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How do you and your partner determine who drives and who is in the back with the patient?

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In the UK, as a Paramedic I hold responsibility and accountability for everything that happens in the ambulance. To answer the question, I decide base on the patients condition, if there is any doubt in my mind then I travel in the back. 

San Diego City; had just switched to emt b and medic cars. It was a big deal to let the emt ride in back alone with a patient for ever. Finally medics got so burnt basics could take bls calls for the medic. Super conservative system. New York City was bls or als buses, and the senior crew member or the one who's shift it was did the driving. Making the less senior or over time tech do all the patient work. It sucked. My favorite is just switching every job. Makes it fair. Some systems don't allow for it unfortunately. I had a friend who had a partner who drove all the time because he was to big to fit in the passenger seat! That's ems!

Nicole- Here abouts it depends. If I have a paramedic partner, we alternate calls. If I have an EMT partner, then ALS calls are handled by me, BLS calls by my partner. Conversely, I am also a Field Training Officer in my service, so when I have a paramedic trainee, then they get all ALS calls, while I handle BLS calls, except when they are really new, then they handle all calls, initially. That is when they are a 'third rider', and during this time I am in the back with them. Hope this helps.

If it's a basic call then the basic or specialist takes the call, if ALS then the medic takes it.  If we get slammed with a bunch of basic transfers we will alternate just to break it up.

As a BLS service, whoever is the EMT is in the back. It's rare to have our ambulance staffed by 2 EMTs, it's usually Basic with a EMR driver or less. Only certification you need to drive our ambulances is an EVOC course and current CPR.

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