Can less ALS mean better BLS?

[yowzer]

No axe to grind here, but the answer would be that you can give YOURSELF meds, not somebody else under your auspices as a professional. And even giving them to yourself, if you have comorbidities the formal advice would be to "consult your physician" first.

In other words, in some way or another, a professional capable of assessing the risks and benefits ought to be involved if you're not a healthy and vim young buck.

Patient: Can I have some tylenol?
EMT: Are you allergic? When was the last time you had any?

*places a single-dose package where the patient can pick it up*
Want some water to wash that down?

*document patient self-administered XXXmg of whatever*


This is a very common scenario when it comes to things like first aid stands at events, often staffed by people with even less training than us clueless EMTs.

 

[Brandon O]

This is a very common scenario when it comes to things like first aid stands at events, often staffed by people with even less training than us clueless EMTs.

Kind of an interesting work-around...

 

[ExpatMedic0]

I my opinion this whole EMS mindset needs to shift from who can do what skills and procedures (like a technician), to more of a clinician with additional training and education that can do something for those %80 of calls who do not require time sensitive emergency interventions. Tell me what good it does in the bigger picture to simple reduce the number of Paramedics and have more BLS units transport more patients to the hospital? It may allow more paramedics to hone their emergency "ALS" procedures, but I think there are better answers to the bigger picture of the whole idea if we look outside the box.

 

[yowzer]

Kind of an interesting work-around...

Not that different from assisting patients with their own meds (AKA opening the pill bottle for them), which is already allowed in my protocols.

 

[Summit]

My only issues with tiered systems is that "niceties" like anti-emetics and pain management are often excluded.

For instance, abdominal pain. In most systems, that's a BLS complaint. But ALS providers can mitigate it.

Or a simple fracture. Splinting works, but splinting + fentanyl works better.

I worked for a paid rural system that had BLS ambulances and ALS fly cars. It was left largely EMT discretion to cancel or continue ALS unless the call specifically mandated ALS. But you can still have problems.

I remember one call, 50F icy-slip-and-fall displaced humeral fracture, 9/10 pain, 15 minutes to the little level IV. My partner cancelled ALS. I got back on and told ALS to continue. I had them loaded in the ambulance with a line when the medic rolled up and said:
"This patient looks fine! Why the hell did you make me come? Can't you handle a fracture?"
"This patient could use some fentanyl. 9/10 pain. I started an IV just for you."
"BS. She'll be fine."
"She doesn't need fentanyl to live, but she's hurting."
"Well, breaking a bone hurts."
"Roger that. I'll only disrupt your TV watching in the future if we need you to intubate or something else cool. But, if that was your mom, I think you'd have a different attitude."

I got one hell of a dirty look and was told he went to the chief over it. I never heard anything more on the subject, which told me where my chief stood on it. :rofl:

 

[RocketMedic]

did she get her fent?

 

[Summit]

did she get her fent?

yes