Difference between BLS and ALS calls?

[patzyboi]

I know procedures and scope of practices are different, and how they are difference. But what is the difference in having BLS and ALS calls?

For example, in an EMT and paramedic unit, if there is a "BLS" call, the paramedic will sometime drive, and let the EMT do the patient care work.

Thing is, isnt everything the EMT do can be improved with paramedic work?

 

[EMT B]

Thing is, isnt everything the EMT do can be improved with paramedic work?

However godly they may seem to you, there are some things that they just cant fix in the field. prime example is a patient with an AAA. they need a surgeon, not a medic.

 

[NYMedic828]

I know procedures and scope of practices are different, and how they are difference. But what is the difference in having BLS and ALS calls?

For example, in an EMT and paramedic unit, if there is a "BLS" call, the paramedic will sometime drive, and let the EMT do the patient care work.

Thing is, isnt everything the EMT do can be improved with paramedic work?

Absolutely nothing is different between an ALS and BLS call. What is different is the assessment and treatment parameters of the provider on that call.

When the paramedic drives, odds are they have a very stable patient who just needs a taxi ride to the ER.

Yes, a paramedic may do everything an EMT can do. A paramedic SHOULD be far better in their assessment, treatment and differential diagnosis.

 

[DesertMedic66]

Unless you are in some places in California where if there is a medic on the ambulance the medic has to take the call regardless if its ALS or BLS.

 

[VFlutter]

Both have lights and sirens and that is all that matters h34r:

 

[leoemt]

I routinely take patients that in all honesty should probably go ALS. Problem is we have so few Medics and the county doesn't allow private medics. Fortunately, I am close to a bunch of hospitals so as long as I can get them there alive then they are in good hands.

Stabbings, unconscious trauma, Hypoglycemia DLOC, Anaphalaxis, etc. They all ride in my ambo.

 

[mycrofft]

I know procedures and scope of practices are different, and how they are difference. But what is the difference in having BLS and ALS calls?

For example, in an EMT and paramedic unit, if there is a "BLS" call, the paramedic will sometime drive, and let the EMT do the patient care work.

Thing is, isnt everything the EMT do can be improved with paramedic work?

CHange a tire?

 

[abckidsmom]

I ride with BLS partners. Say we get a psych call. BLS right? Say my inexperienced partner says the wrong thing, puts his foot in his mouth, does nothing good for the patient, and magnifies the problem, whatever it is.

I have about 20 times the experience, and 50 times the education in dealing with psych problems.

Who has the responsibility if the patient goes crazy and jumps out the back of the truck?

Who is going to lose sleep at night?

Yeah, I tech in most of the calls. I'm not a paragod type. I really am not. But I don't love the idea of choosing to let inexperienced, undereducated providers "practicing" unsupervised on real sick people. They deserve our best.

 

[mycrofft]

Yeah, I tech in most of the calls. I'm not a paragod type. I really am not. But I don't love the idea of choosing to let inexperienced, undereducated providers "practicing" unsupervised on real sick people. They deserve our best.

Of any rating, right?

 

[AnthonyTheEmt]

I routinely take patients that in all honesty should probably go ALS. Problem is we have so few Medics and the county doesn't allow private medics. Fortunately, I am close to a bunch of hospitals so as long as I can get them there alive then they are in good hands.

Stabbings, unconscious trauma, Hypoglycemia DLOC, Anaphalaxis, etc. They all ride in my ambo.

I hope you're kidding about that. Most of those, if not all, are ALS calls. Especially the anaphylaxis. Absolutely NOT a BLS call

 

[Aidey]

No, he isn't kidding. He works in Seattle, and Medic One is well known for pulling stuff like that.

 

[DesertMedic66]

I hope you're kidding about that. Most of those, if not all, are ALS calls. Especially the anaphylaxis. Absolutely NOT a BLS call

As the poster said he/she is close to many hospitals. Transporting to a hospital is a better idea then waiting for ALS if the hospital is closer.

 

[Aidey]

Half the time ALS are the ones who have dumped the pt on the BLS crew...

 

[EpiEMS]

Stabbings, unconscious trauma, Hypoglycemia DLOC, Anaphalaxis, etc. They all ride in my ambo.

The good news is penetrating trauma patients need transport more than anything else -- BLS measures are just a bonus (http://www.ncbi.nlm.nih.gov/pubmed/21166730, http://theemtspot.com/2011/03/12/should-we-let-the-cops-transport-our-patients/).

Also, ALS doesn't really do much as far as broad, system-wide outcomes in trauma (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292763/, http://www.ncbi.nlm.nih.gov/pubmed/17975392).

