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Local Protocals... Do You Ever Break Them?


Do you ever break local protocals?  

28 members have voted

  1. 1.

    • Sometimes if I'm with the right people.
    • I'm and EMT on paper but in the rig I'm a Paramedic.

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Do any of you ever break local protocols?

The other night a medic I'm not used to working with expected me to stick at PT. Under our company policy and local protocols I can't do that. I felt like a tard cause I told him in front of a PT and PD that I couldn't and wouldn't do it. He seemed surprised thus making me look even more like a tard. Later I spoke to him about it and well....... Some people feel that they can cross the line if they are comfortable with their medic partner, and don't get caught.....

I just wanted your thoughts on this.....



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I know when to follow them and when there just too damn retarded for the situation and nothing really fits so you go by what ya know. I dont go above and beyond my scope of practice. Thats just not right. The most ive done is get and IV preped for my partner while she was intubating. But ya know there was no access. I did have it going through my head that i could of done it if there was access. But there wasnt so i didnt and neither did she. So yes i have thought about it but never have done it.

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I use common sense, I do not go outside of my protocols they are there for protection. I am a paramedic so not much we can not do, when I was an EMT I did not go outside the protocols. If something was to go wrong at least you have the protocols to back you up with your medical Director.

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Good for you! Stand your ground and don't let another provider push you into doing something you don't feel comfortable or can't do. That is outstanding that you were able to tell that person no.

And you should NOT feel like a "tard" for telling him no. You know your bounds, limits and restrictions. The fact that he doesn't seem to know makes him more the idiot. You came out of that looking better than that paramedic.

As for protocols...

your protocols are there for a reason. Protocols are guidelines for treatment but are not the end all and be all of patient care decisions (and my local protocols say as much). Stick to what the protocols tell you to do, but don't let them limit you. If you feel the need to operate on the edge (or just beyond) of what your protocols suggest then you need to call the doc. That is why s/he is there. Couple that with proper and thorough documentation and you'll be fine.

Don't feel stupid for standing up to that guy. Feel strong and know that you did the right thing.

Be safe.

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My medical director has it even published in our protocol book (over 200 pages) that "Protocols are guidelines ONLY" It is upon the desecration of the EMT or Paramedic to utilize and make decisions upon clinical knowledge. She would fry us if "we stuck to the protocols" on every call. As from her mouth "I don't want cook-book medics".. She expects us to be clinicians.

Be safe,

Ridryder 911

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Let me rephrase my original statement, Our protocols are there for us to be able to do standard of care, across the table and then each person is treated as a individual. I can not say that I have never deviated from our protocols cause I have but to benefit pt care.

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I can't think of any specific time that i have... I try and stay true to them.. they are there for a reason... but like what mcad said... there may have been times where for the benifit of the pt... protocols have been bended depending on what person i am riding with.. we have medics who because we have to get a line on the person... will try a third time if they can't get it in 2x. for whatever reason... but like i said... any time they may have... it has been for DAMN good reasons.. not just for sh*ts and giggles....

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At the private ambulance I used to work for our MD would allow us to go outside our protocols if monitored by a paramedic. I had a great partner and we had a great system and worked as a team.

She taught me how to read (she was an instructor) EKG's so while she was assessing the pt I could run a strip and tell her if it was normal or not. I got her drugs and IV's ready. This freed her up to spend more time with the patient. I never did anything that I felt uncomfortable with, such as ET tube or sticks.

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