As much as paramedics hate to admit it, though, most EMS calls don't really require their expertise. Your general "accident with minor injuries" doesn't really need a medic unless someone is having trouble breathing or has a decent head wound. But for your average busted arm, slip and fall in a supermarket, abdominal pain from constipation... Yeah, the person will be fine until a Basic gets them to the ER. Meanwhile, the Basic is acting as a pre-hospital triage, getting a base set of vitals, gathering information about allergies, medications, past history, demographic info... All that stuff that the hospital is going to need anyway.
Basics, when used properly, aren't going to kill anyone. As Rid pointed out, they are little more than basic first aid. In cases that require that, you're fine. It's when they are being used for more than that, like being the only unit dispatched to a difficulty breathing call, that the problems arise.
I usually stay out of these threads cause it is the same year after year and Rid has a bit more patience than I do.
Having said that, I disagree with your opening statement. All medics I have known including myself know that the majority of the calls do indeed result in BLS level of care. Having said that, do you think it is NOT in the patient's best interest to let a medic determine that first with an ALS assessment? We do it backwards...a medic should see them first and then downgrade if necessary, not the other way around. You can not compare this to a hospital setting either and tell me how a nurse sees the patient before the doctor, because in that setting, the doc is right there and the nurse is an educated professional...so no relevance to this discussion.
EMS is its own entity and can not be compared to those standards, we have to set our own precedence. Now will you still disagree with my position, do you think the patient should see a basic first then medic, or a medic then downgrade to a basic?
Regardless, I do not mind BLS calls because I am here to provide patient care. My skill set and knowledge is NOT divided into BLS or ALS, all I know is patient care. I perform whatever intervention is needed, be it from a soothing voice and calm atmosphere to intubating and providing pain relief. My "expertise" which you stated is not needed the majority of times shows either the lack of knowledge (ignorance) on your part or an overly inflated ego.
I am here for the patient, not hobbyists, not do gooders feeling good about themselves, but the patient and their needs. I think one of the most overlooked "skills" that a paramedic performs is PAIN RELIEF or CONTROL. Many, many "BLS calls" would benefit from some sort of pain relief, yet because this is not in the knowledge or skill set of a basic provider, they neglect to call for intercept and opt to transport the patient for whatever distance because they got that splint on and distal pulses are present.
Average busted arm : Pain relief
Average slip and fall: Pain relief or opt to utilize selective spinal immobilization protocol...also rule out or recognize underlying medical conditions that may have contributed to a slip and fall/just cause they are by a Wet Floor sign does not mean that is why they fell
Abdominal pain from constipation: how do you know it is constipation..regardless, yet again PAIN relief, ALS assessment for underlying conditions since Abdomens have about 1000 differentials
Do you see the recurring pattern? If you were the patient, would you not want an ALS assessment first and then a downgrade? Wouldn't you want pain control during that 10-20 minute ride to the ER?
Of course you would!! But this would be because you know higher level of care exists or pain relief could be available. The general public is ignorant of these facts. They see an ambulance and assume paramedics are on board. If something is not done, they are unaware it was available. This is where we step in...we take the initiative and go a step beyond. We do not want the patient to have to request or demand better care, we should provide it because we are professionals whose sole aim is to give every patient the best care possible from the start.
