i for one am not above calling for als backup if i think the patients condition warrants it. i work for a fire/ems service in rural oklahoma. on my crew, we have three basics and one intermediate. it just so happens our intermediate is our shift commander and getting him to run on a call after midnight takes a act of congress.
for example, we get a 0400hrs call on a diabetic patient who is unresponsive. the shift commander takes the call but yet elects to send out the bls crew. once we arrive on scene, the patient is laying in bed and is out. will not even respond to verbal stimuli but grunts to painful stimuli. we check the blood sugar with glucometer and get a rediculous high reading. so we call back to the station and have our als guy come out to push some D50. when he arrived, he did his job but it was obvious he was not happy about being there.
i believe my als guy has been in the business for a while and doesn't like to take calls. someitmes, i question if he will even show up when the big one comes in. in the event he doesn't, i do know other intermediates and paramedics numbers from other crews i will not hesitate to call if needed. i am a fresh new basic and if i feel i am in a pinch, i'm calling someone and could care less what time it is. this may change in time with experience but for now, i'm not taking chances. patient care is my highest priority and i will go above and beyond to better their chances of survival.