Basics and Intermediates ONLY No more BLS 911 ambulances?

[spenac]

So should we stop having Basics and Intermediates on 911 ambulances? Should all 911 ambulances be staffed with 2 Paramedics? Why or why not? Do you see conflict between Paramedics and lower certifications?

Here is the shocker, I say only Paramedics should be on 911 ambulances. I as an EMT-I and for many years before an EMT-B in rural areas often as the highest level of certification feel this way because with the limited education we have, we should not be making medical judgements. Regardless of what the books say we have to diagnose in order to treat, and we have to little education to do it right. I am in a very remote area, with very progressive protocols. Of the more than 50 drugs maintained on our BLS/MICU ambulance I administer all but 5 without calling for medical authorization. In my service and surrounding areas services the paramedics treat me as a fellow paramedic. At my second service I am often put with paramedics that honestly should not be in EMS, because the director knows I know my stuff and trusts that I will intervene on behalf of the patient. I have kept on more than one occasion the idiots from killing somebody. Yes I am blowing my own horn, I am darn good at what I do and as such I have the freeness of speech to say it ain't right.

I have self educated myself, reading, studying, picking brains of medics, nurses, and doctors. I have took it on myself to attend any education programs I can get to. No one with the limited education we have should have so much responsibility. It is also unfair to have 1 paramedic stuck making all the calls. Yes 90% of all calls could probably be taken safely POV if we are all honest on here. But when somebody really needs help why should one person be stuck making the call. I am going to go for Paramedic soon, to have more education to back the treatments I have to give already and to be able to handle more in the future. I will also be pushing to have only Paramedics staffing 911 ambulances.

[samanthamedic8]

I dont think that the trucks should be ran with two medics. But at least one would be nice. There are your calls that a B or an I can take and there is nothing wrong with that. But then there are the ones that a medic needs to take. I am and I and alot of the time the service i work for has crews of Bs and Is and no medics. This im not ok with, if you have the capability to do a medic per shift then do it. Split your codependent medics up and have one on each shift. And im not talkin a hosptial RN to be your ACLS keep them in the hospital. Now if your service is one that hires RNs then thats great cause you will train them like a medic and they will know the way things are ran. But if they just work in the hospital and have never stepped foot in an ambulance then keep it that away.

[AnthonyM83]

I'll defer to the old thread by DustDevil asking anyone to justify having EMTs on 911 ambulances (or similar). Only one people could come up with was financial reasons.

[tator55]

NO.

Its an incredibly wasteful system in my mind. 2 medics to transport someone who has been throwing up for a day? Where is the point in that?

2 medics to transport a lil old lady who fell off her chair and has a small bruise on her forearm? again, where is the point?

EMD should be able to determine the seriousness of a call, and disptach the appropriate level of response. If it is miss-EMDed, the basics on scene will recognize that and ask for an ALS intercept.

IMHO, having only ALS transport units is a waste of money and resources that could be put to better use.

[AnthonyM83]

Tator, financial reasons aside, is it still a waste of money?

[samanthamedic8]

So many times you show up on scene and you have been dispatched to someone with SOB, and you end up with a blue. No that Bs or Is cant handle this it would just be nice to have a medic. So thats why I think every truck should have one medic.

[brentoli]

NO. Yes.

Its an incredibly wasteful system in my mind. 2 medics to transport someone who has been throwing up for a day? Where is the point in that? What made them throw up for the day? What else is there to the story? Dehydration? Cardiac issues? Internal bleeding?

2 medics to transport a lil old lady who fell off her chair and has a small bruise on her forearm? again, where is the point? What caused her to fall? What is the underlying nuerological condition? Orthostatic hypotension?

EMD should be able to determine the seriousness of a call, and disptach the appropriate level of response. If it is miss-EMDed, the basics on scene will recognize that and ask for an ALS intercept. I am a dispatcher. I can only dispatch the information I am given over the phone. I don't care how much I interogate, people will only tell me what they want to tell me. EMD sucks by the way. It is useless. It doesn't prioritize worth a crap.

IMHO, having only ALS transport units is a waste of money and resources that could be put to better use. What better use?

[akroeze]

So many times you show up on scene and you have been dispatched to someone with SOB, and you end up with a blue. No that Bs or Is cant handle this it would just be nice to have a medic. So thats why I think every truck should have one medic.

what's a blue?

[brentoli]

So many times you show up on scene and you have been dispatched to someone with SOB, and you end up with a blue. No that Bs or Is cant handle this it would just be nice to have a medic. They cant handle it. Thats the thing. They can only do CPR and bag a paitent. No ACLS skills. I'll be the first to tell you, I can do CPR, and I can do ventillations, but I can't handle a code. Any EMT-B that tells you they can is a liar.

So thats why I think every truck should have one medic.

what's a blue?

I assumed a cardiac arrest. Maybe she meant something diffrent.

[spenac]

Darn Brent the dispatcher, you have given some darn good comments here. I might have to be a little nicer to you.

Again I do almost everything Paramedics do. I do chest decompression, cricothyrotomy, pace, RSI, etc. But I should not be doing it, and the paramedic should not have to do it relying on an EMT-I or B. There should be someone at equal level to help or step in if things go bad which they can and will.