How do ALS feel doing BLS calls?

MMiz

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In services with ALS/BLS units, how do you ALS people feel doing the BLS calls?

In general I find that ALS don't like doing the BLS calls, but when we're backed up, they have to step in.

I understand the frustration, as many medics have earned their medic license.

Some don't mind the BS, I mean BLS calls, and others can't stand 'em.

Your thoughts?
 

AJemt

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well i'm not an als provider, but most of our medics are more than willing to step in and help out where needed. one night i was working in the city, we had already had 3 bls calls (and i was done half of the first chart) and the 4th came in, emotional class something-BLS (can't remember if it was 2 or 3) and my partner (medic) goes i'm taking this one. no arguments, it's mine. i said fine (bc there wasnt' much else to say and besides if i had tried to discuss it with him....not that i was looking forward to a psych call anyways.
there was a situation where one of our medics picked up an open wheelchair van shift and went in, and when said medic arrived they were told that they could go on the city micu and make it a power truck and the emt would go to the wcv and the medics response was "absolutely not. i picked up the wcv shift, i'm gonna do the wcv shift, it isn't fair to the emt and if you aren't gonna let me do the shift i picked up i'm going home." or something to that effect.
 

Jon

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I've often worked MICU's - the One co. had ALMOST NO ALS runs overnight, but lots of Wheel-chair psych overnight (Done by the on-duty ALS crew - only 24/7 crew). My partners and I always switched off, but if the medic was finishing a chart and they were up, I'd do it.

I did work with one guy who couldn't drive.. so when we got backed up, I'd do the wheel-chair paperwork and drive.

I also worked with one medic who, as a basic, worked with one of the childern's hospital transport teams' locally... She usually took the peds, because she knew all about peds.

I've also had the opportunity to work Wheel Chair (as an EMT) - honestly, for a few extra bucks, not a bad deal.. no lifting, most of your patients are nice and can talk with you, a good deal.

Jon
 

rescuecpt

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I like BLS calls. If I had it my way, they'd all be BLS "I stubbed my toe" calls. Not because I'm lazy or burned out, but because I'd rather not have people be seriously sick or injured. I'm a sap like that.

Yesterday we had a "syncople episode" which was probably just a case of bad lox. I put the monitor on, she was RSR, everything else seemed stable and normal, so I just sat back and let one of my brand-spankin-new E's do everything (I didn't run any ALS interventions - it would have been hole poking with no point). It was quite relaxing. :)
 

ECC

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A call is a call. I would rather be doing the ALS stuff, but if I were doing nothing then I would be bored.

However, I do believe that if there is an available BLS to come and do the transport, they should step up to the plate and do so, to free up the Medics.
 

Lootsie

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I am not on the ALS level but for one think I am sure is that paramedics don't have a problem to go out on BLS calls. Sometimes it is good to go back to the basics for all of us. I always envayed the ALS and will keep on envaying them for as long a I live.

There are the one or two that have personal or attetude issues but you can work aound it. I believe that if you reached the ALS level you are a paramedic of heart and would not mind to do a call. Afterall, it is all about the pt.

This does not mean that we can waist the valuable experience and resourses of ALS to send them on BLS calls if there is BLS available. :)
 

Flight-LP

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Personally, as a Paramedic working in an all MICU environment, I have no problems working the BLS calls. First off I do not have a choice, second off, it is a welcomed relief to have less work and documentation to complete. Getting backed up on run reports is my biggest pet peeve, I hate running all night and having multiple reports to finish at the end of shift!!!!
 

CanuckEMT

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ALS is standard level of care here. So it doesn't matter the call, they all get an ALS unit.
We decide between us who is going to attend depending on Pt presentation and findings.
 

asysin2leads

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BLS, ALS, so long as I get my paycheck on Thursday, I'll mop the floors. Any ALS provider that has some sort of indignation towards picking up a BLS job needs to get over themselves. Its a person who needs help. Do your job.
 

Phridae

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Originally posted by asysin2leads@Aug 8 2005, 11:18 PM
BLS, ALS, so long as I get my paycheck on Thursday, I'll mop the floors. Any ALS provider that has some sort of indignation towards picking up a BLS job needs to get over themselves. Its a person who needs help. Do your job.
:) Thats so right.
 

mine-rescue-emt

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I'm new to this, so I'll try not to step on anyones' toes...

