Pre-Hospital Care Medical Control Protocols And Procedures: Fill & Download for Free

Here is New York State's Functional Position Description for EMTs:Functional Position DescriptionEmergency Medical Technician - Basic (EMT-B)Advanced Emergency Medical Technician (AEMT)Purpose:Provide a guide for those who are interested in understanding what qualifications, competencies and tasks are expected of the EMT-B and/or the AEMT.Qualifications:Complete the Application for Emergency Medical Services Certification (DOH-65), including affirmation regarding criminal convictionsSuccessfully complete an approved New York State EMT-B or AEMT courseAchieve a passing score on the practical and written certification examinationsMust be at least 18 years of age by the end of the month in which they are scheduled to take the written certification examinationKnowledge and Skills required show need for high school or equivalent educationAbility to communicate effectively via telephone and radio equipmentAbility to lift, carry and balance up to 125 pounds (250 pounds with assistance)Ability to interpret oral, written and diagnostic form instructionsAbility to use good judgement and remain calm in high stress situationsAbility to be unaffected by loud noises and flashing lightsAbility to function efficiently without interruption throughout an entire work shiftAbility to calculate weight and volume ratiosAbility to read English language, manuals and road mapsAbility to accurately discern street signs and addressesAbility to interview patients, patient family members and bystandersAbility to document, in writing, all relevant information in prescribed format in light of legal ramifications of suchAbility to converse, in English, with coworkers and hospital staff with regard to the status of the patientPossesses good manual dexterity with ability to perform all tasks related to the highest quality patient careAbility to bend, stoop and crawl on uneven terrainAbility to withstand varied environmental conditions such as extreme heat, cold and moistureAbility to work in low light situations and confined spacesAbility to work with other providers to make appropriate patient care decisionsCompetency Areas:The EMT-BMust demonstrate competency is assessment of a patient, handling emergencies using Basic Life Support equipment and techniques. Must be able to perform CPR, control bleeding, provide non- invasive treatment of hypoperfusion, stabilize / immobilize injured bones and the spine, manage environmental emergencies and emergency childbirth. Must be able to use a semi-automatic defibrillator. Must be able to assist patients with self-administration or administer emergency medications as described in state and local protocol.The AEMT-IntermediateMust demonstrate competency in all EMT-B skills and equipment usage. Must be able to provide Advanced Life Support using intravenous therapy, defibrillator and advanced airway adjuncts to control the airway in cases of respiratory and cardiac arrest.The AEMT-Critical CareMust demonstrate competency in all EMT-B skills and equipment usage. Must be able to provide Advanced Life Support using the AEMT-Intermediate skills and equipment. Must be able to administer appropriate medications.The EMT-ParamedicMust be capable of utilizing all EMT-B and AEMT-intermediate skills and equipment. Must be able to perform under Advanced cardiac Life Support (ACLS) and Basic Trauma Life Support (BTLS) standards. Must be knowledgeable and competent in the use of a cardiac monitor/defibrillator and intravenous drugs and fluids. The EMT-Paramedic has reached the highest level of pre-hospital care certification.Description of Tasks:Responds to calls when dispatched. Reads maps, may drive ambulance to emergency site using most expeditious route permitted by weather and road conditions. Observes all traffic ordinances and regulations.Uses appropriate body substance isolation procedures. Assesses the safety of the scene, gains access to the patient, assesses extent of injury or illness. Extricates patient from entrapment. Communicates with dispatcher requesting additional assistance or services as necessary. Determines nature of illness or injury. Visually inspects for medical identification emblems to aid in care (medical bracelet, charm, etc.) Uses prescribed techniques and equipment to provide patient care. Provides additional emergency care following established protocols. Assesses and monitors vital signs and general appearance of patient for change. Makes determination regarding patient status and priority for emergency care using established criteria. Reassures patient, family members and bystanders.Assists with lifting, carrying and properly loading patient into the ambulance. Avoids mishandling patient and undue haste. Determines appropriate medical facility to which patient will be transported. Transports patient to medical facility providing ongoing medical care as necessary enroute. Reports nature of injury or illness to receiving facility. Asks for medical direction from medical control physician and carries out medical control orders as appropriate. Assists in moving patient from ambulance into medical facility. Reports verbally and in writing observations of the patient's emergency and care provided (including written report(s) and care provided by Certified First Responders prior to EMT-B/AEMT arrival on scene) to emergency department staff and assists staff as required.Complies with regulations in handling deceased, notifies authorities and arranges for protection of property and evidence at scene.Replaces supplies, properly disposes of medical waste. Properly cleans contaminated equipment according to established guidelines. Checks all equipment for future readiness. Maintains ambulance in operable condition. Ensures cleanliness and organization of ambulance, its equipment and supplies. Determines vehicle readiness by checking operator maintainable fluid, fuel and air pressure levels. Maintains familiarity with all specialized equipment.

