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I'm a dispatcher but occasionally I get called to jump onto a wheelchair van and run a quick transport because everyone else is booked solid. One particular time I was asked to transport a patient who was perfectly stable and noncombative, but who nevertheless suffered from paranoid delusions...

AngelTrack is a cloud EMS software thing that was developed right here where I work, after the owners brought in a partner who writes cloud software. I use it every day (the dispatch and PCR elements, at least me personally) and it's pretty sweet. It was supposed to be just for us, but now...

Our industry doesn't work that way. Try calling for lift assist more often than, say, twice a week, and see what happens. But that's not the point. The point is: at what weight does a crew need to call lift assist in order to keep the risk of injury below (say) 0.2%? A typical burly male...

It is not honest to insist we regard a bariatric-capable crew as equal to a crew that requires a lift-assist. No matter what words you choose, a crew that needs list-assist is less useful to dispatch, more expensive for the company, and less safe for the patient. Saying "change your hiring...

Yep yep. When loss-leaders are used to bankrupt all the smaller competition, it is called predatory pricing. In most circumstances that is illegal, but it's up to the feds to put a stop to it. Unfortunately our federal government suffers from regulatory capture, where the regulators are paid...

Now look what you've done. You whipped out the moral condemnation, and shut down the conversation. You got to have the feeling of virtuousness, yeah, but the rest of us are now unable to discuss an actual real-world problem affecting female EMTs. We have to go back to work today and pretend...

Stay away from law enforcement. Most departments are driven by seniority, so as the newbie you'll spend years working nights in the worst parts of town. Of course, if you're in it for the long haul, then you'll be sitting pretty after a 10-15 year march. And maybe you'll advance more quickly...

I don't recall. But if you drive down to Galveston and poke around at Scholes field, where the rig choppers operate, I'll bet the people hanging around will know.

I think he covered everything, except for the seniority issue. At most fire departments, seniority is a Big Deal, and there is absolutely no way to short-cut through the system no matter how smart or capable or hardworking you are. The guys who've been there longest, will always get first...

You'd think that. And then there's Acadian.

Here in Houston it's all payola. SNF administrators have become utterly brazen, asking out loud (in a private meeting in their office) what their cut will be. Or demanding free wheelchair mileage even though that is specifically illegal (anti-kickback statute). One local small EMS...

We took over transport at a local hospital, and we found out what this unnecessary IV stuff is about. The previous EMS had implicitly trained the hospital staff in how to get everything billed as ALS, even stable, AOx4 wheelchair discharges. The attendings would sign anything you shoved in...

One advantage of supervisors on trucks is the effect on cleanliness and equipment care. If crews know that irritable supervisors are frequently and randomly assigned to trucks, they know that they are at risk of a "Who the f*** was the last crew on this truck?! Look at this f***ing mess!"...

Okay, then followup question... Suppose a patient wants transfer from one ER to another ER, not because he requires a higher level of care, but because he wants to be in a hospital closer to family, or to be in "the hospital that Reader's Digest says is the bestest", or whatever. And suppose...

Also consider working on an offshore drilling rig. You'll fly out by helicopter to be stationed for 48 hours or perhaps longer, treat what you can on-scene, and fly the rest back onshore. Pay's good and the job is exciting. One of our paramedics just left to do exactly that, and I hear he's...

At my company, the only time anyone cares about gender is for bariatric situations. Our female EMTs are fine as long as they get assigned to a kneeling ambulance. But if they end up on a non-kneeler, everyone in dispatch regards that unit as inferior. As a result, that unit gets dispatched...