Personnel Vol FD/1st Resp

[neiowa]

Looking for ideas on how you utilized/integrate medical professionals in your 1st Responder.

Small Rural FD. Have also provided 1st Responder/Medical for many years. At one time EMT-B, dropped to 1st Responder a several years ago due to lose of trained EMT. Typically 12-15 med. calls/year. Need to increase our pool of manpower to keep (or improve) or service. Training new EMT is expensive and as we operated on $15k/year + grants (Fire and everything else) $ are a bit tight.

We have at least one ARPN, two RN (surgical), two LPN residing in our Fire District that likely would participate. Have not tapped them as first 1st Responder (new idea). Anyone in similar situation and how may utilized/integrated such trained professional med personnel in their 1st Resp service? Problems/issues with utilizing "higher" level personnel?

We have limited ability to buy $500 Minitor pagers. And don't need to have 4 nurses at every call (of the few we have). Establish an on call schedule?

[Catch22]

Various solutions, part of which are dependant on Iowa's Bureau of EMS (or equivalent) regulations.

Do you have any EMT's that are qualifed as instructors? If so, you may be able to teach MFR or even EMT in-house. Does the local EMS agency have instructors that would trade off some of the tuition costs for MFR or EMT for your voluntary services?

The situation you describe is similar to what we're dealing with in regards to our medics. While us medics try to keep each other apprised of each others' schedules, sometimes we just don't have coverage. In that case, we start letting our EMT's know so that we have someone responding. It's very rare we don't have at least an EMT on a scene. However, we may be blessed in that regard.

If you can get to where you can at least do MFR in-house, at least you increase your odds of having someone with some kind of training responding and the higher-trained personnel are a blessing. Of course, unless you're providing ALS, nurses and RN's are nothing more than EMT's anyway.

[KanFireman]

I would check into Iowa EMS Regulations before attempting to tap into those sources. At least in Kansas they would have to challenge the KBEMS exams for whatever certification level (typically Paramedic) they want to practice at before they'd be allowed to provide medical care to anyone other than immediate family outside of a definitive care facility at or below that level.

[Eng34FF]

As Kan fireman mentioned, they may need to challange the test and get their EMT-?. Also need to watch scope of practice. There may be things that they can do as a nurse that they can't do as a EMT. That can get confusing for some.

[neiowa]

Good point on cert. Will check that out.

[Catch22]

I would check into Iowa EMS Regulations before attempting to tap into those sources. At least in Kansas they would have to challenge the KBEMS exams for whatever certification level (typically Paramedic) they want to practice at before they'd be allowed to provide medical care to anyone other than immediate family outside of a definitive care facility at or below that level.

It's interesting how that varies from state to state. Here, if they're a nurse (RN, not LPN or anything else below that level), have ACLS, and are approved by the agency's medical director, they can function as a medic. What's funny is the same applies to a physician, he has to have the ACLS to function in the field with an EMS agency. They don't have to challenge a test or anything.

[bradenframe]

Ask your medical director first?

I'm not sure how it is up there...but down here in Texas...the Medical Director can credential anyone they want at whatever level they want...

Meaning...if your Medical Director said all RN's who pass his Scope of Care test and Scope of Care practicals can practice at a EMT-Basic level...then no additional training is necessary? The Medical Director can sign off on just about anything down here...I'm a Nationally Registered EMT-B/Texas HHS EMT-B...but I can't use some of the procedures I'm trained on because it's not in my scope of care from my Medical Director...BUT at the same time...if for some reason my Medical Director decided I was ready...he could allow me to operate at a Paramedic Level...even though I'm not a Paramedic, Nationally or through TX HHS.

I'd suggest talking to your MD first to see what they're comfortable with? Why start all this training if the MD ain't kosher with it?

B Frame

[LVFD301]

I guess the first question - do you have a medical director, or just work with the local ambulance service?

If all you are providing is bls first responder, It is just up to your medical director, unless iowa state throws a wrench in it. The APRN, or any other RN is not going to bring anything more to the table. There is just not more that they can do, at BLS levels.

Something else to consider, there is an old joke about "what is the scariest words at an accident scene" with the answer "I am a nurse, can I help?"

A nurse, APRN, Surgical, etc, without additional specific training for outside of the hospital/clinic setting, can often be no help at all, even a problem more than a help.

Sort of like putting a lot of EMT's in a hospital setting, it just does not work sometimes.

[DeputyChiefGonzo]

Something else to consider, there is an old joke about "what is the scariest words at an accident scene" with the answer "I am a nurse, can I help?"

A nurse, APRN, Surgical, etc, without additional specific training for outside of the hospital/clinic setting, can often be no help at all, even a problem more than a help.

Truer words have never been spoken...

[rescueraver]

Non Emergency care providers

LVFD301 I guess the first question - do you have a medical director, or just work with the local ambulance service?

If all you are providing is bls first responder, It is just up to your medical director, unless iowa state throws a wrench in it. The APRN, or any other RN is not going to bring anything more to the table. There is just not more that they can do, at BLS levels.

Something else to consider, there is an old joke about "what is the scariest words at an accident scene" with the answer "I am a nurse, can I help?"

A nurse, APRN, Surgical, etc, without additional specific training for outside of the hospital/clinic setting, can often be no help at all, even a problem more than a help.

Sort of like putting a lot of EMT's in a hospital setting, it just does not work sometimes.


LVFD 301 I have to agree with you. I have had arrived on scene of mva's with "nurse or Dr". so and so rendering aid. One occasion one health care provider were trying to remove a patient from a car that was "smokeing". A ruptured radiator was the cause. These health care profesionals could be a great asset to the emergency services especialy the volunteers. But they need to be trained to work at a emergency scene. They need to learn about hazards and self protection. As people are volunteering less we need to look for those kind of people to help out.

[LVFD301]

As people are volunteering less we need to look for those kind of people to help out.

Totally correct - but we need to be sure to provide them the training and guidelines to follow.