Basics and Intermediates ONLY No more BLS 911 ambulances?

[brentoli]

What about these super army medics? They think they are paramedics, but can only operate as an EMT-B in the civilian world. But try to pass themselves off as the best thing since sliced bread.

[Scaramedic]

If not then the ALS crew should be able to educate the caller as to when to call 911...

Can we use baseball bats or tasers or something?? :twisted:

Peace,

Marty

[AnthonyM83]

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

Aside from monetary reasons, why would one prefer having ALS only units?

And do you think BLS level crews are trained well enough to detect underlying problems to chief complaints that seem BLS on the surface.

[spenac]

Aside from monetary reasons, why would one prefer having ALS only units?

And do you think BLS level crews are trained well enough to detect underlying problems to chief complaints that seem BLS on the surface.

Did you mean why would one prefer "not" having ALS only units?

Definitly BLS are not trained or educated enough to decide what needs ALS.

[tator55]

Thank you for proving my point. You have proven that an EMT-b or EMT-I have no business deciding who needs ALS. So hurry go get your paramedic before the law changes.

Have all trucks respond with 2 paramedics. Maybe with all Paramedic staff they would be able to deny BS transports thus more than saving enough money to cover the extra cost. Plus with time and education people would learn that hey you can put a bandaid on yourself thus lowering call volume.

I am quite able to determine if ALS is needed on my call or not. There have been time i have canceled ALS because they were not needed, and there have been other times when i have requested ALS or asked ALS to step up their response because it turned out to be a more serious call than dispatched.

How is denying transport a sound policy? You don't want to transport a BS call as a Medic? Fine, leave it to BLS transport. Thanks for proving my point.

Aside from monetary reasons, why would one prefer having ALS only units?

And do you think BLS level crews are trained well enough to detect underlying problems to chief complaints that seem BLS on the surface.

I don't prefer ALS only transport units, thats the whole point of this discussion.

Yea, I do in fact believe that BLS crews have the ability to detect that there is something wronger than what it seems on the surface. Do i have to know exactly what condition it is? No, but if it exceeds my education as a Basic, then i will get on that radio and request an ALS response. Basics have the tools to determine if an ALS intercept is needed. They are called training, brains and equipment. If any vital sign is remarkably out of the normal range, with no good reason apparent (i.e. elevated heart rate for someone who twisted an ankle while running i would not call ALS for), and i would not hesitate to ask for ALS and expedite transport.

[spenac]

How is denying transport a sound policy? You don't want to transport a BS call as a Medic? Fine, leave it to BLS transport. Thanks for proving my point.

Yea, I do in fact believe that BLS crews have the ability to detect that there is something wronger than what it seems on the surface. Do i have to know exactly what condition it is? No, but if it exceeds my education as a Basic, then i will get on that radio and request an ALS response. Basics have the tools to determine if an ALS intercept is needed. They are called training, brains and equipment. If any vital sign is remarkably out of the normal range, with no good reason apparent (i.e. elevated heart rate for someone who twisted an ankle while running i would not call ALS for), and i would not hesitate to ask for ALS and expedite transport.

Well if you had more EMS experience than the underwear I am wearing I might consider your argument. But as it is every statement you made is BS. First I have authority to deny transport. I feel that anyone that feels every caller that asks to be transported even if it's just to go to lunch needs to get out of EMS and just get your taxi permit, you'ld make more money.

Before I got my EMT-I I thought I could properly decide what was ALS or BLS. How wrong I was. When and if you last longer than my socks in EMS and get some education you will see I am right. It scares the hell out of me kids barely shaving if shaving are making the call pretty much on who lives and who dies.

Go grow up, get some education, and send me money for new socks and underwear.

[tator55]

Well if you had more EMS experience than the underwear I am wearing I might consider your argument. But as it is every statement you made is BS. First I have authority to deny transport. I feel that anyone that feels every caller that asks to be transported even if it's just to go to lunch needs to get out of EMS and just get your taxi permit, you'ld make more money.

Before I got my EMT-I I thought I could properly decide what was ALS or BLS. How wrong I was. When and if you last longer than my socks in EMS and get some education you will see I am right. It scares the hell out of me kids barely shaving if shaving are making the call pretty much on who lives and who dies.

Go grow up, get some education, and send me money for new socks and underwear.

No thanks, I love volunteering, and I can speak clear English, so obviously i do not qualify as a taxi driver.

