I am looking for information to help sell our local offcials on why we need to advance to ALS EMS Services.  We our the last county in our state that does not have any available.  I am trying to find hard statistics on advantages of ALS.  If anyone has any help please let me know.


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I don't intend to imply anything about your dept. However, the first consideration must be are we competently delivering care now? Are we optimizing pt discharge outcomes and leveraging our limited resources with our current equipment and training. If you are, and your staff is hungry for more .... WOW!

There are many sources of research based data available. Be prepared to find and present research on both sides of the argument so that naysayers believe you are presenting a balanced argument.
1) Visit your closest library. Preferably a college library or hospital library. Usually the librarians will be willing to help you gather resources for you to conduct a literature review. Read the research. Understand what they are writing. Don't just read the conclusions.

2) Check out the closest Paramedic courses what do they have to say? Another ALS service will bring them business. I would expect them to be active in your attempt to market change. Consider interviewing some graduates and inspecting their pass rates for national and/or state exams.

3) Purchase a subscription to: http://www.informaworld.com/smpp/title~content=t713698281
This is a better value than JEMS or EMS Magazine in that it is research and not opinion couched in research anecdotal experience.

4) Peruse http://nasemso.org/EMSEducationImplementationPlanning/Toolkit.asp the educational standards are changing for a reason. Your original question highlights that reason.

Should you have questions please advise here or direct on email. My participation on this forum is inadequate by my standards.

Good post, and happy research.
simple medics push drugs...drugs save lives...if I am in full arrest...I want some one to know how to run a 12 lead and push epi.
1st...you have to have good,trained people to do the ALS...then you need to recognize the liabilities involved and last but far from least...you need to remember....BLS saves lives....all the ALS in the world won't do shit if you forget the basics.....
Although I work for an agency that functions at the EMT-Intermediate level, I've maintained my EMT-Paramedic certification for 12 years. This statement is so very true. I'm often reminded of the old saying "EMT always comes before Paramedic". I've also met more than a few paramedics who have forgotten this. But in my opinion, every taxpaying citizen in this country should have access to pre-hospital ALS.

Another good area to research would be your nearest STEMI and EMSC programs, if any are available near you.
Hey Paul... and other readers... is it true that doing a hard pre-cordial thump with a witnessed arrest in many cases restarts the heart, taking away the need for ALS?

And Edward... to not have ALS capabilities is no longer acceptable practice. It is the minimum standard most places now. Why? In many cases, ALS folks end up doing BLS types of things (the basiics) but they do them very well. How many lives do you need to justify the extra liability or expenses? 1, 2, 3... Even if it is just one a year, it will always be worth it. You and your department simply need the training and tools to do the job. Do it!
Mike...I have done ACLS and PALS for the past 30 years and the "thump" hasn't been mentioned in a few years...Don't get me wrong ALS does have its merits...I just don't believe that it is the cure all for every call...as it sometimes happens ALS people are so hung up on "Advanced care" that they forget about the "A,B.C's" then they are doing ALS on a dead patient.....we joke that "Paramedics saves lives, EMT's saves Paramedics."
Yep. Before you can be a good Paramedic. You need to be a great EMT. Then you need to remember to be a great EMT. With the gyrations that AHA has made in the past few years. There is the suggestion that great CPR and Defib works better than all the meds. However, as you all know the meds potentiate the effectiveness of other BLS therapies. Bottomline, good EMT skills. Thus, taking us back to my original post. Edward make certain you have got great EMTs before making the jump. If your EMTs are only good they will make marginal Paramedics.
i am a basic....i can do basic things i can hook up a 12 lead and run a strip take some vitals and make a pt comfortable as possible to get them care....over half of our dept is als we have two intermediates and lots of enhanced there is times i have had to call als out on a call....we are all volenteers here.....the most recent on was a burn victum .... she had 1st 2nd and 3rd degree burns.....I had to sit and watch this pt suffer because i couldn't get als out for a time and i wasn't. As soon as a class if offered i will be taking an enhanced class around my area because of this....I felt so bad that i couldn't help my pt at the time....ALS is a big part you can save lives just by pushing small amounts of meds or given a simple bad of saline....I don't know where i would be without my als staff
I am looking for information to help sell our local offcials on why we need to advance to ALS EMS Services. We our the last county in our state that does not have any available

Well first off, what level of service are you providing now and how close is the closest ALS service? Are there incentives for the providers to be ALS? Can the costs be afforded, especially with start up? What type of level of ALS are you looking towrds, Paramedic only or something a little less like Intermediate?

I see you are a paramedic, but the service you are affiliated with is perhaps BLS. Do you work in a hospital type of setting then? Is there service you want to expand part of a fire based EMS service, or stand alone EMS? How many other services are in the county right now?

I am trying to find hard statistics on advantages of ALS
Well advantages, in a nut shell, are more options for EMS and more interventions for pt care. There can be more revenue generation with doing ALS skills and there would probably be more ALS intercepts done, increasing call volume. If looking to be a county type of ALS provider, perhaps costs can be deferred by the county.

Here are some sticky points to consider though. How many paramedics or intermediates are currently available to start providing the service? Is there enough interest for people to commit to at least a year long paramedic certfication class? Who pays for the class? If you are relying on volunteer EMS for services, is there willingness to hire paramedics as full time? Are you looking at a public ALS service, like just currently stepping up existing EMS, or are you looking at private ALS service as well? Have you considered both? Are there enough ALS emergencies to justify the step? What are the plans to maintain CME hours, or refresher training?

What I could see happening is if you are looking for a current EMS service to step to the level of ALS, this could be too much for volunteers. What I mean is schooling is a lot of work, moreso than just EMT basic, and with many career depts asking for paramedic,etc, what incentives are there to stay a medic in the U.P.? Why wouldn't someone use the schooling, get the cert, and look to use those skills elsewhere? Also would the increased demand for ALS personnel be too much for someone who is volunteering?
Lisa...Think about how I feel at times...In my Department we do not run Advanced care so therefore I have to work BLS....Now at work I am an Advanced care team member...I work in a Burn Intensive care unti....But I have to sit there while someone else tries (sometimes several times) to get a line in and then fumble with meds and the lines while doing strips (EKG's) I once tried to help by at least putting the leads on and running the strip but the equipment was pulled away from me and I was informed by this paramed that I had no business working with it as I was only a "basic".....I understand....I only have 32 years experience of ER, ICU experience and have had my EMT cert since I was 17 (back then you could get it at 17) up to Paramed level....

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