What is considered a BLS call in your area

Rid
I believe in another post you said you were working with some "lawmakers??", that is good as its the only way to make changes. Unfortunatly it will take many more than just you to make a change. 50 states and 300,000,000 + people is a lot to change. Even if you could get one state to come up with a new minimum standard it would be huge. The politicians tend to move slow without some motivation, (votes). If you could educate the people as to the difference between what they have vs could have. They may scream loud enough to provide some motavation.

Whether health care is paid for by Government or privately, (through insurance or the hip pocket), it isn't cheap. If people want good accessible health care, they are going to have to pay. One way or the other.

I know its been in the news about US politicians looking at the Canadian health care model. Don't copy what we have. Try to do better. Our system is good in many ways, but definately not perfect. Go ahead and copy the good stuff, you've got my permission ;);), just change the bad to something better.

PS Try to have it done before I semi retire to a warm place with a great beach.:):)
 
Part of the problem is that each state is allowed to develop their standards under the minimal guidelines of NHTSA. Most states barely will exceed any further. I do work on State as well on the National level but ironically; it appears that we agree on more national level than on state individual levels.
More emotional and territorial boundaries are made, as even witnessed on this small forum site.

I agree and realize Canada has their problems, they did have the foresight to change things a few years ago we did not. You were able to replace training with educational standards, something we are still attempting at. Slowly but surely. As well, although you have volunteer systems the resistance of increasing in education does not appear to be challenged as much. This even goes up the chain of levels as well.

Hopefully, before either another medical division begins to start to perform EMS role, we can develop a better working plan.

R/r 911
 
All calls are BLS. All calls are ALS. Hopefully both show up.
 
I dont really know what setup you guys have over there. Here we have an ILS and BLS on one vehicle and our ALS respond on the PRV. We seldom have the ALS on the ambulance.

So basically any call attended will have an BLS and ILS on scene, depends on the service responding to the scene.

As previously mentioned in the thread, any call is a BLS call and any call is an ALS call. It all depends on the situation at hand. You can get a serious MVA or a minor MVA. You can get a chest pain that requires BLS treatment and you can get a chest pain that requires ILS or ALS intervention.

It all start with the basic treatment rendered as soon as possible. If you have to end up calling for ALS backup or intervention, it doesn't mean you dont know what to do for your patient, it merely means that you have exhausted your trained expertise. (Unless you omit your protocol)
 
I still can't get my hands around this "BLS or ALS" call...

there is NO SUCH THING!!!
it is either ALS available, or ALS not available...

If available, and not needed, care is transfered to a BLS crew...

it is a top down approach, best for the patient... the highest trained (read ALS) makes the call...

you guys talk about it totally backwards... assuming BLS unless BLS determines that it is an ALS call...

Bascially, you would have the most important decisions made by the least qualified...

sorry, but that is just totally the wrong way to look at it.
 
I, as a BLS provider, cancel medics all the time. The patient is always stable, never had loc or sob and usually is just needing transport to the hospital. More often than not ALS triages the same types of patients down to me if they are on scene first. I am a medic student. So I want calls to go ALS both for the patient and my personal learning so I am inclined not to cancel medics.
 
All posted by ResTech:
Who is saying cancel ALS on cardiac patients?
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Apparently you are given the next quote:
You mean a EMT can't assess if a chest pain is of a cardiac, pulmonary, or misc etiology based on exam and index of suspicion?
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That is correct sir, you can't. Chest pain should be considered cardiac in origin until someone with the knowledge to make that determination is available.
You state BLS cannot make a determination if ALS is needed or not.. thats just bullsh*it... I do it and my peers do it all the time.... under a state-wide protocol!
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Ahh, good old cookbook medicine. Great stuff. Except for when it kills people. Then it's prett sh!tty.

Just some highlights.
 
firecoins said:
I, as a BLS provider, cancel medics all the time. The patient is always stable, never had loc or sob and usually is just needing transport to the hospital. More often than not ALS triages the same types of patients down to me if they are on scene first. I am a medic student. So I want calls to go ALS both for the patient and my personal learning so I am inclined not to cancel medics.
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yes, well we don't do "transports", we are 911 only...
and, for the percentage of patients, even with ankle sprains and fractures that are very painful, would we cancel ALS? if you ask the medic's out here, they would say foolish... most of the medical calls usually need something ruled out...

of course, there will be some calls where ALS is not needed... i know that...

but a "top down approach" makes much more sense for the patient than a "bottom up" approach...

also, as you are a medic student, perhaps you should take a broader look at who will be canceling most of the ALS... not medic students, but basics with the 100 hour class that everyone talks about...
 
skyemt said:
yes, well we don't do "transports", we are 911 only...
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I think you're reading a little too much into his post. Even 911 units transport patients, how else do they get to the ER?
 
JPINFV said:
I think you're reading a little too much into his post. Even 911 units transport patients, how else do they get to the ER?
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ok, mr smart aleck...

however, there are many on this site who differentiate 911 from "transports", apparently of the inter-facility type..

all i did was say what we do...

too much time on your hands, i guess?
 
Ha Ridryder u define what a paramedic is ha do you know how many medics it takes to screw in a lightbulb??
 
skyemt said:
ok, mr smart aleck...

however, there are many on this site who differentiate 911 from "transports", apparently of the inter-facility type..

all i did was say what we do...

too much time on your hands, i guess?
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Meh, it is spring break right now.