No. Simply because Intubation is an invasive technique and can not be preformed unless you are under a medical control. In other words, you have the permission of a medical doctor to perform the procedure. He knows you and trusts you to be his hands away from the hospital environment. That you have been properly trained in intubation and that you probably (human factors) won't miss the tube and kill your patient. Almost 100% of pre hospital EMS operate on protocols. This simply means that in situation that call for a specific treatment IE: intubation to establish and protect the airway, you can intubate without contacting online medical control. When you get to the hospital the treating doctor will almost always sign your treatment orders. If the doc feels you acted improperly, he won't sign then you have to deal with your off line medical control. So a short answer too your question is No, a first responder cannot legally intubate in the field unless of course they are a licensed MD ( who will assume all care and go to the hospital with the patient) or paramedic acting in the line of duty.

To begin, you must understand there is no cure for a slipped, herniated, or ruptured spinal column disc regardless of how you describe, or what you call the injury. They are all the same. A spinal column disc has ruptured and the gelatin like material filling the disc is pressing against a nerve. Usually forcing the nerve against the boney structure of the vertebrae. The severity of the injury and resulting pain will depend on the location of the rupture. In almost all cases the injury was caused by a simultaneous bending, lifting, twisting motion placing an awkward strain on the lower back. The discomfort from the injury will usually arise twenty-four to seventy-two hours following the injury. The discomfort is brought on when the offending nerve swells from the irritation of the pressure against it. The swelling must be brought under control before relief will be obtained. Aspirin, extra-strength varieties, are typically the best medicinal remedy. Once the pain subsides gradual stretching and flexibility exercises should be commenced with caution.I know this because in 1961, at age thirteen, I suffered a lower back injury ultimately diagnosed as ruptured disks at L4-L5, S1-S2. The diagnosis occurred twelve years later in 1973 as the result of a myelogram performed by Dr. Joseph Brady, a neurosurgeon. Each year during those twelve years there were typically four to six episodes of severe crippling low back pain that pretty much ruled my life.Following the myelogram Dr. Brady performed a laminectomy, and then a second myelogram and laminectomy in 1975. The diagnostic and surgical procedures were performed at Sacred Heart Hospital in Norristown, PA. Following the first procedure Dr. Brady cautioned me that a second procedure was likely because of the damage that had accrued over the years. Following the second surgery, Dr. Brady explained that the nerve damage was so extensive he expected I would need to wear leg braces the rest of my life. Fortunately, that prognosis has so far proven wrong.Despite a prolonged recovery period following the second surgery, and then an extensive period of physical therapy, severe back pain episodes continued. Significant muscle atrophy occurred in my right calf, some in my left calf, and more extensive nerve damage and atrophy in my left foot. The pain from the atrophy would often rival the low back pain.In mid-1976 we moved from West Norriton Township, PA, to Cinnaminson, NJ. Following the move, I entered the care of Dr. Benjamin Smolenski, Orthopedic Surgeon, practicing at Zurbrugg Memorial Hospital in Riverside, NJ. From mid-1976 throughout 1979 I had several severe low back pain episodes, twice being hospitalized and treated with traction.In January 1980, following an examination and exhaustive conversation discussing my condition, I left Dr. Smolenski’s office thinking I could not continue my life in the manner I was suffering. I had a wife I loved, a responsible job as CFO for a publicly-traded Company, a home, and three active young children ages 7, 4, and 1. But my thought was that everyone would be better off without me.Two weeks later, during a follow-up appointment with Dr. Smolenski, he gave me a copy of a then recently conducted study revealing the best remedy for patients suffering chronic low back pain was achieving minimum body weight and physical conditioning emphasizing strength and flexibility. Ironically, it was the most conservative protocol from all the known protocols for treating low back pain.During the ten-minute drive to reach home, I vowed I was going to undertake the regimen described in the study. Within six months I lost thirty-five pounds with the combination of counting calories and launching a daily exercise regimen. There was a new gym adjacent to my work