FRO Question

[Guest guest]

When I am the responding agency that is responsible for the patient care and

transport, yes. I believe that in order to be a official First Responder that

they must have a tranport agency sign off on it.

Henry

Re: FRO Question

Gentlemen,

Sorry, but I'm gonna have to disagree with you on this one with an

explaination.

If a volunteer department is wanting an FRO designation with all the

perks and grant opprotunities that come with and applies, then they

should follow all the regs and rules. No argument there. But, if

you have a volunteer department, especially in a rual setting, that

is working with an EMS system to better thier area, receive training

(regardless of certification or not) through that system and

responds to administer care to that level, why in the world are we

wanting to place regulations on a department who is trying to help

within their means?

All I have heard over the past few months on this list is how to

regulate and administer rules. I agree in certain situations, that

should be, but when you need FROs, registered or not, do you really

think the patient cares if their card is up to date or not? Yes,

all should have trianing and be keep up to date with the EMS system

they are assisting, but you start issuing regulations and rules at

some of these departments that we have tried to foster a

relationship with, who did not want anything to do with EMS because

of lack of knowledge or misinformation, then we will go back to a

greater than 30 minute pt contact and care (in some areas of my

county, more than that.)

Yes, any department that wants to assist should have training by the

EMS system serving that area. They should be encouraged to further

their training and move to certification, but I will take a handfull

of ranchers and farmers with come-a-londs and prybars with Red Cross

First Aid Training that want to help and have the common sense than

some of the metropolitan departments crews.(For the record, I work

for one of those departments) .

There is no greater harm than the harm caused by death. Lets not

bind these departments that are trying to reach out with chains that

will cause them to withdraw out of the pre-hospital care system and

cause EMS to suffer a step back in the name of regulation.

With Soap Box in hand,

L.

Colorado Conty EMS

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12/10/2007 2:51 PM

[Guest guest]

Obviously we have some folks that are taking my comments a little to personal. I

have no issues with responsible first responder or first responder organization.

My issue is the ones that are irresponsible. No one controls them and they

answer to no one.

Henry

Re: FRO Question

Gentlemen,

Sorry, but I'm gonna have to disagree with you on this one with an

explaination.

If a volunteer department is wanting an FRO designation with all the

perks and grant opprotunities that come with and applies, then they

should follow all the regs and rules. No argument there. But, if

you have a volunteer department, especially in a rual setting, that

is working with an EMS system to better thier area, receive training

(regardless of certification or not) through that system and

responds to administer care to that level, why in the world are we

wanting to place regulations on a department who is trying to help

within their means?

All I have heard over the past few months on this list is how to

regulate and administer rules. I agree in certain situations, that

should be, but when you need FROs, registered or not, do you really

think the patient cares if their card is up to date or not? Yes,

all should have trianing and be keep up to date with the EMS system

they are assisting, but you start issuing regulations and rules at

some of these departments that we have tried to foster a

relationship with, who did not want anything to do with EMS because

of lack of knowledge or misinformation, then we will go back to a

greater than 30 minute pt contact and care (in some areas of my

county, more than that.)

Yes, any department that wants to assist should have training by the

EMS system serving that area. They should be encouraged to further

their training and move to certification, but I will take a handfull

of ranchers and farmers with come-a-londs and prybars with Red Cross

First Aid Training that want to help and have the common sense than

some of the metropolitan departments crews.(For the record, I work

for one of those departments) .

There is no greater harm than the harm caused by death. Lets not

bind these departments that are trying to reach out with chains that

will cause them to withdraw out of the pre-hospital care system and

cause EMS to suffer a step back in the name of regulation.

With Soap Box in hand,

L.

Colorado Conty EMS

------------ --------- --------- --------- --------- --------- -

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Checked by AVG Free Edition.

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12/10/2007 2:51 PM

[Guest guest]

You may sign off on their protocols, but how can you be held responsible for

what they say and do? They are not your employees.

Tom & Marsha LeNeveu

Paramedic, Future RN; & RN

Fort Worth Texas

Email: TomMarshaLeNeveu@...

yahoo Group: Christian_Medic

Re: FRO Question

Gentlemen,

Sorry, but I'm gonna have to disagree with you on this one with an

explaination.

If a volunteer department is wanting an FRO designation with all the

perks and grant opprotunities that come with and applies, then they

should follow all the regs and rules. No argument there. But, if

you have a volunteer department, especially in a rual setting, that

is working with an EMS system to better thier area, receive training

(regardless of certification or not) through that system and

responds to administer care to that level, why in the world are we

wanting to place regulations on a department who is trying to help

within their means?

All I have heard over the past few months on this list is how to

regulate and administer rules. I agree in certain situations, that

should be, but when you need FROs, registered or not, do you really

think the patient cares if their card is up to date or not? Yes,

all should have trianing and be keep up to date with the EMS system

they are assisting, but you start issuing regulations and rules at

some of these departments that we have tried to foster a

relationship with, who did not want anything to do with EMS because

of lack of knowledge or misinformation, then we will go back to a

greater than 30 minute pt contact and care (in some areas of my

county, more than that.)

Yes, any department that wants to assist should have training by the

EMS system serving that area. They should be encouraged to further

their training and move to certification, but I will take a handfull

of ranchers and farmers with come-a-londs and prybars with Red Cross

First Aid Training that want to help and have the common sense than

some of the metropolitan departments crews.(For the record, I work

for one of those departments) .

There is no greater harm than the harm caused by death. Lets not

bind these departments that are trying to reach out with chains that

will cause them to withdraw out of the pre-hospital care system and

cause EMS to suffer a step back in the name of regulation.

With Soap Box in hand,

L.

Colorado Conty EMS

------------ --------- --------- --------- --------- --------- -

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Checked by AVG Free Edition.

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12/10/2007 2:51 PM

[Guest guest]

Here is an example:

Pretty extreme but it does happen. First Responder gets on scene (could be

certified, may not be) speaks with patient and ask if the patient is Ok and

patient says I think so, first reponder cancels EMS. Four or five minutes later

patient looks worse or is complaining and first reponder calls us back. Heck of

a response time right.

First Responder arrives at a house call, not certified go into the house, talks

to patient, patient gives out all kinds of personal health information to non

certified First Responder because he/she thinks they are medical personnel

because she did indeed call for an ambulance.

What exactly do you believe First Responder stands for? And I am only speaking

to Medical First Response. Who are they first responding for? The transporting

agency, thats who.

In the patients mind they are part of us so if they are in appropriate or not

responsible we get lumped in with that thought.

We have first responder groups here that do a good job and we work as a team.

Its the non team players that cause and issue. And once again if you are the

transporting agency or anyone else including public officials, you have no

control.

So lets be clear are you stating that First Responder agencies or responders do

not have to answer to anyone that they respond for?

Henry

Re: FRO Question

Gentlemen,

Sorry, but I'm gonna have to disagree with you on this one with an

explaination.

If a volunteer department is wanting an FRO designation with all the

perks and grant opprotunities that come with and applies, then they

should follow all the regs and rules. No argument there. But, if

you have a volunteer department, especially in a rual setting, that

is working with an EMS system to better thier area, receive training

(regardless of certification or not) through that system and

responds to administer care to that level, why in the world are we

wanting to place regulations on a department who is trying to help

within their means?

All I have heard over the past few months on this list is how to

regulate and administer rules. I agree in certain situations, that

should be, but when you need FROs, registered or not, do you really

think the patient cares if their card is up to date or not? Yes,

all should have trianing and be keep up to date with the EMS system

they are assisting, but you start issuing regulations and rules at

some of these departments that we have tried to foster a

relationship with, who did not want anything to do with EMS because

of lack of knowledge or misinformation, then we will go back to a

greater than 30 minute pt contact and care (in some areas of my

county, more than that.)

Yes, any department that wants to assist should have training by the

EMS system serving that area. They should be encouraged to further

their training and move to certification, but I will take a handfull

of ranchers and farmers with come-a-londs and prybars with Red Cross

First Aid Training that want to help and have the common sense than

some of the metropolitan departments crews.(For the record, I work

for one of those departments) .

There is no greater harm than the harm caused by death. Lets not

bind these departments that are trying to reach out with chains that

will cause them to withdraw out of the pre-hospital care system and

cause EMS to suffer a step back in the name of regulation.

With Soap Box in hand,

L.

Colorado Conty EMS

------------ --------- --------- --------- --------- --------- -

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Checked by AVG Free Edition.

Version: 7.5.503 / Virus Database: 269.17.0/1180 - Release Date:

12/10/2007 2:51 PM

[Guest guest]

Henry,

I am just trying to understand what the issue is. An irresponsible FRO will be

held accountable in civil court, or in criminal courts if they truly make bad

mistakes. Currently there are avenues for patients to take when mistakes are

made by any health care worker (no matter the level of training or

responsibility.)

So the question looms. Should FRO's be certified? Licensed? Registered? Why

not have levels of FRO just as there are levels of EMS providers, and Levels of

EMS personnel and Levels of Hospitals. Try this as a starting point for FRO's.

1. Registered FRO - Minimum EMS certified personnel, hand shake agreement with

local EMS.

2. Certified FRO - All personnel certified by state at an ECA level or above.

Operates as BLS FRO. Written protocols, and written agreements with local EMS

and Medical Control.

3. Licensed FRO - All personnel certified by State at EMT level or above.

Operates at BLS or ALS level of FRO. Written protocols, and written agreements

with local EMS and Medical Control

IMHO, I believe that FRO's should work hand in hand with local EMS transport

service. As well the local EMS transport service should work hand in hand with

the local Hospital. But one does not control the other, nor can one be held

responsible for the other.

Tom & Marsha LeNeveu

Paramedic, Future RN; & RN

Fort Worth Texas

Email: TomMarshaLeNeveu@...

yahoo Group: Christian_Medic

Re: FRO Question

Gentlemen,

Sorry, but I'm gonna have to disagree with you on this one with an

explaination.

If a volunteer department is wanting an FRO designation with all the

perks and grant opprotunities that come with and applies, then they

should follow all the regs and rules. No argument there. But, if

you have a volunteer department, especially in a rual setting, that

is working with an EMS system to better thier area, receive training

(regardless of certification or not) through that system and

responds to administer care to that level, why in the world are we

wanting to place regulations on a department who is trying to help

within their means?

All I have heard over the past few months on this list is how to

regulate and administer rules. I agree in certain situations, that

should be, but when you need FROs, registered or not, do you really

think the patient cares if their card is up to date or not? Yes,

all should have trianing and be keep up to date with the EMS system

they are assisting, but you start issuing regulations and rules at

some of these departments that we have tried to foster a

relationship with, who did not want anything to do with EMS because

of lack of knowledge or misinformation, then we will go back to a

greater than 30 minute pt contact and care (in some areas of my

county, more than that.)

Yes, any department that wants to assist should have training by the

EMS system serving that area. They should be encouraged to further

their training and move to certification, but I will take a handfull

of ranchers and farmers with come-a-londs and prybars with Red Cross

First Aid Training that want to help and have the common sense than

some of the metropolitan departments crews.(For the record, I work

for one of those departments) .

There is no greater harm than the harm caused by death. Lets not

bind these departments that are trying to reach out with chains that

will cause them to withdraw out of the pre-hospital care system and

cause EMS to suffer a step back in the name of regulation.

With Soap Box in hand,

L.

Colorado Conty EMS

------------ --------- --------- --------- --------- --------- -

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Checked by AVG Free Edition.

Version: 7.5.503 / Virus Database: 269.17.0/1180 - Release Date:

12/10/2007 2:51 PM

[Guest guest]

They are not your employees true, but if they are part

of the same EMS System for that area ('system' being

the key word), you *may* have some leverage on

addressing the FRO's boss, president, director, etc.

about concerns.

At least, that's my thinking...

--- Tom LeNeveu wrote:

> You may sign off on their protocols, but how can you

> be held responsible for what they say and do? They

> are not your employees.

>

> Tom & Marsha LeNeveu

> Paramedic, Future RN; & RN

> Fort Worth Texas

> Email: TomMarshaLeNeveu@...

> yahoo Group: Christian_Medic

>

> RE: Re: FRO Question

>

>

=== message truncated ===

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____

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[Guest guest]

Tom,

I believe that the current rule is a good one. However, their is not

ramifications if the rule is not followed. That is all I have been trying to

point out.

