How do you like doing IFT only at a BLS or ALS level ?

[emtbasic13]

I was just wondering how other emt's and medic's who work for a IFT only service like what they do ? Also is there realy any differance between a ALS and BLS transport in what you do in the back, besides monitoring meds ?

[DwayneEMTP]

I'm going to guess that you are a new EMT, or perhaps not an EMT yet. I'm not meaning to be offensive, but when you say, "besides monitoring meds" it shows that you have no real idea what the job of a medic or good basic is.

There is a world of difference between Basic and paramedic regardless of the type of work that you do. EMS is assessment, the more knowledge you have the more competent your assessment (in gross terms). I can think of very few times when I've 'just' done anything when in contact with a pt, and I can guarantee that monitoring meds has never been in the 'just' category.

Good questions. If you tell us a little more about you and your experience we can help better.

Dwayne

[emtbasic13]

Yes I am a basic. What I was referring to is I know what you do as a basic emt when doing IFT transports of a bls level patient. I was just asking if when your patient is a als patient on a ift transport is there anything different that you would do, besides monitoring the meds and your general assessments that you would do on any patient.

[mobey]

Yes I am a basic. What I was referring to is I know what you do as a basic emt when doing IFT transports of a bls level patient. I was just asking if when your patient is a als patient on a ift transport is there anything different that you would do, besides monitoring the meds and your general assessments that you would do on any patient.

This is a horribly worded question.

What would I do on ANY patient.

ALS assessment

ALS critical thinking

ALS treatment.

I feel like your asking us what ALS things we do on any ift patient? What answer are you expecting?

I would pace, hang Dopamine, intubate, and needle decompress all patients

[DwayneEMTP]

I think what Mobey means is that an ALS pt is ALS most often, though not always, because there is something significantly wrong with them. What is wrong with them? Well, how many pts do you have...

On each pt an ALS provider must attempt to determine what the issue is, whether they have been previously told or not, attempt to determine a baseline for their condition at this time, decide whether or not they will accept them, increase, decrease, begin and/or discontinue treatments based on their knowledge and assessment, and then start over and do it again.

I think what you may be asking is, "Is ALS really all that different from BLS when some of the ALS providers I drive for are complete tools that can't tie their own shoes?" And that would be a perfectly fair and valid question...The answer is yes, it should be completely different, even if it looks really easy to you. Unfortunately in some places of employment, in some systems, it's no different at all. Am I on the right track?

Dwayne

[emtbasic13]

Dwayne and Mobey your both correct. I was just wondering what do you do as a paramedic on a ift, than I would on onw as a basic on a bls. I never have did a als ift call before. So I was wondering what's different besides your patient being on a iv with meds from the recieving hospital. But thanks for the answers. Sorry if I worded the question weird.

[Bieber]

Dwayne and Mobey your both correct. I was just wondering what do you do as a paramedic on a ift, than I would on onw as a basic on a bls. I never have did a als ift call before. So I was wondering what's different besides your patient being on a iv with meds from the recieving hospital. But thanks for the answers. Sorry if I worded the question weird.

It all depends on the patient's condition. If the patient is stable, it could be as simple as keeping an eye on the monitor and drips and transporting; if the patient's unstable, it could include managing their hemodynamic status with fluids or medications, ventilating/intubating the patient, so on and so forth.

[uglyEMT]

I want to take a crack at this one.

emtbasic13 I too am a Basic but handle alot of ALS calls with Paramedics onboard so maybe I can help shed some lights.

First off, please do not take offence at this question, but you do know what each level of EMT does correct? In other words what each levels scope of practice is.

With that said...

The question posed is very open ended. ALS do a whole range more things then a Basic would. During a BLS IFT you are basically (no pun intended) dealing with a stable patient that requiers little to no invasive treatment. You are basically checking vitals and patient comfort during the transport. Now on an ALS transport you can be dealing with unstable patients (cardiacs being brought to a coronary center from a clinic, trauma being brought to a Level One from some where else, burn victim to a burn center from a regular ED, ect ect ect) you will be dealing with invasive procedures or equipment (intubations, IVs, meds, pacing, ECGs, ect ect ect) which are above the Basic's scope of practice.

The big difference between the two is the patient's requirements during transport and what those requirements would lead to if the condition changes. Like I said before they way the question is worded is very open ended and thus does not have a specific answer. I tried to break it down to the lowest common denominator.

Now if your asking what would a Basic's role be during an ALS transport where you have a medic or nurse onboard then it is a little easier. You would be doing what they tell you to do. Its that simple. When I have ALS onboard my rig they dictate to me what they want done. Be it recheck vitals while they do IVs, I have spiked IV bags for them if more then one bag is being hung (they hand me the bag so the meds are correct), I have hung bags for them, unwrapped IV lines, handed them stuff out of their bag, ect. It is really up to the ALS what they will expect from you. The more you work with them and the more confident they are in you the more hands on you become. Now understand this though, they will never ask you to do something outside your scope of practice or will harm a patient. You are being a second set of hands for them if necessary. There are times you will be relegated to a seat warmer because what needs to be done you are unable to do, do not take offence when this happens it just means the patient requires a higher level of care then you can provide at that time.

If you have specific questions about what ALS does then by all means ask away. I know for sure the paramedics here will be more then willing to answer them.

Edited January 6, 2011 by UGLyEMT

[fiznat]

Don't confuse "ALS" interfacility transports with "Critical Care" interfacility transports. Around here, truly unstable patients who require transport between facilities almost always go by helicopter or a ground critical care team that includes nursing staff. Regular paramedics who do "ALS interfacility transports" will generally be doing stuff like transferring stable patients who happen to require cardiac monitoring, have meds on pumps, or other basic ALS stuff like that. It may be different elsewhere, but around here you need to have your CCEMT-P cert if you are going to do the critical care stuff, and most rank and file medics don't have that.

[emtbasic13]

Thanks for the answers to the questions they where all very helpful. I was just trying to get a bigger picture of what a als ift does. Like I said before where I am at most ift services are bls only. And the hospitals have there own in house ift teams that handle the majority of the als transfers. So theres no need to contract a outside service to do them. And yes I do know what each level of emt does .

But all of your answers where very helpful and make doing als ift's sound pretty interesting. Can't wait to become a medic and do some. (Don't worry I am in no rush to jump into medic school, probably woun't be untill I finish my BS degree in 3 years). I am perfectly fine being a basic, but I do want to go to emt-I/85 school this year if I can. ( For all who are woundering why I said I/85 and not I/99, SC doesn't have a I/99 just I/85 only.)