What would you add? ALS and BLS

[Achilles]

I'm going to repeat the formal name, taken from the official Detroit website "The Emergency Medical Services Division of the Detroit Fire Department." When the FD has a division called EMS, that makes EMS part of the fire department.

oh, and if case you still didn't get it, from the Detroit FD's main page:
"The Detroit Fire Department is comprised of 10 divisions:
Administration Division
Firefighting Division
Fire Marshal Division
Community Relations Division
Emergency Medical Services (EMS) Division
Apparatus Division
Communications Division
Medical Division
Research and Development Division
Training Academy"

so again, just because it's not the firefighting division, doesn't mean it's not part of the fire department.

I guess I should add reading comprehension to the BLS skillset....:unsure:

You can repeat it as much as you'd like. I stated in my post I was wrong

I edited my last post as I did some further research on my knowledge so I beleive that's why posted that.
Once again I was wrong.

 

[sneauxpod]

since the OP is from Detroit.....

lets get the FD out of EMS, give EMS enough units to handle the call volume without needing help, give larger EMS system a career path, transitioning it from a job to long term career with one agency, give dispatch the authority to send the closest unit (AVLs in every truck, tracking where units are), MDTs for busier systems, ALS treats sick people only, BLS is educated enough to know the difference between sick and not sick, and when ALS is and isn't needed, supervisory personnel with management training, management with bachelors degrees in management areas at the minimum, and masters degrees preferred, and more focus on evidenced based medicine instead of "well this is how we have always done it, so if you don't do it this way, the QA nazis will be sent after you."

oh yeah, and more education so better documentation and fewer run-on sentences.

Every company around my area uses AVLs already and lets just say AVLs are a waste of time if you dont have dispatch that actually knows what theyre doing lol.

ummm, no, it's not: http://www.detroitmi.gov/DepartmentsandAgencies/FireDepartment/EMS.aspx

And the first line of the site is: "The Emergency Medical Services Division of the Detroit Fire Department shall provide the highest level of pre-hospital care to the citizens, visitors, and stakeholders of the City of Detroit." While the latter part is a joke, the first part is 100% accurate.

oh yeah, funding, actually fund EMS with the $$$$ needed to do it's job without relying on any other agency to "stop the clock."

Actually it is a totally separate thing, theyre under the same department technically, but its run more like a private company than a municipality. Fire and EMS in detroit have virtually zero interaction unless EMS has to standby on a fire. Plus now there are a lot of private ems that run around as DEMS. So by all technicality yes youre right. but in all reality its both right and wrong.

To clarify for those who dont know what an A-Pack is (accessory pack), It is a bag in Michigan that we have that has strictly medical event medication. Epi, Albuterol, ASA, Nitro, etc. heres a link for you if you want to know exactly what its all about.

http://www.ocmca.org/documents/PharmacySection.pdf
Skip to pg 708.

 

[DrParasite]

You can repeat it as much as you'd like. I stated in my post I was wrong

sorry about that, your original post (before you edited it) said this:

Umm yes it is http://detroitfirehouse.wordpress.com/faq/

I must have submitted before you edited it. As a side note, never use a blog (or anything that uses wordpress) as support for your argument; facts are always more accurate that random people's opinions.

and to follow it up, your right, you need to fund the EMS system. That means funding for an AVL in every truck, as well as an MDT. And the money to train dispatchers in how to do their jobs right. and enough trucks to handle the call volume.

Burn looks like a good movie.... but I bet the Detroit EMS people work at least 4 times as hard as the Detroit firefighters. statistically they definitely go on more calls, and I would fear for my life a lot more if I was on a two man truck going on some of the calls they go on without any backup vs being on a 4-6 man company. Just saying.

 

[Aidey]

This thread is heading off track fast. Lets stick to discussing what you would or wouldn't add to EMS.

And just in case there is any doubt about what that is. On topic means answering the following question.

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.

 

[Clare]

We're spending millions on developing an electronic PRF either on a laptop or a tablet.

I am torn between liking the speed of data entry and how it can be used for audit and stuff and liking the ease of filling out a paper from and that a laptop or tablet would cost a lot and be quite heavy.

 

[zmedic]

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..

It's nice if you are running an EMT/medic truck. So if there is a fracture the EMT can start the line while the medic is pulling up pain meds. Or on a cardiac arrest the EMT can do the line and put the patient on the monitor while the medic intubates and pulls up ACLS drugs. Or on an MI the medic can talk to the patient and work on the ECG and deal with drugs etc.

When I was in colorado it was an add on class for EMTs. I found it pretty useful.

 

[Tigger]

It's nice if you are running an EMT/medic truck. So if there is a fracture the EMT can start the line while the medic is pulling up pain meds. Or on a cardiac arrest the EMT can do the line and put the patient on the monitor while the medic intubates and pulls up ACLS drugs. Or on an MI the medic can talk to the patient and work on the ECG and deal with drugs etc.

When I was in colorado it was an add on class for EMTs. I found it pretty useful.

Now in Colorado EMT-IVs can draw up and administer front line cardiac arrest drugs under a medic's request. This is a service option and requires additional training beyond the actual IV class.

 

[zmedic]

Now in Colorado EMT-IVs can draw up and administer front line cardiac arrest drugs under a medic's request. This is a service option and requires additional training beyond the actual IV class.

We used to do that, though it wasn't in the protocol. Espically since our meds didn't have to be "drawn up." When the medic wanted epi it was just a matter of opening the box and screwing the two pieces together.

 

[Fish]

Can they do IOs? Curious

 

[Tigger]

Can they do IOs? Curious

There is at least one agency already having EMTs with the IV add on doing IV. Colorado Springs Fire also just got a waiver approved to have basics preform IOs, but it is yet to be implemented.

When I took my IV course I was trained in tibial IO access in the event that the state makes it a non-waiver skill.

 

[Clare]

There used to have a level called Intermediate Care Officer that could start IV's but not give IV drugs, then ICO was renamed Paramedic, then there was a level developed called Upskilled Paramedic that could give adrenaline and morphine but now that the Degree has come about Upskilled Paramedic has been renamed Paramedic and had a large number of drugs added (I think its about 15 in total)

I do not see the point in having somebody who can start an IV but not give drugs.