BLS Ambulance Staffing

[TransportJockey]

Well, this topic to me has no bearing and I am letting some steam off here. Where I am at ALS gets sent for just about everything. Acutally I feel like a glorified ambulance driver. BLS shouldn't stand for Basic Life Support , it should stand for BAND AID Life Support. 99% of the time we get to the call and just take the strecher in. Why have all that required equipment when you don't get to use it ? BLS is better off going back to cadiallac ambulances, why pay all this money for equipment ?

ALS SHOULD be sent to everything. Every pt deserves an ALS assessment. If you feel so left out, continue your education and become an ALS provider

 

[JustMarti]

obviously a bit after the fact, but...
I'm from rural MN, a bedroom community with a 45 minute drive ONE WAY to the nearest hospital. Here in Mn we can run with a minimum of 2 EMT-B's...
we also have "driver's only" (minimum training is CPR, First AID and CEVO)... which can save our butts on a serious call. When we need ALS we call for intercept or the heli. Yes, it would be WONDERFUL if all our crew were EMT-B's, but we barely have enough to cover full time as it is.
Please keep in mind that things may be different in rural areas, and ALL our members are needed and valued.

 

[Joel Yarberry]

I believe the last sentence in JustMarti's post reply is the smartest thing i have heard sence i joined EMTLIFE. Im an EMT going to school to be a medic. I think some titles are not given enough credit. It doesn't matter if you are Paramedic, EMT, First Responder, or just cpr cert. u make a difference. EMS is a team!!!

 

[CAOX3]

Yes we are a team in theory however the relationship is fractured. If we spent as much time working together as we do tearing each other apart we wouldnt have half the problems we do.

 

[TransportJockey]

Yes we are a team in theory however the relationship is fractured. If we spent as much time working together as we do tearing each other apart we wouldnt have half the problems we do.

The whole US EMS style of doing things is fractured.

 

[AaronMRT]

We need at least 1 MRT & 1 EMT to roll and the MRT will drive while the EMT is in the back, but if we happen to have 2 MRTs & 1 EMT, the additional MRT will assist in the back of the rig.

 

[eynonqrs]

ALS SHOULD be sent to everything. Every pt deserves an ALS assessment. If you feel so left out, continue your education and become an ALS provider

I disagree for several reasons:

1) In my county BLS services are mainly ran by volunteer services, ALS is provided by paid services. The ALS units also run calls in the City of Scranton. They are dispatched by the county EOC, the ALS units have AVL units in them. The closest unit get's dispatched to the call. Some sections of the county are rural areas. There are days it gets so busy that there may be 1 or 2 ALS units in the county. So, if they get sent on bulls#@*! calls and someone is having cardiac issues or other critical issues and they are not available to give them lifesaving medications or other measures, what good is it ?

2) Remember the computer GIGO ? It means garbage in = garbage out. In order to be a good paramedic, you need to be a good EMT first. EMT's now have no skill value, from the poor instruction to the everything ALS. Therefore poor EMT's=poor paramedics. This is no joke, because I see unfolding right in front of my eyes. EMT's value is becoming less and less these days.

 

[AJ Hidell]

Always amusing how many Basics think they are qualified to comment upon Advanced Life Support.

 

[eynonqrs]

Always amusing how many Basics think they are qualified to comment upon Advanced Life Support.

For your information, I have been doing this for 17+ years. I am no rookie, and I do have the right to comment on this. I remember when ALS was only dispatched to a trauma or other serious condition. Not for someone with a fever, stubbed toe or nose bleed. My comments are based on observations and experience. So don't assume EMT-B's are all dumb. It makes me sick that we (EMT's) get treated like scum. I am no dumb a**. That is all.

 

[AJ Hidell]

Dumb, no. Ignorant, yes.

Whether it is seventeen years or seventy years is irrelevant. Being an EMT-Basic does not result in the knowledge or context necessary to make informed and intelligent comment on the theories of ALS practice.

And all EMT-Bs are rookies.

 

[Shishkabob]

Dumb, no. Ignorant, yes.

Whether it is seventeen years or seventy years is irrelevant. Being an EMT-Basic does not result in the knowledge or context necessary to make informed and intelligent comment on the theories of ALS practice.

And all EMT-Bs are rookies.

This is where you and I always disagree, AJ.


Just because someone has a B after their EMT does not mean they are not educated. They could have a BS in microbiology for all you know and just haven't started medic school yet.



Don't judge someone by their patch, but by their willingness to learn.

