How is 911 EMS provided in your town/city/county?

[Jon]

I'm curious as to what sort of areas each of us run in.

ALS would mean FULL ACLS capable units, ILS would be intermediate-staffed unit with some advanced capabilities.

This is asking about normal operations, not special situations. The "All" ALS-transport catagory would include anyplace where "occasionally" a BLS reserve unit might be in service and answer a call beyond normal demand for the system. Likewise, an All-BLS system might have ALS-transporting units for a special event.

 

[TTLWHKR]

The service I work for, when I'm not broken is all ALS transport. Even LDT's have ALS on board. The only thing we use BLS providers for is drivers. I don't know what the local services do, I know the one that took me didn't do ALS - and they didn't rendezvous with one either. But the hospital does have an ALS squad truck, sort of like what "Squad 51" was; it's an F550, 4 man cab, 4x4. They run two medics on the one truck and carry enough gear to provide ALS for two patients. I got this off their advertising flier. Services up here advertise...


<edit> I didn't use MS Spell checker this time. :angry:

 

[emtbuff]

We run BLS for all calls and very seldom do we call for ALS. About the only time it would make since for us to us ALS is if we are doing a long distance transport max time of 1 hour and the pt would start to crash then we call for ALS but just locally we just scoop and run if it looks bad or even if the page sounds bad. Most of the time our transport time is with in 15-20 min. Depending on where we are at out in the country or if we are with in town it is minutes.

 

[Wingnut]

All ALS here, 1 medic and one EMT on each rig, sometimes 2 medics. We don't have EMT-I's here either.

 

[vtemti]

I couldn't vote. In Vermont ALS is Intermediate level. ACLS would be a medic response.

If our unit responds with only BLS providers then we have to call it BLS. If our unit responds with Intermediates, but no ALS interventions were needed, we still call it a BLS response. When ALS interventions are needed then we can call it an ALS response and if we have a paramedic intercept us, then they ride with us and practice their level in our unit, but for billing purposes, we have to call it ALS transport with ACLS intercept.

Gets confusing, I know :wacko:

 

[MedicPrincess]

ALL ALS here as well...

1 medic, 1 basic.

And the FD's respond on every med call, regardless of nature, to provide first responder service

 

[Wingnut]

Originally posted by EMTPrincess@Jul 17 2005, 07:03 PM


And the FD's respond on every med call, regardless of nature, to provide first responder service

I should have added, we do that too.

 

[CodeSurfer]

Originally posted by EMTPrincess@Jul 17 2005, 07:03 PM
ALL ALS here as well...

1 medic, 1 basic.

And the FD's respond on every med call, regardless of nature, to provide first responder service

Thats how things are run here... except it's usually 2 medics on the ambulance and at least 2 medics in the engine company. The only time BLS responds is if ALS downgrades it and doesnt want to transport. Usually ALS transports any call no matter how minor because the hospitals are so close it would take more time for them to wait for a BLS rig and give a turnover etc.

 

[Margaritaville]

It boils down to whomever shows up at the firehouse.

Paramedic or CRT or CRT-I - Als unit. EMT or FF - BLS unit.

 

[Jon]

Originally posted by vtemti@Jul 17 2005, 02:26 PM
I couldn't vote. In Vermont ALS is Intermediate level. ACLS would be a medic response.

If our unit responds with only BLS providers then we have to call it BLS. If our unit responds with Intermediates, but no ALS interventions were needed, we still call it a BLS response. When ALS interventions are needed then we can call it an ALS response and if we have a paramedic intercept us, then they ride with us and practice their level in our unit, but for billing purposes, we have to call it ALS transport with ACLS intercept.

Gets confusing, I know :wacko:

so - what can an "I" do in your neck of the woods??

 

[TTLWHKR]

Originally posted by MedicStudentJon+Jul 18 2005, 10:48 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Jul 18 2005, 10:48 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-vtemti@Jul 17 2005, 02:26 PM
I couldn't vote. In Vermont ALS is Intermediate level. ACLS would be a medic response.

If our unit responds with only BLS providers then we have to call it BLS. If our unit responds with Intermediates, but no ALS interventions were needed, we still call it a BLS response. When ALS interventions are needed then we can call it an ALS response and if we have a paramedic intercept us, then they ride with us and practice their level in our unit, but for billing purposes, we have to call it ALS transport with ACLS intercept.

Gets confusing, I know :wacko:

so - what can an "I" do in your neck of the woods?? [/b][/quote]
Stay in the baby medics crib and play with your toy ambulance?

 

[vtemti]

IV access, Bloods, aspirin, D50, Glucagon, Epi, Narcan, Albuterol, Nitro, Thiamin and hopefully Benadryl soon.

I know, VT is behind the rest of the country, but ya see, we have this problem. Our State Med. Director is the head of our largest Medical School ER and is so paranoid that the field organizations will take procedure practice away from his students that we always fight tooth and nail to get what need. Fine for Northern VT, but sucks for us. Southern VT does not exist in their eyes, but we constantly fight for more.

 

[SafetyPro2]

Currently, we only provide BLS. Essentially, you can't run an ALS volunteer service in LA County because the County require you to staff two medics 24/7 to be an "ALS service" and we can't guarantee that with the way we're currently set-up. And, if you're not an "ALS service", even if you have ALS-level trained personnel, they cannot provide ALS-level care through your organization (just BLS). There is a new option for "part-time" ALS assessment units (one medic instead of two), but you have to have a true ALS unit simultaneously dispatched in order to even use an assessment unit.

We CAN call for ALS from neighboring agencies, but the LAC protocol states that BLS cannot delay transport to wait for an ALS unit if the ALS unit will take longer to arrive than it would take for the BLS unit to transport. Since the nearest ALS unit is roughly the same distance from us as the hospital is, once we get on-scene and determine ALS is needed, we're committed to a BLS transport unless there's a delayed extrication situation. The only way around it would be to simultaneously dispatch an ALS unit with our BLS unit, but that's not really practical unless we're willing to pay big bucks to the neighboring department for an automatic aid agreement to cover that. About the only time we ever get into it is for wilderness calls where the Sheriff's Department sends their ALS SAR chopper and the occasional serious TC/MVA.

We are exploring contracting with a private ambulance service to provide the 2 medics 24/7. This, however, is only feasible if we're able to pass a tax assessment, and at the moment, that's not looking like its gonna pass.