Are volunteer BLS services beneficial?

[JPINFV]

Most are merely EMTs and I mean this sarcastically as well, because it seems to me that unless you are a paramedic, you really should not even be a part of the EMS world or so it seems thats the way most of the posters (or posers) on here feel.

Ah, the ad hominem attack. Best saved for when you have no real response to an argument. Do you understand why people, including some EMT-Bs on the site, are against basics being sole medical providers?

[Dustdevil]

Well put. It's unrealistic to say stop all volunteer ems, and implement all paid. Never going to happen. It's a gradual thing, which will hopefully balance itself over the next 15 years or so. EMS is a relatively new business. The Wright Brothers' plane didn't just instantly turn in to a 747. Things are changing, but it won't happen overnight.

That's about as poor an analogy as you could have possibly used. The Wright brothers invented something from the ground up. We're not doing that. It is no longer the 1970s, and EMS is no longer a new business. In fact we are a lot older than many currently prospering industries and professions. We already know exactly how to run state of the art EMS. There is nothing to be invented here. The product is developed. We just have a lot of idiots in a lot of communities who are totally ignorant of that fact and refuse to get on board.

[WelshMedic]

Dust makes a good point here, EMS is not a new profession. It should be constantly evolving, developing itself and gaining the respect of it's peers in the healthcare community. An utopia? Well, it shouldn't be, but whilst there is so much infighting and backstabbing going on then I'm afraid you have a long way to go....

For what's worth, I do believe there's a role for volunteerism in EMS, but not in it's present form. I would suggest that the anglo-saxon model of Community First Responders would be more appropriate.

Have volunteers respond in their community in cases of life-threatening situations. Back this up with a paid ALS transport capacity that will start to provide definitive care. Recognize the volunteers for what they should be: motivated individuals that want to serve their community and not have them fill in the gaps in professional health care due to a lack of political will to change the situation.

Every form of certification that allows an EMT-B (I, A, CC, whatever) to perform ALS on the cheap is not addressing the real issue, the need for ALS in every community; regardless of the financial situation. Surely everyone agrees that they would want the best when it was their turn?

If EMS is to get the respect it so desperately craves, then this is the only way forward. Make EMS paid, all ALS and degree level entry. The rest will follow automatically.....

WM

[akflightmedic]

I deal with a areomedical service here that tends to get a little pig headed on scene and refuses to listen to a report from somebody that has been with the pt for 20 minutes waiting for there arrival.

Sorry but I feel the need to respond to this one. I will say I used to feel the same way before I started flying and I was a Paramedic!! It irked me to no end that they would jump in and barely look at me, much less acknowledge they were listening.

After I started flying, I realized I was doing the same thing for several different reasons.

First, I was familiar with the services in my area. I knew their capabilities and limits.

Honestly, as a basic on the ground for 20 mins with my patient, there is VERY LITTLE you can tell me that I will not find on my own in a minute or less when I perform my exam. There is also very little you can tell me that will change ANYTHING I need to do for the patient, the care rendered will remain unchanged. I am going to do my exam anyways, so please feel free to continue talking while I do it. I will also be listening to breath sounds almost immediately when I approach the patient, so don't let that bruise your ego when I plug in while you are mid sentence.

Time is of the essences and there are things I need to assess and interventions to perform. I do not need a play by play of the past 20 minutes. It is irrelevant. Once I feel I have all pertinent information (Notice I said me and not you) I will dismiss you and say thank you. This is not social hour and I will not ask about you or your family. My thoughts are entirely on the patient and the care. I will come across as gruff or even rude, but you know what, I do not care at that moment as it is neither about me nor you. I am being professional and giving my undivided attention to this patient that necessitated a helicopter response.

When receiving a patient from a medic, I do extend a little more attention (depending on the medic, how they are acting, what they are saying) because there initial findings are more relevant if they did indeed observe something pertinent. I also take the time to quickly assess the patency of their IVs or check tube placement prior to moving the patient. If I walk up and they start spewing off irrelevant details or sounds as if they do not know what they are talking about, I start my exam from scratch and acknowledge them the same way I would a rural vollie BLS squad. I do not have time for mediocrity and neither does the patient.

All of this may sound snooty and some may say "he forgot where he came from", but that is so far from the truth. It is BECAUSE I remember where I came from that I do these things.

It is called professionalism. I invite any of you to do grand rounds with a trauma surgeon and see how quickly you get eaten alive with the typical EMS education. You think feelings get hurt on this board...you have no clue.

