# Question?



## Muppet (Jun 14, 2011)

So, I told you about the new tac. team / warrant squad that accepted me and a few other for medics on the team. My issue... My partner, who happens to be an EMT-B (BASIC) was given chest needles to carry in his chest rig for TCCC. I am torn. I know he went to medic school but failed out and now he gets to carry chest needles? This is telling me AND him that it's ok to fail and you still get awarded with things / such as being called a medic. I talked to the medical director and he assurred me that this was an oversight but this guy is running around claiming to be a tac. medic now....... I talked to him / brought it up to the team boss / M.D. Am I over reading this or am I correct to assume that this can be problematic?

Signed: Pissed off PARAMEDIC. :)

F.M.


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## Diamondback 2/2 (Jun 15, 2011)

EMT-B's can't use chest needles? They teach that shit in CLS, and issue one in every IFAK now. I would have thought that an EMT-B would be able to do a lot more then someone who went through CLS? But then again I don't know shit about EMT's and levels of skill. It was explained to me that 68W are only EMT-B's, but are trained to do much more.

Outside of that, it was also my understanding that SWAT Medics were EMT-P's and above (i.e. Paramedics, PA's and M.D.'s)?


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## Muppet (Jun 15, 2011)

JAB said:


> EMT-B's can't use chest needles? They teach that shit in CLS, and issue one in every IFAK now. I would have thought that an EMT-B would be able to do a lot more then someone who went through CLS? But then again I don't know shit about EMT's and levels of skill. It was explained to me that 68W are only EMT-B's, but are trained to do much more.
> 
> Outside of that, it was also my understanding that SWAT Medics were EMT-P's and above (i.e. Paramedics, PA's and M.D.'s)?


 
In the Army / military all together, EMT-B's ARE trained to do alot more, I know I was... That being said, civilian EMT-B's cannot preform invasive skills w/o having they're medic cert and command under a medical director. Tac. / warrant medics on my team are all paramedics and a few docs. My partner is the expection, why I do not know but I hope things get fixed. The first time, and I add GOD FORBID, this kid gets to use a chest needle and places it wrong and the powers to be find out that he is NOT a paramedic, it is going to hit the fan. Just my 2cc. I may be over analyzing this, but....

F.M.


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## Ranger Psych (Jun 15, 2011)

A:  You're an individual who was recently picked up for the team. Congrats.
B:  You're an individual who was recently picked up for the team. Obvious implication, everyone there was hired for a reason and you didn't do the hiring.

C:  The individual you bring up has had current training and has passed the requirements for selection to the team, correct? If so, what is the problem.
D:  As long as he operates under the standing orders/protocols/procedures that the med director provides, it doesn't matter. It's not your ass that's on the line, it's the Doctor that is directing mr NREMT-B to perform specific tasks.

Provided he receives or has received the training associated with performing a Needle Thoracentesis... and it's in the standing orders, etc. I don't particularily see what the problem is. Then again, focusing on the facts that a needle decompression, starting an iv... both are really no-brainers. That, and you're losing sight that as a tactical medic your primary focus is going to be on trauma related issues, not the medical issue majority that being a paramedic allows you to handle.

I mean, how many cardiac emergencies in a tactical situation aren't caused by the onset of lead poisoning?  I'm not sayin, i'm just sayin.

Your primary concern should be providing proper care to your potential patients,  stop polishing that national registry rocker. LOL


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## policemedic (Jun 15, 2011)

Ranger Psych said:


> D: As long as he operates under the standing orders/protocols/procedures that the med director provides, it doesn't matter. It's not your ass that's on the line, it's the Doctor that is directing mr NREMT-B to perform specific tasks.



In PA, he may be allowed to do this as a physician extender (using the provisions of the medical practice act) under the MD's direct supervision and direct order, but he cannot do it alone under standing orders according to the current scope of practice laws.  There are supposed to be new tactical protocols from the state, and these may include an exception for this (I hope not), but these aren't in place.  An EMT with needles is miles outside his lane in our state.



Ranger Psych said:


> That, and you're losing sight that as a tactical medic your primary focus is going to be on trauma related issues, not the medical issue majority that being a paramedic allows you to handle
> 
> I mean, how many cardiac emergencies in a tactical situation aren't caused by the onset of lead poisoning? I'm not sayin, i'm just sayin.



Actually, I've been doing the SWAT medic thing for years, and while trauma is a part of it, a majority of the care I've provided has been medical.  You end up taking care of team member's chronic issues, diabetic/epileptic/pregnant etc. suspects or bystanders, and the list goes on.  I'm not saying trauma preparedness isn't important; it clearly is.  But to say that medical issues are rare is not accurate in my experience.


