The scope of practice can be defined as those emergency activities and treatments that EMTs can or cannot do as defined by law. The purpose of legalized scopes of practice is to ensure that all those people involved in patient care have the required education, training, and certification to perform certain duties.

EMT’s Can’t Make Their Own Decisions

There will be cases where people may be willing to do things that lie outside their scope of practice in order to attempt to save someone’s life. Unfortunately, many times in such scenarios, the medication or treatment is applied inappropriately and the patient goes into cardiac arrest or passes away. Things outside the scope of practice are more likely than not something for which the emergency medical technician has not been trained.

The EMT follows medical direction at all times as communicated by a doctor, but when the scope of practice is deviated from the patients’ health and well-being is affected, and not only does the EMT come into disrepute, but the entire profession can be blemished because it did not adhere to high standards. In medical practice one can’t go ahead and make your own decisions because patients entrust emergency medical technicians with solid decisions that come from experience and not just something they have thought up themselves. Ideally, emergency medical technicians as well as other health providers work collaboratively to provide quality patient care.

What To Do When Adults Refuse Treatment

Sometimes a mentally competent adult may refuse emergency medical care and the EMT scope of practice includes making sure that the patient consents before beginning emergency care. When treating a minor, an EMT must obtain the consent of the parent or guardian. It is within the EMT’s scope of practice to get the patient to fill out a refusal form, after they have tried to persuade the patient to receive care and medication.

When an EMT is on duty they are required by law to care for a patient who requires it. On the other hand, it is not required of an EMT to help a patient when they are off duty. If the EMT stops to help a patient, they are required by law to help the patient right up to the point when the patient is transferred to a medical facility.

All of us can remember occasions when we have seen EMTs at work among the sick, injured and traumatized, quietly getting the job done. The requirements of an EMT job are demanding, physically and emotionally. They have to be physically strong and in shape to pick heavy bodies up and run with them to safety. They also have to be emotionally stable to handle people and animals who are mangled, suffering and beside themselves with grief.

EMT’s Do Different Tasks In Different States

People cannot be blamed for getting a bit confused about EMT’s and their scope of practice because first of all they are called different things in different states, and their duties differ from state to state. The most common certification in emergency medical services is the EMT with different levels of certification common to most states. Although EMT-Basic, EMT Interediate and EMT-Paramedic are known in some states, they are called other things elsewhere and EMT-Intermediate is even falling away in some areas. In the industry EMT-Paramedics are referred to as plain paramedics, and where a paramedic may be trained to suture in one state, in another state that would not be in their scope of practice. Both basic EMTs and paramedics respond to emergencies, but where basic level training provides elements of emergency medical training, the more advanced EMT paramedic addresses the care of patients after initial resuscitation.

Emergency medical service is certainly a complicated industry. It is quite complex to pin point the way things should be done simply because there are different rules in each state. If you are really in doubt and want answers, you can contact your state’s EMS office for information and advice.

EMT scope of practice defines permissible activities for emergency medical technicians. Their scope of practice is determined by laws within a particular state. Any health care workers who violate these laws can jeopardize their chances of practicing as an EMT, they could lose their professional license and could also face civil lawsuits. The appropriate scope of practice for EMT’s is to ensure that the public is always at the receiving end of medical help from those who are actually sufficiently trained and qualified to offer them.

Prescribing Of Medicine

It happens quite often in a health care scope of practice that the question comes up about whether a licensed medical professional may prescribe medicine. Sometimes there are restrictions on what type of drugs may be prescribed. In the United States, not every health care professional is allowed to prescribe certain drugs . An EMT may be able to dispense medication to a patient under a physicians orders, but without the proper licensing, they would not be allowed to. In some areas of the United States for instance, a licensed EMT may not be able to start IVs, while somewhere else they may be allowed to.
The scope of practice as permitted by law may be even more limited in certain health care institutions. A hospital may have a policy of restricting the activities of anyone who isn’t a physician as a cautionary measure, even though the law in that jurisdiction permits other licensed health care workers to perform the procedure or activity. EMTs and other medical staff need to understand institutional policy so that they do not take part in practices that are assumed to be within the scope of their tasks.

Different Levels Of EMT’s

There are four levels of EMT and each level will have its own minimum skills and knowledge base.

