Question for Our EMT/Paramedics/Medics/Doctors

**Rick** · 08-30-2009, 10:52 PM

I'm in the process of upgrading my medical kit and I want to upgrade my training as well. There are a lot of products on the market that, clearly, a layman has no business attempting to use. Things like cricothyrotomy kits, O2 administration, IV saline, etc.

However, I also know that, as rare as the need might be, someone's life could be saved if the person on hand had the training and tools to perform a more sophisticated intervention.

My first question is, at what point in First Responder or EMT training do those types of procedures get employed if they do at all.

I have had both first aid and CPR. Actually, I've been through several first aid classes and several CPR refresher classes but nothing beyond.

My second question is what classes should I be looking at for general knowledge and training with no end game intent to use it as an occupation. I just want the training to have the training.

Hopefully, this will help some others as well.

**oldsoldier** · 08-31-2009, 08:10 PM

[QUOTE=Rick;150064] cricothyrotomy kits, O2 administration, IV saline, etc.

My first question is, at what point in First Responder or EMT training do those types of procedures get employed if they do at all.

Good question(s) Rick, Most of the Items you mention with the exception of O2 is administered my a paramedic or higher, The O2 can and is used by even people with little or no training. most of the others IV's etc. usually are used under the direction of a Dr.

I recommend EVERYONE take some training. Depending on your current level of training, I recommend since you already have some basic training to take a CERT course and a first responders course. In all liklyhood unless you really want to do so an EMT or paramedic course won't be needed as most cities have crews that will respond in very little time. It would also be a good idea to take a couple of advanced classes if they offer then in your area. Classes like wilderness rescue,or water rescue. Many areas have volenteer rescue teams/fire departments. That would love to have more members and will often provide training free to team members.

**Rick** · 08-31-2009, 08:47 PM

I've actually been looking for a First Responder course. I figured in the absence of any other info that was as good a place to start as any.

**catfish10101** · 09-01-2009, 12:28 AM

The first responder course is great, but for waht you are looking for, you will need at least, Basic paramedic. Probably better to go intermediate paramedic. First responder is basically First aid, cpr, aed, delivering a baby, putting in airways, etc. Mainly keeping the patient alive until paramedics arrive. Blood goes round and round, air goes in and out.....anything different is a problem.

**Rick** · 09-01-2009, 12:30 AM

Originally Posted by catfish

Blood goes round and round, air goes in and out.....anything different is a problem.

Oddly, I can keep that straight. There's hope (the feeling not the forum member).

**Riverrat** · 09-01-2009, 09:21 AM

With the hiking you do, and being outdoors quite a bit, I would look at the Wilderness FR course, they teach the basics of FR level, with the added bonus of wilderness training. Here they are put on by both St. John Ambulance and Red Cross. Oxygen therapy is taught in the FR courses, but for IV u would have to go paramedic level, cricothyrotomy is a doc level, at least that is the way it is here.

**Rick** · 09-01-2009, 08:39 PM

I'm not really looking to be able to do those things. They were just examples. It would be nice, of course, to have that kind of knowledge. My wife is an RN and she puts me to shame on the medical stuff. Sometimes I just get "the look" when I ask a question.

**mcfd45** · 09-03-2009, 12:14 PM

I would have to go ahead with the EMT basic course for most people. At the very least you have it to fall back on when your job goes.

**Boker** · 09-03-2009, 05:30 PM

Originally Posted by Rick

I'm in the process of upgrading my medical kit and I want to upgrade my training as well. There are a lot of products on the market that, clearly, a layman has no business attempting to use. Things like cricothyrotomy kits, O2 administration, IV saline, etc.

However, I also know that, as rare as the need might be, someone's life could be saved if the person on hand had the training and tools to perform a more sophisticated intervention.

My first question is, at what point in First Responder or EMT training do those types of procedures get employed if they do at all.

I have had both first aid and CPR. Actually, I've been through several first aid classes and several CPR refresher classes but nothing beyond.