 

[Sasha]

I disagree for several reasons:

1) In my county BLS services are mainly ran by volunteer services, ALS is provided by paid services. The ALS units also run calls in the City of Scranton. They are dispatched by the county EOC, the ALS units have AVL units in them. The closest unit get's dispatched to the call. Some sections of the county are rural areas. There are days it gets so busy that there may be 1 or 2 ALS units in the county. So, if they get sent on bulls#@*! calls and someone is having cardiac issues or other critical issues and they are not available to give them lifesaving medications or other measures, what good is it ?

2) Remember the computer GIGO ? It means garbage in = garbage out. In order to be a good paramedic, you need to be a good EMT first. EMT's now have no skill value, from the poor instruction to the everything ALS. Therefore poor EMT's=poor paramedics. This is no joke, because I see unfolding right in front of my eyes. EMT's value is becoming less and less these days.

and how are you to decide what is BS and what's not?

17 years and still an EMT? You don't have the eduation to make that decision. EMTs are becoming less and less valuable because people are realizing it's little more than a boy scout and you can better service your patient as an ALS provider then a BLS provider.

 

[JPINFV]

Oh, this should be good.

/me pulls up a seat
/me puts some popcorn into the microwave.

 

[Shishkabob]

Oh, this should be good.

/me pulls up a seat
/me puts some popcorn into the microwave.

/me takes popcorn out when done, and sits down.

 

[Mountain Res-Q]

/me takes popcorn out when done, and sits down.

Wanna a beer?

 

[TransportJockey]

and how are you to decide what is BS and what's not?

17 years and still an EMT? You don't have the eduation to make that decision. EMTs are becoming less and less valuable because people are realizing it's little more than a boy scout and you can better service your patient as an ALS provider then a BLS provider.

I really have to agree with this point. BLS providers are glorified first aid providers. For FD that should work because you are a first responder, but dedicated EMS should always be there right after with ALS professionals

 

[Sapphyre]

/me takes popcorn out when done, and sits down.

/me pours caramel on the popcorn and pops open a Diet Sunkist Orange

 

[VFFforpeople]

My area, 1 EMT-1 Medic. EMRs are on the fire trucks (and those are very few, as about 87% of the FDs here are either medics,or EMT-Bs.) ((we also have 6 EMT-I)).

 

[eynonqrs]

and how are you to decide what is BS and what's not?

17 years and still an EMT? You don't have the eduation to make that decision. EMTs are becoming less and less valuable because people are realizing it's little more than a boy scout and you can better service your patient as an ALS provider then a BLS provider.

This makes me sick. Don't call me stupid and I take offense to this response. Let me tell you folks something. I have been on ALS units for a long time. I have worked with medics that have been medics for 20+ years, and told me that some calls that they dispatch ALS to is BS. I ask the questions, I do look up and read up on things of this nature. What is ALS going to start IV's and put monitors on every pt ? Do you really need that ? I am done here. I am going to fu@$*& puke ! This thread needs a time out or lockout.

 

[Melbourne MICA]

Two Tier

In Melbourne we run a two tier system comprising "BLS" cars that are probably about the EMT-I level ie they use a number of ALS skills and have an expanded scope of practice. The second tier is MICA - Full ALS Paramedic level.

The "BLS" guys are taught when and under what circumstances to call for a MICA unit if the dispatch GRID sends them by themselves first up. Basically all time critical pts. Many dispatches get two cars first up. Whoever gets there first will decide if the pt warrants more or less care.

There are no BLS volunteers, no first aiders, no mixed crewing trucks and the fire department has no involvement in EMS except for an EMR first responder role in arrests. (There are two or three CERT community based vollies in some very small remote communities as well who get sent backup with pro ambos anyway).

Our BLS guys do three years minimum education (now uni based ) with a degree qualification at the end of it. When I did it it was in-house three years full time, probably about 42 weeks (6 semesters)face to face in school education with on-road instructor training all through the course.

MICA types are very worried about the number of very young and inexperienced staff making decisions under the new pre-emplyment model we have.

We are also loath to the idea of MICA running predominantly on "fly cars" - though we have a few currently. Single responder ALS in a sedan - the idea is thoroughly flawed as far as I am concerned and without any basis in evidence as to its superiority or equivalency with two man ALS crews. (I'm happy to argue that point by the way).

It's bad enough that our bosses seem to have turned their backs on hand picking the right people to become ambos. We don't need to send a guy by himself hoping a BLS car will arrive on time in the first place and that the crew is capable of assisting him in the back. A dependent system - not a good idea.

The general principle here has always been to use ALS a bit like special forces deployment - when the case looks like a time critical emergency or when a "BLS" crew identifies one and calls for us. But the BLS guys still have an important role and lots of skills to use until the MICA crew arrives.

For the most part our experienced BLS guys (deliberate qualification) are very reliable and good operators. As for the toddlers joining the job (for some its their first job) I''l keep my mouth shut for now.

MM