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I only wish that we could swap with someone of lower rank. If the patient is going to any facility on a hospital campus such as a doctors appointment, cancer tx etc then the highest level must always ride. Only units with a medic on board can transport to the ED unless a basic unit is doing a transfer and has to divert. Even then depending on the location a ALS unit might be dispatched to intercept and continue transport to the ED.
The only time you can allow a lower level to ride with the patient is in the case of transport to a home, nursing home, or some other off campus facility or residence. Usually these calls are handled by basic units to begin with so those chances do not come along often.
I do agree with you that sometimes it is nice to put the shoe on the other foot so to speak. Most of our basics would jump at the chance to ride on anything that involves going to the ED. I prefer a basic partner that is not timid and does not melt away into the shadows while on scene. I'm always more than happy to have them perform anything within their scope of practice prior to transport if the situation allows for it.
wow thats pretty restrictive. Most places I have worked allowed pt condition to dictate who rode it in. We could also triage a pt down to a BLS (emt/emt) truck.