medicwithabullitt

my appologies, I reread your post and missed the part about the weopon and LS. I still would have gone ALS on this probably. Theres just too many unknowns

Due to the fact that this was a penetrating trauma and the area you described, I would say ALS. But then again there really isn't enough information to say. How big was the weapon or knife? Was it serrated? what was the loss of blood? Was he having SOB..? LS? more info about the initial assessment needs to be known before you can make this determination.

I have my own Opinions on "BLSing" Pt's. Esp if there is a ALS truck on scene. In our area this doesn't happen. ALS cannot turn a Pt over to BLS, regardless of Pt status.

Ok so anyone who has worked in EMS for a period of time has run into some type of similar situation at least once. With that being said I see allot of "what ifs" or "well if they would haves" We all know that " AMS" Pt's regardless off ETOH or Hypoglycemic or what ever, that are belligerent and uncooperative are difficult to assess. I don't see whats wrong with this video. The way I see it they had a uncooperative Pt for whatever his condition was and they did what they could to get the guy in their truck to transport him. Like someone said before, we weren't there so we only know a piece of the story that we seen on video. We can all sit here and criticise all day long and argue over a forum, but really, whats this going to accomplish. Some people over analyze things too much. There is no call that is perfect and that is why were use the term "practice" IMO

I guess its not for everybody. Im not in it to get rich, and it beats going in and doing the same job in a factory or office everyday. Ya it sucks working 24 hours away from your family and on holidays and weekends. I make a decent living and only work 9 days a month. So there are the "frequent flyers" that call you at 3 am for the same ol bs, on the flip side the job is fun and makes you feel good at times. Yes, there is alot of stress, but there are alot of times its fun. Where else can you go to work and sit around in your shorts and T shirt and get paid to do it. Its all in what you make it. I have been in the field for 11 years and will be in it for alot more to come. A trash man may make more money in some areas but what kid looks up to a trash man. I know its alittle off topic but just thought id share my thoughts... To each and his own.

Jake this is an example of the billing for ALS I AND ALS II:

Resident ALS-II ER $500.00

Resident ALS ER $425.00

Resident ALS Non-ER $350.00

Resident BLS ER $325.00

Resident BLS Non-ER $250.00

Non-resident ALS-II ER $600.00

Non-resident ALS ER $525.00

Non-resident ALS Non-ER $450.00

Non-resident BLS ER $425.00

Non-resident BLS Non-ER $350.00

Mileage per loaded mile: $7.75

(ER=emergency Non-ER=non-emergency, ALS=Advanced Life Support BLS=Basic Life Support)

I pulled this from my Distrct's billing department. Hope that helps a little,

Thanks medicwithabullit, but CCEMTP simply showing up does not warrant being able to charge as far as 9-1-1 is concerned. I will agree with Rid and saboats on that one. There does have to previous interventions preformed prior to transport. My argument (I use this term loosely) was that since we do transfers from hospital to hospital with drips and vents much like those stated above, and don't charge a SCT charge to the Pts, we don't need a CC prior to our EMT-P. I will agree that it does put a spin on the standardization issue, and for those of us who have taken this class, knowledge of these practices are very benifical. The problem is that there are hospitals out there who will give a medic a crash course on how to work the pump, and send us on our way. The next step for the discussion would be to find out the percentage of Pts who suffered from the lack of SCT support in these situations to justify the charges.

wow ALI you did your homework... I am not doubting this one bit, I know of a district that does it and was under the assumption it could be done. What you guys are saying does make sense, I just hope this district knows what they are doing is wrong..

I believe this is just a good way to get some CEUs and pick up some good knowledge, but the biggest bonus that I can see in this area is for billing purposes. The extra letters allow for high cost to the PTs....I may be way out of line here, but thats how I see things around my area.

You are correct big man If a CCEMTP is on a call then they can bill it as critical care transport or SCT. CCEMTPs are reconized in our state.

Good Job and it sounds like you handled yourself well. You maintained the airway and thats the most important thing you could have done.