EMS Systems There Are Many Different EMS

EMS Systems There are many different EMS systems that utilize advanced life support (ALS) professionals in different ways. Some EMS systems will have an ALS professional on all first response units such as found in the Portland and Washington County. The ALS group is a team of highly trained individuals that provide more advanced medical care to patients while they are in transit and their training exceeds that of an EMT for example.

Generally these teams are composed of three individuals that include a standard paramedic, a critical care paramedic, and an emergency care practitioner (FCEMS, N.d.): Paramedic (EMT-P) - Paramedics are licensed individuals who can perform tasks beyond that of an EMT. These tasks include: cardiac monitoring, intubation, and administering IV medications. Critical Care Paramedic (CCEMTP) - Critical care paramedics are similar to paramedics except that they are certified to provide more care to patients in critical conditions.

Through their training, they are allowed to use sensitive machines that are often just used in ICU, perform tasks like blood administration, and chest tube insertion among others. Emergency Care Practitioner (ECP) - ECPs are paramedics who have passed special certifications to conduct clinical practices. Although the all ALS concept seems to intuitively provide a higher level of care to emergency situations, this fact has not been established in the research.

Another alternative is to use a two tiered system that utilize a basic life support service for situations in which an ALS is not called for. Generally a dispatch professional will run through a set of predetermined questions that will allow them to determine the nature of the emergency and the level of service required (Hicks, 2011). Other distracts have even more tiers and will include a BLS team, a BLS ambulance, and an ALS ambulance.

Operationally such a system is more complex because the dispatcher will have to determine the team to be called and different varieties of teams will have to be on standby. Therefore there can be inefficiencies created. For example, in one EMS system in New Jersey the ALS units often show up separately in Ford Explorers and have no transport capabilities (Barnett, 2011). Most of the BLS services are comprised of volunteers and the ALS crews perceived at least by some to add expense to the system.

It is difficult to discern the financial implications of a tiered system. The New Jersey system for example utilizes a significant amount of volunteer labor but then the ALS crews that are in a separate vehicle can be significantly more expensive than ALS staffed ambulatory care due to delays and the ALS billable hours. As opposed to taking the patient to a nearby hospital, the ambulance may actually wait for an ALS crew to show up on the scene causing a host of inefficiencies.

Whereas cities such as Portland may pay more in human resources expenses as well as training, they likely achieve financial benefits.