Too Many Medics? Debating a Tiered Response vs. All-ALS EMS System

There’s been an ongoing debate in EMS, emergency medicine and fire service literature regarding whether or not having too many paramedics practicing at the ALS level leads to skill degradation and negative patient outcomes. These concerns have stemmed from the growing number of ALS-only EMS systems across the United States—a departure from more regionalized systems of ALS, where a paramedic unit (or units) served a number of communities that were supported by BLS services. These systems are largely being replaced by instituting paramedic services in all communities, and includes both paramedics staffing ambulances as well as first responding engine companies. This has led to the “paramedic on every corner” philosophy that’s a good sell to communities and its constituents. In a recent editorial in Firehouse Magazine, Chief Gary Ludwig argues that more paramedics isn’t necessarily a bad thing. The argument that scaffolds Chief Ludwig’s argument is that even if paramedics aren’t getting skill maintenance in the field, these skills can be maintained through practice through simulation or in a skills lab setting. He argues that by the same logic, we should have fewer firefighters based on the decreased number of fires in the past 25 years. JEMS: Ambulance Crew Configuration: Are Two Paramedics Better Than One? It’s true, fires have decreased in the last few decades, which has led to a change in the landscape of the fire service and the services they provide. It...
Source: JEMS Administration and Leadership - Category: Emergency Medicine Authors: Tags: Exclusive Articles Operations Administration and Leadership Source Type: news