Who drives?

[WilliamTomFrank]

How do you decide who drives the ambulance?

Is a person assigned to always drive or do you take turns?

Or is it just who gets there first?

[explcdt8]

In the volunteer ambulance I'm with, you must be 21 and pass an EVOC course to be put on the drivers list.

As far as who would drive if two qualified drivers show to a call, it would probably be the one who is NOT the EMT (so they can work in the back with the pt), or the most senior driver.

[Stormrage]

We fight for it out here, lol

[CACBAND]

How do you decide who drives the ambulance?

Is a person assigned to always drive or do you take turns?

Or is it just who gets there first?

Out here in Arizona most all ambulances are ALS (1 EMT and 1 Medic) unless they are solely interfaculty (2 EMTs). In Arizona, the state does not certify below the EMT-B level (there is no state first-responder (NREMT-FR)), therefore, to be one an ambulance out here you have to an EMT.

The EMT drives to and from the call in most all cases. This allows the medic to review their field guide on the way in, so if the call comes in as a ped code, what size tube does he want, how much of what drug does he want etc (its saves scene time if he knows without thinking once he gets there what he wants to grab).

[WilliamTomFrank]

??? Whats the difference between a Medic and an EMT?? or a First Responder?

[MDEMT280]

??? Whats the difference between a Medic and an EMT?? or a First Responder?

Scope of practice. An EMT (more accurately, an EMT-Basic) is a basic life support provider. They receive training in basic skills like splinting, bleeding control, etc. They're allowed to give a few medications, and maintain airways with less invasive methods.

A paramedic (EMT-Paramedic) is an advanced life support (ALS) provider. They have a much larger list of allowed medications, can perform more invasive procedures, can do EKG interpretation, etc.

Of course, states will vary in what they allow. Some allow an EMT-B to start IVs and intubate, some don't. Generally, though, you're looking at the difference between 150-200 hours of training for an EMT-B to 1,500-2,000 hours for an EMT-P.

Who drives? If it's an ALS call, and there's one ALS provider, then that provider is with the patient and the other person drives. If it's a BLS call, or if it's an ALS call with two ALS providers... Flip for it. Seniority. You drive the first half of the shift, I drive the second half. I'm in a cranky mood today, so you deal with the patient and I drive. I don't like city traffic, so you drive. You drive like an idiot, so I'm driving. I'm new, so I want to work on my patient care, you can drive. ... It can be determined one of many ways, the key is coordination and communication with your partner.

[kaylee2710]

Scope of practice. An EMT (more accurately, an EMT-Basic) is a basic life support provider. They receive training in basic skills like splinting, bleeding control, etc. They're allowed to give a few medications, and maintain airways with less invasive methods.

A paramedic (EMT-Paramedic) is an advanced life support (ALS) provider. They have a much larger list of allowed medications, can perform more invasive procedures, can do EKG interpretation, etc.

Of course, states will vary in what they allow. Some allow an EMT-B to start IVs and intubate, some don't. Generally, though, you're looking at the difference between 150-200 hours of training for an EMT-B to 1,500-2,000 hours for an EMT-P.

Who drives? If it's an ALS call, and there's one ALS provider, then that provider is with the patient and the other person drives. If it's a BLS call, or if it's an ALS call with two ALS providers... Flip for it. Seniority. You drive the first half of the shift, I drive the second half. I'm in a cranky mood today, so you deal with the patient and I drive. I don't like city traffic, so you drive. You drive like an idiot, so I'm driving. I'm new, so I want to work on my patient care, you can drive. ... It can be determined one of many ways, the key is coordination and communication with your partner.

+1... That's pretty much how my partner and I did it. Most often it depends on how your relationship is with your partner. Depending on who I was working with I either always drove or always "teched" there was really no switching for some reason.

[noelchabanel]

The licensed person who gets there first is the primary caregiver and should go in the back to maintain continutity of care. Even if it's an ALS call and the first person to show up is a Basic, the first person there should stay with the patient if it's possible. Other than that, we usually play it by ear, unless an unlicensed person is on the call with us, then that person always drives. If it's a good call for experience and trianing purposes and we have three responders, we often try to have a newer EMT in the back with someone more experienced to help if the call is in their scope of practice. If it's an MVA or a code and the whole squad shows up then the duty crew and a medic if necessary go in the back and whoever else feels like coming along drives. Most of us much prefer to be in the back, that's where the action is......well, unless it's a violent psych patient :eek: In those cases the more senior person always calls rank and drives ;). We try not to discuss who drives and who techs in front of the patient/family though, that is unprofessional. It's best to decide before you get to the call.

[MDEMT280]

The licensed person who gets there first is the primary caregiver and should go in the back to maintain continutity of care. Even if it's an ALS call and the first person to show up is a Basic, the first person there should stay with the patient if it's possible.

So let me get this straight... I'm assuming you're talking about a situation where providers are responding directly to the scene, not together on an ambulance. If you have a BLS provider show up first, your agency will have the BLS provider continue to provide (BLS) patient care, and the ALS provider will drive -- even though the patient requires ALS interventions?

[noelchabanel]

So let me get this straight... I'm assuming you're talking about a situation where providers are responding directly to the scene, not together on an ambulance. If you have a BLS provider show up first, your agency will have the BLS provider continue to provide (BLS) patient care, and the ALS provider will drive -- even though the patient requires ALS interventions?

We try to have three people on the truck if we can. Of course, that would never work financially with a commercial service. I've been of calls with a critical patient where we have had 5, (one driver, one doing airway, one doing CPR, one pushing drugs, and one taking vitals every 5 mins--no one isn't busy). I have no idea how 2 can handle a code effectively. We often have several show up on scene, if only to calm down the family or help move furniture out of the way to get the patient out of the house. If the person needs an IV or drugs or whatever, the Intermediate or Medic would obviously be in the back. If only two providers were present, the Basic would have to drive. If we have three or more providers, the Basic who arrived first, interviewed and assessed the patient first, and has the whole history from the beginning should remain with the patient and give the hospital report along with the ALS provider if it is possible.

[MDEMT280]

OK, that makes more sense.