The setback of paramedicine back into the 1970s

[Cindy Holland]

Why are these people not being flown out?  There is a nurse on the
helicopter.  Has that issue been addressed with the Senate rep?  
It needs to be added that the nurse needs to be an EMT at the least.  We
experience this in our hospital when the helicopters can't fly and the
patient needs two people caring for them during transport.
We send the highest trained nurse with them and there has to be written
doctors orders with the nurse as to what she can do for the patient
during the transport.  She/he can not just do whatever, there has to be
written orders.  There also has to be a definitive way of communicating
with the REFERRING MD if something were to go wrong enroute and further
orders are needed.
Yes, there needs to be more information added to the proposed bill.  I
agree, you can't just throw any nurse in an ambulance (of of their area
of training and into an arena they are not familiar with)  It very
different in the back of an ambulance than it is in an ER setting.  They
need to really look at this proposal more seriously and incorporate
EMTLA/COBRA and hospital guidelines.
My 2 cents



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-----Original Message-----
From: flightmed-bounces at flightweb.com
[mailto:flightmed-bounces at flightweb.com] On Behalf Of John R. Clark, JD,
NREMT-P, FP-C
Sent: Sunday, April 10, 2005 1:37 PM
To: flightmed at flightweb.com
Subject: The setback of paramedicine back into the 1970s


EMS Community-at-large:
 
On behalf of the New Hampshire Paramedics Association, I ask that you 
take a minute and look at this issue.  New Hampshire EMS providers need 
your support!  If you have any political savvy and would like to prevent

the abomination of the EMS rules and the setback of paramedicine back 
into the 1970s, I urge you to get involved in any way you can (letters, 
phone calls, Association support etc.).  
 
A bill has been introduced in the New Hampshire Senate that would allow 
a nurse with only minimal training in interfaclility transport (relying 
on a module that has not been developed, described nor determined) get 
in an ambulance to transport a patient if the ETA or an appropriately 
trained critical care transport team is greater than 30 minutes.  The 
text of the bill in part follows:   
 
NH Senate Bill 88 - amendment -

/"Insert after NH RSA 153-A:16 II:
 
In the event that a physician determines that an inter-facility transfer

of a Critical Access hospital patient is urgent and the availability of 
two licensed EMS providers exceeds the 30 minutes, a registered nurse, 
certified in emergency nursing and advanced cardiac life support may act

as the responsible provider for the patient during the transfer after 
completion of an inter-facility training module."/
 
The initial draft of NH SB 88, which came out the the blue was 
horrible and basically would have allowed any nurse to jump on any 
ambulance and be a crew member. It was introduced by a Senator that 
responded to the plea of one of his constituent's who is a nurse who 
said it was taking too long to move patients out of the ER.  The general

rule change being introduced would allow any RN to be licensed EMS 
provider.  The amendment above would at least allow a 30 minute window 
before a nurse could Shanghai the transport.
 
For additional info and complete text of the bill, click on the New 
Hampshire Paramedic Association website at  
http://nhpa.home.comcast.net/ and look for the March 28 posting titled 
"Senate Bill 88 - Good or Bad?"
 
Please pass this along to anyone that you believe can help. 

To contact the president of the New Hampshire Paramedic Association, 
email spidermedic at yahoo.com 
<http://us.f535.mail.yahoo.com/ym/Compose?To=spidermedic@yahoo.com>.
The Chief of the NH Bureau of EMS can be reached at 
sprentiss at safety.state.nh.us 
<http://us.f535.mail.yahoo.com/ym/Compose?To=sprentiss@safety.state.nh.u
s> for 
questions or comments.
The NH Legislature's home page is http://www.gencourt.state.nh.us/ns to 
send email and snail mail to one of over 400 legislators.
 
This issue could push paramedicine in NH back into the days of Johnny & 
Roy  if the bill is not blocked.  Get involved!!!
 
Thanks,

John R. Clark, JD, NREMT-P, FP-C
A New Hampshire paramedic
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