Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 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. << > > > > > Quote Link to comment Share on other sites More sharing options...
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