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Pre Hospital Respiratory Therapist


1EMT-P

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Do any of you work with Pre-Hospital Respiratory Care Practitioners/Therapists?

Can you be a little more specific?

Are you talking about RTs who are not EMTs or Paramedics, who work on an ambulance solely in an RT capacity?

Are you talking about RTs who are not EMTs or Paramedics, who work outside of the hospital environment, possibly in home care, etc..., but not on an ambulance?

Are you talking about EMTs or Paramedics who also happen to be RTs?

I have worked with a few on the ambulance, and have been one myself. There are a couple here at EMT City who are currently dual role RT/Medics.

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Washington and N.C. have a few scene HEMS teams with RT/RN configuration. They also do inter-facility transport. Florida has a little stipulation in the EMS statutes that a scene responder must be an EMT-P. So, Florida allows almost everyone to challenge the test.

Several ground, fixed and helicopter teams have RN/RT configurations for interfacility transport especially cardiac, neonatal and pediatric. These teams all have an impressive scope of practice, knowledge and skills that exceeds the paramedic training.

Many times you will fine people like myself who started very young in EMS with the paramedic credential and then went on to RRT. If their interest is still "rescue and scene", they may keep their EMT-P. If they go on to the specialty inter-facility, it is not necessary. The pay difference is pretty great also. Even with many years in EMS, I would barely come close to what I make as an RRT in the hospital. In most hospitals, transport therapists usually have achieved the highest levels of training and are at the top pay step.

N.C. also has the best defined pre-hospital rules outlined in their statutes.

http://www.ncrcb.org/Final-Declaratory%20R...d%207-12-07.pdf

However, the same skills and scope of practice are utilized in many states and teams.

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Do any of you work with RRT's who are not EMT's or Medics, but have advanced scopes of practice and who work in the critical care/pre-hospital emergency care environment.

Examples: Flight RRT or Ground CCT RT or Pre-Hopital EMS RT... Not Home Care RT...

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I only know of one person who fits that bill and I've lost track of him ever since he decided to find his Center.

He moved to southern New Mexico on some land there. Said he was gonna grow some type of herb and just chill. It helps that he was very independently wealthy.

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Do any of you work with RRT's who are not EMT's or Medics, but have advanced scopes of practice and who work in the critical care/pre-hospital emergency care environment.

Examples: Flight RRT or Ground CCT RT or Pre-Hopital EMS RT... Not Home Care RT...

What may seem as "advanced scope" of practice may actually be their every day life in the hospital. IABPs, A-line insertion, RSI, conscious sedation, central lines, IVs, intubation and all the meds, especially if the RRT is an ECMO team member, are just part of the job description in RRTs for progressive ICUs.

And just like EMS, RT job descriptions vary from area to area. The scope of practice is usually written into each state's statutes for a wide variety of advanced practices. However, just like EMS, advanced scope of practice in the statutes doesn't mean every department takes advantage of it. In some areas, both RT and EMS have very advanced scopes of practice defined in their statutes but still practice in the dark ages.

Also, while there are many CCTs that utilize the RRT as a team member, many times the RRT is just "drafted" to go on the transport because the ICU attending has sized up what has been sent to us as a "CCT" team and doesn't feel comfortable with their skills or knowledge. An ICU nurse and/or RRT employed by the hospital may be elected to accompany the patient with the CCT team.

Not all CCT teams are created equal. For some, it is just a name on the truck to impress the local town folk.

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