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Old 03-14-2008, 08:50 PM   #1
Jayxbird521
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What is considered a BLS call in your area


In my area chester county pa a accadent/entrapment, fall, stabing, or chest pains and maternity are bls i think some of them need to be als becase half the time we end up requesting the medics.


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Old 03-14-2008, 09:18 PM   #2
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Chest pains are handled as a basic first response? I think I'd need to know a little more about your area before I know how to respond to this situation.


In the area that I worked (Southern California), all 911 calls were paramedic first response.
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Old 03-14-2008, 09:30 PM   #3
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well, i dont know about your area but in some places every call has a bls first in with medics to follow if need be. some places only have a few medic rigs to cover several counties so youd better be damned sure you need em before they get toned.

i have what some would call the benefit of working in a densly populated urban setting. most of the fire depts are als and there are a hundred privates that run als with it seems a new one starting up every week. i very rarely find myself in the situation of not having a -p truck when i need one. quite the opposite, i end up cancelling medics on calls that "sounded bad" and thus were dual dispatched.
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Old 03-14-2008, 09:55 PM   #4
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Originally Posted by KEVD18 View Post
i have what some would call the benefit of working in a densly populated urban setting. most of the fire depts are als and there are a hundred privates that run als with it seems a new one starting up every week. i very rarely find myself in the situation of not having a -p truck when i need one. quite the opposite, i end up cancelling medics on calls that "sounded bad" and thus were dual dispatched.
I worked between the two extremes. 911 first response via "EMS based fire suppression," but there weren't any paramedics with the private companies in the county. Thus, SNF->ER calls were either 911 or BLS. Yea, lets just say that the SNFs defaulted to BLS if there were any doubts on the patient's condition.
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Old 03-14-2008, 10:18 PM   #5
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Yea, lets just say that the SNFs defaulted to BLS if there were any doubts on the patient's condition.
well yeah, i mean its cheaper right?

in my area, every nursing home is required to have a transport contact with a private service. its supposed to be just for routine txp but, well, some people are stupid. some nurses think that they are supposed to call their contract provider for EVERYTHING. ive seen my dispatcher have to call the local fd for arrests they called us for. us being a company whos base is 40 minutes away. ive also been present for the phone call for the pt complaining of diff breathing. so my dispatcher asks all the assesment questions to ascertain the level of difficulty. when he figures out the pt is really in trouble and says ok well we cant help you but ill call the local rescue, the story suddenly changes and the pt gets better. they dont want a box assignment showing up and causing a ruckus. they just want an ambulance.

oh stupid people....
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Old 03-14-2008, 10:51 PM   #6
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pretty much anything where and IV isnt place, the monitor isn't put on, or a med, other than O2, isn't given... so that leaves pretty much psychs, domestics, and b.s. calls
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Old 03-14-2008, 10:54 PM   #7
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Quote:
Originally Posted by Jayxbird521 View Post
In my area chester county pa a accadent/entrapment, fall, stabing, or chest pains and maternity are bls i
I know an EMTB can handle all of those emergencies, but I would feel more comfortable if, in addition to the basic, someone else was on the rig, such as an I or P. Like I said, BLS providers can indeed treat those patients, but often I think ALS should be needed (ESPECIALLY depending on the longer response time. Few minute transport? not as much). Not saying this about your particular area, there is only so much a BLS crew can do with a cardiac arrest, for example, before ACLS is needed.

***I am NOT at all saying Basics can't do anything; I completely disagree with that, but we can argue this in a different thread (I think there is one already out there) if need be***
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Old 03-14-2008, 11:54 PM   #8
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I know an EMTB can handle all of those emergencies,
**please dont intrepret the following as bls bashing. im a bls provider so it really wouldnt be logical to bash myself**

define handle? are we able to reduce preload and afterload, reduce myocardial oxygen demand, treat hypotension, complete the thrombolytic checklist, examine the electrical conduction of the heart so as to accuratley prepare the er, draw labs so as to reduce the door to drug time etc et al.

sure, we can control bleeding, asa and nitro(either prescribed or unit supplied), stabalize c-spine. we can even deliver a baby(assuming nothing goes wrong right). but real treatment isnt in our scope. medics can really treat the problems, maybe not definatively but certaintly better than we can. remember, high flow diesel really isnt treatment, its what you do when you cant treat or treatment fails.

as a side note, i know some places have basics that can start lines and what not. this was written as a generalization
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Old 03-15-2008, 03:18 AM   #9
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It appears from reading all the posts, that there are different call out criterias for the different areas with regards to the level of care which is dispatched. I would think these call out criterias are used to manage the resources available for a certain area.

I work for a private service, yet have very good relationships (Personal) with the ALS from the the other private and government services, and we help each other out a lot, should the the one be busy. What I am trying to say is that at the end of the day we all have one common goal: The patient, no matter the level of care.

To answers your original post, although we have call out criteria, i don't follow them (My bad) strictly. Our BLS are dispatched to any call, and then back up will follow as soon as it is available (if not already dispatched). I don't think that ALS is only there for patient management, there are many other things for them to do, such as, quality control, training, scene safety and extra hands even for a green code. It would however also largly depend on the resources available, prior to dispatching on every call.

It is sad to see that: "you better be sure you need them before you tone them" it is an attitude that is not only witnessed on this side. It should not the end of the world if an ALS gets cancelled, but rather a case of would the ALS have been needed, he/she would have been there halfway already!!

Just to shed some light...
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Old 03-15-2008, 04:31 AM   #10
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define handle?
I guess not loosely enough you: we can treat them as we are trained to do in the situation until higher care (ie hospital) is available.
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