ALS or BLS

[Ace844]

I'm actually surprised there was even a question in this case..!!!

[akroeze]

Just out of curiosity, if the patient remained in the condition she is in for the entire transport would you do any ALS skills on her other than a monitor? Just curious, not making a point or anything.

[AZCEP]

Watch closely, at least one IV, consider a second, hope the ALS tricks don't have to appear.

[Dustdevil]

Not quite sure exactly what you are asking. Are you asking if a BLS unit on scene should call for ALS?

Are you asking if the patient requires ALS care?

Are you asking if it should have been dispatched as ALS?

No, yes, and yes.

[Ace844]

Just out of curiosity, if the patient remained in the condition she is in for the entire transport would you do any ALS skills on her other than a monitor? Just curious, not making a point or anything.

It would depend on what my assessment came up with, and how the pt presented. How reliable was that 1st B/P? What were the next 3? So with blood loss of that magnatude with a pt with this hx, you're gonna say, BLS, sayianarai?? I'm surprised to hear that from someone fo your ESM educational stature...

ACE

[Ridryder 911]

ALS, the reason since she is dialysis one would not prefer to initiate a true :fluid" challenge however with a recent post surgery, and potential major electrolyte importance and hemodynamic changes, potential for danger is there....

R/r911

[akroeze]

It would depend on what my assessment came up with, and how the pt presented. How reliable was that 1st B/P? What were the next 3? So with blood loss of that magnatude with a pt with this hx, you're gonna say, BLS, sayianarai?? I'm surprised to hear that from someone fo your ESM educational stature...

ACE

Sorry if I didn't interpret your post correctly but you seem to think I want this patient to be BLS. In no way shape or form do I think this person should be BLS if ALS is an option. I was just genuinely curious what ALS interventions would be done for the pt because I didn't know. There were no hidden meanings in my post.

[Ace844]

Sorry if I didn't interpret your post correctly but you seem to think I want this patient to be BLS. In no way shape or form do I think this person should be BLS if ALS is an option. I was just genuinely curious what ALS interventions would be done for the pt because I didn't know. There were no hidden meanings in my post.

I apologize if I was wrong and misread the context of your post. For me I think this truely would be a very hard call to amke in the context of a written scenario because so much would depend on the H&P-P/E and observation. This pt would defenately get the full ALS work up, but as to whther I would progress to meds or lots of fluid for HYpotension and shock....That would depend on alot of the aforementioned factors and what i found during the course of my pt contact.

Out Here,

ACE844

[Savoy6]

We've become spoiled with ALS, spoiled as in relying too much on it and spoiled as in ruined- no one other than 1person came up with a reason for ALS. 1 IV- As I said in my post , what is a crystalloid going to do. I do believe a rationale was asked for.

Let's go back in time before the proliferation of ALS. BLS was it.

Will a paramedic riding with this patient monitoring her have any different outcome from an EMT doing the same. put away the ego's and think. Look at outcome.

And I hope that last post wasn't a personal attack regarding education stature. This is like brainstorming, there is no right or wrong. Don't jerk your knees, give it some thought.

[Ace844]

We've become spoiled with ALS, spoiled as in relying too much on it and spoiled as in ruined- no one other than 1person came up with a reason for ALS. 1 IV- As I said in my post , what is a crystalloid going to do. I do believe a rationale was asked for.

Let's go back in time before the proliferation of ALS. BLS was it.

Will a paramedic riding with this patient monitoring her have any different outcome from an EMT doing the same. put away the ego's and think. Look at outcome.

And I hope that last post wasn't a personal attack regarding education stature. This is like brainstorming, there is no right or wrong. Don't jerk your knees, give it some thought.

There was no personal attack involved. Everyone here should know that even at 'their stable base-line' a dialysis pt is one of the most sick and complicated we can encounter as clinicians in medicine. Fact of the matter is just the dialysis treatment itself can soemtimes cause metabolic and physiologic problems. Now compund that with a 10-20% total volume Blood loss. This patient clearly needs ALS asessment and potentially interventions to treat co-comittant 'disorders' which are or could be occuring with this patient. The patient recieveing early beneficial care which is unavailable for the average basic to provide is what is important here. Furthermore there is so much rationale I could post loads of info about it. This patient warrants ALS, there is no question. If you need for me to post more info on dialysis and renal failure, and or point you in the direction of some sources to get you started I will be more than happy to. Furthermore, I would expect you as a long time member of this site to know better than to think this is about being X mins for a hospital and more about providing your patient with access to appropriate timely treatment as well as continuing care.

Out here,

ACE844