location that opened at five A.M. I joined the gym and began a fitness regimen. Over the next twelve months, I had several minor low back pain episodes that I treated with extra-strength Bufferin and sometimes rest.From January 1981 until May 1996 I was free of low back pain. In May of 1996 I carelessly lifted a box of books which brought on a severe low back pain episode. The episode was resolved with three epidural steroid injections. Since then I have not suffered another severe low back pain episode.In February 1983, my wife and I watched the pre-recorded ABC Wide World of Sports broadcast of the 1982 Ironman. We were captivated watching Julie Moss, the leading woman, collapse time again within two miles of the finish from the effects of dehydration, to be passed within yards of the finish line.Overcome with emotion following that broadcast I told my wife, “I’ve never done anything athletically significant. I’m going to do that race.” Her logical response was, “You’re crazy.” I didn’t swim, cycle, or run, yet that day I vowed I was going to someday complete the Hawaiian Ironman Triathlon to validate conquering my low back pain.On October 18, 1986, I completed the Hawaiian Ironman Triathlon in twelve hours, forty-eight minutes, and fifty-three seconds. I finished in the middle of the pack within my age bracket, and overall. I gained entrance to the race as a lottery contestant. My triathlon competition times were not fast enough to qualify me for the race but my finishing time was faster than many contestants, younger and older, who qualified for the race. Crossing the finish line that day, I knew I could control my back pain for the rest of my life and lead a “normal” life.I gained entry to the 1991 Hawaiian Ironman via the lottery once again with the goal of besting my 1986 time, but I had to withdraw a month before the event because of a severe saddle sore on my left buttock that would not respond to treatment. I was disappointed but satisfied knowing, that though five years older, my swimming, cycling, and running times were significantly improved from 1986 by better training, nutrition, and hydration practices.Since undertaking my 1986 Ironman commitment I completed numerous Olympic distance triathlons (1.2-mile swim, 25K bike, and 10K run), the Great Chesapeake Bay Bridge Swim twenty times from 1987 through 2008 (4.4 miles), the Atlantic City Ocean Marathon Swim, numerous open water swims of varying distances (none less than a mile, none more than five miles), numerous 10K runs, three half marathons, three marathons, eight Century (100 miles), six Double Metric Century (135 miles) cycling events, and one 200-mile cycling event (aptly titled “The Longest Day” – held on the first day of summer).All my athletic competitions were fund-raising events and I once tallied I raised and contributed over $500K for those efforts. My athletic endeavors began after age thirty-four. Learning to swim, and swim effectively at that age is a challenge. Almost as challenging was learning to run and cycle efficiently. In hindsight, it was a wonderful personal experience. Further in hindsight, my wife was right. It was a crazy undertaking. But one that I would undertake again if faced with the same situation and circumstances.My new found physical fitness at thirty-five led to learning to ski and play tennis. My wife literally skied before she walked. Skiing opened a family and personal activity venue that led to many great family and romantic vacations we never would have enjoyed otherwise. My career benefited significantly from my new-found health. I discovered friendships and relationships that never would have happened otherwise. We traveled extensively enjoying parts of the world we never would have enjoyed had I not conquered my back pain. I ran, swam, and cycled in parts of the world I never imagined I would visit. Every beach vacation, every overloaded station wagon vacation, everything we did as a family or a couple, every activity with my children and grandchildren, benefited immensely from my new found physical condition. The benefits still accrue today.At this stage of my life I sometimes marvel at what might have happened if Dr. Smolenski had not casually handed me the copy of the back-pain study in January 1980. I marvel too that during my years of back pain misery there was no comprehensive medical or fitness system advocating exercise as a daily and lifelong regimen to the pathway to good physical and mental health. No comprehensive medical or fitness system offering the products and services to serve the need of people like me.Today pain suffers have more lifestyle health solutions than ever before. But many still need inspiration. They need to know and understand what they can and must do to achieve a quality of life they maybe cannot imagine. Many need a good true lifelong story to inspire them.Good luck to you.