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Do you allow your Basics to perform ALS Skills?


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Devils advocate:

What's the difference between a medic drawing up the meds and giving them, and the medic drawing up the meds and having his basic push the plunger? If the meds screw up the patient, it doesn't matter which provider actually administers the drug, does it? (not legally speaking, of course...)

And now my personal view:

At my system, EMTs can only give patient prescribed Nitro, Albuterol, ASA, EpiPen. Hell, if I'm going to give one of those 4 drugs anyhow, what's the difference between me giving mine from the ambulance, and an EMT giving it? Same med, same indication, just different doctor prescribing.

Edited by Linuss
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If they are simply acting as an assistant to you then thats not quite as bad, e.g. giving meds you have drawn up as opposed to drawing up meds themselves.

Now it may be a little different where you guys are in the US given the huge difference between BLS and ALS. I think us Kiwis and Australians are a little spoilt in that many times we have another person there who can start a line, give some adrenaline or other meds, or do a rhythm analysis and zap the patient while somebody else secures an airway or takes overall clinical leadership of the situation.

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IF the person is a medic student and cleared by their clinical director to perform the skill... then yes. Observation is closely monitored and still may not be allowed to perform. If a student cannot tell me why they are doing something, they will not be allowed to do it. If they try to jump right in for the ALS stuff and skip over BLS just because "they can use it", they will not be allowed to perform the skill. Maturity and knowledge base is a big thing for me on the ambulance... I want the student to know what they are doing before they are allowed to do anything. If they do not know, I will tell them to study it and come back to me when they do know it. Liability is a big issue. If that person screws up, it is MY ass.

I will not cover for them and say "Yeah I did it." I will also not allow a person to perform anything out of their scope, even if they are a student. Just because they are a medic student, does not give them the ability to pop a chest.

Practicing skills outside your scope of practice is illegal. If you are a paramedic and you happen to be volunteering/working on a BLS ambulance and then meet up with an ALS... you still CANNOT perform ALS skills. Yes, you are a paramedic, but you are not "working" as one at that moment and therefor not covered under that scope of practice.

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Practicing skills outside your scope of practice is illegal. If you are a paramedic and you happen to be volunteering/working on a BLS ambulance and then meet up with an ALS... you still CANNOT perform ALS skills. Yes, you are a paramedic, but you are not "working" as one at that moment and therefor not covered under that scope of practice.

Here not only can you work as a medic if medics arrive you can even perform certain interventions without calling for medics at provider option.

Just depends on your local.

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