Questions to EMT personnel working security

[BoyInBlue]

I have just completed my EMT-B course. I still need to take the National Registry test. I have no intention on working on an ambulance, but rather just want an extra cert. to add to my resume. Just some questions:

-What to expect on the NREMT exam?

-Do I need to convert my NREMT cert to a local San Diego County Cert?

-Am I governed my the NREMT guidelines or by Local Protocol, if I was working as primarily security, secondary on site EMT. Example: NREMT can administer Activated Charcoal, but in San Diego EMTs cannot, does that apply to me too?

[HotelSecurity]

Good luck! I too took the EMT-A course back in the early 80's not to work on ambulances but because I saw the skills could be used in my line of work. (Hotels obviously!). The pratical exam was VERY though. My whole class took it after graduating from the EMT course & no one passed it the first time. (I never re-took it & consider myself a First Responder level EMS provider).

[EMTGuard]

I have just completed my EMT-B course. I still need to take the National Registry test. I have no intention on working on an ambulance, but rather just want an extra cert. to add to my resume. Just some questions:

-What to expect on the NREMT exam?

-Do I need to convert my NREMT cert to a local San Diego County Cert?

-Am I governed my the NREMT guidelines or by Local Protocol, if I was working as primarily security, secondary on site EMT. Example: NREMT can administer Activated Charcoal, but in San Diego EMTs cannot, does that apply to me too?

I see these types of questions posted from time to time in EMS forums. I'm always suprised that the EMT Instructor has not covered this in class. The course I took through a Baton Rouge Technical Colage had a excellent teacher who probably over prepared us for the National Registry exams and told us exactly what to expect. Sure she was known as a real task master and had about 50% of the studends drop out of class over 6 months but those of us who made it sailed through the NR practicals and exams.

First- What to expect on the exam? The National Registry exams are looking to see if you retained the exact formulas and steps for each skill you covered. It's like a dance, Step one to step 2 to step 3 and so on. Miss one step and you don't get that skill. Example is the splinting station. Make sure to verbilize EVERY step and check those pulses on the limbs regularly, before during and after applying the splint.
Do you need to convert your NR to local? Not sure about your jurisdiction but I did here in Louisiana. Once I got my National Registry card I took it to my State Dept of Health and Hospitals and submited my paper work of my State card.
On your security job you should be governed by your site specific protocals. At the Steel Mill where I'm contracted the Safety and Medical Department has a agreement with a local health clinic in town. One of the Doctors there acts as our Medical Director. The EMTs can ask for certain equiptment such as Combitubes or Glucomiters through the Nurse in charge of the medical department at the plant. The Nurse will discuss this with the Doctor and if they warrent that it's a useful skill or piece of equiptment the Doctor will approve it and the plant manager will get a request to order the necessary gear. EMTs work under a written set of protocals detailing them what care they may give employees in any given situation. Some may be regular stuff that is covered in EMT class such as bandaging and administering O2. Things I do regularly which weren't in my EMT trainign is applying Burn Cream. In class you are told to cool the area and apply loose steral dressings. Applying gels and later ointments was new for me. We see the patients not just for 15 minutes but for days after and do many duties found in nursing. Another thing I routinely do is give out OTC drugs such as Tylenol, Maylox and cold and flu tablets. I also drug screen employees after accidents or injuries. The pee test consists of a triage I do and a sample being sent off to the lab.
Working without a Medical Director could open up your company to some problems. Without clear protocals you are goig to be covered by your local version of the Good Samariton act. If this is how you will be working, be sure to stay within your training. Do only what you know and have been taught to do. Don't operate beyond your level or you could set yourself up for a lawsuit.
Congrats on taking your EMT class and good luck on the NR exam. Let us know how you do on it.

Steve

[BoyInBlue]

Thanks EMTGuard that helped a lot. I just passed the practical exam too. I am just waiting to take the computerised NR test.

Basically I wanted this cert. for my nightclub security job. There is one EMT on site (which will be me). And I will be responsible for medical calls. Being a nightclub my bread and butter will be: (fights) soft tissue injuries, drug overdosing, slips and falls (fractures), stuff like that.

I will also be required to put together a BLS Bag. I plan on bringing a D size o2 tank as well. I bought the Maxi Medic Bag (empty) from Galls http://www.galls.com/style.html?asso...og&style=BG087 and plan to add the basics. Are there any items you recommend or discourage?

[HotelSecurity]

In Quebec we are not allowed to have ANY OTC drugs in our first aid kits, not even Asprin. No ointments either only antiseptic.

EMTGUARD: Do you have any experience with "Water-Jel" for burns? I like it a lot for the types of burns & scalds that we see in hotels.

[BoyInBlue]

In Quebec we are not allowed to have ANY OTC drugs in our first aid kits, not even Asprin. No ointments either only antiseptic.

EMTGUARD: Do you have any experience with "Water-Jel" for burns? I like it a lot for the types of burns & scalds that we see in hotels.

God bless America for our drugs and guns.

[JB diligence]

In Quebec we are not allowed to have ANY OTC drugs in our first aid kits, not even Asprin. No ointments either only antiseptic.

EMTGUARD: Do you have any experience with "Water-Jel" for burns? I like it a lot for the types of burns & scalds that we see in hotels.

I have used Water-jel, many times, works great on heat induced burns, have had complaints with chemical (powder) burns so make sure the patient has thouroughly flushed the affected area.

In cases where you're patient has a burn requiring the large burn blanket, cover the Water-Jel dressing with a blanket to keep warm as it can induce hypothermia, due to the cooling of a large area.

