spenac Posted September 11, 2007 Share Posted September 11, 2007 The protocols still need to be approved by the state, no? Wisconsin DHFS is trying to return all services to the state level. No more John Wayne services. Sorry Dust, couldn't resist. Nope if the Doc is comfortable with open heart surgery by the basics, it's alright :twisted: , well maybe not that far but almost. The state only checks that you have the equipment and meds that are required for the procedure. State wide protocols are a bad idea. Because I am so far from the hospital I need to be more aggressive in treatment than someone that has a long transport of 15 minutes. If we were dumbed down to the level of protocols that I have at my part time service we would have more people die or have worse outcomes for those that live. I would not mind seeing a statewide minimum protocol that allowed medical director to go beyond based on local need. Might weed out some of the medicaid fraud taxis. As I have always said ONE SIZE DOES NOT FIT ALL. Link to comment Share on other sites More sharing options...
RomeViking09 Posted September 11, 2007 Share Posted September 11, 2007 In GA that DHR sets the Scope for the state, each region can go above based on need but needs approval of the DHR (example State Wide "law" EMT-B can work on a truck in all but one region you must be EMT-I to work on a truck and there is no such thing as a BLS Truck once you get north of macon) GA Had Scope for EMT-B, EMT-I/85, and EMT-P before the state used the NREMT Scope and Exams the had EMT (About the same as an I/85), EMT-CT (about the same as an EMT-I/99), and EMT-P (Went beyond NREMT-P). We still have EMT-CT running around but for the most part if your in GA you need to Be an EMT-I or a Medic. This does prevent the chance of a BLS truck showing up for an ALS call. Link to comment Share on other sites More sharing options...
Richard B the EMT Posted September 11, 2007 Share Posted September 11, 2007 Protocols can change. New York State used to allow EMT-Bs to transport patients on an established IV line. No longer. Now, we can transport a "saline lock" but not an IV, you must have higher medical authority disconnect the IV, or find a Paramedic to go along with the patient. Link to comment Share on other sites More sharing options...
firespec35 Posted September 12, 2007 Share Posted September 12, 2007 You did good, I had a MVA w/ ruptured diaphragm as an ALS unit. guess what we did? The same damn thing. We ended up going back to assist the flight crew on getting her to the trauma center. Link to comment Share on other sites More sharing options...
iMac Posted October 11, 2007 Share Posted October 11, 2007 You arent technically allowed to leave. This would be considered an MCI and since as described in this call you are the highest level of care, you can't leave the scene until more units show up. Triage, triage, triage. I would strongly consider Air med evac if you have it available. That you would be allowed to do and stay on scene while that patient air lifted. Maybe I'm not understanding the question? Link to comment Share on other sites More sharing options...
shannon710 Posted October 11, 2007 Share Posted October 11, 2007 So ALS expected you to waste the better part of this trauma patient's GOLDEN HOUR on waiting for them?? THATS NUTS!!! You stated as well that they were 30 minutes out...in the OPPOSITE direction of the hospital that was only 22 minutes out from you? Your actions saved this womans life, i can't believe they would put their ego in front of a life! If you had waited for them, and all they would have been able to do for her was what you had already done, she wouldn't have made it to the hospital for almost an hour as opposed to the 22 minutes it took you to load and go. Great judgement call, I would have done the same. Link to comment Share on other sites More sharing options...
iMac Posted October 12, 2007 Share Posted October 12, 2007 shannon, breath. Link to comment Share on other sites More sharing options...
BEorP Posted October 12, 2007 Share Posted October 12, 2007 You arent technically allowed to leave. This would be considered an MCI and since as described in this call you are the highest level of care, you can't leave the scene until more units show up. Triage, triage, triage. I would strongly consider Air med evac if you have it available. That you would be allowed to do and stay on scene while that patient air lifted. Maybe I'm not understanding the question? To review the patients and how they would be triaged under the START system: - 16 year old female in cardiac arrest: she is dead and never coming back (Black/Blue) - eight people on the mini-bus: minor bumps and bruises, all can walk (Green) - 40 year old female with "BP 80 systolic and falling rapidly": even if she has radials right now she won't for long with that BP (Red) So after our triaging we have nine patients who require treatment and only one who appears to have serious injuries. The Greens can be watched and treated by the EMT-B and First Responder from the "rescue tender." Hopefully now that makes is clear why it would not be in the best interests of the patient to waste time on scene. Link to comment Share on other sites More sharing options...
shannon710 Posted October 12, 2007 Share Posted October 12, 2007 lol..iiiiinnnn, ooouuuttt...thanks i feel better now..lol :wink: Link to comment Share on other sites More sharing options...
iMac Posted October 12, 2007 Share Posted October 12, 2007 glad I could help =D> Link to comment Share on other sites More sharing options...
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