[PWFD4194]

I am hoping someone has some input into this issue. Who gets to determine if an ALS technician can provide ALS? Does they agency have over all authority? I keep getting alot of different opinons I was always under the impression it was at the discretion of the Medical Director and agency?

[Signal 12]

WELL HOW ORGANIZED IS YOUR AGENCY ..?

[firstdue627]

I've heard various different things depending on the agency. I've heard of some agencies that the Medical Director must meet you and approve of you practicing ALS.... I have heard of some departments that require you work a certain number of ALS calls with a already approved ALS provider and then they will vote/approve you, and I have heard of departments that once you get your ALS card and county REMAC your allowed to practice ALS immediately....

Really up to the individual department, and depends alot on what policies the Medical Director has set for the department to abide by.

[Signal 12]

Well, everyone likes to argue that there is no difference between the City and the vollies. If your an FDNY EMT and you take and pass a NYS Paramedic class, your a medic. However your not an FDNY Paramedic, nor will you practice, be promoted, or paid as one until you take and pass the NYC MAC exam and go through the FDNY EMS Academy paramedic upgrade program. So this is an example of an agency that has state certified ALS providers riding around on the bus, that can only practice and work on the BLS level.

Large or small, practical or impractical, every agency can have their rules. An EMT class is not just available through VEEB or FPA, but through many other agencies and services not that well known to the average pre-hospital care provider. You could take and pass the North Shore LIJ Health System Paramedic class, or you could barely scrape by in the Fat Lou's Medic and Accupuncture Class of Staten Island. Both agencies get you ready to take and pass the state exam, however it is in the best interest of the agency, regardless of the size or status (paid/volley/private/municipal), to have their own verification/certification process.

[jayg359]

I know in my neck of the woods our medical director dictates who can and who can not practice ALS. His feeling is "it's my license" and he makes the rules. After you get your NYS card for either CC or medic and remac card, then he tests you. If he doesnt feel you are up to par, too bad.

[signal21code1]

Originally Posted by PWFD4194

I am hoping someone has some input into this issue. Who gets to determine if an ALS technician can provide ALS? Does they agency have over all authority? I keep getting alot of different opinons I was always under the impression it was at the discretion of the Medical Director and agency?

Keep in mind, that an ALS provider, is an extension of the Medical Director, s/he practices under that Physicians license, so if your dept. medical director does not want someone practicing, they dont practice. It is really as simple as that. Now if your MD feels that the Nassau County vetting process thru FPA or VEEB is good enough to ensure that quality ALS is provided, then thats fine. If the MD wants to put extra tests in place that is certainly their prerogative.

[squad51]

Originally Posted by signal21code1

Keep in mind, that an ALS provider, is an extension of the Medical Director, s/he practices under that Physicians license, so if your dept. medical director does not want someone practicing, they dont practice. It is really as simple as that. Now if your MD feels that the Nassau County vetting process thru FPA or VEEB is good enough to ensure that quality ALS is provided, then thats fine. If the MD wants to put extra tests in place that is certainly their prerogative.

Well said. In addition, the agency can decide if that povider can practice as an EMT at all. In NYS you are only an EMT when you respond as part of an authorized agency. The following are excerpts from NYS DOH policy statement 98-5:

“Certified persons have NO authority or responsibility to respond independently. In NY there is no duty to act as an individual citizen, regardless of certification or licensure. Individuals may respond only as a part of an authorized agency's response system and within an EMS system.”

"...responsibility is placed on authorized EMS agencies (Registered or Certified Ambulance, ALSFR) to insure their personnel provide care according to established standards and protocols.”

Also part 800:

800.21 GENERAL REQUIREMENTS
An ambulance service shall:
P: have and enforce written policies concerning:
6. minimum qualifications and job descriptions for all patient care providers, drivers and EMS dispatchers;

Theoretically if an agency wanted you to make 100 trainings a year in order to be an authorized EMT they could. So the medical director dictates who acts as an ALS provider, but the officers of the agency decide who touches a patient at all...

[brandweer]

True, however there are some grey areas....


To practice ALS in Nassau, you must be a member of an ALS agency, which brings you under the agency medical director who has the final say in ur agency as you work under their license. You must have a valid ALS card (CC/P, nassau doesnt recognize EMT-I) and a valid ETI certifiication.