Aside from that its a great product, even though it smells like fake Christmas tree scent and is messy.

[EMTGuard]

In Quebec we are not allowed to have ANY OTC drugs in our first aid kits, not even Asprin. No ointments either only antiseptic.

EMTGUARD: Do you have any experience with "Water-Jel" for burns? I like it a lot for the types of burns & scalds that we see in hotels.

I've never used "water-jel" before. In Fact, before taking this job I had never put any kinds of ointments or salves on a patient. For minor to moderate burns at our steel mill the SOP is to use a Silverdine salve. It's a white creamy lotion that comes in blue tub. We rub it on the burn and it immediatly cools.
As for the OTC drugs, no we don't normally carry any in our EMT bags either here in Louisiana. The thing to remember is that I'm doing more of a clinical healthcare response. An employee shows up complaining of diarrhea we give out Imodium. Sinus problems? We give out non-dowsy cold tablets. My EMT bag in my partol van does not have any of that. Just the usual BLS equiptment.
As everyone knows I love to include photos in my posts to help explain or state things.
So, here are a few photos of my first aid/nurses clinic I go to at least once a night when I'm not patrolling or sitting at the man gate guard shack answering phones and signing in trucks.
First we see the shelves with the OTC drugs and other stuff we issue out.

On the opposite side of the room is the nurses desk. Here you will find the log books were we record any and all patient interactions. When someone calls me and says "Can I have some Tylanol for a bad headache?" I say, "Dude, you can have anything in that cabinte you need as long as I write it down in the Nurses logbook."

We also have a exam bed which is almost never used and a chair parked under a really big lighted magnifying glass. This is where we check out patients complaining "I got something in my eye."

In Fact, I used my camera to take a 360 degree video of the whole room.

More in just a moment.

[EMTGuard]

I've mentioned in other posts about having to do drug tests on employees after accidents or injuries.
We have the usual lab type Kroll paperwork and sample kits. In addition we have a triage strip which we use to do a preliminary test.

I get a pee sample, put some in the tube which will be sent to the lab and then I place a couple of drops on the triage test strips.

If all the spaces show a little purple line then the employee has tested negative on our prelim test and he can return to work.
We still send off the sample to the lab for a more thorough test which takes a few days. I just put it in a basket in the nurses fridge and the DHL guy will pick it up on the next business day.
Yess that's my hand.

[EMTGuard]

Around the plant we have stratigically placed "Medical Pick Up Points". It's the EMTs job to know where all of teh Pick up points are. When a supervisor yells over the radio, "We need a EMT in the Roll Mill" that can mean quite a large area. The same supervisor saying "We need the EMT to meet us at Pickup point 9 for an injured employee" gives us a better idea of where we need to go. Pickup Points are marked with big metal signs like this-


In addition to the contract Security/EMT and the Nurse who comes in on weekdays, the plant has several employees trained up to Medical First Responder level to assist the patient and help the EMT on scene. The plant recognises these employees with their own reserved parking spaces in the Employee Parking lot. The spaces are marked with signs like this-


I hope this has given you some idea how things are at my post. I have to get on the road and head to work. Another 12 hours awaits.

[HotelSecurity]

The Quebec law does not allow a first aider to administer OTC drugs. Therefore we are not allowed to provide them. We can however "SUGGEST" to a person with for example, a burn, to take an Asprin for the pain if they are not allergic to them.

[Maelstrom]

The Quebec law does not allow a first aider to administer OTC drugs. Therefore we are not allowed to provide them. We can however "SUGGEST" to a person with for example, a burn, to take an Asprin for the pain if they are not allergic to them.

I believe we have a similar scenario too, unless a Doctor has supplied a written order for the drug (even OTC supplies) it can't be administered by the Nurse (either Division 1 or Division 2 endorsed), hence the creation of PRN drug orders (or as required) set out & reviewed/renewed by the medical officer periodically... naturally fully trained Paramedics (Universtiy Degree) aren't restrained by this process

[N. A. Corbier]

Without a medical director, I don't believe you should be acting as an EMT. You can act as a lay rescuer, using your First Responder training, but without an actual medical director overseeing your medical procedures...

You're gonna run into some serious problems. Lay rescuers, for example, usually don't intubate, or run metered O2 on patients.

Things like that are done under the "authority" of the medical director.

[EMTGuard]

Checking in from work. (waves to everyone)
One of the other things is if you want it just for "another cert" the National Registry requires you to reregister every 2 years. That means you will need 48 hours of Continued Education in the form of classes or siminars. I'm not sure wereyou live but here in Louisiana you can only get a fraction of those hours through distance learning such as articles in JEMS magazine or online CE companies. The rest have to be in a classroom type setting. Plus you also have to have a medical director or EMS supervisor check off on the practical skills the National Registry wants to know. For me that means paying out of my own pocket for the required Continuing Education and also paying for the 36 hour refresher every 2 years. I'm lucky the my Site supervior can sign off on my skills and I'm able to take the refresher course here at my plant from the same company contracted to provide first responder classes. CE hours are tough. If you aren't in a fire department or EMS agency where you have regular in house classes or get time off to attend seminars then you may fnd it hard to get your CE hours.
Many companies have found it much simpiler to only go so far as Medical First Responder in their certifications. Class is shorter, the requirement for CEs and refresher is much less and the skills the rescuer can perform, (O2 admin, glucose, bandaging, splinting and treatment of burns), can be handled by a MFR just like they would be by a EMT.
I congrat you on your cert and wish you well. I just hope that in 2 years you don't find yourself to be over certified and let things lapse.