Effective: 02-28-25
Supersedes: 10-31-24
Purpose: When an ambulance transports a patient receiving care at the Advanced level of ALS, the ambulance must be staffed with a minimum of two EMTs, at least one of whom is certified at the Advanced EMT level. When an ambulance transports a patient receiving care at the Paramedic level of ALS, the ambulance must be staffed with a minimum of two EMTs, at least one of whom is certified at the Paramedic level, provided certain conditions are met.
Policy: Brewster / EasCare Ambulance Service will at all times meet or exceed all applicable ambulance staffing and dispatch requirements.
Procedure:
1. Brewster / EasCare Ambulance has a well-established advanced life support (ALS) deployment model with consists of a mix of dual Paramedic, Paramedic/Advanced, Paramedic/Basic, dual Advanced, Advanced/EMT and Paramedic (Class V) resources.
2. The ambulance service, in conjunction with its affiliate hospital medical director(s) and in accordance with administrative requirements of the Office of Emergency Medical Services has established a minimum experience level and skill competencies for each of its Paramedics / Advanced / and EMTs working in a Paramedic/Basic or Paramedic/Advanced staffing configuration.
2.1. Skill competency and protocol compliance is reviewed as part of our ongoing quality assurance program, and Field Supervisors play a critical role in coaching, mentoring and evaluation. Upon Supervisor recommendation, team members with at least six months of Advanced Life Support experience and consistent skill competence may be designated in the scheduling software to be paired to work in a Paramedic/Advanced or Paramedic/Basic staffing configuration. Any deviations from these minimum staffing requirements for extraordinary situations must be authorized by an area manager.
3. In accordance with ALS Staffing regulations, the ambulance service has identified certain criteria, approved by the affiliate hospital medical director and listed below, in which two Paramedics would be required to provide appropriate care, based on the patient's medical condition and acuity.
3.1. In such situations, either a dual-paramedic staffed unit will be dispatched, or in the case when a unit with only one paramedic is dispatched, (P/B, P/A, P), a second paramedic will also be dispatched. The second paramedic could be a second Brewster or EasCare ALS unit, an ALS level field supervisor, or an ALS unit from another service.
3.2. In cases where the two ALS level personnel are dispatched separately, the first Paramedic on scene should assess the patient and may cancel the second unit if the second paramedic is not necessary. When a second paramedic is required, it is expected that both Paramedics will assess the patient, determine a treatment plan, and treat the patient accordingly.
· Unresponsive or unconscious patient
· Cardiac Arrest
· Party Not Breathing
· Childbirth Emergencies
· Hemodynamic instability
· Anaphylactic Shock
· Patient Entrapment
· Pediatric Trauma
· Mechanical Ventilators
Reference: 105 CMR 170.305