ALS upgrades

[gaelicfirefighter]

As a BLS provider in a large urban area with transport times under 10 min, we have a numer of protocols and smo's we must consider when upgrading to and ALS response. What are the reasons you have to upgrade (your protocols) and what personal reasons would you consider upgrading.

I have uploaded our:

EMS Policies and Procedures

First Responder SMO's

BLS SMO's

ALS SMO's

Dispatch Protocols

Look under Resouces. Then downloads. Then Policies - Enjoy!

[JPINFV]

In the county I worked in (ALS first response for 911 calls, no private company paramedics), the ambulance companies set their own protocol for a code 3/call medic (resp/cardiac compromise, internal hemorrhage, and imminent birth for mine) with the only county protocol to be to transport BLS is transport time is under response time. In general, unless you were calling calling medics or transporting emergent for insanely stupid reasons, there seemed to be little oversight past the company. It is important to note that for 789 sq. miles of county area (not all, but mostly, populated either) there were just over 20 hospitals with an emergency department, so short transport times are generally the rule, not the exception.

For a "non-emergent" transport going to an ER, (a misnomer since probably a majority could be classified as urgent and a measurable amount could be considered emergent), I considered the entire patient. Simply put, chronically ill patients do not fit well into the boxes normally built by EMS officials and educators. Yes, it's nice to say that a patient with an irregular and borderline tachycardic patient should get ALS. That's nice, but considering the number of SNF patients that fall into that category (or, God forbid, an EMT-B actually puts the "Sick-Not Sick" CE patient assessment into use), the fire department would be run ragged. Due to those conditions, in general, ALS upgrades were based on how comfortable the crew was with the patient, and remember, ignorance is bliss.

To add one final thing to the above, there are plenty of calls that warrant an ALS first response (abnormal labs is one of my pet peeves), but not necessarily an ALS 2nd response/emergent transport.

[Dustdevil]

I have uploaded our:

EMS Policies and Procedures

First Responder SMO's

BLS SMO's

ALS SMO's

Dispatch Protocols

Cool move. Plus 5. :thumbright: