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Do you allow your Basics to perform ALS Skills?


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There was a reply on the Basics Doing ALS stuff thread that got resurrected here two days ago.

I have a question.

When is it ok for basics to perform ALS procedures.

There are a few scenarios where this might occur

1. EMT in medic School - they have learned ALS Stuff like IV's, Intubations, Defibrillations, Medications. Do you allow them to perform those skills while you are watching and there. They are not performing in a student capacity but as an employee of the company. Do you let them do this?

2. EMT just waiting on his medic license - doesn't know if he passed but is sure he did. Do you allow them to perform ALS skills

3. EMT just starting medic school - do you teach him yourself?

4. EMT not in medic school but says he knows how to do it.

Are any of the above scenarios acceptable?

I say no, none of the scenarios are acceptable reasons to let a basic do an ALS skill based on the liability to the company, to the EMT and most of all the liability to you the medic.

If you think it's acceptable for the basic to be doing skills they are not licensed to perform but have learned in a school setting I'd like to hear your reasons.

REMEMBER - the basic is not performing as a student on his/her ride-alongs. But they are working in the capacity of an EMT only.

I remember one call I was on as a new EMT/employee. My preceptor was working with a very good medic. Called on a near respiratory arrest and I went out to get the backboard and when I got back, the EMT was intubating the guy.(the guy died from a missed intubation) I asked why she was allowed to intubate when I knew she wasn't supposed to and they told me to shut my mouth if I wanted to work there for very long. Ending to this story was that I didn't work there very long.

I told a close friend who was a medic there about what happened and he walked me to the supervisors office and told me to tell the supervisor. The supervisor took a report and my next shift I was told that I was fired for some silly reason. Not a good week for the Ruffemster but I learned a valuable lesson that week.

Principals are worth standing up for and I stood up for mine and although the patient did not fare well, my conscience was clean.

The person who missed the intubation and her partner are still at the company.

Edited by Ruffems
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There was a reply on the Basics Doing ALS stuff thread that got resurrected here two days ago.

I have a question.

When is it ok for basics to perform ALS procedures.

There are a few scenarios where this might occur

1. EMT in medic School - they have learned ALS Stuff like IV's, Intubations, Defibrillations, Medications. Do you allow them to perform those skills while you are watching and there. They are not performing in a student capacity but as an employee of the company. Do you let them do this?

They are not licensed by any state to perform anything ALS.

2. EMT just waiting on his medic license - doesn't know if he passed but is sure he did. Do you allow them to perform ALS skills

They are not licensed by any state to perform anything ALS (as far as anyone knows at that particular moment).

3. EMT just starting medic school - do you teach him yourself?

They are not licensed by any state to perform anything ALS. You may or may not be authorized by any state or employer to teach ALS.

4. EMT not in medic school but says he knows how to do it.

They are not licensed by any state to perform anything ALS.

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They are not licensed by any state to perform anything ALS.

They are not licensed by any state to perform anything ALS (as far as anyone knows at that particular moment).

They are not licensed by any state to perform anything ALS. You may or may not be authorized by any state or employer to teach ALS.

They are not licensed by any state to perform anything ALS.

I think that 1-4 is covered by your response - they are not licensed anywhere in the US to perform ALS procedures. But this happens every day. You have a close knit partner situation. One is in medic school and the medic partner allows the emt who is in medic school to start an IV.

I have seen it happen, several times and I always say something about it but usually the offending people say "It's no big deal, the patients don't know any different" or something like that.

When is it OK to allow it to happen?

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I'm not sure I see the need to have a dedicated thread to the topic at hand as it is essentially an extension of an active thread? Would it not be better to have a consolidated discussion?

Take care,

chbare.q

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I'm not sure I see the need to have a dedicated thread to the topic at hand as it is essentially an extension of an active thread? Would it not be better to have a consolidated discussion?

Take care,

chbare.q

Which thread are you referring to ? I wasn't aware this was a discussion somewhere else.

Ruff, I have answers, but I kind of wanted to see how this played out a bit more before I gave my opinion on it.

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I've had partners back when I was in medic school let me start lines on THEM for practice, but never let me perform an ALS procedure on a patient. That's how I feel as well.

The closest I came to ALS on a patient was drawing up meds for my medic, and they always double checked what I was giving them anyways, even for drugs in my Intermediate and basic scopes

Edited by JTpaintball70
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Which thread are you referring to ? I wasn't aware this was a discussion somewhere else.

Ruff, I have answers, but I kind of wanted to see how this played out a bit more before I gave my opinion on it.

Basics doing advanced care thread that is around eight pages long, with nearly eighty replies and three thousand views.

Take care,

chbare.

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Within the guidelines of Ruff's scenario, there is absolutely NO REASON an EMT should be performing ALS procedures!

Each level of EMS has its own scope of practice. There is no reason to step outside of your scope of practice. If you want to do all the ‘cool stuff’ that the medics get to do, put your ass in a class and learn HOW to do it properly, WHY to do it, and WHEN to do it. When it becomes your scope of practice, then you can do it when appropriate.

Question for the medics that allow things like this to happen: Are you REALLY willing to risk your license, your reputation and your job just to allow a lower license the ‘thrill’ of stepping into a Medics world? Is it a matter of being too lazy to do it yourself? Is there really any situation that comes along that is too ‘overwhelming’ for you to mitigate until extra ALS ‘backup’ can arrive? (This is excluding MCI situations and multiple patient settings).

Granted, I’ve worked some pretty ‘hairy scenes’ where the medic could have definitely used a couple more hands for ‘ALS stuff’, but when I offered to call in for an additional ALS rig, was told not to. I have a difficult time stepping into a position that puts me into a scope of practice that is above my license level.

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Depends on what is classified as "ALS" remember, each state is different....in PA its ALS to "prick a finger" for a blood glucose....

Edited by EMTDON970
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Depends on what is classified as "ALS" remember, each state is different....in PA its ALS to "prick a finger" for a blood glucose....

Please.... Expand on this.

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