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## policemedic (Jun 15, 2011)

JAB said:


> EMT-B's can't use chest needles? They teach that shit in CLS, and issue one in every IFAK now. I would have thought that an EMT-B would be able to do a lot more then someone who went through CLS? But then again I don't know shit about EMT's and levels of skill. It was explained to me that 68W are only EMT-B's, but are trained to do much more.
> 
> Outside of that, it was also my understanding that SWAT Medics were EMT-P's and above (i.e. Paramedics, PA's and M.D.'s)?



Do not get me started on the 68W training programs. There are holes in that you could drive a platoon of Stryker MEVs through. I had to spend a lot of time bringing my junior Whiskeys up to speed on things they thought they knew, but didn't. In many ways, the schoolhouse produces soldiers that don't know what they don't know.

To answer your other question, in SWAT the term medic is used generically.  It doesn't always indicate a paramedic.  In fact, my team is looking at sending a cop to EMT-B class so that there is a back-up to me (besides our medical director).  If it happens, that guy will be a 'team medic'.


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## policemedic (Jun 15, 2011)

Firemedic said:


> So, I told you about the new tac. team / warrant squad that accepted me and a few other for medics on the team. My issue... My partner, who happens to be an EMT-B (BASIC) was given chest needles to carry in his chest rig for TCCC. I am torn. I know he went to medic school but failed out and now he gets to carry chest needles? This is telling me AND him that it's ok to fail and you still get awarded with things / such as being called a medic. I talked to the medical director and he assurred me that this was an oversight but this guy is running around claiming to be a tac. medic now....... I talked to him / brought it up to the team boss / M.D. Am I over reading this or am I correct to assume that this can be problematic?
> 
> Signed: Pissed off PARAMEDIC. :)
> 
> F.M.



You will lose the argument about the title.  Suck it up.

The good news is:

You will win the argument over what he is allowed to do.  With that said, nothing says he can't possess the stuff (he just can't use it).  It's nice to have people to carry stuff for you... In any case, will he be deployed alone?  If not, it's not much of an issue because he'll be supervised by the doc or paramedic, who will be telling him to do EMT tasks, thus freeing up the more experienced hands for things that require more skill and education (just like on a regular MI, shooting, or pin job).


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## Red Flag 1 (Jun 15, 2011)

Ranger Psych said:


> A: You're an individual who was recently picked up for the team. Congrats.
> B: You're an individual who was recently picked up for the team. Obvious implication, everyone there was hired for a reason and you didn't do the hiring.
> 
> C: The individual you bring up has had current training and has passed the requirements for selection to the team, correct? If so, what is the problem.
> ...


Pretty much says it all, IMHO.

Be the professional.

Remember that Sheriff Andy Taylor let Deputy Barney Fife carry a bullet for his revolver in his pocket. Barney could not load and fire his "weapon" without Sheriff Andy's ok.

RF1


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## Muppet (Jun 16, 2011)

Thanks men. I appreciate it and have looked it in a different way now. Thanks for getting my head out of my ass for me.

Psych: I am NOT polishing my rocker. LOL:)

F.M.


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## georgiamxer45 (Jun 29, 2011)

Hey Firemedic,,,,here in SC we have EMT-B's that "carry" chest needles, IV kits, etc.,,,,,but Med.Direction hasn't signed off on them using it.  Here we tell them to concentrate on the ABC's at a call,,,,don't get caught up in the "names, titles, or adjectives" this guy uses or is assigned.  If an EMT-B can start an IV,,,great,,,but here,,,like I said, their scope of practice doesn't allow it,,,,so,,,control what you can control,,,and that is ALS,,,,and it will all come out in the wash when the shit really hits the fan,,,,,have a good 'un!!  and be safe!!


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## TLDR20 (Jun 29, 2011)

Firemedic said:


> So, I told you about the new tac. team / warrant squad that accepted me and a few other for medics on the team. My issue... My partner, who happens to be an EMT-B (BASIC) was given chest needles to carry in his chest rig for TCCC. I am torn. I know he went to medic school but failed out and now he gets to carry chest needles? This is telling me AND him that it's ok to fail and you still get awarded with things / such as being called a medic. I talked to the medical director and he assurred me that this was an oversight but this guy is running around claiming to be a tac. medic now....... I talked to him / brought it up to the team boss / M.D. Am I over reading this or am I correct to assume that this can be problematic?
> 
> Signed: Pissed off PARAMEDIC. :)
> 
> F.M.



Here is the thing with that man, not even taking into account the various ass pains of lawsuits and stuff. But if I trust a brand new 18B who can barely spell gun in english to perform a needle D on me if I ever needed it. I think you can trust a guy who failed out of Paramedic school. I might even let an 18A do it if I were to have the need for a D. Just saying.


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## mike_cos (Jun 29, 2011)

cback0220 said:


> .


Cool your new avatar!!!! Bwahahahahah uhuhuhuhuhu ROFLMAO!


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