Then you are obviously a supermedic compared to what we have in Delaware. They cannot deny a transport, nor can any EMT, regardless of level. ALS can BLS release, in which case the Basics transport on the ambulance, and the medics get back in the suburban and go back to quarters.

Great way to encourage new people. "I am older, therefore what i say goes, no discussion" Dont ya love where the system is going where people who want to join in are discouraged by people dumping on them all day?

So obviously my argument has some type of substance to it, since if i was older (not a better EMT, just one with more time) you would consider it?

In the county I'm from, medics who treat BLS like dirt don't last long. They either leave or learn to respect us.

[brentoli]

No thanks, I love volunteering, and I can speak clear English, so obviously i do not qualify as a taxi driver.

Then you are obviously a supermedic compared to what we have in Delaware. They cannot deny a transport, nor can any EMT, regardless of level. ALS can BLS release, in which case the Basics transport on the ambulance, and the medics get back in the suburban and go back to quarters.

Great way to encourage new people. "I am older, therefore what i say goes, no discussion" Dont ya love where the system is going where people who want to join in are discouraged by people dumping on them all day?

So obviously my argument has some type of substance to it, since if i was older (not a better EMT, just one with more time) you would consider it?

In the county I'm from, medics who treat BLS like dirt don't last long. They either leave or learn to respect us.

You are 18. You have taken a 120 hour class taught at the 8th grade reading level. What is there to respect? I am young and an EMT-B and I do not DEMAND respect, as you put it. I know where I stand, and I know what I don't know. No one with 120 of training, yes training; not education, belongs on a 911 ambulance. You really don't even belong on a transfer ambulance. That could be a thread all on it's own though.

[spenac]

No thanks, I love volunteering, and I can speak clear English, so obviously i do not qualify as a taxi driver.

Then you are obviously a supermedic compared to what we have in Delaware. They cannot deny a transport, nor can any EMT, regardless of level. ALS can BLS release, in which case the Basics transport on the ambulance, and the medics get back in the suburban and go back to quarters.

Great way to encourage new people. "I am older, therefore what i say goes, no discussion" Dont ya love where the system is going where people who want to join in are discouraged by people dumping on them all day?

So obviously my argument has some type of substance to it, since if i was older (not a better EMT, just one with more time) you would consider it?

In the county I'm from, medics who treat BLS like dirt don't last long. They either leave or learn to respect us.

Ah almost earned a little respect but then you used the V word.

If you think it takes supermedic to say no to a guy that wants transported to lunch you really are just a taxi driver wanta-be.

Oh welcome to EMS. I am happy to help the youth that don't think they're GOD. Basics and Paramedics look to work with me. I teach, I work, but I also tell you how it is. When I was growing up more than 30 years ago a wrestler used to say "I talk the talk, and walk the walk". And thats me, I don't go with the crowd, I go for whats best for my patients and at times thats educating them by saying no. Maybe thats some of your problem you need to be told no. Open your mind young grasshopper and I will teach.

[CBEMT]

What i think i was getting at is that people who support BLS emergency ambulances cite clinical conditions such as those listed in order to justify their existance, but the examples given are hardly emergent conditions that didn't warrant a 000 call to begin with. Kind of makes it a senseless argument from my twisted perspective

I think I see where you're going, but you're looking at it the wrong way.

You don't consider "BLSable" patients to need EMS in the first place. Well, guess what? You're right. Now, I don't know if people don't call 911/000 for this stuff where you are, but they do in the States. And most of them will not accept any outcome to the call other than transport to a hospital ED.

In jurisdictions where EMS is not able to refuse that patient, taking an ALS unit out of service to transport said nitwit is the worst abuse of resources for an EMS system that I can think of with the possible exception of cadaver transport. BLS transport is more than indicated.

Seattle has an interesting system in this regard. It's fire-based but it has to be the best fire-based system anywhere, and probably one of the top EMS systems in general (I know Dust doesn't agree, but oh well).

ALS patients go by SFD ALS "Medic One" transport units (their medic school is something of a legend in the area). SFD BLS units will transport life-threatening patients that are closer to the ER than ALS is to the patient, and respond with ALS to assist and drive as needed.

The BLS trucks also respond to the obvious BLS calls. If the patient is not appropriate for ALS and can wait a little bit to get to the hospital (taxi ride), SFD BLS will request an AMR unit to transport the patient. AMR by contract is required to keep x number of units available for nothing but SFD transports at all times.