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

[theantichick]

Love my medics in the ED. A few have the "field doctor" syndrome, but honestly not a huge number. By and large they are huge assets. I'm also in Texas and their scope is limited in the ED, but if you have the appropriate training/skills validation and medical control, they can be a huge help. Not just for the skills, but for the extra set of trained and experienced eyes. While they can't legally assess a patient for the chart in the ED here in TX, I've had many times where the medic brought something serious to my attention just from transporting the patient from the waiting room and thus we got on top of it that much faster.

[tech1000]

We do! I LOVE THEM! They typically are more task-y people, but they tend to put in our IVs and give meds. Sometimes they have to cath patients or just get VS and do more "tech" tasks. They don't tend to chart any sort of assessments on patients, although they are allowed to- as long as I do my primary. But it has really made my job easier to do. Some areas we just get slammed and our PMs really help us out with handling some of the meds and IVs!

[TLSpaz, ASN, RN]

I am in Texas too. Our medics' scope is defined by our EMS director who is also one of our ER medical directors. Some of the things our medics can do are triage, start IVs, draw labs, insert catheters, do EKGs, and give meds. They have Pyxis access for all meds except controlled substances. They can't pull controlled substances but they can administer them and they can witness wastes in the Pyxis as well. I don't know what we would do without our medics. One night recently, we were short one RN and only had a medic in triage. Ideal staffing is a charge nurse, three RNs, three medics, and a tech. On this particular night, we had two RNs, one medic and one tech. That was a rough night that served to well remind us how much we rely on our medics to keep through-put at an optimal level.

[WhoniverseNurse]

Love having Paramedics in our ED. They can essentially do everything in the ED that they can do in the field with a couple somewhat annoying exceptions: they can't officially assess, only gather data; they can't initiate drips (except NS / LR); they don't have access to our Pyxis medication machine (but can push most meds).

[NeedMoreCoffee]

The paramedics that I worked with in the ED were totally AMAZING. We appreciated them so much. They generally acted just like nurses, with a few restrictions. The one I remember most specifically was that they weren't allowed to transport monitored patients to the floor.... which was strange to me, since they, reestablish airways better than we do- with tools made of metal and such. However the Medics were always so pleasant and nice and willing to share knowledge with the nurses - we all had a great time.