Boston EMS

[FireMedic049]

1) Nebulized Albuterol was started in Boston as a "Special Project Waiver" with the state several years ago. It was successful enough that the state adopted it as a BLS intervention. Intranasal Narcan started the same way.

 

2) For the most part, Boston operates as a non-transporting ALS service, just in ambulances. There has been talk over the years about putting the medics in SUVs, etc, but there has been concern that they may end up on a scene and a BLS truck would either be delayed or unavailable and the medics would be stuck there. There is only one medic supervisor per shift. With rare exception they do not actually "work" as medics and transport in BLS trucks.

 

3) Except when extremely busy, a BLS truck is always sent with and ALS truck. Typically, if the ALS crew is going to work the patient, they will go in the ALS truck. Sometimes, for a variety of reasons they may end up in the BLS truck. In this case everything in the ALS truck is duplicated in a portable form. For critical patients, both medics will ride in back and the BLS will drive. In less acute cases, if in the ALS truck, the medics will transport by themselves, leaving one medic in back and the other driving.

 

4) I guess this depends on your definition of "needs". Without getting into a philosophical discussion about what ALS can and should do, I would say that its fairly rare for someone who "needs" ALS intervention not to get it. That being said, Boston is unique in the fact that 90% of the transports go BLS. There are other systems, one just on the other side of the river that ALS' 90% of their transports. Plus, there a numerous private ambulance companies around town that are used for mutual aid when needed and available.

 

 

 

 

Thanks for the info.