Paramedic Intercept Info.

[IslandEMS]

We currently have a small BLS service with 230+/- calls per year. We have 3 Paramedic providers that are often on call or available for intercept. I am looking for a way to provide ALS services when they are needed and when we are able to provide the coverage. We are not able to staff 24/7 365 with a paramedic so ALS licesure is not possible. Any ideas you might have or sources of information would be greatly appreciated.

[medic5587]

This is regulated by state. In Minnesota you can apply for a part-time ALS license. I would call your state regulatory board to see what is available for your service. My opinion only; the cost for an ALS service might not be justified by that low of a call volume? Good luck.

[IslandEMS]

In Michigan we have a similar law. Allowing for a 2 year with a 2 year extension to make a transition. Has anyone been part of a program to add advanced protocols to a system. With the staffing problems for rural ems it is hard to provide staff 24/7 above the bls level. It is also tragic to toss aside advanced skills since they can not be provided 24/7. I think the protocol changes might be the way to go. Does anyone have any such protocols?

[cfaulknor]

Well, I live down in Boyne City (about an hour away) we have a non-transporting ALS "Echo Car" that carries a drug box, a Lifepak 12, and other such ALS equipment. perhaps if you had a paramedic drive one of those around, then that would count as staffing, and would work for an intercept.

[Eyegor]

Since I am not up on MI DOH laws I can only give you a general picture. In rural upstate NY we have many 100% volunteer ALS agencies. The problem starts with that many of these agencies only have a small handful of ALS providers. This leads to the medics either getting burned out or vast gaps in coverage, usually both. Now many of our counties do priority dispatching but.... until a crew is assembled they never know if they are getting ALS or BLS. If the vollies can only muster a BLS crew and now must request ALS from a commerical provider you've lost valuable minutes when a intercept may take 20-30 minutes and the tones dropped 10 minutes ago.

I guess what I'm trying to say is that 3 medics does not an ALS agency make. Its not fair to your medics, your patients, or your dispatchers. Your goals are admirable. Keep working the problem.

[firemedic37]

I know of a ambualnce service that is a "PROVISIONAL" ALS service and they only have two paramedics and run approx. 250 - 300 calls a year. This is in Iowa where the states allows a "PROVISIONAL" service, meaning if they have a paramedic on board then they are ALS, if no paramedic shows up then they are just a BLS service.

[mstovall]

Hancock County Ky has a great set up. They make a few more calls than you, around 1500 I have been told. They have an ALS intercept vehicle that is in there central dispatch. The medic will respond to every call. Then, they will do an ALS assessment. If it is an easy BLS run, they go back to station. If it is an ALS run, they jump the truck and a vol. fire will run his chase vehicle to the main station. It works great for them and they would be a good contact for ideas on how to do this. PM me and I will get their info if you want it.

Michael

[unknown]

In Arkansas- they pray like all heck we have a Helicopter available, BLS isn't any good to that cardiac patient that is about to start circeling the drain........

[medic511]

Many state regulations, however well-intentioned, seem to me to work a real hardship in situations like Island is facing. Here in Utah, the state requires that to be a paramedic level response organization, requires having two medics on duty 24 x 7 x 365. Trouble here in Utah is that any organization, however large, only needs two but every ALS provider, however small, also needs two medics. Thus, you can run 4 or 5 street trucks with only EMT-I crews so long as you have two medics in a chase (supervisor, or rescue) vehicle on duty in your area. It gets worse when you read the rest of the rule, which requires that BOTH medics respond to any ALS call. So, what happens is that two medics respond in an SUV (we call them rescues here), then one hops out and gets in the ambulance and the other drives the rescue back to the station. The result is that only one medic does anything. But, and here lies the real absurdity in this state, if you have only one ambulance you STILL have to have two medics on duty (or on call) and they BOTH have to respond to the scene. Once at the scene, only one has to ride with the patient!

The state just does not seem to get it that having a Paramedic Driver is not really of much benefit to the patient. And yet these regulators consider themselves rational, intelligent people(?).

I think that in EMS we are less tolerant of this sort of absurdity than in many other fields because it has such an immediate and obvious impact on the care received by our patient and while this rule may make sense in a metropolitan area, it simply denies many patients ALS care in the most rural areas, whichare the areas that have the longest transport times, which are the very people who, IMHO, need ALS care the most.

[Dustdevil]

So, leave both medics in back and let an EMT drive them in.

Problem solved.