paramedics and basics working together or separate?

[Handsome Robb]

I like working with an I. Never worked with a B so I can't comment.

Double medic is rad provided you don't step on each other's toes.

No offense to the Bs on here but in my opinion ILS should be the minimum level for staffing a 911 unit.

 

[Chris07]

No offense to the Bs on here but in my opinion ILS should be the minimum level for staffing a 911 unit.

If only more places recognized them. If we had Intermediates or AEMTs here I would be one happy camper.

 

[jgmedic]

I like working with an I. Never worked with a B so I can't comment.

Double medic is rad provided you don't step on each other's toes.

No offense to the Bs on here but in my opinion ILS should be the minimum level for staffing a 911 unit.

Spent my career until this month working B/P. Now in a dual paramedic FD system with 90% of my dept being P's, so with the engine we often have 5 or 6 medics on scene. There is good and bad to both, I find myself having a bit of trouble delegating ALS skills as I am used to doing it all myself.

 

[wadford]

I currently work 911 with my medic partner. I do agree with the theory that sometimes basic partners can get rusty with their assessment skills simply because when we arrive on scene our medics are generally doing an initial just to determine if it will be their ride. Now it is absolutely true that basics in a 911 ALS system will get (hopefully) proficient with ALS assist skills. I can't remember the last time I had to do a rapid trauma assessment. Most of the BLS calls that I run are very focused in their chief complaint and depending on the transport time will dictate how much information I am able to get out of that patient. It also depends on the kind of medic you work with. There are some who will let you do anything and everything within your scope of practice and teach you along the way for things that aren't, and then there are some who would just rather do it all themselves. Just depends on the kind you're with.

 

[Jambi]

Spent my career until this month working B/P. Now in a dual paramedic FD system with 90% of my dept being P's, so with the engine we often have 5 or 6 medics on scene. There is good and bad to both, I find myself having a bit of trouble delegating ALS skills as I am used to doing it all myself.

There's a study somewhere that shows that peak patient outcomes peak at two paramedics on scene, and start dropping from there to the point that it's was lower with 4 medics on scene than with just one.

Of course I cannot find the link ATM, but thought I'd toss that in there for a little humor.

 

[grub]

My EMT

I have a very good EMTB who knows me very well and we make a great team. He will soon be a medic and was trained by me and a medic program. There is only so much a medic can do that an EMT can't do on a pt. If I can treat my Pt. with ALS procedures
while my EMT partner is getting the V/S,bandaging,ECG,backboard,c-collar etc, Then...Iv's,meds, and intubation are a small task compared to his. As a team, we are pretty tough. Medics tend to forget 12 lead patch positions because their EMT does it all and even backboard strapping in good time. Sometimes, two medics are a crowd : ) Just my thoughts.

 

[grub]

Spent my career until this month working B/P. Now in a dual paramedic FD system with 90% of my dept being P's, so with the engine we often have 5 or 6 medics on scene. There is good and bad to both, I find myself having a bit of trouble delegating ALS skills as I am used to doing it all myself.

I worked AMR in Hemet and know exactly what you mean

 

[Bullets]

Yeah, riding the seat every call, and being responsible for all the reports get really old after a while. Working with a basic, in a system where they will do the BLS calls, it's difficult to work out a 50/50 split due to ALS and BLS call types.

I would assume its heavily weighted to the BLS side though...At least around here the vast majority of calls are BLS. While we run P/P and B/B. In 2012 only 14% of calls were ALS treats

 

[EpiEMS]

No offense to the Bs on here but in my opinion ILS should be the minimum level for staffing a 911 unit.

+1 to that!

As a follow-up: transporting units should be BLS, with ALS fly-car support. It just doesn't make sense to staff a ton of B/P units and tie up medics with what are truly BLS calls.

 

[the_negro_puppy]

We work medic / medic or medic / student medic

like doing both- working with another medic for a while where you dont always have to do as much work, then helping teach and mentor.

 

[Bullets]

That being said, our B's and I's get the chance to run without paramedics and experience life without the fancy dancy ALS help too. I think both are formative.

As an EMT (B) i agree with this, but NJ does not recognize the AEMT. Id do it in a heart beat

 

[esmcdowell]

I've run both, and have no real preference. when I'm with another medic, we work in tandem and switch off teching the transport. When I'm just with basics, I usually (but not always and with several exceptions) let them do the initial contact and assess the patient, and determine if they can handle it, or if I need to step in and begin ALS care. While they're doing their assessment, I'm right beside them listening and watching everything going on in case I need to step in and begin ALS care. If pt is BLS, I let the basic do the care work and I'll set up the stretcher and any other equipment needed. That way my basics get the experience of doing assessments and knowing what patients need ALS called for, and which don't, in a controlled (relatively) environment with a medic two feet away from them if I'm needed.

 

[jgmedic]

I worked AMR in Hemet and know exactly what you mean

Recently? If so, I'm sure I know you. I just went part time.

 

[Jambi]

Recently? If so, I'm sure I know you. I just went part time.

And I just got a job there part-time lol

 

[xrsm002]

My company lets intermediates and paramedics alternate for the ALS position, of no medics are available they put an intermediate on the truck with a basic. Its pretty sweet.

 

[Btalon]

My agency runs Medic/Basic(I/AEMT) on every shift. If their is a basic and a medic and it's a bls call, the basic techs the call and the medic drives. If it goes above the basic level the medic techs it and the basic drives.

When it comes to an intermediate/aemt, if it is that provider level and doesn't exceed it, they frequently let the intermediate handle the call if they feel comfortable.

If the f/d responds and we have a driver, then we have 2 in the back, either medic/basic or medic/intermediate and share the responsibilities. This frequently happens on hot calls and both of us are busy. Some teams work better together than others and the more you work with each other, it becomes clockwork and there is very little guidance needed.

It works well this way and lets the medics have breaks from reports and basic tasks. It also allows basics to keep up skills and have hands on with patients and not just drive.

The company also has another station that has a transfer truck, 911 truck that is at aemt/intermediate level and they are expected to handle all calls up to their abilities and protocols. They can call for a medic intercept vehicle that is also staffed at all times by the company. Of course it rolls on certain calls automatically, but they also can be called by other local ambulances for the same thing.

Both seem to work well for the areas that they cover.