• A level 1 EMT or First Responder is the most basic EMT and cannot administer any oxygen or medications. They are able to control hemorrhaging. Their certification lasts for four years.

• EMT Basic – depending on where they practice, EMT-B’s are trained in CPR as well as automatic external defibrillators.

• EMT Intermediate – has far more training and experience. The EMT-I/99 level is the closest level of certification to Paramedic, and these EMT’s may perform many techniques that the EMT-Basic may not – what they are permitted by law to do varies significantly from state to state.

• EMT Paramedic – responsibilities of a paramedic vary from state to state according to different legislation Because of the performance of invasive procedures and the broader scope of practice for paramedics, they require a higher level of training than EMTs

The thing to remember is that each state needs to review the National Scope of Practice Mode in light of their own laws and regulations, and new laws will need to be implemented and training programs updated.

What Can Be Done In And Out Of Scope Of Practice

While EMTs work primarily out of their ambulances, there is an increasing number functioning in health care settings like physician’s rooms, hospitals, sport departments and clinics for instance, and the EMT scope of practice in these fields mean the maximum level of care that the EMT or First Responder may provide. Their scope of practice basically includes, but is not limited to, things like patient transfers to different medical centers, vitals, medical and trauma assessments, the administration of different types of drugs, basic life support as well as other things. Certain treatments will only be allowed to be performed if the First Responder and the EMT have received training approved by the EMS Board. Every community may tailor the protocol to their particular region, but must ensure that they remain within the approved scope of practice. Scope of practice statements provide guidelines to EMT’s who face situations outside of their normal scope of practice.

EMT scope of practice is made harder by the fact that each individual state has their own scope of practice. It is true that when it comes to non-invasive patient assessments, nobody is particularly going to worry about who is doing what, but when it comes to something for more invasive like cervical dilation then its going to be important to know who has the training to do what. Some procedures must be authorized by the right medical authorities and must be performed according to written and published protocols. Some procedures may even require direct verbal orders from medical command physicians.

EMT’s may disobey the instructions of a physician whenever the instructions are obviously wrong and are going to result in harm to the patient. Sometimes an EMT will question a physician’s orders particularly if the EMT sees that the orders actually contravene established best practices and are about to jeopardize the safety of the patient. Many times also, due to the unavailability of physicians, emergency medical technicians may sometimes find themselves having to make quick decisions that under regular circumstances would be made by physicians.

EMTs And Paramedics Not One And The Same

Many people think that an EMT and a paramedic are one and the same thing but certainly not. An EMT gets about 150 hours of basic training while a paramedic around 1800 hours for a trainee paramedic and where an EMT with their scope of training may not be allowed to give intravenous injections for instance, paramedics are allowed to give shots plus other more advanced treatments.

EMT-Basic’s Scope Of Practice

Certified EMT-Basics may perform all procedures and administer medications in certain states, but contact with medical authorities is required prior to administration with some exceptions. For instance if contact with the medical authority is not possible, the following medications may be administered to save a life:

• Aspirin
• Oxygen
• Epinephrine 1:1,000 via EpiPen®
• Oral glucose gel

EMT Basics may also perform any procedure or administer any drug contained in certain protocols. They work in conjunction with other medical providers and when operating in the pre-hospital environment, their actions are governed by protocols set by higher medical authorities. The EMT-B is the lowest level of EMT certification and their scope of practice allows them to perform the most basic procedures while out in the field. They are allowed to administer oxygen and glucose. Some states allow an EMT-B to perform some duties alone, depending on the health department regulations. EMT-Basics are trained with the necessary skills to assess a patient’s condition. The training and scope of practice will allow them to provide care for cardio, respiratory and trauma emergencies; all the time being overseen by a physician.

Conclusion

It is most important that EMTs who offer professional medical services, maintain adequate knowledge of all their training in order to give a professional and efficient level of service. Patients expect that EMTs have undergone rigorous training in order to attend to them in their need with adequate knowledge and skills. The medical profession is huge with a vast number of professionals all possessing different skills and levels of expertise. Each fraternity has their own code of practice to ensure that everything is done correctly, and that the lives of patients are not put in the hands of people not authorized to treat them.

