I agree with you wholeheartedly. There are also other

percutaneous cricothyrotomy devices on the market besides using the

handy IV catheters.

Kenny Navarro

> Kenny - There are differing views on the use of needle crics. One

is that it does sustain a pt. for a short period of time and until

they receive a surgical airway. The other extreme is that needle

crics are a joke, useless, and a cause for negligence. There are

Medical Directors on both sides of the view and many do have needle

crics in their protocols (including our company). Subsequently,

paramedics & instructors too will differ in their opinion. It might

be safe to believe that a 10, 12, or 14 gauge catheter (as long as

it has enough oxygen pressure behind it) beats the heck out of no

airway. <<

[Guest guest]

Don, I agree with you wholeheartedly. There are also other

percutaneous cricothyrotomy devices on the market besides using the

handy IV catheters.

Kenny Navarro

> Kenny - There are differing views on the use of needle crics. One

is that it does sustain a pt. for a short period of time and until

they receive a surgical airway. The other extreme is that needle

crics are a joke, useless, and a cause for negligence. There are

Medical Directors on both sides of the view and many do have needle

crics in their protocols (including our company). Subsequently,

paramedics & instructors too will differ in their opinion. It might

be safe to believe that a 10, 12, or 14 gauge catheter (as long as

it has enough oxygen pressure behind it) beats the heck out of no

airway. <<

[Guest guest]

Don, I agree with you wholeheartedly. There are also other

percutaneous cricothyrotomy devices on the market besides using the

handy IV catheters.

Kenny Navarro

> Kenny - There are differing views on the use of needle crics. One

is that it does sustain a pt. for a short period of time and until

they receive a surgical airway. The other extreme is that needle

crics are a joke, useless, and a cause for negligence. There are

Medical Directors on both sides of the view and many do have needle

crics in their protocols (including our company). Subsequently,

paramedics & instructors too will differ in their opinion. It might

be safe to believe that a 10, 12, or 14 gauge catheter (as long as

it has enough oxygen pressure behind it) beats the heck out of no

airway. <<

[Guest guest]

Wow, surely you are not arguing that a SLAM course is all any EMS

provider needs to become proficient at airway management? If so,

why would you need to go to a certificate paramedic school? Why not

just go to the SLAM course and be the airway expert for your squad?

The NSoP is creating another level of paramedic - not better, just

different.

If you need to provide transtracheal airway alternatives to your

patient, why is the surgical cricothyrotomy better than the

percutaneous cricothyrotomy. Do you think the patient really cares?

Kenny Navarro

> Why go to a 4 year degree whebn I can take a S.L.A.M. (steet level

airway maintenance) course and get the same knowledge and skill. <<

[Guest guest]

Wow, surely you are not arguing that a SLAM course is all any EMS

provider needs to become proficient at airway management? If so,

why would you need to go to a certificate paramedic school? Why not

just go to the SLAM course and be the airway expert for your squad?

The NSoP is creating another level of paramedic - not better, just

different.

If you need to provide transtracheal airway alternatives to your

patient, why is the surgical cricothyrotomy better than the

percutaneous cricothyrotomy. Do you think the patient really cares?

Kenny Navarro

> Why go to a 4 year degree whebn I can take a S.L.A.M. (steet level

airway maintenance) course and get the same knowledge and skill. <<

[Guest guest]

Wow, surely you are not arguing that a SLAM course is all any EMS

provider needs to become proficient at airway management? If so,

why would you need to go to a certificate paramedic school? Why not

just go to the SLAM course and be the airway expert for your squad?

The NSoP is creating another level of paramedic - not better, just

different.

If you need to provide transtracheal airway alternatives to your

patient, why is the surgical cricothyrotomy better than the

percutaneous cricothyrotomy. Do you think the patient really cares?

Kenny Navarro

> Why go to a 4 year degree whebn I can take a S.L.A.M. (steet level

airway maintenance) course and get the same knowledge and skill. <<

[Guest guest]

And then there were three...

" And if three people do it, three, can you imagine, three people

walking in singin a bar of Alice's Restaurant and walking out. They

may think it's an organization. And can you imagine fifty people a

day,I said fifty people a day walking in singin a bar of Alice's

Restaurant and walking out. And friends they may think it's a

movement. " - Arlo Guthrie

Kenny Navarro

>>

Also, I would much rather have someone who has formal training in an

advanced procedure performing that procedure on me, as opposed to

someone who merely has his medical director's permission. <<

[Guest guest]

And then there were three...

" And if three people do it, three, can you imagine, three people

walking in singin a bar of Alice's Restaurant and walking out. They

may think it's an organization. And can you imagine fifty people a

day,I said fifty people a day walking in singin a bar of Alice's

Restaurant and walking out. And friends they may think it's a

movement. " - Arlo Guthrie

Kenny Navarro

>>

Also, I would much rather have someone who has formal training in an

advanced procedure performing that procedure on me, as opposed to

someone who merely has his medical director's permission. <<

[Guest guest]

Is it too late to want to go back to the church and have a Thanksgiving

dinner that couldn't be beat. . . ?

>>> kenneth.navarro@... 12/6/2004 1:35:59 PM >>>

And then there were three...

" And if three people do it, three, can you imagine, three people

walking in singin a bar of Alice's Restaurant and walking out. They

may think it's an organization. And can you imagine fifty people a

day,I said fifty people a day walking in singin a bar of Alice's

Restaurant and walking out. And friends they may think it's a

movement. " - Arlo Guthrie

Kenny Navarro

>>

Also, I would much rather have someone who has formal training in an

advanced procedure performing that procedure on me, as opposed to

someone who merely has his medical director's permission. <<

[Guest guest]

Is it too late to want to go back to the church and have a Thanksgiving

dinner that couldn't be beat. . . ?

>>> kenneth.navarro@... 12/6/2004 1:35:59 PM >>>

And then there were three...

" And if three people do it, three, can you imagine, three people

walking in singin a bar of Alice's Restaurant and walking out. They

may think it's an organization. And can you imagine fifty people a

day,I said fifty people a day walking in singin a bar of Alice's

Restaurant and walking out. And friends they may think it's a

movement. " - Arlo Guthrie

Kenny Navarro

>>

Also, I would much rather have someone who has formal training in an

advanced procedure performing that procedure on me, as opposed to

someone who merely has his medical director's permission. <<

[Guest guest]

Is it too late to want to go back to the church and have a Thanksgiving

dinner that couldn't be beat. . . ?

>>> kenneth.navarro@... 12/6/2004 1:35:59 PM >>>

And then there were three...

" And if three people do it, three, can you imagine, three people

walking in singin a bar of Alice's Restaurant and walking out. They

may think it's an organization. And can you imagine fifty people a

day,I said fifty people a day walking in singin a bar of Alice's

Restaurant and walking out. And friends they may think it's a

movement. " - Arlo Guthrie

Kenny Navarro

>>

Also, I would much rather have someone who has formal training in an

advanced procedure performing that procedure on me, as opposed to

someone who merely has his medical director's permission. <<

[Guest guest]

We've covered this question before, but I will repeat it. Two words:

University Degree. And accredited at that, no less. The more pieces

of paper we have, the better we look to other professions. Not saying

the SLAM courses are a waste of time of course, which I know they are

not.

-aro

> >> In my Opinion there are skills such as surgical airway

> technequics, Chest decompression and the addition of a 4 year degree

> to be able to preform them would put our service back to a basic

> level service. <<

>

>

>

>

>