nsmedic393 - this one is for you

[Neesie]

Hi nsmedic393. I was just reading some posts and came across one that you had put a little input into. The post was discussing giving EMT's or PCP's more skills such as 12 leads. I wanted to start a new post because I wasn't sure you would get this message otherwise.

So, what one of the comments you made was that you didn't think that pcp's or emt's should be allowed to do IV's because there is really no need for them to start one UNLESS an ALS medic was with them as their partner. Well, just to let you know, I work for a strictly BLS service and we do IV's. Yes, there is a need for them even at our lowly level of EMT/PCP. We give IV's so we can counteract the effect of hypoglycemia. We give D50W. We use IVs when there is equal or greater than 500ml blood loss. We give IV's for people who are having cardiac problems and need nitro. We can't give nitro unless an IV has been initiated. People who have blunt trauma to the chest (ex:steering wheel in the chest )will get an IV. Somebody with a bilateral femur # gets an IV. Someone who has overdosed and will need an IV at the hosptial will get an IV by us en route. AND any other time that we think a pt may need an IV but it is not part of our protocols, we will call the hospital for approval to do an IV.

So in conclusion, I am a huge advocate for EMT/PCP caregivers to be able to do an IV. You are right, it isn't hard to do one. We are very capable to do them. And there is a NEED for BLS to do IV's.

[Ridryder 911]

And there is a NEED for BLS to do IV's.

First problem is realizing that IV is not a BLS. Do you realize by introducing fluids you are technically changing the homeostasis of the body ?.. Are the fluids really going to help ? ... Even in the case of the NTG, laying the patient supine the NTG is transient and will wear off. Trauma .. fluid resuscitation has been proven not to be effective, and if you are do need fluid resuscitation they need more ALS than an IV.

There are only two criteria for IV's prehospital: introducing of medication and re-hydration secondary to hypovelemia.

R/r 911

[PRPGfirerescuetech]

Hi nsmedic393. I was just reading some posts and came across one that you had put a little input into. The post was discussing giving EMT's or PCP's more skills such as 12 leads. I wanted to start a new post because I wasn't sure you would get this message otherwise.

So, what one of the comments you made was that you didn't think that pcp's or emt's should be allowed to do IV's because there is really no need for them to start one UNLESS an ALS medic was with them as their partner. Well, just to let you know, I work for a strictly BLS service and we do IV's. Yes, there is a need for them even at our lowly level of EMT/PCP. We give IV's so we can counteract the effect of hypoglycemia. We give D50W. We use IVs when there is equal or greater than 500ml blood loss. We give IV's for people who are having cardiac problems and need nitro. We can't give nitro unless an IV has been initiated. People who have blunt trauma to the chest (ex:steering wheel in the chest )will get an IV. Somebody with a bilateral femur # gets an IV. Someone who has overdosed and will need an IV at the hosptial will get an IV by us en route. AND any other time that we think a pt may need an IV but it is not part of our protocols, we will call the hospital for approval to do an IV.

So in conclusion, I am a huge advocate for EMT/PCP caregivers to be able to do an IV. You are right, it isn't hard to do one. We are very capable to do them. And there is a NEED for BLS to do IV's.

Then your not doing BLS, your doing ALS and the discussion is useless. Furthermore, BLS does not NEED IV's. Period. You have ALS educated providers for IV's and D5W.

Advocate all you want. Plenty of people have advocated for stupid thingzs over the years. Doesnt make it right.

[paramedicmike]

This is a troll if ever I saw one. But I just can't help myself.

There is no *need* for IVs started by BLS providers. Obtaining IV access is an ALS intervention requiring education, training and understanding beyond what's available through a BLS training course. It's not a skill. It's a procedure complete with risks, complications and is not needed on every patient.

BLS education does not address or incorporate into the training (different from education) when an IV is needed, warranted, or required. It does nothing to address the thought process that goes behind the decision as to whether or not an IV will be initiated. If you, as a BLS provider are starting IVs for any reason, I hope your medical command doc has some kick a$$ malpractice insurance.

No, BLS does not need IV access. If anything, your BLS system NEEDS access to a paramedic staffed ALS system to ensure proper and even (at times depending on the provider) intelligent patient care.

And before you start going off about how we don't know what we're talking about, this topic has been addressed in several threads throughout the forums. Do a search, read the threads and then, and only then, come back with your questions.

-be safe.

[Lithium]

Again, I will reiterate from a post I just posted in ... I agree with nsmedic. BLS personnel should not be doing ALS interventions.

peace

[medic001918]

Here we go again. Haven't we discussed the basic level providers giving IV's enough? Do a search and you'll find lots of discussion about this very topic. I'm sure noone's opinion has changed since the last time we discussed it.

Shane

NREMT-P

[Neesie]

Well I suppose this will be the last that I say about this then. I am new here and didn't realize this topic has been discussed already. I would like to mention though that I have been "EDUCATED" in IV administrtation. I do believe that Canadian EMT/PCP is much different than the American EMT. We are educated in the complications that can occur, the treatments and the indications and contraindications involved. They don't just let anyone that wants to do an IV do one. Of course we have to be educated! It is okay that you don't agree with me. It is also okay that emt's in the states don't have the same training that I do as a pcp in Canada...and yes, PCP is just a fancy name for the old emt with a few additions to the education.

If there are any Alberta EMTs out there that care to put their 2 cents worth...please feel free to back me up on this!

Just one other question...do you believe that EMT's should not be allowed to administer D50W as well?

[Dustdevil]

Just one other question...do you believe that EMT's should not be allowed to administer D50W as well?

American EMT's? Absolutely not. They shouldn't even be on an ambulance at all, except as a paramedic student.

Alberta EMT's? Probably not. A year is barely enough to drill the basics into you, much less advanced physiology and pharmacology. I hear from Ontario PCP's all the time that 2 years was hardly enough.

[Nate]

Do we really need to have these constant talks of BLS doing ALS skills? If someone really wants to do that skill, then they need to go and become the level of certification. Like everyone says, there is more to an IV then just sticking it in someone. A little 0.9% NaCl can hurt a patient if you give it to the wrong patient.

[Neesie]

When I saw you replied Dust, I was a little scared!! lol

Maybe my suggestion to anyone that wants to tell me that I can't do the things that I have been trained/educated to do is research and compare the courses! Take a look at the Alberta guidlines and course criteria. Look also at the Saskatchewan criteria. THEN if you must, you can debate that with me and tell me that I should not be allowed to do the things I can!

Neesie