Does anyone have any links to studies to the efficacy or ineffectiveness of ALS first response in pt outcomes?
Does anyone have any studies on the tiered BLS/ALS vs an all ALS system?
Background:
My department has 41 ambulances - 37 ALS, four BLS. 15 ALS are double medic, 14 have an EMS officer as one of the medics, and are for training. The remainder are medic/EMT staffed. We have 37 engines that have a medic and ALS equipment as minimal staffing. We have eight Heavy Rescues, which may or not be ALS. We have seven EMS Captains, which are all medics, and also carry ALS equipment. We also have 14 Truck companies that are BLS.The population is 1,080,000 or so, on 395 sq. miles.
We use a version of EMD that was changed to include many more calls as ALS. On each first due ALS call we have an engine or medic response. On a second due, an engine from that first due will respond. On highway incidents, we get an engine and medic for each direction, and a rescue/BC/EMS Capt. if it's a possible pin job. EMS Captains are dispatched on all cardiac arrests, and on all ALS calls where the medic on the medic/EMT ambulance is the sole provider. The county has a policy of requiring two medics on every ALS call.
I feel that this is overkill. We used to have a tiered system. All of our medic/EMT buses used to be BLS. having every engine ALS is also overkill, IMO. I'd like to see studies that would show that we don't need ALS engines (or to the contrary). I would also like to see studies that advocate a tiered system (or to the contrary).
Examples of systems in use as an example would be useful as well.
Thanks.
Does anyone have any studies on the tiered BLS/ALS vs an all ALS system?
Background:
My department has 41 ambulances - 37 ALS, four BLS. 15 ALS are double medic, 14 have an EMS officer as one of the medics, and are for training. The remainder are medic/EMT staffed. We have 37 engines that have a medic and ALS equipment as minimal staffing. We have eight Heavy Rescues, which may or not be ALS. We have seven EMS Captains, which are all medics, and also carry ALS equipment. We also have 14 Truck companies that are BLS.The population is 1,080,000 or so, on 395 sq. miles.
We use a version of EMD that was changed to include many more calls as ALS. On each first due ALS call we have an engine or medic response. On a second due, an engine from that first due will respond. On highway incidents, we get an engine and medic for each direction, and a rescue/BC/EMS Capt. if it's a possible pin job. EMS Captains are dispatched on all cardiac arrests, and on all ALS calls where the medic on the medic/EMT ambulance is the sole provider. The county has a policy of requiring two medics on every ALS call.
I feel that this is overkill. We used to have a tiered system. All of our medic/EMT buses used to be BLS. having every engine ALS is also overkill, IMO. I'd like to see studies that would show that we don't need ALS engines (or to the contrary). I would also like to see studies that advocate a tiered system (or to the contrary).
Examples of systems in use as an example would be useful as well.
Thanks.