Sunday, March 13, 2011

They Say More Lives Are Saved by BLS Than ALS, but...

I've heard, more than once, that "more lives are saved by BLS than ALS."

Maybe so.  CPR is a BLS skill, after all.  As is controlling bleeding.  And we can assist, or provide, ventilations.

But sometimes, there are some ALS options that sure would be nice to have available.  
I happen to live in a region that doesn't allow BLS (or ILS) providers to do much of anything.  It is very, very conservative.  So although we have to test out at the state level for everything in the state curriculum, much of it, we can't actually do in the field.

Most of the time, it doesn't make much of a difference.  We don't often have the opportunity.

But sometimes, there are some things I'd like to be able to do.

D50 comes to mind.  I can start an IV, on a patient older than 16, but can't do anything with it other than a lock, or saline.
Some people would argue for LMAs, but they aren't used in this region at all, let alone for BLS or ILS providers.  And I can't intubate, because the region requires capnography, and my agency does not have the equipment, or the finances to get it.
Chest decompression is disallowed by my region.  I've had a couple of patients where it sure would have been nice not to have to wait, even though I don't think it ultimately made much difference that there was a delay of a few minutes.

The current thing I would like to be able to provide? Breathing treatments for someone not previously diagnosed with Asthma.
Had a very sick patient recently.  Bilateral wheezing. Significant respiratory effort, enough not to be sustainable for long.
What was I allowed to do?
Put oxygen on 'em.  That was about it.
Almost enough to get me to look into that medic class sooner than I was planning. Almost.

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