All good points. And yes we did collar the pt before having them lay on the long board. The Ked + lb presents some packaging problems and removing the ked after boarding is all around a bad thing.

In our jurisdiction the ALS is also a chase vehicle and at their discretion will ride along or not. Practice here is for the ALS to always arrive on-scene in consultative capacity. If the Paramedic takes pt care at all they must ride along. Commonly they will stand back as the call is assessed by the B or I. At first indication of shock or other serious situation they will step in and commit to the call. I am not versed on the protocols from med control on the guidelines for "triaging the call down to the BLS team" There must be something in the Standing Orders for that.