Here's a situation for you to ponder.

[goodgrief]

I aspire to be good enough someday to tell if someone is breathing from 100 feet away at 60mph, but I fear I have some ways to go :/

this skill is only taught at paramedic online programs

giggle

 

[CAOX3]

So let's play the hypothetical game................

Say you have a stable BLS patient in the back with your EMT-B partner and you roll up on this nasty wreck. Being the awesome Paramedic you are, you get out and start intervening on the trauma patient and realize he requires a little SMR, some bandaging, and an IV to counteract the massive hypovolemia he is suffering from. With the help of the local FD, you start stabilizing this nice individual and eventually the primary EMS unit arrives. 2 EMT-B's jump out and rush to your side and freak out because neither of them can treat or transport your patient as he has an IV. NOW WHAT?????????

You can't leave your first patient as your presence is required to be a legal ambulance (unless you live in one of those jacked up states that actually thinks it's ok to have only 1 EMT on an ambulance). In addition, you can now not leave your second patient as you have provided interventions that you cannot turn over to the 2 EMT-B's.

Personally, I'd make the notification and continue on with my current commitment.

Im confused you stated the original patient was BLS in nature, what interventions are you providing and then allowing the EMT to ride?

Have one of the EMTs from the arriving unit drive your original patient and your partner to the hospital and you and the other emt transport the ALS patient.

 

[Flight-LP]

Im confused you stated the original patient was BLS in nature, what interventions are you providing and then allowing the EMT to ride?

Have one of the EMTs from the arriving unit drive your original patient and your partner to the hospital and you and the other emt transport the ALS patient.

Negative ghostrider, responding 911 BLS unit is a different agency. They are not authorized to operate my company's units. Next thought.................

 

[lightsandsirens5]

Here if its determined that your original patient is stable, you can stop and render care until another ambulance arrives on scene. We are allowed to work to our level, if its a medic unit the they are allowed to initiate ALS interventionsas long as those interventions are not being used by the original patient.

Meaning you can't take your first patient off the monitor and use it on the second patient.

Obviously one provider needs to stay with the original patient.

Seems reasonable, any question on stability of the original patient and you radio in and continue on.

Side not if your en route to an emergency and come upon another emergency, we are not allowed to stop we radio in and continue on are original call.

I could be wrong, but I think in WA you are allowed to stop as long as someone stays with the pt. That being said, my agency majorly frowns on it and while it is not a firing offense first time, you will be reprimanded rather severely and told in no uncertain terms that that was the last time you will ever stop with a pt in the back.

Ethically/morally? If I had a completely stable pt, I would be sorely tempted to stop and assist until another unit arrived. Don't know if I would, seeing as how my service will chew on you for doing that, so I hope I never get in that situation. Now say we are on our way out to a routine call. (Syncope, now conscious w/ 0 c/o and A&Ox4 and we happen upon Linuss's truck overturned and his partner ejected into the ditch because Linuss was doing 80. We would not stop in this case.......oh wait, never mind. In this case, on the way out to a call, no pt in the rig, we would inform dispatch of the location and nature, then request to be diverted to this call and have another rig sent to the BLS non emergent call. The other crew will verbally abuse you when you are back at the shack of course, but that is about all the reprimanding you will receive.

 

[Flight-LP]

your a paramedic with a radio and or cell phone. Why are you being caught with your pants down on who is showing up? Scene Size up and communications are important.

Your either in your area and know what resources are available. You can request an ALS unit or another BLS unit to get your unit. Or your in an unfamiliar area in which you should be able to contact 911 and find out what resources they have available.

So I call 911 and find out what resources are available and I find out its a BLS service. So where does that get me?

Some areas have hundreds of providers. If I'm operating on, lets say, a private ambulance, then I have no real need to know what resources are available as I'm not responsible for that emergency services district. Again, I'd make the notification and let the responsible agencies work out the logistics.

The point I am making is that you would place yourself in a higher classification of risk if you initiate care on a patient in an unknown district with unknown resources. It's a risk that I personally will not take and its one that I have been fortunate enough to always have a written policy on.

 

[lightsandsirens5]

Negative ghostrider, responding 911 BLS unit is a different agency. They are not authorized to operate my company's units. Next thought.................

Are you a private service?

Out here we are all county "employees" and all have to pass the WA EVOC. I have had firefighters, cops and deputies drive me in. I have even done this exact scenario. Me ILS crew, multiple pt MVA, me the only one over Basic on scene or even responding. So I "give" my ambulance to a firefighter and my basic driver did pt care while I remained on scene with more critical pts as the bird was only about 10 out and it was a 20 min transport to the closest ER. Maybe not the best thing, but it was the only thing I could do. (No there were no ALS or ILS units even available to start rolling for the first 15 or so minutes.) Triage and I took the worst pts, the rest of them got BLS crews, sucks, but what can you do?

 

[Flight-LP]

In this hypothetical scenerio yes.

Even when working for a rural county operated 911 system, a high performance urban system, or a fire based service, no one other than the EMS crew (or fire crew in the fire based system) operated the ambulance, period.

 

[reaper]

In this hypothetical scenerio yes.

Even when working for a rural county operated 911 system, a high performance urban system, or a fire based service, no one other than the EMS crew (or fire crew in the fire based system) operated the ambulance, period.

Easy. Transfer your pt to the arriving crew and you transport the ALS pt. Problem solved.

 

[lightsandsirens5]

Easy. Transfer your pt to the arriving crew and you transport the ALS pt. Problem solved.

Well you solve problems fast.

VOTE REAPER FOR PRESIDENT! AND SECRETARY OF STATE! AND JUST ABOUT ANY OTHER POSITION IN OUR MESSED UP GOVERNMENT RIGHT NOW!!!!!

 

[reaper]

Well you solve problems fast.

VOTE REAPER FOR PRESIDENT! AND SECRETARY OF STATE! AND JUST ABOUT ANY OTHER POSITION IN OUR MESSED UP GOVERNMENT RIGHT NOW!!!!!

NOOOO!

I cannot afford the pay cut!h34r:

 

[lightsandsirens5]

NOOOO!

I cannot afford the pay cut!h34r:

That's ok! Just go in there and write up tons of pay increases and benefit packages for yourself like the rest of them. And don't forget. If you raised every American's taxes .5% a year and directed that into your paycheck, you would be rich rich rich. Lol.

Ok. End of my thread hijack. I stop before I get chewed on. Probably too late anyhow, but oh well.

 

[remt]

What if the stable pt is going to a hospital outside of the service area of the newly arrived BLS crew?

 

[Flight-LP]

Or if that patient is in your company's care due to an insurance contract not present with the other providers. This is a predominant reason for a written policy that covers this type of scenerio. Some companies expressly forbid their units from stopping and rendering aid if it interferes with their business operations. So unless lawfully ordered to stop and initiate care by law enforcement, they are not allowed to stop.

 

[Sasha]

So unless lawfully ordered to stop and initiate care by law enforcement, they are not allowed to stop.

Didn't stop in my answer!