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Ambulance Crew Configuration: Are Two Paramedics Better Than One?

Discussion in 'EMS Talk' started by DrParasite, Oct 9, 2018.

What is the appropriate number of paramedics on a call?

  1. 1

    15 vote(s)
    62.5%
  2. 2

    7 vote(s)
    29.2%
  3. 3

    0 vote(s)
    0.0%
  4. 4 or more

    2 vote(s)
    8.3%
  1. Billy D

    Billy D Forum Lieutenant

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    Excellent, thanks for clarifying. It's been awhile since I looked so I didn't know it was for training. If they are at a 1:1, are they considered ALS or BLS for IFT purposes?

    On a side note for people, I remember one time a person was bit by a dog at a gym in Los Angeles. LAFD dispatched a light force to the call, which is a ladder truck and fire engine together. 6 EMT-Basics on scene, no transport, to treat the smallest wound ever. It was pretty funny seeing LA drivers staring thinking there was a big fire when it was a dog bite.
     
    Last edited: Oct 10, 2018
  2. NPO

    NPO Forum Deputy Chief

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    They are ALS as far as IFTs are concerned. However, most IFT paramedics operate under a slightly resteicted scope. They just have to call 911 for any true ALS stuff they find.

    Oh yeah. I've seen a Task Force (plus ambulance) for abdominal pain. That's a ladder truck, 2 engines and an ambulance for what's likely BLS.
     
    Billy D likes this.
  3. rescue1

    rescue1 Forum Asst. Chief

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    I think a big problem is the relatively limited (in my opinion, given the minimal education--very justified) scope of BLS providers compared with the expansive scope of medics who can treat anything from nausea or mild dehydration all the way to tachydysrhythmias and refractory asthma. This leads to overstaffing ALS because there is a decent sized subset of relatively stable patients who still benefit from ALS care.

    If AEMTs or something similar were more broadly available I think a system mostly made up of AEMT staffed ambulances with paramedics available for serious calls either in chase cars or ALS ambos would be ideal. This is similar to the setup in Australia/NZ/Canada. Ideally we'd also have the education and funding they have over there too, but one thing at a time I guess.
     
  4. NomadicMedic

    NomadicMedic EMS Edumacator

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    This is the model we’re moving to in my system. I’m a huge fan. Fewer medics seeing sicker patients.
     
  5. rescue1

    rescue1 Forum Asst. Chief

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    You're in Lancaster, right? Are you using medic chase cars or medic ambulances?
     
  6. Remi

    Remi Forum Deputy Chief Premium Member

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    This may have been addressed in the article (didn't read it - sorry), but hasn't research shown better outcomes in systems with fewer paramedics?

    The perfect model IMO is one that keeps the number of paramedics down and dispatched only to true emergencies, yet still provides a second paramedic when that may be beneficial (which is almost never, as long as your BLS providers are well-trained). The best way to do that, I think, is with well-trained BLS providers on the ambulances and fly cars staffed with two paramedics.
     
    DesertMedic66 likes this.
  7. DesertMedic66

    DesertMedic66 Forum Troll

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    This. Having fewer medics allows medical directors to make sure they are proficient in their skills and knowledge which may lead to expanded medication and/or skill set.
     

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