Questions From a Reader, Part Two

Here's the next set of questions from our intrepid reader:

1. What are the indications of "Medic 1" "Medic 2", etc.? Seem to be a unit
of a vehicle with one or more people of varying qualifications.

Well, that's exactly it. Some jurisdictions have what is called a "tiered" system where some ambulances go out as Basic Life Support (BLS) that can do interventions and care to a certain point and others go out as Advanced Life Support (ALS) which are usually staffed by at least one EMT-Paramedic. The term "Medic" is usually a shortened version of "Paramedic" which indicates an ALS unit.

To get even more confusing, some areas will staff all their ambulances as a BLS unit, staffed with EMT-Bs and have paramedics in a "Chase Car" or a vehicle that is not capable of transporting a patient. Typically, the BLS ambulance will arrive along with the Medic in the chase car. If ALS is needed or indicated (indicated is a fancy medical term for "needed"), then the 'medic will ride in the back of the ambulance with his (or her) specialized equipment to provide advanced care. The MacMedic works this way, I think, and you can find much more information about it from him.

My jurisdiction has BLS ambulances, which are called "Ambulance" on the radio and ALS ambulances, which are called "Medic" units. They're basically the same except for staffing and some equipment. Further discussion of this answers the next question:

2. What kind of vehicles are these, though? At first, I thought they are
what we know as ambulances. But, then you often refer in descriptions to
"ambulance arrived". (See how much is assumed!?) It seems you sometimes
leave the vehicle you came in to ride in "the ambulance" or "the unit".

My "unit" is an ambulance (dispatchers in my area use the local accent which drops the "u" from the word and it frequently is spoken as "Ambuhlance"). In this jurisdiction being and "ambulance" means it is staffed with EMT-Basics, has equipment for Basic Life Support (BLS) only and is capable of transporting a patient (up to 3 in extreme circumstances). We do not have "chase cars" or anything like that. Every medically oriented vehicle that is dispatched, with the exception of EMS (Emergency Medical Services) supervisors are capable of patient transport.

The only other medical "unit" that is dispatched in my jurisdiction is a "Medic" unit. As my ambulance is called by it's number ("Ambulance 123," for example), medic units are the same ("Medic 45"), As mentioned above, a "Medic" unit is staffed by personnel trained and certified to provide ALS and the vehicle is equipped with the gear and drugs to enable them to do their jobs.

The term "Medic" can refer to both the "unit" (a specially equipped ambulance) and the people that staff it (paramedics). So, yes, these "units" are exactly what you know as "ambulances." The differences between a "Medic" unit and an "Ambulance" are not outwardly obvious. In fact, we use the same vehicle make and model for most of them. In my writing, unless I say otherwise, one can safely assume I mean a regular BLS ambulance when I refer to my "unit" or "ambulance" since I'm only licensed to work as an EMT-B in my area. This may change in the future as I become more personally qualified.

Now, know this: as many jurisdictions exist in the United States, there exist variations on these themes. As our federal government has assigned the regulation and operation of medical services to the states and these states to the local level, each state and local jurisdiction has determined how they want business done. The discussion on how each state has evolved their EMS system and what forces have affected their outcome is a discussion too long for this entry. Suffice it to say that one can encounter many different systems, configurations and organizational models for EMS throughout the country.

I hope my explanation hasn't been too confusing. To the reader who is not in the EMS industry my advice is this: allow your understanding and definitions of terms to be flexible but allow that an EMT is generally a short term for EMT-B and a 'medic is a short term for Paramedic. An ambulance is an ambulance is an ambulance. They mostly look the same but the difference between a BLS unit and an ALS "medic" unit has to do with the level of care and interventions each unit can provide.

Ah, maddog, you always take the easy questions, eh?

Hit the comments link or email me with more questions if you need clarification or with clarification if you think I'm way off track. The comments link will allow others to chime in with their 2 cents.

--maddog