Paramedics welcome in the ER

By JOHN HULTGREN
Kentucky EMS Connection

FRANKFORT — The door is finally open for paramedics to work in the hospital emergency department.

The Kentucky Administrative Regulation Review Subcommittee adopted 902 KAR 20:016 unanimously this morning in Frankfort. The regulation, which applies to hospitals and their operations and services, authorizes paramedics to work in an emergency department and perform skills consistent with their scope of practice, including triage.

The regulation had been opposed by nursing organizations.

At the legislative hearing, Kentucky Nurses Association president Barbara Hawkins told the committee that her organization was "concerned with the term triage," and said they would "like to see the paramedic's scope of practice defined before it is put into the regulation."

Patti Howard, who was representing both the Kentucky and the National Emergency Nurses Association, said that "triage is not an appropriate role" for paramedics in the hospital environment, "based on their training." Howard is the EMS training coordinator for the Lexington Fire Department.

Howard also said there is a paramedic shortage, and that allowing paramedics to work inside the hospital "will increase that pre-hospital shortage, and if we can't get those patients to the hospital," then medical care will suffer.

Howard, who consented that paramedics are trained in triage, said that the training was adequate for pre-hospital care but was not extensive enough for a hospital environment. Howard later, under questioning, agreed that nursing students receive no triage training in nursing school.

Speaking in support of the regulation was Nancy Galvani, who represented the Kentucky Hospital Association, and County Judge Executive Anthony Stratton, chairman of the Kentucky Board of EMS.

Galvani said that a paramedic's scope of practice had already been defined, and that paramedics would still have to prove to the hospital that they were competent.

Prior to Kentucky House Bill 469, signed by Governor Patton last spring, paramedics had always been limited to the pre-hospital environment. Language preventing a paramedic from operating outside of the pre-hospital environment had always been inserted into regulations by the nursing lobby. 

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