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ALS or BLS? Help me decide...


benanzo

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Be careful when you Google. There are many EMS organizations in Washington who call themselves Medic1. It's all a play off the original which is King County Medic One. When you Google it, make sure you include the "King County" as part of your search criteria.

King County Medic One has one of the best EMS systems in the US. They have a very progressive and involved medical director. They are ALS only which means their paramedics only do ALS calls. If it's BLS the local BLS truck takes the call. While their system won't work everywhere, I think they do an awful lot from which the rest of us could learn.

Hope that helps.

-be safe.

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I did some homework, but I'm still confused one issue...is it AMR that provides the BLS transport for King County, or does a King County ambulance staffed by a BLS crew do the BLS transport?

They seem like they are actually from another world, their education standards should be used to model similar service IMHO. I think that the citizens of King County seem to have a pretty awesome ambulance service. I'm sure they (and the paramedics who work for them) are very proud of this.

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KING County does NO BLS transports or calls. The private company AMR handles all BLS emergencies. If ALS is needed, then the Medic1 guys roll. You are correct. It is an awesome service and if I were younger or just getting started, I would give them very serious consideration.

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He has pneumonia again, probably courtesy of the SNF unit. I do not agree that BLS should handle this, I think the SNF unit needs to learn how to activate an ALS response. This patient needs IV access, needs to be monitored, probably needs rehydration, and could possibly benefit from pharmacological interventions which a BLS unit cannot offer. I would have the ALS respond...................

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KING County does NO BLS transports or calls. The private company AMR handles all BLS emergencies.

So... if they get on the scene and find a BLS emergency, what do they do? Babysit the patient for fifteen to twenty minutes til a BLS unit shows up? Refuse and leave? Just seems like a lot of weird loopholes in that system.

Not to mention that any system that has basics evaluating whether or not patients need ALS is FAR from being a great system, no matter how smart their medics are.

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So... if they get on the scene and find a BLS emergency, what do they do? Babysit the patient for fifteen to twenty minutes til a BLS unit shows up? Refuse and leave? Just seems like a lot of weird loopholes in that system.

Not to mention that any system that has basics evaluating whether or not patients need ALS is FAR from being a great system, no matter how smart their medics are.

Any basic worth their weight can look at a patient through an assessment and determine what, if any ALS could be done, and determine from there. But, then again, we come from two different worlds, and I guess things are a bit different here.

BLS assessment, initiate ALS, start transport, treat enroute. Meet ALS if possible, if not, complete transport.

I must ask, what does the BLS transport do if the patient turns emergent?

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Let me correct my phrasology. They are not DISPATCHED to BLS emergencies, if they happen to roll up on one, they will transport.

There is no need for babysitting, the first responders do that. The guys on the engine or flycar, they babysit and call for ALS or BLS.

This is for Dust....as critical as you are of US EMS systems, this is one I think you should study before passing judgement. I am not saying they are the end all and be all but they have their act together, its been an excellent system for years and if we all followed their lead we would have the salaries and respect we deserve across the nation.

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I'm not passing judgment. But if they are picking and choosing their patients, there are very well established risks involved in that process, which does not speak well of their system.

They may be the most clinically sophisticated medics in the universe, but if they are neglecting to respond to patients who need them, they suck. Such is the risk of a tiered system.

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