While I am trying not to get into the BLS vs. ALS debate, could I just point a couple of things out?
The higher up the chain your credentials get, the better your assessments get.
Assessment is not just about ABC, though that is the early part, it is much more complex, even in out of the hospital settings. Without understanding of basic and clinical sciences it is impossible to perform any meaningful assessment. Based on the current EMT curriculum, only a very limited set of pathologies are even mentioned, certainly not detailed. (please do not tell us all how your basic class was so much more, until you are reading Robins and coltran Pathological Basis of Disease, Harrisons Principles Internal Medicine, Sabastion Textbook of Surgery, or Nelson's Pediatrics you got a grossly oversimplified education of pathology, probably so much so most of it doesn't even qualify as "true.")
With such a limited view it is absolutely impossible to even determine who is suffering from a lifetheatening condition, like thyroid storm, which isn't even mentioned in Emergency Care. How about acute renal failure? Meningitis?
The role of the Basic is to offer the most simple assessment and treatments aimed at preserving air going in and out and blodd going round and round. Whether it is bleeding, cardiac arrest, or obstructive airway disease, the main point if the providers role is to get a higher level of care involved.
This is by no means useless and shouldn't be downplayed as not helping. But to say Basic Life support is the foundation of anything is simply false. Basic science is the foundation of medicine. Some medical students will not even learn to do CPR untill their 3rd or 5th year. That is considerably along in their education. It is a skill taught to nonhealthcare providers, and even the healthcare provider level is passable by high school students and people with no medical knowledge or inclination. Even Instructors of such do not have to be healthcare providers.
More importantly, the amount of patients that are encountered with conditions where BLS as we commonly know it play a direct role with interventions is relatively small. (probably less than 5% of all patients encountered)
For those few patients though, BLS will likely have a positive impact.
What is the BLS provider going to do to prevent or mitigate shock? Give high flow O2 which only makes a difference in a handful of pathologies? The highly disputed Trendelenburg position? A blanket despite prevailing movement towards theraputic hypothermia? Crystalloid solution? Attempt to maintain a SBP despite no direct correlation to perfusion status? This is a very ill concieved argument.
Good airway management? That sounds very generous. Providing some form of airway management is a situation where BLS is worth its weight in gold, but again, basic CPR teaches airway positioning and ventilation with both barrier device and BVM. A patient is no better benefitted from a head tilt chin lift by an OPA or NPA (they are devices so you don't need to allocate somebody to the airway maneuver) as well, a BVM and basic adjunct like NPA or OPA is no worse than a combitube, king, or whatever crash airway you like. Even intubation prehospital in under serious scrutiny.
If you are going to argue the benefits of BLS, that's cool, I'll help. But what you presented is not a winner.
The higher up the chain your credentials get, the better your assessments get.
Assessment is not just about ABC, though that is the early part, it is much more complex, even in out of the hospital settings. Without understanding of basic and clinical sciences it is impossible to perform any meaningful assessment. Based on the current EMT curriculum, only a very limited set of pathologies are even mentioned, certainly not detailed. (please do not tell us all how your basic class was so much more, until you are reading Robins and coltran Pathological Basis of Disease, Harrisons Principles Internal Medicine, Sabastion Textbook of Surgery, or Nelson's Pediatrics you got a grossly oversimplified education of pathology, probably so much so most of it doesn't even qualify as "true.")
With such a limited view it is absolutely impossible to even determine who is suffering from a lifetheatening condition, like thyroid storm, which isn't even mentioned in Emergency Care. How about acute renal failure? Meningitis?
The role of the Basic is to offer the most simple assessment and treatments aimed at preserving air going in and out and blodd going round and round. Whether it is bleeding, cardiac arrest, or obstructive airway disease, the main point if the providers role is to get a higher level of care involved.
This is by no means useless and shouldn't be downplayed as not helping. But to say Basic Life support is the foundation of anything is simply false. Basic science is the foundation of medicine. Some medical students will not even learn to do CPR untill their 3rd or 5th year. That is considerably along in their education. It is a skill taught to nonhealthcare providers, and even the healthcare provider level is passable by high school students and people with no medical knowledge or inclination. Even Instructors of such do not have to be healthcare providers.
More importantly, the amount of patients that are encountered with conditions where BLS as we commonly know it play a direct role with interventions is relatively small. (probably less than 5% of all patients encountered)
For those few patients though, BLS will likely have a positive impact.
What is the BLS provider going to do to prevent or mitigate shock? Give high flow O2 which only makes a difference in a handful of pathologies? The highly disputed Trendelenburg position? A blanket despite prevailing movement towards theraputic hypothermia? Crystalloid solution? Attempt to maintain a SBP despite no direct correlation to perfusion status? This is a very ill concieved argument.
Good airway management? That sounds very generous. Providing some form of airway management is a situation where BLS is worth its weight in gold, but again, basic CPR teaches airway positioning and ventilation with both barrier device and BVM. A patient is no better benefitted from a head tilt chin lift by an OPA or NPA (they are devices so you don't need to allocate somebody to the airway maneuver) as well, a BVM and basic adjunct like NPA or OPA is no worse than a combitube, king, or whatever crash airway you like. Even intubation prehospital in under serious scrutiny.
If you are going to argue the benefits of BLS, that's cool, I'll help. But what you presented is not a winner.
