BLS refusing handoffs from ALS?

[EMT City Administrator]

Hmm........ let's keep this in check.

[hfdff422]

Actually, this is likely not a State to State thing, more likely it is a system to system difference in protocols (hospital to hospital). It is frequent here that BLS level patients get checked by a medic, but get transported BLS.

[Thunderchild145]

Point being, paramedics have better assesment and treatment skills than EMT-Basics. Even -without- ALS supplies like IVs, cardiac monitors, etc. etc. etc. The paramedic using his knowledge of A&P is better prepared to assess the patient and give a handoff to the ER. And, as before mentioned, it's usually not acceptable for an ALS provider to turf a patient to BLS providers, at least here.

[Asysin2leads]

You know, I guess I'm kinda surprised someplaces have a problem with ALS handing off to BLS. Never thought it was such a big deal, really. If the patient is stable, the BLS crew is comfortable, and everything is on the up and up, I think its efficient use of resources.

[ERDoc]

When I was in the field in NYS, this issue came up. We contacted the state and were told that on a BLS call an ALS person is not acting as an EMT-CC or paramedic, but as an EMT. Due to this, they are able to transfer care to another EMT. Obviously this pertains to NYS and may vary by state. I seems like a waste of resources to force an ALS provider to take a BLS call when there is a BLS provider that can take it.

[ERDoc]

Point being, paramedics have better assesment and treatment skills than EMT-Basics. Even -without- ALS supplies like IVs, cardiac monitors, etc. etc. etc. The paramedic using his knowledge of A&P is better prepared to assess the patient and give a handoff to the ER. And, as before mentioned, it's usually not acceptable for an ALS provider to turf a patient to BLS providers, at least here.

Doesn't seem like these skills are of any use if you can't use them to care for the pt. I imagine even an EMT could pass along the message to the ER that the pt has RUQ pain. I still don't see why this needs a medic, especially if there are no ALS supplies.

[whit72]

thunderchild wrote:

Point being, paramedics have better assesment and treatment skills than EMT-Basics. Even -without- ALS supplies like IVs, cardiac monitors, etc. etc. etc. The paramedic using his knowledge of A&P is better prepared to assess the patient and give a handoff to the ER. And, as before mentioned, it's usually not acceptable for an ALS provider to turf a patient to BLS providers, at least here.

Ummm a paramedic without any ALS equipment is what..........an EMT.

Pt. assesment is not an ALS skill.

As far as it not being acceptible for and ALS provider to hand off to a BLS provider, that dosent say much for the competency of your BLS providers.

[monster_medic]

What i think has been overlooked here is that it is not abandonment or neglegent to hand ''down'' a pt to a BLS crew if the ALS crew did only basic skills on the pt. Now if ALS skills were preformed,then no way could or should the pt. be handed down ie. IV intubation, or any drug usage. From where i stand personally i will hand down a pt. to another crew ONLY if i am comfortable with it AND the other crew is comfortable with it. The company i work for does not run two basics on a truck so we only run ALS with MICU capabillities depending on staff on truck.

[mediccjh]

You know, I guess I'm kinda surprised someplaces have a problem with ALS handing off to BLS. Never thought it was such a big deal, really. If the patient is stable, the BLS crew is comfortable, and everything is on the up and up, I think its efficient use of resources.

Thank you!

[AnthonyM83]

It's done extremely routinely in this area and really here you need fire to stay available for other ALS calls, because it's call after call in some areas.

So, I'm just going theoretical here...could an EMT EVER hand down to a First Responder for transport? I'd say no because it's not a BLS versus ALS, it's now title of provider issue (but then again that logic isn't based on any rules I know of), but I'm just bringing it up for kicks as a theoretical.