Hired Paramedics in your ED???

[DSplendid]

Just wondering if anyone else has paramedics working in their ED.

We just started hiring Paramedics; as techs..

Thus Far they can:

Start IV's

Transport mon. pts to tele, or other departments (non-icu)

Defib, Pace, give meds per ACLS protocol (if warranted)

As well as tech duties,...splint, undress, collect labs, ekg...etc.

some grey area of collecting Triage data??? That has yet to be clarified.

My question is what are they allowed to do in your ER? Because it is still new and grey to us. For example; I was orient. a paramedic well known to our staff who was just hired. That night I had a very difficult IV and the doctor let the paramedic put an EJ in. Without blinking he dropped that in like nothing. (no doubt he has done it a million times before) the MD said he would sign it off on his orientation skills check list. Unf. I told him, it was not on his skills list. Nor was intubation later that night, when we had a another diff. tube. Nor was hanging a bag of NS. All which the MD as well as the nurses assumed he would be able to do. We all assume in time as they grow within the ED so will there scope. I mean personally, if your allowed to transport mon. patients and use ACLS drugs...why not a bag of NS. Any feedback would be great. Thanks.....

[needsmore$]

We hire EMTS/ EMT-Ps but their job description does not include meds, intubation, IV starts. They are hired as ED techs-and although they may be able to do higher practice skills under the EMT-P certification and whatever correseponding protocols they follow, they are not able to do those skills here.

The EMT-Ps run through our county EMS services and are not hospital based.

[flightnurse2b, LPN]

i am an EMT-P who spent many years working in the ER as a tech. my job not only to do tech work as you described such as splints, lab draws, ekgs, insert foleys, NGT's, etc, but also to start IV's, EJ's and/or IO's, transport monitored patients, occasionally sit at the tele monitors and interpret strips, give specified IV meds and maintain specified IV drips (including just your KVO NS, etc etc), assist with triaging at the how may i help you window, intubation, respond to hospital wide rapid responses and code blues, defib, pace/assist with cardioversion....

i did not have my full scope in the ED but it was pretty close. we all worked together as a team and things usually ran pretty smoothly...

[NeosynephRN]

I am not in the ED...but in the ICU..we have a few EMT-P's. They can intubate if needed. They have been called down to the ED to sink a tube when the doc there could not get it.

[neneRN, BSN, RN]

Our medics can do foleys, EKGs, transport, hang fluids (normal saline only), IVs, splints, transport, CPR, and defib. They can triage and we do hire medics into RN spots for triage positions (our triage nurses are triage only, we don't rotate).

They CANNOT give any meds (even ACLS drugs), intubate, start EJ or IO lines.

[Dixielee, BSN, RN]

We don't hire paramedics in our ER but I wish we would! We are short 18 RN positions and I don't know how many tech positions right now, are starting to use travelers and are drowning! Some RNs are worried that if we use paramedics, RN positions will be deleted. Well, right now, we are so short it doesn't matter if positions are deleted, there is no one to fill them anyway!

[Thornbird]

Depends upon the state what they are allowed to do as well as hospital policy. In CT, paramedics can't work in the hospital. I guess, in theory, they could work as PCT's but don't as that is far below their usual scope and far below their usual pay scale as well. CT regs are very influenced by "protectionism" by the CT Nurses Association to preserve RN job slots although in the long run this has created an "artificial nursing shortage" because regs require RN's for jobs that could be done by Medics or LPN's.

Your ED staff should check to see exactly what state laws and regs affect paramedic practice in the hospital setting.