Henry

Re: FRO Question

Gentlemen,

Sorry, but I'm gonna have to disagree with you on this one with an

explaination.

If a volunteer department is wanting an FRO designation with all the

perks and grant opprotunities that come with and applies, then they

should follow all the regs and rules. No argument there. But, if

you have a volunteer department, especially in a rual setting, that

is working with an EMS system to better thier area, receive training

(regardless of certification or not) through that system and

responds to administer care to that level, why in the world are we

wanting to place regulations on a department who is trying to help

within their means?

All I have heard over the past few months on this list is how to

regulate and administer rules. I agree in certain situations, that

should be, but when you need FROs, registered or not, do you really

think the patient cares if their card is up to date or not? Yes,

all should have trianing and be keep up to date with the EMS system

they are assisting, but you start issuing regulations and rules at

some of these departments that we have tried to foster a

relationship with, who did not want anything to do with EMS because

of lack of knowledge or misinformation, then we will go back to a

greater than 30 minute pt contact and care (in some areas of my

county, more than that.)

Yes, any department that wants to assist should have training by the

EMS system serving that area. They should be encouraged to further

their training and move to certification, but I will take a handfull

of ranchers and farmers with come-a-londs and prybars with Red Cross

First Aid Training that want to help and have the common sense than

some of the metropolitan departments crews.(For the record, I work

for one of those departments) .

There is no greater harm than the harm caused by death. Lets not

bind these departments that are trying to reach out with chains that

will cause them to withdraw out of the pre-hospital care system and

cause EMS to suffer a step back in the name of regulation.

With Soap Box in hand,

L.

Colorado Conty EMS

------------ --------- --------- --------- --------- --------- -

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.503 / Virus Database: 269.17.0/1180 - Release Date:

12/10/2007 2:51 PM

[Guest guest]

At the risk of sounding like I live in a protected environment, I'm

going to ask what all the hub-bub is about. Here in County, the

county VFD/FR and the corporate FR teams are part of the Austin-

County EMS system along with Austin- County EMS and Austin FD.

(There are a few corporate FR teams that have their own medical director

because of the occupational medicine that is available at that site, but

they are the exception.) We all have agreements with Austin-

County EMS as our transporting agency. Part of that agreement is that we

all live under the Austin- County EMS protocols and medical

direction. That puts everyone in the system on the same page of the same

hymnal and subject to the same standards and disciplinary actions -

career or volunteer, transport or FR.

It seems that by being proactive to bring the FR organizations, though

they are certified individually, into the fold you can increase

proficiency and accountability. This can create a seamless system for

patient care where an EMT is an EMT no matter what organizational patch

they have on their shirt and there is the opportunity for individuals to

improve their skills and abilities within the system. It also puts the

focus on the patient rather than on the politics, competition, control,

defensive medicine and all the other things that have been expressed on

this topic and I saw when I first came to County when the parts

(Austin EMS, Austin FD, County VFDs/EMS, corporate FRs) operated

independently rather than as a true system.

Maybe a change in mindset of how to we bring the independents under our

umbrella would be beneficial instead of how do we control those over

whom we have no control.

I'll head back under my rock now. Barry

Barry Sharp, MSHP, CHES

Program Coordinator

Tobacco Prevention & Control

Texas Dept. of State Health Services

Barry.Sharp@...

________________________________

[Guest guest]

Would not withhold it in any hypoxic patient no matter if they had all of the

above.......just answering the question - when is O2 contraindicated- so if

symptomatic - NEVER

-MH

________________________________

From: texasems-l [texasems-l ] On Behalf Of

krin135@... [krin135@...]

Sent: Wednesday, December 12, 2007 9:01 AM

To: texasems-l

Subject: Re: FRO Question

In a message dated 12-Dec-07 08:22:32 Central Standard Time,

mhudson@...<mailto:mhudson%40mesquiteisd.org> writes:

Retinal Detachment, Acute Anterior Ischemic Optic Neuropathy, Cilliary

Retinal Artery Occlusion, Giant Arteritis???R

and if the patient is otherwise hypoxic and symptomatic, you will withhold

supplemental oxygen from those patients because?

ck

S. Krin, DO FAAFP

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