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• EMT Certificate Program
• Associate Degree in Para-medicine
• Bachelor of Science Degree in Emergency Medical Services Management

What is important is that you take the time necessary to carefully study the various options that are open to you and make your final decision only after you have given the issue due thought. There are advantages and disadvantages to getting a certificate, just as there are advantages and disadvantages to getting a degree, so you will need to see which option better suits your particular goals and situation.

EMT Degree Programs vs. EMT Certificate Programs

There are, as has already been mentioned, a number of options open to you when considering the prospect of becoming an EMT. You can loosely split these into two categories, namely, degree programs and certificate programs. There are three main certificate programs.

However, you also have the options of rolling all three of these into one Associates degree course. This is one of the EMT degree programs that we will consider today. This allows you to get your certification after a two-year course that combines all the aspects mentioned above, making the entire process go faster. There are a number of advantages to doing it this way:

• You will get a more well-rounded education at the end of the day
• You will be given the opportunity to complete additional courses to the regular EMT coursework. These include things like English, Math and Biology.

You will need to weigh these advantages against the disadvantages of degree programs, namely that they tend to take longer to complete than certificate programs. They can also be more expensive. Careful consideration of the resources that you have to dedicate to your studies will be needed here.

Perhaps the most important part of an EMT degree program is that you will be required to complete hands-on practical training. This could take place in an emergency room or in an actual ambulance. This is very important as it will not only prepare you well for any exams that you have to write, but it will also provide you with valuable experience that will help you to get a job in the future. In addition it will make you a more confident EMT once you are working as you will already have a very good idea of what you need to do in order to your job to the best of your ability.

EMT Certificate Program

We will now take a good look at the different program options that are open to those students who would like to eventually qualify as EMTs. There are, as previously mentioned, three main options. The first option, which we will discuss here, is the EMT certificate program.

As mentioned previously, there are three main certificate programs, these are:

• EMT-Basic certificate program
• EMT-Intermediate certificate program
• EMT-Paramedic certificate program

In addition, these can be rolled into one degree program that can be completed over a period of two years.

This program is one that combines a certain amount of field work (focusing on cardiac emergencies, respiratory emergencies, toxicological emergencies, and metabolic emergencies) with classroom lectures (focusing on human anatomy and physiology, pharmacology and medical terminology). Both are equally important for preparing you for what you will be doing once you are a certified EMT. This combination also serves to prepare you effectively for the various certification exams given through the National Registry of EMT. So the advantages are twofold; you are prepared for the theory part, which is the exam that you will need to write, and you are prepared for the practical part, which will be your working life out in the field as an EMT in the future. This is a more comprehensive approach to the field, which is why many people choose this option. In total, you will have to complete about 21 to 45 credit hours in order to get a certificate of this kind.

The greatest advantage is that it is shorter than a degree program, so you will be able to get out there and embark on your new career in the field within a shorter time frame, thereby reaching your goal speedily. The disadvantages are that it is not taken quite as seriously as a degree qualification, and you will not have as comprehensive an education as if you had undergone the EMT degree program in order to become qualified. However you could consider using this as a stepping stone to a higher qualification.

Associate Degree In Para-medicine

There are two main degrees that you can obtain; the associate’s degree and the bachelor’s degree. The associate’s degree is the one we have already mentioned as the two-year degree that contains all of the certification programs in one. However, many universities will require that you already hold an EMT qualification or certification of some kind before you can enter into a degree program. More information about the various prerequisites for this program is contained in the next section. Make sure that you look into the particular prerequisites for your state as they can vary significantly, and make sure that you know what the particular school you are interested in attending requires of you before you take the time to enroll at that school. The curriculum you will follow here will be very strict and structured. It will contain a number of aspects including field work, where you will get the hands-on, practical experience that you need. Another aspect includes formal lectures, where you will learn the theory that you will have to apply on a daily basis in your job as an EMT. Lastly, hospital clinical hours will be completed, where you will learn how to apply what you know in a hospital setting in order to prepare you for your future as an EMT. The required coursework, which we have already discussed, should be adequate enough to prepare you for the examinations that you will have to write in order to attain certification. If you do not pass you will be unable to practice, so this is very important.