[WelshMedic]

It is called professionalism. I invite any of you to do grand rounds with a trauma surgeon and see how quickly you get eaten alive with the typical EMS education. You think feelings get hurt on this board...you have no clue.

Never a truer word spoken..... a few months ago I presented 2 pt's to the same professor of traumasurgery in 2 days. The first time I was a bit distracted (a late night, but heck, I never said I was perfect, did I?). He ripped me apart, he told me to fcuk off out of his ER if this was the best I could do... The following day I made sure it was said right....and got compliments.

If you think we are hard out there on the street, just put yourself in the shoes of a 1st year surgery intern..... you don't know you are born!!!!

WM

[EMT857]

A New Jersey point of view...

As a volunteer EMT-B I would absolutely agree that paid ALS is the way to go. My county is still mainly volunteer BLS first response with Monoc ALS dispatched as needed. A few paid day crews exist here and there. On a busy day we're lucky if they can meet us on the way to the hospital and in the past two years they've actually cut back on MICU rigs on the road. They shut down one post in my town of 45k people in 32 square miles. We have 6 BLS rigs capable of covering the town, to staff these rigs is another story.

Average transport times I would say are 20-30 minutes on top of first waiting an average of 15 minutes for a crew to arrive on a good day. If the squad doesn't have a crew, you could wait 30-45 minutes for a mutual aid crew to get out. We've had days we've run more mutual aid calls than our own.

As much as I enjoy it as a volunteer, I'll be glad when the services go paid ALS. It will be better for the population, but New Jersey being the fine corrupt state it is, who knows when that will happen.

[paramedicmike]

All of this may sound snooty and some may say "he forgot where he came from", but that is so far from the truth. It is BECAUSE I remember where I came from that I do these things.

It is called professionalism. I invite any of you to do grand rounds with a trauma surgeon and see how quickly you get eaten alive with the typical EMS education. You think feelings get hurt on this board...you have no clue.

+100000

I'm glad AK said it because he said it a little more eloquently than I was thinking.

I am fully aware of the care available in my area. I'm also fully aware of the providers and who are worth listening to. There are very few worth listening to. I gotta tell you, if you feel you're being ignored that's on you and has nothing to do with behaviour exhibited by the flight crew.

As AK said, this is not happy hour. This is patient oriented time. That patient is the center of attention from the second I step into your ambulance to the second I drop him/her off at the trauma center.

I do the things I do because I do remember where I came from. I do the things I do because it's about the patient. I couldn't care less, at the time of care transfer, that you think I'm being rude. My advice will be to get over it.

People deserve better than the bare minimum. Let's get out of the mentality that it's all about "me" and that it's about the patient.

-be safe

[Just Plain Ruff]

I think we all agree that this is a divisive topic.

The title of the topic was divisive if you ask me.

We have people who love that they are emt (booyah on you)

We have people who love that they are medics (booyah on you too)

We have people who hate emt's and those that hate medics

We have people who hate both emts and medics the same.

We need to stop posting this type of thread or topic because in my deep seated psyche(scary huh?) I think that these topics are inherently designed to be divisive. The original poster might not have started out to divide but by the nature of the topic it is divisive nonetheless.

All a poster has to do is to read the first 20 or so threads and they will see the underlying belief structure here in the posts.

I for one am getting tired of seeing the same threads(worded differently though) and the same exact group of people here posting replies.

I for one vow from here on out that I refuse to respond to threads where the topic specifically is about EMT's versus medics or paid versus volunteer.

If we stop responding these types of threads will go away.

[Doug]

For those of you who think that even the most remote areas with a call volume of 100 calls a year should dump the volenteers and go for a full time ALS service because "We all want and deserve the best", I expect you to be the first ones to pony up the cash when your local clinic wants $$$ for an MRI/CT/or neurosurgeon on staff....Let's face it evetthing runs on $$$, and yes human life sometime comes down to a cost/benefit analysis. Not every area warrents ALS or even a paid BLS service.

[spenac]

For those of you who think that even the most remote areas with a call volume of 100 calls a year should dump the volenteers and go for a full time ALS service because "We all want and deserve the best", I expect you to be the first ones to pony up the cash when your local clinic wants $$$ for an MRI/CT/or neurosurgeon on staff....Let's face it evetthing runs on $$$, and yes human life sometime comes down to a cost/benefit analysis. Not every area warrents ALS or even a paid BLS service.

I get $15/hr paid 24 hours a day at a service that gets less than a 100 calls a year. This is an ALS truck. The county is almost entirely inhabited by people living below the poverty level. There is no way a county/city can say they can not afford a professional service, they just need to get their priorities right.