BLS refusing handoffs from ALS?

[Lone Star]

Under Michigan protocols, the only way a pt can be 'handed off' or pt care transferred, is to someone of equal or higher licensure. Since a medic made first pt contatct, they cannot legally transfer the care of a pt they deem as a BLS pt to an EMT-I or EMT-B. They will have to transport the pt themselves, and notify dispatch that they are transporting BLS. RUQ pain, fetal postioning ... lack of masses does sound like Cholecystitis. Granted the call MAY be a BLS call, but the medics in this case would be considered negligent under Michigan protocols, and could in fact be facing abandonment charges because they did not follow protocols in the proper transferrence of pt care.

[primemedic01]

LIKE I said ......Where I AM FROM we dont hand off a patient.....to a BLS crew no matter what .....if we are als and we have touched that patient or rendered care in anyway WE DO NOT HAND OFF THE PATEINT....reguardless of what the call is...

Would this mean you don't have BLS crews doing interfacility transfers? Because you would be downgrading care if you had someone in an ER being transfered BLS to a more appropriate facility. So, you wouldn't beable to go from RN's and ER Physicians to a BLS crew, regardless of patient condition?

[Thunderchild145]

Yea. if the FF was also an EMT-P he probably should have gotten in and ridden with you to the ER, even if you didn't have any ALS supplies in the truck.

[chevy]

As my flame-retardant suit is at the cleaners, I won't venture a comment on the pro's/con's of fire dept. medics, however in our region, the entry requirement for P-school students is the same level of training as our fire guys have who are working, so on the first day of class, all PCP students are as trained as any firefighter in our city. (This is a little known fact to John Q. Public).

As per a previous post, a BLS crew can pass up to an ALS, but I don't think the opposite happens. The target for our city is to have 100% mixed BLS/ALS crews as a minimum staffing configuration. Each medic switches between driving/attending after every call. The ALS medic will only "take over from the BLS partner" when a pt requires ALS care, else the ALS medic gets whichever pt comes their way when it's their turn. They don't pass down pt's, even within their own crew.

Before anyone misunderstands my first comment, we run a tiered response service here and the FD plays a huge role as first-responders and plays a major role for difficult pt moves, extrications etc. From what I can tell, it's great team oriented environment where each dept. plays their role as the specialist in specific areas.

..Chevy

[whit72]

thunder child wrote:

Yea. if the FF was also an EMT-P he probably should have gotten in and ridden with you to the ER, even if you didn't have any ALS supplies in the truck.

And the point of that would be........what?

[JPINFV]

My area (which has no shortage of medics) has protocols for transfering care from ALS clearing a patient for BLS transport.

[medic001918]

LIKE I said ......Where I AM FROM we dont hand off a patient.....to a BLS crew no matter what .....if we are als and we have touched that patient or rendered care in anyway WE DO NOT HAND OFF THE PATEINT....reguardless of what the call is...

I don't think negligent would be the correct charge as much as abandonment if this is your protocol. And that's fine that your protocols don't allow this to happen. But it's not negligence or abandonment for every service. This is something that happens daily in the areas that I work, and not an uncommon practice with the field of EMS.

Shane

NREMT-P

PS - Your posts would still be much easier to read with a single period followed by a space instead of a series of periods. It makes me wonder if your spacebar is broken, but there are spaces between words so that can't be it.

[itku2er]

OK SHANE

I was just making a statement about my area.

I know things are different where you are from.

But that doesnt give you the right to keep picking on me.

I know the protocols here i would love to share them with you any time you are willing to get an open mind and read them and not critize me for them.

I personally think you need to listen and read instead of always jump my case about things.

YOU NEED TO LAY OFF AND QUIT PICKING ON ME DUDE......

NOW CAN YOU READ THIS OR DO I NEED TO TYPE IT ONE WORD AT A TIME AND LET YOU PASTE IT TOGETHER?

[primemedic01]

OK SHANE

I was just making a statement about my area.

I know things are different where you are from.

But that doesnt give you the right to keep picking on me.

I know the protocols here i would love to share them with you any time you are willing to get an open mind and read them and not critize me for them.

I personally think you need to listen and read instead of always jump my case about things.

YOU NEED TO LAY OFF AND QUIT PICKING ON ME DUDE......

NOW CAN YOU READ THIS OR DO I NEED TO TYPE IT ONE WORD AT A TIME AND LET YOU PASTE IT TOGETHER?

For one thing, Shane has acknowledged that these are the protocols for your area. He was not criticizing you for your protocols, he just adding that this isn't the protocol everywhere. He was building off your post. It almost seems like you are the one who has a problem dealing with the fact that things are different in other places.

Maybe you just skipped over

I don't think negligent would be the correct charge as much as abandonment if this is your protocol. And that's fine that your protocols don't allow this to happen.

I've noticed a trend in your posts that whenever someone adds somethings to it, or states their opinion on it, or disagrees with it, you automatically jump down their throat. You've done it to me. I think maybe it is you who need to read the posts closer and put a little more thought into what is actually being said.

And with the "..........." issue, people have asked you to stop doing this numerous times, it's irritating, difficult to read, and frankly just annoying. You are 41 years old, and should familiar with correct sentence structure.

Other than that, Happy Friday and have a great weekend!

[medic001918]

For one thing, Shane has acknowledged that these are the protocols for your area. He was not criticizing you for your protocols, he just adding that this isn't the protocol everywhere. He was building off your post. It almost seems like you are the one who has a problem dealing with the fact that things are different in other places.

Maybe you just skipped over

I've noticed a trend in your posts that whenever someone adds somethings to it, or states their opinion on it, or disagrees with it, you automatically jump down their throat. You've done it to me. I think maybe it is you who need to read the posts closer and put a little more thought into what is actually being said.

And with the "..........." issue, people have asked you to stop doing this numerous times, it's irritating, difficult to read, and frankly just annoying. You are 41 years old, and should familiar with correct sentence structure.

Other than that, Happy Friday and have a great weekend!

Thanks Ryan. Not sure there's much more that I can add. And I didn't jump down your throat. I made a suggestion. You can choose to make a change based on the suggestion or not. That's for you to decide. Remember that you are on an internet forum and the way you type is as good as your spoken word in person. Now you can pick how you want to portray yourself among your fellow colleagues.

As far as protocols go, I have no problem discussing protocols. And like Ryan has already mentioned, I already acknowledged that protocols are different from area to area. If your protocol states that if an ALS provider is on scene they must ride the call in to the hospital, then that's fine and the way it's done. It's not how it's done here. It's not negligence. It's not abandonment. So your blanket statement about it being negligence doesn't fly. Am I the one who needs to acknoweldge differences in protocol? Or should you look within yourself and answer that question as well. My mind is open and I'm willing to discuss differences in protocols any time you want to in a civil and intelligent manner.

Shane

NREMT-P