There's no such thing as an"ALS" call.... You have to do the ABC'S, assessment, and all the other alphabet letters before you can worry about doing anything else, and that goes for 1st responders, basics, I's, Medics, Nurses, and MD's!

The only difference between myself and a basic is that I get to poke people with needles and give them meds that will hopefully improve their status before I get them to the ER.

At one time or another, I think we all got into this to help people. (the money is what keeps me going...) If someone is complaining about running a "BLS" call, they need to have a little talk with themselves to see why they're still doing this...it may be time to move on.
 

ma2va92

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Originally posted by mine-rescue-emt@Aug 31 2005, 10:51 PM
I'm new to this, so I'll try not to step on anyones' toes...

There's no such thing as an"ALS" call.... You have to do the ABC'S, assessment, and all the other alphabet letters before you can worry about doing anything else, and that goes for 1st responders, basics, I's, Medics, Nurses, and MD's!

The only difference between myself and a basic is that I get to poke people with needles and give them meds that will hopefully improve their status before I get them to the ER.

At one time or another, I think we all got into this to help people. (the money is what keeps me going...) If someone is complaining about running a "BLS" call, they need to have a little talk with themselves to see why they're still doing this...it may be time to move on.
very well said............


I'm ALS... but if it's BLS or BS ... I like the idea of being there if they need help or there are time when they thing they need help.. and it's a ride to the hospital with some chat time

thats why I like being a volly...


if anything can change... dispatch could try to get more info...so we're not flying to a chest pain that is really chat time....but that will come in time as the EMD is put into action.......
 

trauma1534

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What's fair is fair. There is no need to burn out BLS, if ALS is not backed up. I'll run a BS call. I do however have a problem with ALS personel running wheelchair van calls. I think they should be reserved for non-certified people. But if anyone should have to run them between als and bls, it should be bls. Let's face it. If a cardiac call comes in and you have tied up your ALS taking granny back to the nursing home in the middle of the night, then you have in my opinion abused your als provider and ran them for no reason.

Every bls call, ambulance, has a potential of becoming an als call. Fred down the street who calls every friday night because he has gas, might be really haveing a heart attack. Ya never can tell about them frequent flyers. :rolleyes:
 

CaptainPanic

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Around here in this rural area we have only one service, and that one service is ALS only, so they end up doing BLS-ALS calls, including the WCV calls. It would be nice if the EMS Director saw that everytime his local unit was tied up taking granny back to the nursing home at 3 in the afternoon, there might be an MVA within the local area, that DOES need the ALS unit, so they end up having to call 2nd out and F&R has to send their truck, or grandpa may decide to present an MI.

We have a total of 7 trucks to cover 928 sq miles, and with 3 crews stationed in different areas to cut-down on response times.

He really needs to have 5 crews one of wich could be BLS that also does local WCV calls, with a secondary BLS crew to do the Little Rock transports that usually take anywhere from 6-8 hrs to complete, round trip. When YCEMS has a LR Tx, that ALS unit is tied up for the day and theres not much they can do about it at this point. :(

-CP
 

mine-rescue-emt

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Who's to say that granny won't code on her transport? With the exception of pushing drugs and intubation, is there anything a bls unit can't do for her? They can still put in an OPA/NPA, start CPR and shock. Same goes for the MVA. Does it take a paramedic to put on a c-collar? How about doing a rapid assessment? Last I checked, as an intermediate, I do pretty much the same scene sizeup and patient assessment as my basic counterparts do.
With the exception of a few circumstances, a good EMT can provide the same quality of care a medic can. The only thing that may change is the scope of practice and what your local protocols will allow.
The first thing a First Responder should do is establish the patient has an airway and that the rate and quality are adequate.
Surprisingly enough, I've seen doc's in the ER do the same thing.

Don't get me wrong... some Medics can do pretty impressive work with all the little gadgets and gizmos available. There are also some medics I've seen that I wouldn't trust to correctly fasten the velcro on my 3 y/o son's shoes.
 

Rangat

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In South Africa -in the areas with an infrastructure i might ad- ILS goes out to all calls standard, and the Paramedics goes out on request or provisionally in Response Vehicles. Thus ambulances work 3x more calls than PRV's.

