Your Controversial EMS-Related Opinion

[StCEMT]

It doesn't have to be better for me, just not worse. Most arrests, sure I don't really care. But especially now when I have sick patients for 30-40 miles in a very resource limited area, the Lucas is a must. If something happens on the way, I barely have 2 people most of the time (including myself) and some of the help I get may or may not be helpful at all.

 

[EpiEMS]

It doesn't have to be better for me, just not worse. Most arrests, sure I don't really care. But especially now when I have sick patients for 30-40 miles in a very resource limited area, the Lucas is a must. If something happens on the way, I barely have 2 people most of the time (including myself) and some of the help I get may or may not be helpful at all.

I agree. If clinical outcomes are the same but it makes operations easier, it’s a win.

 

[Aprz]

I think you’re probably right - no way are you getting 7 medics (except in California), nor would you need them. The optimal mix is going to vary widely by response time, I think.

Even California is hurting right now.

 

[EpiEMS]

Even California is hurting right now.

That’s what happens when you burn out 6 medics by sending them all to BLS toe pains!

 

[MackTheKnife]

All for bougie and VL, y'all know the McGrath X3 and a bougie is my **** even if it kinda goes against the grain a bit for common VL set up advice.

Now I've absolutely successfully taken a bougie and Mac 3 for a DL on a person who checked 4/6 HEAVEN criteria boxes and all in all it wasn't too hard. I'd absolutely have preferred my McGrath though.

Miller #3 for me.

 

[StCEMT]

Miller #3 for me.

It's been a few years since I've used that blade

 

[MackTheKnife]

It's been a few years since I've used that blade

Haven't tubed in awhile myself, but when I did, that was my go to except for peds, obviously.

 

[MackTheKnife]

Although airway management comes up with most patients, you realize that anesthesiologists/CRNAs do 99 other things during a day too?

But not ED things. Again, this is specific to airways.

 

[chriscemt]

I think you’re probably right - no way are you getting 7 medics (except in California), nor would you need them. The optimal mix is going to vary widely by response time, I think.

Johnson County, KS is probably getting 7 medics on most codes.

Does the study referenced above make the distinction between EMT and paramedic?

 

[FiremanMike]

I think you’re probably right - no way are you getting 7 medics (except in California), nor would you need them. The optimal mix is going to vary widely by response time, I think.

An arrest here gets an engine, a medic, and a battalion. This would be 4, 3, and 1, all of whom are paramedics.

Sometimes I go as well, so potentially 9 paramedics, but always at least 8..

 

[E tank]

An arrest here gets an engine, a medic, and a battalion. This would be 4, 3, and 1, all of whom are paramedics.

Sometimes I go as well, so potentially 9 paramedics, but always at least 8..

too many cooks....

 

[Jim37F]

Meanwhile here a code gets a single Fire company and single Ambulance. If the ambulance is one of the two BLS rigs, they'll also send one of the two medic Rapid Response suvs (or if they're the closest unit). So that's at the most, 3 medics, usually just one, maybe 2 normally.

 

[FiremanMike]

too many cooks....

I mean, sure.. I get that argument, but it only holds true if it’s a group of undisciplined medics. We train on having 1 voice be the quarterback and empower people to speak up, but only when necessary.

The other side of the coin is that it’s nice having everyone at a level where everyone can perform everything when needed. There’s also more heads thinking at an ALS level who can identify differentials or things that are being missed.

 

[CCCSD]

I mean, sure.. I get that argument, but it only holds true if it’s a group of undisciplined medics. We train on having 1 voice be the quarterback and empower people to speak up, but only when necessary.

The other side of the coin is that it’s nice having everyone at a level where everyone can perform everything when needed. There’s also more heads thinking at an ALS level who can identify differentials or things that are being missed.

And more wasting time on scenes because…paramedics. Seven of them…

 

[Tigger]

And more wasting time on scenes because…paramedics. Seven of them…

How, given the example of a cardiac arrest, would more paramedics cause a scene delay? Please use specifics.

I read all these “BLS crews had better outcomes in trauma” articles where everyone dumps on medics. And rightfully so, but if you don’t know how to get off a scene when it matters, you’re a poor provider, level not withstanding.

Well educated paramedics are not inherently stuck staying on scene longer. And I’d argue that a smart paramedic probably recognizes more times when it’s advantageous to quickly transport a subtly presenting patient over a BLS crew who may never have been afforded the assessment skills to do that.

 

[CCCSD]

Too many egos. LACFD is one good example. Why have seven people on the scene when only a few can actually process the actions needed. The rest are just bodies. I’ve watched paramedics argue about who was more qualified to handle a call. Too many cooks. Hell. Ask a group of seven paramedics which airway adjunct is best, and you’ll have 7 different opinions…

 

[jgmedic]

LACo is pretty much the worst option. Next to OC.

 

[EpiEMS]

Johnson County, KS is probably getting 7 medics on most codes.

Does the study referenced above make the distinction between EMT and paramedic?

Nope - it doesn’t distinguish among the number of EMTs vs. medics on scene.

 

[ffemt8978]

If you have seven medics on one call, what happens when if three more calls come in at the same time?

 

[DesertMedic66]

If you have seven medics on one call, what happens when if three more calls come in at the same time?

7 other medics respond. Some ALS fire departments are only staffed with medics.