What I was getting at was that I didn't take his post to mean that he was working IFT, but simply that the patient on that call didn't require any treatment outside of a ride to the hospital. I'd also argue that a lot of interfacility EMT-Bs would put a lot of 911 EMT-Bs to shame when it comes to medical patients.
 
Lets remember to keep this thread on topic and to follow the community guidelines. Lastly, if you don't have anything nice or constructive to say, don't say it!
 
skyemt said:
yes, well we don't do "transports", we are 911 only...
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How do you get people from the scene of a 911 call to the hospital? You transport them. They don't magically appear in the ER unless YOU transport.

i only take 911 calls. If a patient has a minor problem, they don't need ALS and I transport them to the hospital
 
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I skimmed through quick, but figured I would throw in my 2 cents. I work in and around Worcester MA, and since I know MA is technically seperated in specific regions for protocols, I can only vouch for what happens here. First and foremost, I work for a "private" company, and if there is any way they can get away with "making" a call ALS, they will, its all about the money. Unless otherwise requested, most emergency calls will be sent ALS, but we get a lot of MD offices that ask for BLS and such. If ALS isn't there, BLS will obviously go, so I guess it depends on the circumstances. I realise this didn't explain anything, haha... ok... chest pain, labor, SOB, significant MOI -> ALS, trauma, cva, weakness, general calls -> BLS. This makes sence in my head, sorry if its retarded, its been a long day for respiratory diseases, and we're cutting up pig hearts tomorrow, hooray! haha.
 
firecoins said:
How do you get people from the scene of a 911 call to the hospital? You transport them. They don't magically appear in the ER unless YOU transport.

i only take 911 calls. If a patient has a minor problem, they don't need ALS and I transport them to the hospital
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well, you only took one sentence from my post and took it out of context...
no, they don't "magically appear" in the ER...

however, in my next post, which you failed to quote, i explained exactly what i meant by that.
feel free to go back and read it.
 
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Keith said:
I skimmed through quick, but figured I would throw in my 2 cents. I work in and around Worcester MA, and since I know MA is technically seperated in specific regions for protocols, I can only vouch for what happens here. First and foremost, I work for a "private" company, and if there is any way they can get away with "making" a call ALS, they will, its all about the money. Unless otherwise requested, most emergency calls will be sent ALS, but we get a lot of MD offices that ask for BLS and such. If ALS isn't there, BLS will obviously go, so I guess it depends on the circumstances. I realise this didn't explain anything, haha... ok... chest pain, labor, SOB, significant MOI -> ALS, trauma, cva, weakness, general calls -> BLS. This makes sence in my head, sorry if its retarded, its been a long day for respiratory diseases, and we're cutting up pig hearts tomorrow, hooray! haha.
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among the elderly, weakness may be the only symptom of an MI...
yet you list that and strokes as BLS calls??

sorry, makes no sense.
 
Now, I hope many will see the problems and the need of ALS on all emergency EMS units.

OB calls and no assessment of fundal height, treatment of complications of high risk type patients.

BLS on CVA's? A differentiation and advanced assessment should be made to tell the difference between a subarachnoid bleed and an occlusion HAS to be made ASAP! The difference is between fibro therapy and not. Time is the essence (< 3 hrs. of onset of s/s).

Can a basic perform such differential diagnosis? Even Paramedics should attend and be certified in Advanced Stoke Life Support (ASLS). There is prescribed treatment and detailed neurological examinations that can be made to determine the location, degree of the stroke. Very important information to be notified to the ER and Stroke Team.

Wow! More & more, I learn about how poorly our EMS Systems across the nations are, no wonder our mortality and death rate is high in comparison to other countries with aggressive EMS systems. Really it is embarrassing!..

R/r 911
 
ALS get's alerted on all CVA calls but 9 out of 10 times they get cancelled unless the patient is having respiratory issues or some other immediately life threatening problem. ALS isn't gonna do anything for a stable CVA pt. except a lock and throw the monitor on.

You oxygenate the pt. and transport. And the two hospitals we transport to don't have Stoke Teams. This is standard and ALS kinda expects to get cancelled.
 
ResTech said:
ALS get's alerted on all CVA calls but 9 out of 10 times they get cancelled unless the patient is having respiratory issues or some other immediately life threatening problem. ALS isn't gonna do anything for a stable CVA pt. except a lock and throw the monitor on.

You oxygenate the pt. and transport. And the two hospitals we transport to don't have Stoke Teams. This is standard and ALS kinda expects to get cancelled.
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Wow! How discouraging and dangerous it is to patients. Glad my family is not located in those areas. Oh, by the way, what is a "stable CVA" patient? If an assessment is not performed. One cannot determined if the penumbra has been affected or an active subarachnoid bleed has occurred, this can NOT be determined using triage on a phone. Ignorance amazes me. Maybe that is why stroke is the third leading cause of death and the leading disability.

How much oxygen you place on the patient? NRBM @ 15 lpm? Congrat's you may have just cause increased more cerebral ischemia! Of course, what does neurologists and strokelogists know?

Your hospitals do not perform fibrolytics on CVA's? Geez.. wished I was an malpractice attorney. Litigation's on NOT performing fibro's on new onset of CVA (non-hemorrhage) is more likely than if you DID perform it and they had complications. Don't believe me do a lit search or better yet talk to any TKAse drug rep. they are proud to give you the statistics.

*Hint.. it is the national standard of care, per ECC/AHA.

http://www.asls.net/introduction.html

Again, a shame many EMS Systems are stuck in the 70's

R/r 911
 
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