If a Paramedic turns up on a BLS call, he will be highly bored. He will do the nessacary, and wait around for us to arrive. :ph34r:

They don't really mind (most of them) except if it's walking around Moaning Myrtles. <_<
 

Medic38572

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My feelings are this as a Paramedic I dont mind to make an a call. Thats why I schooled for two years. But I like many feel that bls calls should be made by the EMTs. The reason is this I feel that when you get out of EMT school you are just certified or licenced. And you have to agree just that. You have no experience except what you did on clinical rotation's. The place for you to get this experience is in the field in the back of the truck. Im not saying that all EMT's cant do there jobs, I have seen several new Paramedic's spaz on the first true emergency they have run. And they have been doing hundreds of hrs of clinicals. But when you are in control for the first time its differant and everyone here can relate to that. By putting EMT's in the back running granny back and forth you not only give then the extra clinical experience on a non - emergent patient but you also instill confidence in them. Giving them a chance in a controlled enviroment to properly assess there patient's with out all the stress of having to deal with a very sick patient.


Just my thought's.......................... ;)
 

rescuecpt

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My first call as a basic EMT after my card arrived was a very messy car accident. Guess what, I handled it just fine, my patients (PLURAL) lived, and I did my job- I got them to the hospital in better or the same shape as when I found them.

When I became ALS, I was thrown into the field by myself - and I almost killed my first patient because medical control told me to give them the wrong drug, and I wasn't experienced enough as an ALS provider to know any better. I "fixed" it, I guess you could say, and she ended up living.

Medic38572 - I think your generalization is unfair to the many level headed, smart, capable basic EMTs. It's not rocket science. I have met MANY moronic ALS providers. I have also met many ALS providers who went straight to medic school out of basic school and have little to no experience on their own. One's ability to react to a situation and have a positive outcome has less to do with their clinicals and their status as BLS or ALS and more to do with their personal character and strength.

My clinicals were a joke, most of my hospital time was spent in a corner not being allowed to do much of anything. Luckily I was riding 6 days a week and made my own experiences on the ambulance.
 

Medic38572

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Originally posted by rescuecpt@Nov 7 2005, 05:31 PM


Medic38572 - I think your generalization is unfair to the many level headed, smart, capable basic EMTs. It's not rocket science. I have met MANY moronic ALS providers. I have also met many ALS providers who went straight to medic school out of basic school and have little to no experience on their own. One's ability to react to a situation and have a positive outcome has less to do with their clinicals and their status as BLS or ALS and more to do with their personal character and strength.

My clinicals were a joke, most of my hospital time was spent in a corner not being allowed to do much of anything. Luckily I was riding 6 days a week and made my own experiences on the ambulance.
Rescuecpt,
My generalization is not what it appears to be. What Im saying is this!
Without experience one tends to look over many things on a patient. Why because of the stress of the call. If you have an EMT on an ALS truck he does get some experience exspecially on MVA's with multible patients. HE or SHE has know one on one contact with a single severe respitory distress patient. no one on one contact with a severly hypovolemic pt with a GI Bleed. Im not saying that they cant come out doing there job. Thats not what Im saying. What Im saying is that most people learn better hands on, combined with the books. I work as a medic fulltime on a truck I have 16 yrs experience behind me 14 as a Paramedic. I also work in an Emergency room Part-time I enjoy my jobs I learn something every day I go into work. I see something new all the time. I enjoy working with new EMT's and Paramedic's. Because every year I learn something new when they get out of school. But I still believe that the best experience is in the back of a truck.
The best thing you can do is throw a new Paramedic out to the wolves. They in most case's have several years in ems. But throwing an EMT to the wolves just after getting out of school is wrong.
 

Jon

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Originally posted by rescuecpt@Nov 7 2005, 05:31 PM
My clinicals were a joke, most of my hospital time was spent in a corner not being allowed to do much of anything. Luckily I was riding 6 days a week and made my own experiences on the ambulance.
You too???

We were BELOW the ER techs... we did the 12-leads while they (usally an EMT w/hospital training) got an IV... :huh:

We helped the nurses take rectal tempratures. :rolleyes:

Oh, and if we were REALLY lucky, we got to watch a resident get there 1000th tube...

Jon
 
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