ER Techs allowed to give meds??

  1. Here’s my (EMT/ER tech as well) thoughts. First and foremost it depends a little bit on what state you’re in, and almost 100% on what your ER medical director approves. That being said, your state scope of practice (which is what I assume you’re referencing) as an EMT is only for you as an EMT and not an ER tech. As an EMT you are operating outside the hospital, without access to any of the resources of the hospital right at your fingertips. In the ER, you have doctors assessing the patients and ordering specific treatments which you’re carrying out. All the hospital needs to do is train you in proper ways to administer these medications, have a written guideline about what you can and can’t give, and have the medical director sign off on your ability to do so. Again I’m not sure about the EMT scope of practice where you are, but generally speaking IV’s aren’t included, but a large proportion of ER’s allows techs to start IV’s.

  2. To add on, with a pill, you know the dose and have a solid object to give and the math is usually non-existent or simple enough. But drawing up medications to administer IM is completely different. You need to make sure that you know the concentration you have vs what you need and that you actually draw up only what you need. Also with IM you need to be able to make sure you actually know how to administer it correctly -as unlikely as it is, you could end up administering IV instead of you happen to poke just into a vessel.

  3. If you work in a state where physicians can delegate practice, such as Texas, the medical director can allow you to do quite a bit outside your scope. They are responsible for making sure you're trained appropriately to perform the skill and they are liable if you make a mistake.

  4. This. As a Texas EMT or Paramedic, I could basically do a cesarean if I’m comfortable with it and the doctor gives the order and doesn’t mind delegating.

  5. It’s not in your scope of practice as an EMT, but that scope of practice doesn’t apply when you’re working as an ED tech. The ceiling of care you can provide in the ED will usually be defined by your state’s nurse practice act, specifically the “delegation of nursing activities” section (or something along those lines). Essentially, this lays out the things that a nurse can delegate to a tech, CNA, etc., and it’s often written broadly enough so that, with certain exceptions, it basically boils down to:

  6. It might have been a COVID rule. In MN, when the state of emergency was in effect they suspended most of the licensing requirements, meaning medical directors could just decide what level of care you were. Nobody got any legal exemptions though, and it was worded more along the lines of "we're not saying you can do this, but we're not going to check if you did."

  7. When there are shortages of nurses and other health professionals there are usually provisions to allow a certain amount of leniency on scope under supervision. The alternative would be closing the department.

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