# ALS Assist Skills for BLS Providers



## frdude1000 (Sep 10, 2011)

Anyone have any resources for ALS assist skills for BLS?  Im looking for a video or something to show how to assist an ALS provider with monitor, IV setup, airway, etc.


----------



## Shishkabob (Sep 10, 2011)

Here's a PDF I found off a quick Google search

https://docs.google.com/viewer?a=v&...lZC8wo&sig=AHIEtbSxBSpkadQaL4Xbd4cFgoPcTsly5A

I also know the back of my EMT book had common ALS assist items, such as spiking a bag, placing EKG electrodes in the proper spot, and airway control.




Do you work with the same medic routinely, or a bunch of different medics?  Do you have access to a medic and some ALS gear?  If so, go over it with them.  Each medic is different in the what / how / when aspect, but should be able to help in the generics like spiking an IV bag / getting the normal IV supplies ready.


----------



## emergancyjunkie (Sep 10, 2011)

My book has als assist aswell 

Sent from my Desire HD using Tapatalk


----------



## Nerd13 (Sep 10, 2011)

Every medic does things differently so as the above poster said if you work with the same one all the time then ask them. It'd be a good respect building/bonding thing. If you don't work with the same medic all the time most of them would probably be more than willing to take a few minutes and show you how to spike a bag or place patches and so on. It's pretty easy stuff and after you do it a few times you'll have it pretty well memorized anyway. You could also ask another BLS provider what they do.


----------



## DESERTDOC (Sep 11, 2011)

I think it would be really cool if my EMT stepped up, came to me and said teach me stuff that I can do to make calls smoother for you from an EMT stand point.

Would have covered setting up for intubation.

Flooding IV tubing, and knowing which bags I may want to include Blood-Y's.

Which meds I may want set out according to what is going on with the patient.

et etc.

The best EMT's in the world are the ones I say very little to on a call and are 5 steps ahead of me.

They are invaluable.


----------



## feldy (Sep 11, 2011)

my paramedics taught me that...i ride a ALS truck as a basic so its expected that i know how to do all that


----------



## katgrl2003 (Sep 11, 2011)

DESERTDOC said:


> The best EMT's in the world are the ones I say very little to on a call and are 5 steps ahead of me.
> 
> They are invaluable.



One of my old partners and I could run a critical ALS run without saying a word to each other. We knew exactly what the other was going to do and what they needed. I knew when he was ready for me to get up front and drive. We had BLS crews come assist a few times, and they usually backed off because we were, "scary brilliant" together, in the words of one of the EMTs.


----------



## VCEMT (Sep 11, 2011)

The company I worked for as an EMT taught each EMT, in a class, how to assist a medic. 

Nothing to it, grab equipment, set up a lock, spike a bag, blood tubing, monitor, and other basic skills that were taught in school. After that, you get ALS contacts and get certified to work with a medic. 

Essentially, my EMT employment was an internship and medic school prep with pay. Intead of payments.


----------



## NomadicMedic (Sep 11, 2011)

My service has a formal ALS Assist class that we teach to the BLS providers, since we have over 15 volunteer fire companies that we provide ALS services to. I can dig up the class materials, if you're really interested.

Otherwise, just teach the basic stuff...


----------



## firecoins (Sep 11, 2011)

EKG class and Phlebotomy class.


----------



## Martyn (Sep 12, 2011)

frdude1000 said:


> Anyone have any resources for ALS assist skills for BLS? Im looking for a video or something to show how to assist an ALS provider with monitor, IV setup, airway, etc.


 

Just a question from a confused Brit, just exactly what did you learn during your training? Not trying to be rude or anything, really!!! It's just that on my basic training we got taught how to do a 3 lead, spike a bag and get the ET ready. On ride-alongs it was always my job to spike the bag and have a Tegaderm and tape etc ready ready for IV's. Is it really that different in different states?


----------



## Tigger (Sep 12, 2011)

Martyn said:


> Just a question from a confused Brit, just exactly what did you learn during your training? Not trying to be rude or anything, really!!! It's just that on my basic training we got taught how to do a 3 lead, spike a bag and get the ET ready. On ride-alongs it was always my job to spike the bag and have a Tegaderm and tape etc ready ready for IV's. Is it really that different in different states?



It's program dependent in many places. My instructor recognized that EMTs in this area of Colorado play the paramedic assistant role a lot and not much else (no BLS trucks around), so he devoted a day of class to ALS assist type things, like spiking bags, placing 5 and 12 leads, operating the MRx monitor, setting up the laryngoscope, and maybe some other things I don't remember. In comparison, most of the EMTs I work with in Massachusetts have never had that sort "training," where the BLS truck is very common.


