BLS Ambulance Staffing
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tlkennedy5
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In our system, each ambulance is staffed with 2 EMT-B's. Then we have several paramedic fly cars (Explorers) that are dispatched with each call. Both units usually arrive on scene around the same time. If the medic is needed, he rides in the rig and one of the EMT-B's will take the Explorer back to the station. If the medic is not needed, he radios dispatch that he is back in service and available.
As for first responders, most of the fire fighters that run med calls as first responders in my area are EMT-B's, with several of them being medics. Regardless though, if they are needed in the rig they jump in the back, but they aren't employed with county EMS and aren't regularly staffing the ambulance. Kentucky is supposedly phasing out FR all together and is going to add in EMT-Advanced (Intermediate). That will be interesting to see how that works out...
As for first responders, most of the fire fighters that run med calls as first responders in my area are EMT-B's, with several of them being medics. Regardless though, if they are needed in the rig they jump in the back, but they aren't employed with county EMS and aren't regularly staffing the ambulance. Kentucky is supposedly phasing out FR all together and is going to add in EMT-Advanced (Intermediate). That will be interesting to see how that works out...
sarahharter
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one of the companies i work for has first responders. they are only drivers. but there have been many times on bls and als calls where i need help. and they cant do anything. i now im only an emt and i wish there was always a medic. but i just dont get the point of there being first responders on the truck when they cant do anything really but drive. they are not allowed pt contact in the back of our truck. some of our drivers aren't even first responders they just have basic first aid and cpr.
BLSBoy
makes good girls go bad
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And we get mad why when EMTs are called ambulance driver?
We confuse the hell out of the citizens with non essential personnel too lazy to get a 110hr course.......
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sarahharter
Forum Crew Member
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exactly. i hate having to explain why my partner is just standing there and doesnt help. some people asked my why they are even on the truck. along with people saying oh u just drive an ambulance, its ridiculous.
BLSBoy
makes good girls go bad
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We will not advance our profession with observers who play with lights and sirens being allowed on ambulances.
This is something that frustrates the hell out of me.
This is something that frustrates the hell out of me.
BLSBoy
makes good girls go bad
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Jersey is similar, at least for the members of the first grade counsil. (I refuse to acknowledge them by capitalizing, or correctly spelling the name of their org. that is dedicated to keeping NJ EMS in the dark ages) They require an EMT, and a driver.
We will not advance until we make it a minimum standard to be a crewman on an ambulance.
Disgraceful.
Simply disgraceful.
AJ Hidell
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If they aren't even allowed to assist with patient care, I don't get the point of even requiring FR certification in the first place. Seems pointless, doesn't it? If I'm going to have someone who is there only to drive, I'd at least want him to have some training in that purpose. Otherwise, FR, EMT, or whatever, he's of no more use to me than a McDonald's cashier.
BossyCow
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EMS is not a spectator sport. I do not want anyone in the back of the ambulance with me and the patient that is not able to help with patient care. At the very minimum, as a new EMT I want them familiar with the shelves and inventory so they can fetch and carry stuff for me. I don't want to have to reach around you, step over you, or have to ask you to get out of my way.
If you can't help, ride up front.
If you can't help, ride up front.
If you can't help then why in the hell are you there in the first place?
BossyCow
Forum Deputy Chief
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triemal, I'm a rural volly district. I may be the only EMS responder to a call. If its a 360lb pt in dka, I'm not going to care what level of medical training the responder has if they are able to help me manuever the pt into the ambulance. Depending on the geographical location of the call, I may be driving the ambulance myself and have only three non-medical trained responders who show up at the scene POV. Or I may be on scene directly from home in my POV.
While this may not be the optimum level of care in a perfect world, it is the reality of my location. We can debate endlessly the rightness or wrongness of it, but in the meantime, on the way to a perfect system with none of these issues, the rest of us still have to make these determinations and manage a scene that may have non EMS personnel responding.
Won't argue with that, but it does bring up the next question: if you have people in your service that aren't able to provide pt care, is it because they are still in the process of learning how, or is it because they really don't want to and only drive?
