What would you add? ALS and BLS

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sneauxpod

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If there was one thing you could add, subtract, modify or improve in EMS as a whole, what would that be? You can only choose one thing and it cant be how much we get paid or anything of that nature because we all want that lol.

Personally, I would like to see BLS have the ability to start IVs and use an A-Pack everywhere because I think that BLS is being under utilized and could really become more effective in our line of work.
 
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Handsome Robb

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What's an A-Pack?

Alright...this has been talked about over and over again and never ends well.

BLS needs more education before you give them more toys.

ALS needs more education before you give them more toys as well.

If I could change one thing about the system I work in it'd be ILS ambulances with ALS chase cars that only go to high acuity calls. I don't mind running BLS/ILS calls all night but having fewer medics getting more contact with sick patients would help with skills degradation and burnout.

To take that further, and by no means is this intended to be derogatory towards BLS but I think EMT should be gone except in certain situations (read: rural systems with low volume that have trouble getting staff) and make ILS the minimum standard of education.
 
lightsandsirens5

lightsandsirens5

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ALS needs more education before we continue to let themy play with the toys they already have!

But if I could change one thing, it would be the public perception of EMS. I'd start by requiring the customer to self pay for all medically unnecessary calls. I'd hope that would help to kill the attitude of entitlement so prevalent today.
 
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Handsome Robb

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lightsandsirens5 said:
I'd start by requiring the customer to self pay for all medically unnecessary calls. I'd hope that would help to kill the attitude of entitlement so prevalent today.
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It's great in theory but good luck enforcing it.

Another thing I thought of would be the ability to refuse a transport. Its not something to be used often, I'm talking about the people that call at 0-dark-thirty because they want a ride to the the hospital to get their prescription refilled...or the people that are blatantly obvious about using the ambulance as a taxi to get around town. Ties back into lights' statement about reimbursement.
 
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Aprz

The New Beach Medic
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Super agree with L&S and NVRob. Obvious I'd prefer more education instead of taking toys away from paramedics. I'd like to see BLS go, and have ILS be the minimum/standard, put ALS in chase cars/reserve them for higher acuity calls.

If I had to pick one thing, and one thing only, I'd agree with making ILS the minimum. I don't believe most require more than BLS, but what bothers me is that BLS isn't capable of managing anything if some does go wrong... we just upgrade to lights and sirens and divert to the nearest facility. <_<
 
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NYMedic828

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beating_a_dead_horse.jpg
 
EpiEMS

EpiEMS

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BLS: more schooling, more layperson-level toys (if a bystander can get a BGL, an EMT should be permitted to do so, as well).
ALS: more schooling, more focus on core competencies and where the A in ALS makes a demonstrated difference (i.e. evidence-based EMS care and EMS systems).
 
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NYMedic828

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sneauxpod said:
Personally, I would like to see BLS have the ability to start IVs and use an A-Pack everywhere because I think that BLS is being under utilized and could really become more effective in our line of work.
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What purpose does an EMT starting an IV actually serve outside of maybe giving D50?

Permissive hypotension is the new thing, not that it has reached EMS yet but realistically rapid fluid resuscitation isn't as necessary.

I'd like to see EMTs able to give IM meds within reason.

At some point you are just crossing the line into a lesser trained lesser paid ALS provider.
 
EpiEMS

EpiEMS

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NYMedic828 said:
I'd like to see EMTs able to give IM meds within reason.

At some point you are just crossing the line into a lesser trained lesser paid ALS provider.
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What sort of IM meds would you have in mind?
 
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NYMedic828

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EpiEMS said:
What sort of IM meds would you have in mind?
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Glucagon epi narcan. Maybe Benadryl.

90% of services already allow epi pens. Epi pens are a lot of money. Syringes and epi ampules are cheap. It's just a waste to use epi pens cost wise.
 
medichopeful

medichopeful

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NYMedic828 said:
What purpose does an EMT starting an IV actually serve outside of maybe giving D50?
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Maybe the OP was thinking of it as a paramedic assist skill?
 
EpiEMS

EpiEMS

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NYMedic828 said:
Glucagon epi narcan. Maybe Benadryl.

90% of services already allow epi pens. Epi pens are a lot of money. Syringes and epi ampules are cheap. It's just a waste to use epi pens cost wise.
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I guess they see EpiPens as closer to foolproof?
 
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NYMedic828

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EpiEMS said:
I guess they see EpiPens as closer to foolproof?
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No question that's the reason, but this being a hypothetical thread, at some point we need to jettison the extra weight...

We can't so this lowest common denominator crap forever...
 
EpiEMS

EpiEMS

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lightsandsirens5

lightsandsirens5

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EpiEMS said:
BLS: more schooling, more layperson-level toys (if a bystander can get a BGL, an EMT should be permitted to do so, as well).
ALS: more schooling, more focus on core competencies and where the A in ALS makes a demonstrated difference (i.e. evidence-based EMS care and EMS systems).
Click to expand...

Wait, can't an EMT do bgl? I did them as a basic.
 
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Fish

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I don't get the argument for having Basic's start IVs, I do not see the benefit and I am not sure I would ever utilize it. I am a Medic, and I have a Medic partner... If It is my call, I never ask my Medic partner to start my IV, I do it myself. Not that I have a problem with them starting the IV, I just prefer to be the one right next to the patient doing the interventions and speaking with the patient and being hands on with the patient.


I would like to see Paramedicene become a required 2yr degree and eventually a 4yr one. With this pay, respect, educational level and "Professional" status would follow.
 
Clare

Clare

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If my suspicion is correct and we get ventilators and thrombolysis in 2013 then I don't think we need to add anything, maybe CPAP, maybe but apart from that I can think of nothing that we really need enough that justifies the expense.
 
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Fish

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Clare said:
If my suspicion is correct and we get ventilators and thrombolysis in 2013 then I don't think we need to add anything, maybe CPAP, maybe but apart from that I can think of nothing that we really need enough that justifies the expense.
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You don't have CPAP?
 
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