ALS Intercepts

[AnthonyM83]

I certianly agree that procedures like IV cannulation, medication administration and cardioversion are more invasive than say taking a blood pressure and therefore require a higher amount of education and skill.

That does not mean that they should only be "top tier" procedures, or, by that logic, in tje non EMS setting a Consultant Physician would be the only one allowed to cannulate and the Registrars, House Officers and Nurses get lots of practice at keeping thier blood pressure taking up to snuff or something.

Totally agree. With proper education, I definitely think certain ALS procedures can be done by the basic provider. I think Dust would say an auto injector would technically be an ALS procedure. And every provider should be able to assist a patient with that....

[BoCat9]

I have had one call where I have asked for an ALS intercept, really didn't need one and then a couple where I needed one and didn't ask for it. I have also had times where my partner cancelled the ALS I had coming to me and then told me to ride the call, but I digress.

I have started looking at the situations my patient has. If it is something that could benefit from ALS interventions I will look a the distance to the hospital that the patient is going to go to. In almost all cases I won't wait around on scene. If I can be at the hospital before the unit will be able to get to me, I will do what I can and not really even call for another unit. If I will have an extended transport, I will have the intercept meet me en route so it will cut the time to definitive treatment. I have also been told that if a patient I am transporting goes downhill and I ave absolutely no idea where I am that I should 911.

[BushyFromOz]

Meanwhile, nanna with the busted NOF is still waiting for someone to relieve her agonising pain...........

[AnthonyM83]

I have also been told that if a patient I am transporting goes downhill and I ave absolutely no idea where I am that I should 911.

Call 911 for location purposes? Can they triangulate your position in that area? (I know some areas all they know if the cell tower used, but not your actual position) Or for directions? Is your area on the rural side? Do you work 911 calls?

[Kiwiology]

We have a number we can call to speak to the Dispatcher, buggered if I can remember it; 111 is much easier to memorise

[JPINFV]

Call 911 for location purposes? Can they triangulate your position in that area? (I know some areas all they know if the cell tower used, but not your actual position) Or for directions? Is your area on the rural side? Do you work 911 calls?

Sounds like a good idea. When I worked in OC I did a handful of transports down to San Diego over the two years. We didn't have GPS and I'm trying to remember if we had a few SD Thomas Guides in dispatch for these transports or if it was just a printed map. If I have no clue where anything is, at best the 911 dispatcher can give me directions from ____ and ____ to the closest hospital and at worst dispatch someone who can (fire, EMS, LEO) give me directions. I can forsee it being a better option than relying on dispatch trying to find and navigate you through Google Maps or something else...

[BoCat9]

Meanwhile, nanna with the busted NOF is still waiting for someone to relieve her agonising pain...........

They will be waiting just as long or longer if I stay on scene and wait for a medic.

Call 911 for location purposes? Can they triangulate your position in that area? (I know some areas all they know if the cell tower used, but not your actual position) Or for directions? Is your area on the rural side? Do you work 911 calls?

We have a number we can call to speak to the Dispatcher, buggered if I can remember it; 111 is much easier to memorise

I work transport and in most cases neither me or my partner knows the area. I have the number to the areas we go to regularly, but I don't know the numbers to all the places we go to. It's not for direction, I will stop and ask for directions to a street before I tie up a 911 line. This is for an intercept if my patient goes downhill on me.

[BushyFromOz]

They will be waiting just as long or longer if I stay on scene and wait for a medic.

Then they should get the care they deserve first up and not a first aider.

[BoCat9]

Ok, I'm sorry that I am not medic and cannot administer pain medications, but what I am trying to say is that instead of waiting on scene for 15 minutes or more for a medic who can take care of them to a higher level than I can, I will make them ans comfortable as I can and cut the time they have to wait. If the intercept is 15 minutes away and I meet them halfway, it will take 5 min or more the patient will have to deal with the pain. Sure it would have been better to have sent out a ALS unit out in the first place, but sometimes that is not possible or just not done. I do the best I can with my scope of practice.

[Richard B the EMT]

While the system I described that FDNY EMS, and units covered under the NYC 9-1-1 system, can always stand for improvement, (and what system can't stand improvement?), I operate on the premise that it has to be better than where we were, only a few years ago. Again, I believe that can be applied to all EMT City's members and their departments.