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Paramedic triage



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Mar 07, 2009 06:31 PM

Paramedic triage

by klerrn

My hospital is considering placing paramedics at registration for initial triage, I'm not so sure I'm comfortable with that. Has anyone had any experience with this process, the potential liabilty, negligence etc ?


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65 Comments
No. 1
from Displaced
Old Mar 07, 2009, 08:06 PM

Default Re: Paramedic triage
I want to start off by saying that you should feel a little uncomfortable about this since it is going to be something your ER has not tried yet. But, I believe based on what I have seen first hand from the paramedic curriculum, that any well educated and well experienced paramedic should be able to do the job at triage just fine.
Medics learn about all the worst case scenarios in class, even from the beginning in their EMT-B class. They are taught when to "load and go" or "stay and play" which can translate to a sudden onset chest pain that walks in that any nurse would take back to a room right away vs a abdominal pain x 3 weeks that can afford to wait a little longer.
Our ER Techs are Medics/EMT-B's, and sometimes when we are really short we have them in triage alone. They do a great job and we have never had a problem with them. Just last week we had a one of them rush back with a chest pain, he did the ECG and saw the ST elevation x 3, he yelled for a doc and had a clerk put orders in, got blood and sent it down all before a nurse ever stepped in (we were real busy plus he is very good/fast and *only* a EMT-B).

My point: If it is properly implemented, with the right people, it can work out great. But when it comes to liability and negligence issues, that I don't know about.
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No. 2
from MiCountry
Old Mar 07, 2009, 08:48 PM

Default Re: Paramedic triage
When our ambulance service was hospital bases, we used paramedics in our triage. It has worked well. They helped ED out in their downtime this way. I took my children in several times, and was very happy with how well they triaged real emergencies from the misc ear aches, sprains etc. I took children in for things from airway issues due to allergic reactions to non-emergent sprains. The paramedics got it right every time.
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No. 3
Old Mar 07, 2009, 09:23 PM

Default Re: Paramedic triage
The State of Texas laws says that all patients triaged need to be assessed by an RN. But on a personal level I feel parameidcs are quite capable of the triage system. I think we can all work together well.
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No. 4
from awsmfun
Old Mar 07, 2009, 09:55 PM

Default Re: Paramedic triage
I too feel paramedics are capable of triaging. But having an EMT-Basic is like having a CNA triage....And yes, I was a CNA before I was an EMT then I became a LVN then became a paramedic and then an RN.

An EMT-Basic only has 110 hrs of classroom...
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No. 5
from danjw
Old Mar 07, 2009, 10:30 PM

Default Re: Paramedic triage
Depends where you are really. I'd be fine with it because where i live, all our paramedics complete a university degree including clinical studies and another probationary year at the end. They get about the same training as the nursing students really. The only exception being volunteer/private service crews and transport officers (who only transfer patients between hospitals). In fact i'd probably prefer the paramedic to the nurse since the entire focus of the medics training is emergency 1st aide / triage

But i understand that a lot of places have paramedics with less training (emt's) that only do short courses. Then i'd rather have a nurse. I think my rule is: If you've spent less than a year studying medical, i don't want you deciding how much of a priority i am.

Then again, i'm the kind of person that won't bother going to a hospital for anything short of a life/death emergency, so i want someone good at the desk
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No. 6
from llltapp
Old Mar 07, 2009, 11:32 PM

Default Re: Paramedic triage
I agree with most of the previous posts. I worked in an ER where paramedics traiged. Then new docs came in and said no paramedic triage, only RN. It all depends on who the person is. Just like I've seen some RN's that don't belong in triage, I've seen paramedics who don't. Bottom line, I think you should have a minimum level of experience before you get behind the wheel of triage. I've seen our paramedics do incredible things, and yet I've seen outright moronicity (is that a word? lol). But, it's the same with RN's , NP's, and ER doctors.
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No. 7
from needsmore$
Old Mar 10, 2009, 02:40 PM

Default Re: Paramedic triage
WE follow the ENA position statement re-who's able to be assigned to the triage area

That being said, I firmly believe that there are many paramedics that I work with that would do an excellent job and I have worked with several nurses who "on paper" meet the standard, but --- leave aomething to be desired
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No. 8
from Larry77
Old Mar 11, 2009, 02:34 PM

Default Re: Paramedic triage
I'm fine with it as long as they have an RN as a resource....Medics triage all the time in the field so what's the difference in the WR? When it comes to a deeper hx or initiating tx i don't think they are comparable to an RN though...this is where I feel they would need some back-up.
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No. 9
from mattwilson
Old Apr 07, 2009, 03:29 AM

Default Re: Paramedic triage
Paramedics do a lot of the triage at our ER. We see approx 160-200 patients per day and when we have two triages going theres a good chance at least one is a paramedic. About 2 years ago we started hiring paramedics in the ER. They can do pretty much everything the nurse can except be primary on a pt receiving blood, discharge, ect. they can get out and give all meds the nurse can, they can intubate if there isnt a resident or med student before them. Got a little off topic but Paramedics do great at triage.
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