Cardiac Arrest

[PRPGfirerescuetech]

So the use of emt would be what. So cities like Boston and NY have it all wrong, The facts in urban areas you dont need Als trucks on every corner, BLS works fine. you have a hospital on every corner, and the BLS rate is through the roof, That leaves the medics to respond to true ALS calls and their skill can be maintaned. So lets use emts for transports of up to and hour and a half. I think you have reversed the problem. BLS works fine in urban areas, weather you believe it or not, and I believe the paramedic was introduced for the fact that sometimes you have over and hour transport times in some states.

Wow. I missed your posts.

Umm...ok. Im going to be nice here. Warning for the future....your going to lose every BLS vs. ALS arguement at this place.

Paramedic was introduced to provide more for patients in the prehospital setting. This has absolutely nothing to do with distance of transport time, and is actually even silly to think, let alone type.

I agree to a point that BLS is more useful in urban areas, but should NOT be the primary level of care for any EMS system, period. We've progressed past that. BLS is useful for one reason in urban system. For dual BLS trucks in small doses to clean up the bumps, bruises and hangnail calls to free up ALS units for legitimate ALS calls.

THAT if at all, is how you utilize BLS in urban systems.

Your analogy has absolutely no basis is fact, and gives me a headache.

XoX

PRPG, the BLS provider

[whit72]

[web:138aa2cc50]http://www.rescuehouse.com/content/ems-history/004030.php[/web:138aa2cc50]

First here is the history of EMS, EMT's were not trained to help paramedics. Medics evolved from EMT's second urban systems run tiered systems for the fact their is not enough ALS intervention to warrant 30 medic trucks, It is more advantageous to have fewer highley trained medics, responding to all the ALS calls refining their skills. then ALS ambulances transporting drunks and minor MVA's, with single system trauma all day, Believe me Most of BOSTON EMS BLS trucks are staffed with medics and they have plenty of money if they wanted to make all their trucks ALS.

[PRPGfirerescuetech]

So...your saying use EMT's to transport the minor stuff, but continue to staff the medics?

Funny...thats what I said. Glad you've come around.

MEdics were developed to elevate prehospital care, and have NOTHING to do with EMS.

Finally, Boston is not the catch all end all of EMS systems. Do some studying beyond your normal areas, and you will see the light on this topic.

*Class dismissed*

[whit72]

Tiered systems work its proven, And yes Boston is a model EMS system. It is not a financial decision, its a best care desision. Medics role to ALS calls, they have more of an oppurtunity to refine their skills. They are not tied up with BLS calls all day. And the article is the true history of EMS not the stuff your selling.

[PRPGfirerescuetech]

Did you just not read that article, I guess not. No what you said was emt's should be used for first responders. You are saying EMTs dont have a role in EMS you are WRONG period. Yes Boston EMS is a model for ems is urban areas.

I did read the article yes. The article, and you are both wrong.

Your opinion, that article, and your posts are SHINING examples of what is holding EMS back from being anything more than a hobby. Its time to move past "history" and into the future.

Finally, Boston EMS is not, nor will ever be a "model for EMS". Period. There is no one performing close enough right now to be a model for what EMS should be.

If there was, we'd all work there.

[whit72]

Ok do you have any facts to back that up?

[JakeEMTP]

I did read the article yes. The article, and you are both wrong.

Your opinion, that article, and your posts are SHINING examples of what is holding EMS back from being anything more than a hobby. Its time to move past "history" and into the future.

Finally, Boston EMS is not, nor will ever be a "model for EMS". Period. There is no one performing close enough right now to be a model for what EMS should be.

If there was, we'd all work there.

=D> I can't say for certain, however I have researched some urban systems across the country. If there was a EMS model currently in place Austin-Travis would be close. I base that solely on internet research so take it for what it's worth. Boston EMS is far from it. In fact, it probably is an example of how not to run an EMS system.

[PRPGfirerescuetech]

Ok do you have any facts to back that up?

You made the statement that Boston EMS was a model EMS organization, and above the rest.

Therefore, as Punisher taught me in a recent post, it is on YOU to provide evidence of your opinion.

[whit72]

i was talking abouy where the medic came from.

[Ridryder 911]

I think you are missing the sarcasm. Some people on this board do not agree with working arrests I am an advocate for working them.

thak you.

I am not against working aystole patients.. do it all the time, however; aystole patients that have been documented in II leads and traumatic arrests that has not received any resuscitation efforts for a duration period as well as working them then making the decision to cease resuscitation efforts after failure to respond to therapy.. want to talk about protocols.. those are mine. This again is not new, and has been standard of care at most progressive EMS services for over 15 -20 years. Please read thoroughly and carefully... there is a major difference, from arriving on a sudden cardiac arrest, then those who are obviously dead.

Something fishy with whole scenario, and if I was a physician I would inquire on looking at documented strips... 2 +_ 2 does not = 4 here. Either the patient was down longer, or the patient might had a large dissecting aorta or P.E. as discussed. Levity ?.. usually takes a while, and pooling is gravity dependent. (post mortem hemostasis) ..

If the patient has not been properly resuscitated, with no adequate airway, conformed in aystole for > 20 minutes without any ALS intervention.. yes, I would probably call it. Then have a M.E. inquiry....

R/r 911