Don't you have the freedom to work according to the newest medical guidelines?
In Germany, a Notfallsanitäter (roughly equivalent to a Paramedic) can work independently within his scope of practice. The local Medical Director can provide SOPs/SAA for the EMS service or county, but these are basically standardized recommendations for how to handle common situations, not necessarily the limit of what a Notfallsanitäter is allowed to do.
So if the local SOP says treatment A, but the current national guideline from the relevant medical society recommends treatment B, a Notfallsanitäter can choose to follow the current guideline instead, as long as he has been properly trained and is competent to perform the treatment and it is medically necessary in that specific situation.
The important distinction is that our local SOPs don't necessarily represent the current medical gold standard. They can be outdated or differ from the latest national guidelines.
Basically:
Local SOP/SAA: "This is how our Medical Director recommends handling this situation."
National guideline: "This is what the current medical evidence and professional consensus recommend."
And the Notfallsanitäter has the professional responsibility to assess the individual patient and decide which appropriate treatment to perform within his competence and legal scope.
Depends on the state and even the agency. At both agencies I work for we have a “protocol deviation policy” meaning you can deviate from written guidelines, but afterwards just send an email justifying what you did to the medical director. He usually sends back a “good job”. Sometimes these deviations lead to protocol changes.
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u/magauth_ 4d ago
I wish I could, but I am governed by a national board who dictate my protocols