My second question is what classes should I be looking at for general knowledge and training with no end game intent to use it as an occupation. I just want the training to have the training.

Hopefully, this will help some others as well.

I'm currently a RN (ICU). Started as an EMT-Basic and worked my way through the levels to Paramedic (Currently Expired) prior to attending RN school. That stated, lets see if I can answer the questions.

My first question is, at what point in First Responder or EMT training do those types of procedures get employed if they do at all.

Oxygen delivery begins at the EMT-Basic level unless they have expanded the 1st responder roles in the last couple of years. Hard to go wrong with oxygen in the field. There are some contraindications, but 99% of the time its safe. EMT-Intermediates are introduced to advance airway management (Intubation) and IV therapy as well as D50 and Narcan. Paramedics are exposed to emergency procedures, IE tracheotomies and needle decompression, both useful but rarely required. (The skills vary by state.)

Something to consider about the 'advanced' stuff, that if you can't get the patient to a definitive care facility somewhat quick the procedures only delays the outcome. For example if you know how to do a tracheostomy with a pocket knife and a bic pen, how do you plan to ventilate the patient or deliver oxygen. Mouth to pen might seem like a good idea at first.....

My second question is what classes should I be looking at for general knowledge and training with no end game intent to use it as an occupation. I just want the training to have the training.

Thats a damn good question I had never thought about. I started EMT-Basic training when I was 19, so until I graduated RN school it was all I knew for the most part. I'm not sure if any resources exist beyond CPR/First Aid. There are several things I can think of that probably aren't covered in basic first aid that would be useful for folks to know. (The proper field dressing for a sucking chest wound comes to mind.) Perhaps we should start up a survival first aid course.

Taking a EMT-Basic class seems like overkill for what you want and underkill for what you 'need' (YMMV). So much of the EMT world revolves around extraction from vehicles that most people will never need. And it can be summed up: if the scene is safe leave the patient in place, if the scene isn't safe, why are you there?

I've rambled enough. PM if there are any more questions and I'll try to help.

**Rick** · 09-03-2009, 05:38 PM

No ramble as far as I'm concerned. Good info and I appreciate it. I've always thought I had the first aid side of the house covered...until recently. Lately, I've been thinking that a glorified first aid kit might not cut it if something serious were to happen. Even just out in the woods. Broken bones, severe lacerations, water borne illness, etc. are really not covered well with a glorified first aid kit, IMHO.

Let me ask a follow up question. There must be some governing body that tells a community or private business what equipment an EMT should carry. I've been scouring the net but can't seem to find an official list. Can someone point me to that type of document on the internet? I know some things probably can't be acquired without a prescription but I'd like to see the list then decide on what would be right for me.

Thanks to everyone that has responded!!!

**Boker** · 09-03-2009, 05:54 PM

There is a list of links at that bottom:http://www.ok.gov/health/Protective_...ols/index.html

**Rick** · 09-03-2009, 06:00 PM

State Departments (head slap). Sweet! Thanks!!!!

**oldsoldier** · 09-03-2009, 06:05 PM

Rick don't know if this is what your looking for....
http://www.dhs.state.tx.us/emstrauma...ListDraft1.pdf
It may help

**Rick** · 09-03-2009, 06:07 PM

Apparently not. I have to log in to access it.

**oldsoldier** · 09-03-2009, 06:10 PM

If that don't help try googleing EMS equipment protocols

**Boker** · 09-03-2009, 06:11 PM

Just FYI, they rarely take the keys out of the ambulance when parked at the hospital. Just saying....

**Rick** · 09-03-2009, 06:12 PM

Hmmmm. I'll be right back (going to measure garage).......

**hound** · 09-06-2009, 10:58 PM

Look into the Army Combat Lifesaver course. I have taken it twice. It teaches how to deal with many types of injuries. Also both times I took the course we did I.V. training. They aren't hard when someone teaches you how and when to use them. We all stuck another soldier and all of us were stuck by a random classmate. Great training.