In my organization, all members are required to go through each unit at our station. We do not have very many members that are not emt's. They don't have it because they want to help, but don't want to take the EMT class. We never had any problems. Also our service runs a rescue company. Any member that joins our squad must be in for 1 year and get either first aid/cpr, first responder or emt. Therefore, they must ride in the back and get familliar with equipment. It's all about SOP's my friends. And besides, everyone is hurting for volunteers, if you can get any kind of good members it's a plus.
AJ Hidell
Forum Deputy Chief
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I think I would have to question the motives and commitment of those members. Have they ever thought of volunteering to "help" Meals On Wheels? Have they ever volunteered to "help" drive senior citizens on errands and doctor visits? Do they volunteer to drive a school bus? Why are they so anxious to "help" the rescue squad instead of those other agencies?
BLSBoy
makes good girls go bad
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Wackers. Useless wackers.
Well, here is some more answers:
I guess before the comments were fired off, you didn't read the part about the SOP's. They must get CPR/First Aid, EVOC, and must RIDE IN THE BACK and get familliar with all equipment. Secondly, we do more than EMS, we have a rescue, we have an ATV unit with a trailer, we have a collapse trailer. Thirdly, we usually have at least 3 people on the rig for calls, and there are usually 2 EMT's in the back. Out of our active members, there are only 3 that don't have EMT. These people are not useless wackers.
I guess before the comments were fired off, you didn't read the part about the SOP's. They must get CPR/First Aid, EVOC, and must RIDE IN THE BACK and get familliar with all equipment. Secondly, we do more than EMS, we have a rescue, we have an ATV unit with a trailer, we have a collapse trailer. Thirdly, we usually have at least 3 people on the rig for calls, and there are usually 2 EMT's in the back. Out of our active members, there are only 3 that don't have EMT. These people are not useless wackers.
OnceAnEagle
Forum Ride Along
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Holy crap, a lot of heat around on the subject.
My area:
"Standard" ambulance throughout the region: BLS/ALS, or "ALS rig"
.. if the call is ALS, the P takes it and B drives, and vice versa. This has minimum staffing, but most flexibility. The system also prompts for fire first response, usually a squad or an engine, to all calls coded as emergent.
"BLS" ambulance, or "basic bus" (on top of many other fun names, when working commerical): Two EMT's, with protocols and EMD coding to specify what calls, at dispatch, warrant either the redirection of an ALS rig/flycar for added resources.
Very rarely will you see a double ALS unit. In my company, a double ALS unit means that two EMTs called in sick.
As a BLS provider, we have recognition of ALS criteria from the initial assessment pounded into our heads, so if the dispatch doesn't code it correctly, then at least basic care is on scene to support the pt or begin transport to the closest facility with the possibility of an intercept.
My area:
"Standard" ambulance throughout the region: BLS/ALS, or "ALS rig"
.. if the call is ALS, the P takes it and B drives, and vice versa. This has minimum staffing, but most flexibility. The system also prompts for fire first response, usually a squad or an engine, to all calls coded as emergent.
"BLS" ambulance, or "basic bus" (on top of many other fun names, when working commerical): Two EMT's, with protocols and EMD coding to specify what calls, at dispatch, warrant either the redirection of an ALS rig/flycar for added resources.
Very rarely will you see a double ALS unit. In my company, a double ALS unit means that two EMTs called in sick.
As a BLS provider, we have recognition of ALS criteria from the initial assessment pounded into our heads, so if the dispatch doesn't code it correctly, then at least basic care is on scene to support the pt or begin transport to the closest facility with the possibility of an intercept.
aandjmayne
Forum Crew Member
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No such thing as BLS around here.. only ALS one medic and one basic with the occasional ride along student (basic or paramedic)
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Sasha
Forum Chief
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Sounds like you need to get your staffing issues worked out. One EMT in the area is just a little bit on the pathetic side. EMT class isn't a hard thing to pass.