And ALS probably doesn't do much for getting us functioning people back post-arrest. It just produces more brain-dead warm bodies. http://roguemedic.com/2011/12/cardiac-arrest-management-is-an-emt-basic-skill-the-bls-evidence/ and sundry other Rogue Medic posts with great citations for those who are interested).

Granted, yes, ALS is great for lots of medical problems. But for many of the high acuity sort of things we think about EMS being responsible for (penetrating trauma, cardiac arrest), BLS is as good or better than ALS as far as patient outcomes go.

Don't get me wrong, I love having ALS. Pain management is very important, as are several other ALS core competencies. But we need to keep in mind that many of the things we *think* ALS would or should do better at are actually better done with BLS measures (or even just rapid transport without any care en route).

 

[Akulahawk]

Back in the time before time (before I was a medic), I sometimes had to transport the sickest of the sick, those patients that I should otherwise have no business transporting without a medic. I would do it because I could get the patient to an advanced level of care (ED) faster than I could get an advanced level of care to the patient (medic). Believe me, many times I'd much rather just give the patient over to ALS if I could have... I never did it simply because I could. I worked with some EMT's that did it just because they could get away with it. Fortunately, those guys never pushed the boundaries that much... though other companies allowed it.

Never a good idea for an EMT to take patients that require care above what they can deliver unless they absolutely have to...

 

[Sandog]

I ride with BLS partners. Say we get a psych call. BLS right? Say my inexperienced partner says the wrong thing, puts his foot in his mouth, does nothing good for the patient, and magnifies the problem, whatever it is.

I have about 20 times the experience, and 50 times the education in dealing with psych problems.

Who has the responsibility if the patient goes crazy and jumps out the back of the truck?

Who is going to lose sleep at night?

Yeah, I tech in most of the calls. I'm not a paragod type. I really am not. But I don't love the idea of choosing to let inexperienced, undereducated providers "practicing" unsupervised on real sick people. They deserve our best.

Now these statements just irk me. What makes you think an EMTB has less education anyways? I am just a basic, and I have a degree in biology, as well a engineering background, and did I mention 6 years in the Navy.

How about treating basics as something other than under educated half wits.

Really... :angry:

 

[Sandog]

Sorry, having a bad day, just found out my 7 mo. old dog has some congenital bone condition in his hip.

 

[Thricenotrice]

The good news is penetrating trauma patients need transport more than anything else -- BLS measures are just a bonus (http://www.ncbi.nlm.nih.gov/pubmed/21166730, http://theemtspot.com/2011/03/12/should-we-let-the-cops-transport-our-patients/).

Also, ALS doesn't really do much as far as broad, system-wide outcomes in trauma (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292763/, http://www.ncbi.nlm.nih.gov/pubmed/17975392).

And ALS probably doesn't do much for getting us functioning people back post-arrest. It just produces more brain-dead warm bodies. http://roguemedic.com/2011/12/cardiac-arrest-management-is-an-emt-basic-skill-the-bls-evidence/ and sundry other Rogue Medic posts with great citations for those who are interested).

Granted, yes, ALS is great for lots of medical problems. But for many of the high acuity sort of things we think about EMS being responsible for (penetrating trauma, cardiac arrest), BLS is as good or better than ALS as far as patient outcomes go.

Don't get me wrong, I love having ALS. Pain management is very important, as are several other ALS core competencies. But we need to keep in mind that many of the things we *think* ALS would or should do better at are actually better done with BLS measures (or even just rapid transport without any care en route).

Could not disagree more. How about judging on WHERE a patient should go, especially working in a high population like Seattle with I'm sure many different receiving types. Are your assessment skills strong enough to determine the best destination vs killing a pt because you took them to an inadequate facility? So on and so forth? Could go on and on. I was an EMT for 3 years in a busy system before going to medic school, so I'm not just paramedic thinking.

Bls is the basic stuff and definitely necessary, but do not discount the paramedic assessment and treatment. The only exception I can think of is a trauma situation where you are within minutes of a trauma center or capable hospital and they did not need some sort of resuscitation (as far as "Als" calls go)

 

[Aidey]

Now these statements just irk me. What makes you think an EMTB has less education anyways? I am just a basic, and I have a degree in biology, as well a engineering background, and did I mention 6 years in the Navy.

How about treating basics as something other than under educated half wits.

Really... :angry:

Dana is also an RN. And since when did a background in engineering and biology degree help someone manage a psych pt appropriately?

 

[Sandog]

Dana is also an RN. And since when did a background in engineering and biology degree help someone manage a psych pt appropriately?

That really has nothing to do with my point about basics being undereducated, or the myth being perpetuated that they are, but whatever...