Can someone explain why hospital EMTB can start IVs while OOH EMTB cant?

  1. Legally speaking you are not working as an EMT-B in the hospital — or to be more specific, you’re not under the purview of the state EMS board and your scope of practice as an EMT does not apply in this situation. There is no legal requirement for you to be an EMT to work as an ER tech (or any other job in the hospital), but a lot of hospitals prefer to hire EMTs for these positions because they tend to be a better fit than CNAs.

  2. Tennessee has delegated practice in the ER and hospital setting. EMS Scope is the purview of the medical control physician in the ER, and the only thing we can’t do is chemotherapy or charge a unit. ED EMTs can do casting, suturing, and other procedures at the discretion of the ER medical director and training documented.

  3. They probably got trained whether in-house or through a phlebotomy course to get certified. Hospitals want to get useful employees and starting an IV is like the bare minimal I feel like.

  4. Yeah, I know the hospital trains them but i didnt know the laws about being an EMTB and being able to do IVs, but I guess if they technically are an ED tech and not operating under the emt license scope of practice that could make sense

  5. In the ER, while ER Techs may hold an EMT-B license, they’re not actually operating under the EMT scope of practice. The ER Tech scope of practice is determined by the ER medical director or some other hospital protocol so this is why it greatly varies from hospital to hospital. Some hospitals may allow ER Techs to start IVs and Foleys, while others won’t even allow them to disconnect an empty NS bag from the IV.

  6. Ivs are started under the direction of someone of higher care than a basic. Emts can start lines with a medic in my jurisdiction, but now that we have 2 basics on bls trucks there are no lines to be done. Basics can probably start lines in the ER as they're working under the hospitals medical direction.

  7. It depends on what your protocols are and what license you are working under. The system I work in I can start IVs in 911 because it has been approved by our medical director.

  8. I've had it explained to me that we practice under the supervision of the RN and MD. At my ER, the techs are the highest skilled staff members at starting lines. We even get requested to the med surg units occasionally to help their nurses with hard sticks. We were never put through any formal training, on our orientation another tech just sorta showed us how to do it. And we stick dozens of patients per shift, so we get good pretty fast.

  9. It depends on your protocols. In my State EMT's can get endorsed to start IV's. Most hospitals hire EMT's as "techs" that have a different scope of practice to include phlebotomy.

  10. they probably have to get an IV certification. And it’s just entirely up to the medical director. Also EMT can’t do anything with the IV anyways

  11. It’s part of scope where I’m at; super useful if you’re a mixed medic/EMT crew and have a critical patient or code, so the medic can get a jump on drawing meds, or save a minute if you need two lines.

  12. That entirely depends on protocol limitations. With my service EMTs can start IVs under certain conditions if the medical director signs off that you have shown adequate proficiency.

  13. So I’m an ER Tech (in hospital EMT) and a lot of people have talked about training and such. They put us in a classroom, has us start an IV on a dummy arm, and threw us into the shark tank that is the ED lol. So not everywhere has a good foundation of training for this. The army has the same approach. When I went through combat medic school it was basically “yeah this is how you do it now buddy up with the person next to you and start their IV” lol. That’s why it’s important to know the hospital system you are applying to. Some places techs just get vitals and other places they can do IV/IO.

  14. This is not a universal thing at all. I'm not allowed to do IVs in-house, or even correct/silence alarms like downstream occlusions and such. I can do them on the ambo for one of my departments though, as soon as I attend the 2-day course.

  15. In my hospital in Texas, Level 1 trauma center, not even our paramedics start IVs. Falls under Nursing here. I'm an EMT-B working as an ED Tech, and I can take out IVs but that's the extent, we're not even allowed to touch the pumps.

  16. I’m a volunteer in southern Minnesota, and our protocols allow for IVs. We also just received training and approval for IOs.

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