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twist27896

ALS in the Industrial Setting

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I just got a part time job working as a "Industrial Health and Safety Technician" at a large tobacco processing plant. It is a really awesome experience because in addition to the normal medical side of safety, I have the opportunity to learn about equipment and machinery safety and help make policies, perform drug screens, run a medical clinic, etc. My question is does anyone know if any similar setups utilize ALS skills? Although I am an ALS provider with my EMS agency, at the plant I am only functioning as an EMT-B with limited drugs since we have no MD medical director. I am sure somewhere ALS providers are used in the industrial setting with a medical director, but I haven't been able to find much on the topic. Interested to see if anyone has any experience/knows more about this?

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If you have no medical director, then you really don't have any scope of practice beyong basic first aid. The same scope that your kids or neighbors has. If that sounds like I'm trying to bust your balls, I'm really not, but only trying to be clear.

I've worked in many different environments, and the one thing that I've found to be a constant is that very often you're put into a position where your education will outmatch your scope of practice or resources.

Trust me on this...you need to, right now, decide how important caring for those that you're responsible for means to you. As an ALS provider you will, sooner or later, be called upon to treat a patient that you have the education to treat, but not the allowable scope. What will you do then?

I know a medic that, so I've heard, put a few tiny stitches into the flap of a scalp of someone that had fallen in the shower. It was theoretically outside of his scope, but the closest available qualified facility to do so would have been 14hrs distant, min. This medic believed that waiting for that time would have allowed the flap to be damaged leaving this patient with several medical and aestietic issues in the future so decided to act outside of his implied (no clear definition) scope of practice. I've been told that the flap healed nicely with the hair growing normally and very little scarring.

You need to decide where you want to fall. You must decide, before the time comes, to protect your job, do your best medicine, or something in between.

My advice is that you understand your comapany's, country's, and local legal and medical protocols and follow them, as I've heard that the above medic has had his ass handed to him a few times for his/her outlook on "doing the right thing."

Good luck. I'd love to hear what you discover.

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Wouldn't you first need to seek licensing by your county in order to seek Medical Direction? I know in my state the county licenses ambulances and programs. I'd imagine you'd need to adopt protocols and float some kind of application their way in order to seek some kind of Medical Direction.

Might be a place to start!

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Industrial EMS is nothing new, if you want a well preserved vintage ambulance, with low miles, it probably came from a plant somewhere. If your state has a program to license a vehicle as a quick response unit, or squad vehicle.. You could in theory use anything from a golf cart to a cushman. Then you just get them to have a medical director sign on for that unit and you're good to go. Otherwise, you're probably just limited to first aid.

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I work in the Oilsands in northern Alberta. The company I work for has EMR's and EMT-A's in the firehall, but the company also has RN's on site. In the critical pt's the RN's are used along with the EMT-A's to transport and provide care. We also call on ALS units from the city to meet us along the way, who are about 30 min. away. We have a medical director who has approved our protocols and skills. Other Oilsands plants have EMT-P as well as RN's and EMT-A's, they also have a medical director.

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Can an individual, that's not part of a company, have a medical director if a doc will sign off on them?

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I think so, Dwayne, but unless the doc's doing it pro bono, I doubt the average individual (especially if they work for EMS) could afford to pay for the doctor's medical direction.

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