BLS saves lives. ABCs, bleeding control, oxygen and defib. That and making good decisions on where to take the patient
ALS prolongs living, makes the situation better, and improves quality of life.
I'm sure people will say "but on this call, ALS saves the life" and "BLS can't do anything, they don't know enough." and you are right, there are times when BLS can't do anything and ALS did save a life.
but the evidence as a whole says that most of the time under most situations, ALS procedures don't save lives, BLS ones do.
This is an outstanding point, and I am happy someone realized it. To say BLS doesn't saves lives is like a plumber doesn't fix a leaky faucet. BLS is intergral to EMS, and there are times when in certain rural areas they are closer then ALS, and if they weren't there there would be no viable patient for ALS to work with.
EMS as an occupation has one very real enemy: a lack in education and as a consequence, accreditation. Many states, including Texas, is considering new standards for both scope of practice, standard of care, and educational requirements. There is currently talk in the state legislature concerning the issuance of prescription drugs; antibiotics, pain killers, and certain others would be allowed for the "Licensed Paramedic", while the Certified Paramedic would be about the same as the current standard.
It is unfortunate the reason why we are far off key in our profession is becasue all too often insurance companies, the government run ones in particular, will not cover certain hospital visits unless an ambulance is called and transports the patient. It is also unfortunate pts. have resorted to the ER as their primary care physician for basic care. The cold reality is our hospitals are no longer ran by doctors, but crooked insurance companies and executives who are only in it to make money. An ambulance ride is sometimes the only way these people can get care, or they believe they will be seen faster if they go this route instead of by POV.
It is not the patients fault, they are simply doing what they must in order to get care. Medicine is no longer driven by the desire to heal the sick and injured, but rather by the need to generate large sums of money. This causes us to have to transport far more patients whose care is not emergent, and is far more expensive to deliver then it would be if they simply went to the local Dr's office; but in some cases this is not an option; when you know we won't turn you down, and the ER can't legally turn you away, you will take the only option you have to get the care you need. Its a matter of survival.
So, when you take the rising cost of heath care, the lack in education of Paramedics, the dwindling number of qualified professionals in EMS, the corporate take over of medicine, and nearly 1/3 of our nation uninsured; all this coupled with rising transports and rising transport costs, you have a system which is no longer making the difference it was intended to make, and you have a system being asked to do more then it was intended to do and which it not what its job is designed for. Right tool for the right job, but it is a major and complex problem, and one we need to get a grip on quickly before we find ourselves in an archaic profession.