medicnow911 Posted January 9, 2006 Posted January 9, 2006 My private EMS company runs nine 24 hour ALS units in the county we service. We have no basic units. Over the past few years the call volume has increased dramatically, but management has taken to hiring more EMT-B's and we rarely get to work with another medic. The paramedics work 24hrs on and 48 off. The basics can work either 12's or 24's. There is now a new company policy that basics cannot attend on a transfer pt. that has an IV even though it is within their scope of practice in my state under routine iv maintenance. I would speculate that 95% of our calls have to have a medic in the back. Management's motto is that if they are sick enough to call for an ambulance than they at least need an IV. So most of our calls are ALS. And it is not a billing issue. We don't fall into the BLS billing category for the insurances because we only have ALS rigs. So for billing purposes they get billed the same amount, IV or no IV. My question to all of you is how are you partnered? Do you have double medics on your ALS rigs? Our medics at our company are getting really burned out. Our company pages out for people to come in to work for double time when it gets busy or we have a lot of out of town transfers. We had a double medic crew 18 hours into their busy shift the other night and at midnight managent split them up and paired them with 2 basics that were getting paid double time to come in for the extra car. Well the one crew ended up taking a trip from a hospital 50 miles north of Detroit to the Cleveland Clinic. The medic that got stuck going on the trip and attending on the critically ill pt didn't get double time but the basic did. I'm just curious how other companies staff their units.
Dustdevil Posted January 9, 2006 Posted January 9, 2006 Eh... don't get me started. Basics have no business working on an emergency ambulance. Period.
vs-eh? Posted January 9, 2006 Posted January 9, 2006 My private EMS company runs nine 24 hour ALS units in the county we service. We have no basic units. Over the past few years the call volume has increased dramatically, but management has taken to hiring more EMT-B's and we rarely get to work with another medic. The paramedics work 24hrs on and 48 off. The basics can work either 12's or 24's. There is now a new company policy that basics cannot attend on a transfer pt. that has an IV even though it is within their scope of practice in my state under routine iv maintenance. I would speculate that 95% of our calls have to have a medic in the back. Management's motto is that if they are sick enough to call for an ambulance than they at least need an IV. So most of our calls are ALS. And it is not a billing issue. We don't fall into the BLS billing category for the insurances because we only have ALS rigs. So for billing purposes they get billed the same amount, IV or no IV. My question to all of you is how are you partnered? Do you have double medics on your ALS rigs? Our medics at our company are getting really burned out. Our company pages out for people to come in to work for double time when it gets busy or we have a lot of out of town transfers. We had a double medic crew 18 hours into their busy shift the other night and at midnight managent split them up and paired them with 2 basics that were getting paid double time to come in for the extra car. Well the one crew ended up taking a trip from a hospital 50 miles north of Detroit to the Cleveland Clinic. The medic that got stuck going on the trip and attending on the critically ill pt didn't get double time but the basic did. I'm just curious how other companies staff their units. WOW!!!!!!!!!!!!!!!!! HAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!!!!!!!!!!!!!!! *wheeze* *cough* *ahem* *woooooooooooo* *cough* *ahem* *snort* *heh* *woooooo* Man, would I love to see services like this. I....I'm speachless....but the phrase cookbook medicine applies I think. And even if management insists on an IV for Johnny Stubtoe, start a lock, and let the basic attend. Not all IV's have to be bags... Double ACP crews in Ontario are quite rare. The vast vast vast majority are PCP/ACP....
akroeze Posted January 9, 2006 Posted January 9, 2006 To build on what vs-eh said, from what I have seen double ACP crews are all but unheard of because if there are two ACPs then they will make another ALS truck instead in most cases.
noahmedic Posted January 9, 2006 Posted January 9, 2006 It's pretty much the same here. The idea is to spread ALS resources as wide as possible. The only thing I disagree with is a medic attending all calls. We have the same rule here, and it really is a disservice to the EMT's. Most of them want to learn and when possible I try to get a firefighter to drive so we can both be in the back, but you can normally only pull that on true emergency calls.
jw-c152 Posted January 9, 2006 Posted January 9, 2006 As my fellow Ontarians have said, ACP/ACP (advanced care paramedic) crews in this province are rare. In my service you will find that configuration only in instances where a PCP (primary care paramedic) books off and an ACP is called into work overtime with another ACP. As far as ACP's attending ALL calls, it doesn't happen. If the patient requires a level of care above the education/training/skill set of a PCP then the ACP will attend. If the care required falls within the PCP's scope of practice then we will go call for call. If there is a change in patient condition then the ACP can always switch from driver to attendant if necessary. As an example, I, as a PCP, will often attend on an ischemic chest pain call. My ACP partner must start the line and give the fentenyl (if indicated) but I can monitor the patient, administer the Nitro and ASA, aquire/interpret the 12 lead, etc. That being said, the opposite regularly takes place... a car will often be staffed PCP/PCP... J
Dustdevil Posted January 9, 2006 Posted January 9, 2006 Most of them want to learn and when possible I try to get a firefighter to drive so we can both be in the back... You can do that? Sweet!
noahmedic Posted January 9, 2006 Posted January 9, 2006 You can do that? Sweet! Sort of. I pretty much told my supervisor that is what I am going to do, if we need to alter our insurance then so be it. I feel more comfortable with my EMT partner, I know what their limits are, and I know they are committed to EMS, not just a tag along who became an EMT so they could get on with the fire dept. With a random FF/EMT I really have no clue what to have them do, other then CPR, and even that is hit or miss most of the time.
craig Posted January 9, 2006 Posted January 9, 2006 Eh... don't get me started. Basics have no business working on an emergency ambulance. Period. blinkers on again dust? 'emergency vehicles' come to a country where all officers on the vehicle can carry out emergency procedures seems that not having the one service to carry out the work causes ELITISM between the ranks.... ahh dust you have disappointed me. stay safe
Dustdevil Posted January 9, 2006 Posted January 9, 2006 come to a country where all officers on the vehicle can carry out emergency procedures I'd love to! It sure isn't that way here. Doesn't look like it will happen in my lifetime either.
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