CP>        I belive that there are times when prehospital ALS personal
CP>can overstep their bounds. Paramedics are wrong when they delay
CP>transportation of critical pts to "save there lives". I belive this
CP>is the biggest problem. It must be very hard for a surgen to hear
CP>"yea we were on scene for 30 minutes but we did get the second IV". 
To bad you did not stop the pt's bleeding, or notice the colasped left 
lung!   Oh well... I belive that on the hole ALS is a benefit
CP>for the patient, and that is why I became a paramedic. We have to be
CP>made aware of our impact on the patient, good or bad.
There are few good reasons to stay on scene with trauma once the patient 
is in the ambulance. Some people, ALS and BLS, forget that the reason we 
have those things with wheels, called Ambulances, is so that we can take 
people to the hospital. IVs can be done in route, as can intubation, and 
just about any other intervention that we do. If we are on scene with a 
trauma patient for more than 10 minutes, we have to document why we 
delayed transport. Usually, this is a matter of noting extended 
extrication or extraction. Working in an urban system, I've had calls 
that were less than ten minutes from dispatch to arrival at the trauma 
center. No sense in hanging around. OTOH, there are BLS people that will 
wait with both medical and trauma patients for an ALS unit to show up 
when they could well be in the hospital in less time than it took for 
the ALS to get their. But, that is a whole different story. 
CP>        And don't worry there will never be a shortage of
CP>advancedtransfers. There not going to pay BIG money for RNs or MDs to
CP>do it!!
Around here, even with most ALS transports the hospitals send nurses 
along. I am not sure of the reasons, not being in that end of the 
business. 
Gary
þ CMPQwk 1.42 129 þAnd God said: E = «mvý - Zeý/r, and there was light!
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