Wednesday, May 13, 2009

To ALS or BLS, that is the question

I loved Kelly's new writings on EMS1:
http://www.ems1.com/medical-clinical/articles/492833-Too-Much-of-a-Good-Thing

But I'm curious, if EMS is the spinal tap what is SAR? The bastard, kinda dumb, jockish guys? I think so...

But the question remains, is there a place for Advanced Life Support capabilities on a mountain search and rescue team? Many argue yes because of the long transports of critically injured patients.

However, I argue no for a few reasons:
  • Most patients, by the time we get to them are either dead or stable. I have to leave work, change clothes, get to my car, drive to the callout (without being able to go Code 3...), hike/fly/ride into the patient and then transport them out. We're talking hours here.
  • It is damn near impossible to get an IV to stay in and active while moving a patient through the terrain we deal with. (If anyone has any ideas let them rip). Cold skin just aggravates the problem.
  • ALS would mean more shit I'd have to carry in, and I already have a lot. Plus, meds would have to be kept controlled and current. That would be impossible in the back of a civilian car and hard in a non medical (Sheriff's) truck.
  • In my opinion, and this has always been my opinion with EMS, the fastest way to the hospital is the best way. Get in, get the patient, get them the fuck out....
Will I still go to paramedic school if the department pays for it? Hell yes I will.

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