----------



## sdennislee (Sep 13, 2011)

As far as different states being different, I can only comment on Ohio and Alaska. I live in OH and work in Alaska. In AK you must be EMT 2 (EMT I in lower 48) to intubate, while in OH you may intubate as an EMT B. Ohio requires advanced airway class for EMT B. OH only has reciprocity with SC as they also require the advanced airway class. At least they did last time I looked.


----------



## frdude1000 (Sep 13, 2011)

N7LXI, I would love to see your materials if that's possible! Thanks!


----------



## Wes (Sep 13, 2011)

I'd also like to see the ALS assist materials from Delaware, please.


----------



## NomadicMedic (Sep 13, 2011)

I'll hunt it down. 


Sent from my iPhone.


----------



## 18G (Sep 13, 2011)

Not sure which part of Maryland your in, but if your close to Pennsylvania we offer ALS Assist courses pretty frequently. These classes go over intubation & airway management, IV setup, how to prepare pre-filled syringes, EKG's, patient assessment, and other stuff. 

I have taken the class as an EMT and found it beneficial.


----------



## Nick15 (Jan 18, 2017)

I know this is an old thread for a different state, but does anyone know of any places in So Cal that offer this as a class to receive the certification? Some places require EMT's to be als assist certified in order to work with a medic. 


Sent from my iPhone using Tapatalk


----------



## Jdog (Jan 18, 2017)

Nick15 said:


> I know this is an old thread for a different state, but does anyone know of any places in So Cal that offer this as a class to receive the certification? Some places require EMT's to be als assist certified in order to work with a medic.
> 
> 
> Sent from my iPhone using Tapatalk



Congrats on gravedigging a 5+ year old thread lol. Orange County EMT here. I work for a private company with paramedics (ALS-IFT). My company put me through their own class (~3 hours) for my "ALS-EMT" training... basically spiking bags, setting up saline locks, hooking up pt's to the monitor (and how to work the monitor), taking blood sugar, setting up nebulizers/breathing treatments, drawing meds, etc. There's no official certification for it though. In Orange County, it's within our scope to assist a paramedic with these types of things. The only certification would be your Orange County Scope of Practice Accreditation.


----------



## Nick15 (Jan 19, 2017)

Jordy said:


> Congrats on gravedigging a 5+ year old thread lol. Orange County EMT here. I work for a private company with paramedics (ALS-IFT). My company put me through their own class (~3 hours) for my "ALS-EMT" training... basically spiking bags, setting up saline locks, hooking up pt's to the monitor (and how to work the monitor), taking blood sugar, setting up nebulizers/breathing treatments, drawing meds, etc. There's no official certification for it though. In Orange County, it's within our scope to assist a paramedic with these types of things. The only certification would be your Orange County Scope of Practice Accreditation.



I got bored and started searching through here for a topic on this actually haha. 
The reason why I was asking was because I am trying to transfer with AMR. The division I am trying to go to requires all emts who work on a rig with medics be als assist certified. 


Sent from my iPhone using Tapatalk


----------



## DrParasite (Jan 19, 2017)

this is actually a great topic, once that i think is under utilized (at least it was when i went to EMT class back in the day)

1) why would you need a patch to tell everyone that you know how to do stuff? it's even better if you can demonstrate it when asked on a call.
2) if AMR requires the certification, why not ask them how they prefer to get the certification?
3) it's much better to have the ALS providing agency run the ALS assist class, because they know their equipment, and they know what you will be using.  while an EMT from a 3rd party can show you in general terms, it's much better to have a provider who uses that type of equipment demonstrate what they expect fo you.


----------



## EpiEMS (Jan 19, 2017)

DrParasite said:


> it's much better to have a provider who uses that type of equipment demonstrate what they expect fo you.



Especially the provider you're working with/under -- everybody has their own preferences for, say, how best to secure an IV.


----------



## DesertMedic66 (Jan 19, 2017)

EpiEMS said:


> Especially the provider you're working with/under -- everybody has their own preferences for, say, how best to secure an IV.


This a million times. I have my own ways that I prefer and that I find easier so I do not have my EMTs do a whole lot of prep for me. I tend to have everything set up prior to my shift starting.

I make IV rolls so all I have to do is grab it and everything I need is in it ready to go. I have my intubation bag set up how I prefer (Mac 3 on a handle or sometimes on the pediatric handle, 7.5mm tube, bougie, securing device, EtCO2, and suction all at the ready).


----------



## EpiEMS (Jan 19, 2017)

DesertMedic66 said:


> I have my own ways that I prefer and that I find easier so I do not have my EMTs do a whole lot of prep for me.



Hey, as long as you don't yell at me about toilet bowl versus tegaderm versus ripped tape, it's all good! (I'm cautious with ALS assist more for the reasons of medic preferences than anything else.)


