Originally Posted by
FlightNurse
The Scope of practice between a RN and a Paramedic is a wide one, the RN scope is greater. <snip>
Paramedics are usually great at the scene to stablize the patient to get them the hospital. They do not have the training as a RN when it comes to medical training. One would think they would, but its not so.
BTW, I would be interested in know if your friends wife was the one who took over on the emergency on the plane, since your friend was out of his scope of pracitce.
This is a good example of regional differences, or differences per country, and illustrates why (and when) scope matters.
As a paramedic in Texas, my scope is unlimited. Yes, unlimited. I can quite literally do anything my medical director (a doctor) authorizes provided that I'm trained and competent. Given a set of protocols that explains what I'm allowed to do (in many places this is, unfortunately, presented as a set of limitations on what paramedics can do - for me, in my service, this is not the case save some very explicit limitations that require a consult for those procedures that are very, very high risk) I can do them ad nauseum at my discretion. The ambulance I work in is certified as a mobile intensive care unit (MICU), designating that as our level of care we are equipped to provide. For me, in my practice as a street-level paramedic, it includes:
- administering any of the more than 80 medicines we carry including narcotic analgesics, sedative hypnotics, paralytics, anti-psychotics
- implementing invasive and surgical procedures (breathing tubes, cricothyrotomies, chest tubes, needle decompression, pericardiocentesis, etc.)
- providing electrical therapy for cardiac conditions (defibrillation, cardioversion and transcutaneous pacing)
- using mechanical ventilation and managing vent settings, including monitoring capnography/oximetry and adjusting as needed
The problem is that even in Texas there are paramedic-level services that don't approach the level of care we provide - they provide a much smaller subset of these capabilities, yet they're still paramedics. Apply this to other states who DO restrict what paramedics can do, or other countries which define the role of the paramedic differently, and it becomes a complete mishmash. That's why it's so much easier to identify doctors - they're GENERALLY more uniformly trained, and I think it's fair to say they've ALWAYS received more medical training than paramedics... even ones like me who work in aggressive, high-capability EMS systems.
Sorry for the off-topic post, but it seems germane, especially given that you're MUCH more likely to encounter a paramedic on a flight than a doctor, and the paramedics are likely more used to treating acute medical conditions (vs. a doctor, unless they happen to be an ER doc, emergency medicine specialist, or rural healthcare provider).