Does your ALS transport?

[DED1645]

Does you ALS have the ability to transport patients? Do you run combination rigs with an EMT and a medic? What's the breakdown in your neck of the woods?

[emTpromises]

Los Angeles is divided into "L.A. City" and "L.A. County" fire areas. City responds with their own ambulances; county contracts with ambulance companies to arrive on scene with them. I work for one of the companies that runs with county--if the transport is deemed ALS, the county medic rides with us in the ambulance and the squad follows us to the hospital.

Both city and county show up on scene with at least one medic. The ambulance companies that run with county are usually staffed by two EMTs.

Our company also employs a few paramedics. They are mostly on board to facilitate ALS IFTs. If a medic rig shows up on a 911 call, they are usually still treated as BLS. In L.A., if one wants to truly practice as a medic in emergency situations, one's main goal must be the fire department. L.A.'s EMS system is fire-based and they run the show, including determining whether a patient is ALS criteria or not.

The short answer to your question--it depends on which area of Los Angeles from which you call 911 as to whether you will be transported by the ALS responders or if it will be a private, contracted ambulance.

[Dustdevil]

ALL ambulances are ALL medics, ALL of the time.

There are no EMTs on emergency ambulances.

[JakeEMTP]

We only have ALS here. Medic/Medic ambulance crews. Therefore, yes, we transport.

[p3medic]

Tiered system, ALS and BLS, both in ambulances. ALS have the ability to refer pts for BLS transport after ALS assessment. Some calls get only a BLS response, some get a fire dept. first response. So yes, ALS can and does transport.

[JonathanGennick]

There are two medic services in a neighboring county that I'm familiar with. One runs medic/medic, the other medic/basic. Both transport. I've never seen a fly-car type arrangement in my neck of the woods.

Edit: Actually, I'm aware of at least one system downstate that places medics in fly-cars. But there's nothing like that up here in the area in which I work.

[strippel]

We run 10 ambulances during the day. 4 are BLS (2 EMTs), 6 are ALS (1 Medic/1 EMT, sometimes 2 medics depending on staffing).

We normally handle our own city/suburban 911 calls, but frequently get called to assist the volunteer BLS out in the county. They arrive first, or we get there at the same time, we ride along in their ambulance. Otherwise, it's our call, and they go home.

[Dustdevil]

Just wanted to add, that even the first responders where I live are all ALS. EMTs do nothing but drive fire trucks in my neck of the woods.

[jmp6753]

In my area, virtually everyone is a medic. Ambulances (private) have a medic and EMT-IV tech. City fire has medics on all their engines and trucks as well. Some of the very rural engine crews are EMT. Had a call not to long ago with 4 medics on the ladder co, my partner was a medic and I had a medic intern...7 medics...poor patient

[Riaan]

Heaven, thats what it sounds like in some other places!

I am the only ALS paramedic and drive a response vehicle work from 7:30 in the morning until 16:30 ongoing from mon. to fri.(standby after 16:30 until next morning every day, standby 24hrs weekend and every 2nd weekend off from 16:30(fri) until mon. 7:30).

What happens is I respond to all emergency calls (collapse cases to m.v.a.'s etc.) asses pt/s and assist when pt/s need ALS assistance or when I administered meds. I do assist when in hosp confirm ICU transfer or red code pt transfer (ALS).