BLS providers can make or break you. The opinion they have of you as a medic, usually negative, is one you’ll own through your entire career, unless you make an effort to change it.
I want to relate a few BLS/medic stories. There are instances when I’ve been in the EMT’s shoes working with a medic and others where I’ve been the Medic working with a BLS provider. It seems nobody ever talks about the calls that go smoothly, we all focus on the ones that went sideways with a quickness.
I was a new medic, but working as an EMT back in Washington as I waited for a full time paramedic spot to open with an agency that I had applied for. My partner and I were dispatched, along with fire and a county medic unit to a trailer park for a 60 something female with shortness of breath. When we arrived, there was a fire engine and a county medic unit parked in front of the house, so we walked up to the door to see if we could offer a hand, help with patient movement or fetch any equipment. As I stuck my head in the door, I saw an obese woman on a Rascal scooter, working hard to breath, with chugging and sloshing respirations that sounded like a washing machine from across the room. The paramedic looked up at me and said, “You can bring your bed to the door and we’ll walk her out.” Excuse me? This is a BLS call how? I looked back at him and said, “Really? She sounds ALS to me from across the room.” The medic gave me the stinkeye and sighed. It was obvious he wanted to turf this CHFer on me. No way. Not now, not eva. So, I sent my partner out to the medic unit to fetch the medic’s stretcher and watched the lead medic squirt 7 or 8 shots of nitro into this woman’s mouth. Oh yeah, his partner was digging around in the woman’s arm trying to get a line, without much luck. I asked him if he was going to start CPAP. “We don’t have CPAP” he said. He asked me if I could help them get her out to the medic unit. “Sure,” I said. “How about a stairchair?” Nope. Instead, he wanted to drive the patient on her Rascal scooter over to the door and have her walk down the short hallway and the 5 stairs to the carport to the waiting stretcher. Now, you should realize while this is going on, there are 3 firefighters, me and my partner, two medics, and a couple of family members in the living room of a single wide mobile home. It’s tight. It’s getting warm and I knew that we needed to get some people out to make room. I asked a couple of firefighters to grab the stairchair off my truck in case we needed it and help us move the patient to the stretcher. The patient’s daughter looked at me, “Ain’t no way mama gonna be able to take no steps.” I looked at the medic and he just said, “We’ll help her down.” Okay, your call. I’m just the EMT. As it turned out, the Rascal wouldn’t fit down the hallway, the patient was too fatigued to stand and we did need my stairchair to get her out. As we navigated the stairs, we needed to tilt the chair back a little to make it down. As we put the patient on the stretcher, it was obvious that she was even more fatigued, getting ready to quit breathing and was full to the brim. The medic looked at me and said, “Damn, you guys tipped her back, now I have to intubate her!” This is my fault? This medic was behind the 8 ball from the get go. We got the patient out into the the medic unit and as the lead medic started setting up for an RSI, the daughter came charging out of the house. She ran up to the side door of the medic unit and cried, “Mama! You okay in there?” The medic sitting at the head pushed her out of the truck and slammed the door. She looked at me and I realized I was going to have to explain what the medic was doing, how he was “going to make her sleepy and put a tube in her throat to help her breathe.” Now, remember, I was working for a private BLS service that was (and I’m sure still is) routinely treated like shit by the county medics and the fire department and I was the one that was having to explain to the hysterical daughter why the medics were tubing her mom.
I lost any respect I had for that medic system that day. I’d seen them do some shady BLS turfing in the past, and I’d been the victim of a few ALS turfs, but nothing as blatant as a frothy CHF patient. The customer service sucked. The patient care sucked. The whole experience left an awful taste in my mouth and I swore that I’d never be that kind of medic.
Here I am, a couple of years later, working in a busy, county based third service, having to deal with BLS providers every day, on every call. I look back at that call, and I still remember how disgusted I felt when I looked at the medic and watched his shoddy patient care. Was he having a bad day? Did he fight with his wife before the shift? Was he on overtime? Whatever was going on, it was not good and it will always be the memory of that service I take with me.
As a medic, I’ve been the guy that has ticked off a few BLS providers and I’m still learning how not to do that. I’ll tell you about a couple of my recent experiences as a medic dealing with BLS in the next post.




This is my lab partner, digitally intubating Fred. He was not happy.




