ALS using Lights and Sirens back to the hospital

[captainstandup]

In our service L&S rarely used during transport to hospital. Exceptions include Penetrating trauma, S&S AMI needing interventional cath, Stroke, any life threatening or quality of life threatening condition that cant be managed by the crew. I must admit I can understand the rationale for running emergency in California traffic though. Traffic around Raleigh, Durham, Greensboro and for sure on I-77 around charlotte has reached a point that easily delays transports for an hour and sometimes three unless you take measures to get around it. Even a BLS to the hospital can be "urgent" simply due to limited resources, patient and crew comfort and the need to return crews to service as quickly as possible.

[Just Plain Ruff]

Captain

I can understand the need to run hot for all the things you mentioned except one thing.

Getting a unit back in service.

that just doesn't compute in my head. running l&S with it's intrinsic risks to public, patient and responders just to get a unit back in service runs counterproductive in my head.

Can someone explain this to me?

[Just Plain Ruff]

Captain

I can understand the need to run hot for all the things you mentioned except one thing.

Getting a unit back in service.

that just doesn't compute in my head. running l&S with it's intrinsic risks to public, patient and responders just to get a unit back in service runs counterproductive in my head.

Can someone explain this to me?

[JPINFV]

ok let me ask a controversial question. Which I'm sure will bring some wildly heated and probably angry responses.

Should bls ever be dispatched emergency?

Assuming limited ALS resources: Yes.

Assuming unlimited ALS resources: No.

There are reasons that I can think of that might [yes, I'm leaving as much wiggle room as possible on here] warrant a BLS unit to respond and transport code 3. Even then, an ALS unit would probably be preferred for the extra services that they offer [pain management]. An example would be a time critical, non-life threatening event such as moving a patient to a specialty hospital for limb reattachment.

[JakeEMTP]

Traumaking, I don't think anyone in this topic is questioning fire engines going LS to fires....

Is that what he was talking about?

[AnthonyM83]

Seemed like he was defending going code to a dumpster fire (which seems reasonable...you don't know if it's up against a building that might light)...but I guess it was from a joke comment Ruff made.

[Dustdevil]

i have a number of colleagues who believe and some of those colleagues are on this site, they do not believe that a bls ambulance has any business being dispatched L&S unless there is an als ambulance behind them.

Emphasis on the relevant part of that sentence.

I like the way that sounds!

A BLS "ambulance" has no business in EMS. Therefore, a BLS ambulance has no business having lights or siren. Therefore, a BLS ambulance has no business using lights or siren. Therefore, a BLS ambulance has no business being dispatched with lights and siren. Therefore, a BLS ambulance has no business in EMS. And so on...

[tniuqs]

My partner and I almost fell over when we walked into a nursing home to see fire guys standing there looking shocked while the staff was doing "compressions." The pt's entire body was bouncing off the bed, perfectly straight. I don't know about light as a feather, but stiff as a board...ya think. :shock:

Ok Ok: I got a great question once...

So just how much Valium does it take to get a jaw open in ............. Asystole ?

cheers

[Just Plain Ruff]

Dust, I'm disappointed in you. It took you 4 pages and about 4 days to get into this conversation. You are slacking off in your days of being head over heels in love.

[zmedic]

Not to start a fight with Dust, who'd win, but I'd like to talk about the idea of not having BLS rigs. I worked in a county where we were contractually obligated to have a medic on every rig, and that seemed really wasteful. A large percentage of our patients, like 80%, could have been managed on the BLS level. They were stable, didn't need drugs/pain control. It costs the system a whole lot more to have a medic on every truck. A well trained EMT should be able to handle a lot and get ALS backup when they are in over their head. (Clearly ALS should be dispatched immediately to certain calls, like chest pain, SOB, etc.) Thoughts?