----------



## DesertMedic66 (Jan 19, 2017)

EpiEMS said:


> Hey, as long as you don't yell at me about toilet bowl versus tegaderm versus ripped tape, it's all good! (I'm cautious with ALS assist more for the reasons of medic preferences than anything else.)


We haven't carried toilet bowls in well over 6 years haha


----------



## NomadicMedic (Jan 19, 2017)

Not a toilet bowl fan! Those are in our start kits, but I have a stack of Tegaderm that I snagged from the ED that stay with me.


----------



## EpiEMS (Jan 19, 2017)

DesertMedic66 said:


> We haven't carried toilet bowls in well over 6 years haha





DEmedic said:


> Not a toilet bowl fan! Those are in our start kits, but I have a stack of Tegaderm that I snagged from the ED that stay with me.



Thank gosh. I can't stand the toilet bowls! I like the torn tape method - cheap and easy.


----------



## johnrsemt (Jan 21, 2017)

katgrl2003 said:


> One of my old partners and I could run a critical ALS run without saying a word to each other. We knew exactly what the other was going to do and what they needed. I knew when he was ready for me to get up front and drive. We had BLS crews come assist a few times, and they usually backed off because we were, "scary brilliant" together, in the words of one of the EMTs.



Hopefully you are talking about me Kat;   and glad to see you again here.


----------



## johnrsemt (Jan 21, 2017)

What I always told my BLS partners was every ALS patient needs 4 things done:

O2 (if indicated),  VS,  Monitor,   IV Setup.

Whatever I was doing pick one of the other 3.  

Hard to go wrong with that


----------



## NomadicMedic (Jan 21, 2017)

johnrsemt said:


> What I always told my BLS partners was every ALS patient needs 4 things done:
> 
> O2 (if indicated),  VS,  Monitor,   IV Setup.
> 
> ...



VOMIT. Vitals, oxygen, monitor, IV, transport.


----------



## DrParasite (Jan 22, 2017)

johnrsemt said:


> What I always told my BLS partners was every ALS patient needs 4 things done:
> 
> O2 (if indicated),  VS,  Monitor,   IV Setup.
> 
> ...


so every one of your patients get an IV?


----------



## NomadicMedic (Jan 22, 2017)

DrParasite said:


> so every one of your patients get an IV?



When I first started, every patient got stuck. Practice was the best way to build my IV skill set. Now, not so much.


----------



## DrParasite (Jan 22, 2017)

DEmedic said:


> When I first started, every patient got stuck. Practice was the best way to build my IV skill set. Now, not so much.


when I started every ALS patient got an IV stick and a bag of IV fluid.  Also when I started, only 20% of the EMS calls were handled by an ALS unit.  

I wasn't sure if @johnrsemt meant that every one of his patients was ALS, and got the VOMIT treatment, or every one of the patients transported was considered an ALS patient and got the IV


----------



## Handsome Robb (Jan 22, 2017)

DrParasite said:


> when I started every ALS patient got an IV stick and a bag of IV fluid.  Also when I started, only 20% of the EMS calls were handled by an ALS unit.
> 
> I wasn't sure if @johnrsemt meant that every one of his patients was ALS, and got the VOMIT treatment, or every one of the patients transported was considered an ALS patient and got the IV



I'm pretty sure most of his patients are ALS just due to the area he works. Literally the definition of BFE. 


Sent from my iPhone using Tapatalk


----------



## Tigger (Jan 22, 2017)

I can't remember the last time I transported someone and didn't start a line (or have my partner). Rural medicine...


----------



## EpiEMS (Jan 23, 2017)

^ and ^^ and ^^^ More evidence that ALS assist needs are region and partner dependent


----------



## NomadicMedic (Jan 23, 2017)

Honestly, when I get a new partner, I usually take some time to explain how I like things done. What gear I want in the house, what I want set up in the truck.  How I like my intubation stuff set up. Whether I want a bag or a lock. All the little things that after you work with a partner for a while, they just learn through your practice. 

 I agree that some rudimentary skills for all basics should be taught during orientation. Including the big ones, like how to set up the CPAP! God, it frustrates me to no end when I've got a patient who needs CPAP and the EMT is looking at it like it's 4,273 IKEA parts and no instructions.


----------



## EpiEMS (Jan 23, 2017)

@DEmedic, I wish more medics were like that - I get awfully peeved (containing myself, of course) when somebody expects me to know how they like something done when there are multiple valid approaches to it (e.g. securing an IV).

On the CPAP, that's the kind of thing that initial orientation ought to cover. That being said, we use a system that's all of, say, 3 pieces (mask, CPAP generator + tubing, nebulizer if needed) and pretty self explanatory.


----------



## Tigger (Jan 24, 2017)

When they finally let me have an EMT for a partner, I will be happy to let them start all the lines they want, however they want. That's how I got to be decent.


----------

