Scope of Practice

[Guest guest]

Correct me if I'm wrong, but if we were to change the " titles " of Paramedics and

base their skill level on these titles.....would that not force all systems to

become tiered systems? Doesn't a tiered system open one up for liability (i.e.

why did I get a Level 1 and a Level 2 Paramedic, when my neighbor got a Level 2

and a Level 4 Paramedic)?

The DFW area has seen a dramatic decrease in the number of Paramedics that

complete the process now that it has changed from a 6-9 month program to a 14-16

month program. I may be mistaken, but I understand that the schools have

approximately 4-6 people complete the programs now....I'm sure that would change

dramatically if you had to have a 4 year degree to become a Paramedic.

I apologize if all of this has been stated previously, I'm just now catching up

my email.

Macara

Scope of practice

Would it be sufficient to add a level of Paramedic between the SoP levels of

Paramedic and Advanced level Paramedic, and allow that level to function at

what we do now?

If we change the names to Paramedic I, II, and III; level I being the

Paramedic described in the SoP, level III being the Advanced Practice

Paramedic described in the SoP, and add level II.

Paramedic II, Build upon the foundation of the Paramedic I, and add the

special skills that are being requested by the more rural departments.

important to note that those services not wishing to utilize the Paramedic

II level, can always upgrade their services by training their staff. This

level of paramedic has the training necessary to perform the follwowing

skills, including, but not limited to, RSI, initiate and maintain blood

products, retrograde intubation, and the use of colloid solutions. Further,

with additional training which is offered according to nationally accepted

standards, needed skills could be authorized by Medical Directors, offering

the autonomy that we are looking for. A ceiling may be needed here. Create a

list of 'special skills' and set forth a minimum requirement for annual

training, based upon nationally accepted standards.

paramedic I will placate the large metro areas and the large FD based EMS

services looking to offer lower MICU level or tiered response. Advanced

practice stays in to placate the colleges and universities, and level II

will allow the rural areas to continue to offer what they now consider the

minimum acceptable standard of care.

Medical Directors still have autonomy TO A DEGREE, just as they do now.

Education is the key to this, minimum standards MUST BE MET. CE programs and

educational opportunities must be brought up to nationally accepted

standards. Skills training and evaluation must be according to a nationally

accepted standard. higher education is in the air, but level II could

probably be lsited as an AS degree while level III could easily be defined

as a BS degree.

Education is the key, and the sticking point, the further out of town we

get, the more training we need, the more training we need, the more

education we need, the more education we need, the more money we need, yet

the further we are from town, the less money there is to spend, vicous

circle.

I don't particularly like the prohbited skills verbiage, there is just

something I don't like about it. May be the fact that I just can't stand

being told I 'can't' do something (boy would my mother be proud to hear me

finally admit that). But in reality, some ceiling must be made. As

Paramedics, we don't suture in the field, why are we afraid to put that in

writing? It's walking on eggshells to get everyone to agree, but it might

need to be done.

OK, OK, probably not as creative as Mr. Bledson, but it's an alternative.

Right now, that's what we need, we all agree that there are specific

problems with the SoP, but we need to make some quick movement in getting

our opinions known, as well as any suggestions that we have.

Mike