Paramedics in ER

[shannonc102]

Has anyone worked with paramedics in the emergency department? If so, how are your policies and procedures written? What tasks/skills are most useful to you to have them do for you?

We are just starting a program and are looking for ideas :)

Thanks

Shannon

[Esme12, ASN, BSN, RN]

I have....LOVED THEM!

It depends on your state and facility. What is the state going to allow as per the medics protocol? Is the department medical head willing to cover "medical control"?

I have worked where the medics were elevated techs that did lab draw and IV starts. I have also worked where they did basic triage and participates in codes including intubation as well as transport/monitoring critical patients.

[RN403, BSN, RN]

Paramedics in our ER do EKGs, get vitals on fresh patients, start IVs, draw labs from lines. Basically do the same as the techs.

[AnnieOaklyRN, BSN, RN, EMT-P]

Paramedics are not just good for "skills and tasks" we are also great at assessing patients since we do that in the field on our own to develop a plan. ERs who are only going to hire paramedic for "tasks" should just stick with hiring less educated people!

HPRN

[resqbug]

I think it is sad that more ER's don't utilize a full range of paramedic skills in the ER. They bring a lot to the table to be treated as just basic techs.

[Loo17]

My boss told me once that the reason our ED does not employ medics to assist is because it would open the door for the higher ups to decide we could staff less nurses (higher ratios) and supplement with more (less expensive) medics.

[classicdame, MSN, EdD]

they are hired in our ED as techs and we like them because they are so efficient. In Texas the law does not allow them to do what a licensed nurse would do in the ED. EMS license is good only in the field. So they have to be careful about what they do. For instance, they would not be allowed to intubate, create care plan or do full assessment.

[HouTx, BSN, MSN, EdD]

In my state, Paramedics & EMTs scopes of license are specific to 'first responders'. They are considered 'unlicensed' in any other setting.

[tarotale]

Great at doing tasks and helping out at critical situations like code blue or stroke. Not so good at other "undesirable nursing tasks" like cleaning pt, transporting cuz they are PARAMEDICS. I kind of get feel them though, they been doing "field doctors" on the field intubating and running codes, and come into hospital, and they are limited greatly. Well we get paid hell lot more so if they don't want to work hard, whatever.

[icuRNmaggie, BSN, RN]

It has been over ten years now that I worked in a 300 bed med ctr with the Medic Units stationed in our ER.

The paramedics did not count as staff but they helped out if we asked for their help.

Having all of those big guys around was great for morale.

[shannonc102]

Thanks for all the feedback. We are looking to have a somewhat hybrid skill set for the medics (not in the field full capacity) that they are also have the understanding that they do the work that no one wants to do with us too....

[VolsEMTP]

I am a 10 year (ALS 911 Service) ​Paramedic that recently started working in a level 1 ED. We serve a huge region as the only Level 1 facility in a 200 mile radius and also offer some of the most advanced technology in the country as the Regional stroke center for the Southeast. The facility I work at has over 800 acute care beds. The ED has 41 rooms that see between 150-250 Patients per day and it is not unusual to have several critical ICU holds waiting to go upstairs for several hours. Even though I am new to the hospital setting I really enjoy my new career! Paramedics act just as RNs with the same responsibilities. The only skill an RN can do that i cannot is hang/Initiate a blood transfusion. After the blood is hung the medic can monitor and asses the pt until transfusion is complete. We can also push any medication or perform any intervention that an RN can. We are assigned to our own section as if we are no different and can actually perform some skills that an RN (with no additional training) cannot do, such as EJs and Intubation as needed. RNs are better in some situations and Medics are better in others. We all work as a team and get along great. I have not noticed any animosity or "I can do more than you" attitude. We see each other as equals and it seems to be working great!