Bachelor Of Science Degree In Emergency Medical Services Management

The bachelor’s degree program is the longest program of all as it requires that you study for 4 years before you receive your qualification. This may seem like a long time, but it is worth it in the long run because of the career opportunities that will become available to you if you hold an advanced degree such as this one. The program essentially trains you to become an effective manager in the field of being an EMT. You will be working towards a leadership position if you get a degree of this kind, and, although this comes with a much higher load of responsibility, it also comes with a variety of benefits and perks. Some courses that you may have to do in this degree that are omitted from other qualifications are:

• Health science
• Clinical management
• Clinical science
• Business classes
• Marketing
• Financial management
• Statistics

Once you have your bachelor’s degree there are a number of career options open to you, including:

• Advanced paramedic
• EMS instructor
• EMS supervisor
• Paramedic program director
• Paramedic supervisor

In short, the degree opens up doors for you that you would have otherwise not have had access to. It is, however, time-consuming, so you will have to weigh this disadvantage against the various advantages offered.

Prerequisites

Like any degree there are prerequisites that you will absolutely have to meet if you are to enter the degree program. This section outlines the prerequisites that you will have to fill for the two EMT degree programs that we are interested in. read through the prerequisites carefully and determine ahead of time whether or not they are something that you will be able to meet. Let’s have a look at the specifics now.

Associate Of Science Degree In Emergency Medical Technician-Paramedic

In order to get an Associate of Science Degree in Emergency Medical Technician-Paramedic you will need to be able to resent either a high school diploma or a GED qualification. This is the bare minimum requirement. In addition you also need to already be a registered basic EMT. You also need to be well versed in CPR and have the card that proves it. The other prerequisites are going to depend on the school that you apply at. Many require additional background checks and drug screening, but you will have to find out from the specific school what the requirements are.

Bachelor Of Science Degree In Paramedic Studies

At colleges and universities, EMT studies will fall under one of the following headings:

• EMS programs
• EMT programs
• Health science programs

In order to enter a bachelor’s degree program you will need to be a credentialed professional in the EMT field. The degree is essentially an additive to an education you have already had. Again, for most of these programs you may already need to hold an EMT qualification. Several of the degree programs mentioned here are in fact aimed at those EMTs who would like to improve their knowledge and skills in the area. A CPR card is also a prerequisite for the Bachelor of Science Degree in Paramedic Studies.

Coursework

There are a number of different subjects that will form part of your coursework. Firstly it is interesting to note that EMT degree programs tend to have more theoretical courses than EMT certificate programs. However there is a lot of hands-on experience to be gained from both. According to this website these are the main courses that certificate and degree programs tend to have in common with one another. Basically you can be pretty sure that you will at some point have to cover the following topics:

• Patient assessment
• Basic emergency equipment
• Airway obstruction
• Treating trauma
• Cardiac arrests
• Nasal incubation
• Anatomy and Physiology
• English composition
• Biology

If you decide to go for the Associate of Science Degree in Emergency Medical Technician-Paramedic then the following coursework will be on your task list:

• Anatomy and physiology
• Assessment of patients
• Cardiac life support
• Hazardous materials
• Paramedic internship
• Para-medicine
• Pediatric care
• Trauma care

If you would prefer the Bachelor of Science Degree in Paramedic Studies option you will have slightly different coursework to get through:

• Administration systems
• Management principles
• Medical law and ethics
• Paramedic practicum and internship
• Patient and situation assessment
• Pharmacology
• Responding to medical and trauma emergencies

In most cases you will have to complete a combination of field work, clinical hours, and lectures in order to complete your EMT degree program. As you can see above the topics covered in a Bachelor’s Degree are a little more complex and intensive than those covered in an Associate’s Degree.

The essential issue that you will have to face here is what qualification you should get as an EMT. There is a lot of information to be found on each of the qualifications that are on offer. For example, if time is an issue and you need to start working as soon as possible, a certificate program may be your best option. You can always work towards a more advanced qualification later on. If, however, you have the time and the resources to get a degree you will have a well-rounded education that is guaranteed to be of the best quality. In addition you should look into specific certificate and degree programs that are available to you in your area. There are some certificate programs that are better than others, just as there are some EMT degree programs that are worse than others. It is your responsibility to do a comprehensive assessment of the options that are actually available to you in order to make the best decision possible.

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