all ambulances are 2 paramedics only? any EMT positions?
what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?
Every truck is dual paramedic, and almost all of our Admin and Clinical Practices staff are credentialed paramedics too. That level of care allows us to have a great scope of care because we have a minimum of two highly trained providers on every scene. We don’t need permission from a supervisor or contact OLMC to do things like DSI/RSI, surgical cric, pericardiocentesis, hang pressors etc.
I don’t really keep track of a “BLS vs ALS” ratio to be honest. The “ratio” does change from truck to truck, but everyone still gets sick patients.
so doesn't that mean the medics end up treating a whole lot of non-ALS needing patients? leading to the issue of skills degradation, because they just don't get to see enough sick patients to maintain the high levels of competency? Wasn't this one of the documented issues with an all ALS system?
The first step we do to make sure we maintain high levels of competency is to hire the right people. Once they pass our rigerous hiring process, they have to pass our academy and credentialing process, which can take up to a year.
Our medics stay sharp with daily peer to peer chart reviews, Senior Medical Officer KPI chart reviews and Station Lieutenant operational chart reviews. These chart reviews allow us to quickly identify problems (individual and system wide) and work toward resolving them.
We also have quarterly mandatory CE classes, monthly mandatory Medic-CE courses, paid card classes and regular SMO station visits where they update field medics with patient care trends, SOC updates/clarifications and airway management skills verification. Our Clinical Practices staff also publish monthly statistics for the clinical metrics we track.
Additionally, every medic must take an annual skills, written, med math and 12 lead interpretation exam in order to remain credentialed.
