# Sacramento



## MattCA (Oct 18, 2010)

Maybe moving to Sacramento in a couple years. Can anyone give me a brief summary of how BLS runs up there? 911's? I work in San Diego so Im used to pretty much just transporting. Any Idea of the pay? I may be switching to Rural Metro sometime. Is Rural Metro up there so I could possibly make the switch a little bit easier. Thank you in advance.


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## Akulahawk (Oct 18, 2010)

BLS... no 911. Pretty much all you do is interfacility transports. It's pretty boring, actually. You could get partnered up with a medic and then you MIGHT get a VERY occasional back-up 911, but that's rare. Lots more interfacility work and private emergency calls. That's about it. Really. That's what it was 10 years ago, and is what it is now.


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## MattCA (Oct 18, 2010)

Ah I was hoping there would be a change since Im doing the exact same right now. What do you mean back up 911? I know Rural Metro has a bridge program here where you are a driver for a medic.


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## Akulahawk (Oct 18, 2010)

What I mean is that if the 911 system is overloaded and every regular system unit is unavailable, Fire Dispatch will solicit assistance from the private ambulance companies. It's pretty rare, but it has happened. Basically, they're looking for any transport unit that can assist. That's backup 911. 

When I first got into EMS about 12-13 years ago in Santa Clara County, I could expect to run 2-3 of those per day. The system got reorganized and that dropped to 2-3 per MONTH or less.

As far as a training program for a basic to drive for a medic, well, that's up to each individual company. That's what it was back when, and I'm sure it's still that way now.


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## Ewok Jerky (Oct 18, 2010)

as akulahawk stated lots of BLS IFTs. First Responder and AMR being the biggest, also, Priority One, Medic, TLC. Sac County uses Fire mostly for transports and AMR for backup, You can check out surrounding counties for work too as getting on in Sac with anyone except First Responder is unlikely. AMR does a lot of 911 outside of Sac. 

Are you interested in just BLS or do you want to work ALS?


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## MattCA (Oct 18, 2010)

Bummer I was looking forward to 911s. I have 2 years of experience and will have 4 by then. Looking to go Rn so I need to concentrate on that. I don't mind BLS and don't really want a normal job but I may have too.


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## TransportJockey (Oct 18, 2010)

If you're a basic and want to work 911, CA is not, from everything I've read here on the forums, the place you want to move to. More rural states are more likely for a basic to work 911


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## bradford (Oct 19, 2010)

jtpaintball70	" If you're a basic and want to work 911, CA is not, from everything I've read here on the forums, the place you want to move to. More rural states are more likely for a basic to work 911"
That's a pretty blanket statement and I know you meant it as one, but there are plenty of opportunities for EMT-Bs to work 911 in CA. I personally worked as a private ambulance EMT-B running ONLY 911 in Orange County, which is strictly fire-based ALS. But I worked hard and got a chance to do 911 for a couple years before going to medic school. They are few and far between, but the options are out there. Fresno/Kings county, San Luis Obispo county, and Orange County use EMT-Bs for 911. ( Those are the only systems in CA that I am intimately aware of, but I'm sure there are more) If you put in the time and effort I don't see why one couldn't find work running 911 calls in California as a Basic EMT. 
To the OP, I am sorry I didn't answer your question directly, but from everyone I have talked to, private ambulance companies do a fair share of transports in NorCal (AMR, ProTransport, etc.,), maybe not as much as FDs, but there are always opportunities and options. 
Good Luck,
bradford


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## LonghornMedic (Oct 19, 2010)

Check out AMR's operation in Contra Costa County. There are the operator for Contra Costa County EMS. It's a fairly large operation. I think they run around 30 ambulances. I know a guy who has been there a few years and he likes it. They use Basic/Medic on some of their rigs and double Medic on some. It's about an hour from Sacramento.


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## JPINFV (Oct 19, 2010)

Let's give a fair discription of Orange County style EMS, shall we?

In Orange County, the paramedics are only with the fire departments and Mercy Air (and they're called "air ambulance attendants" by the LEMSA, not a paramedic). 911 response is handled one of two ways. Either the fire department provides both paramedic response and ambulance transport, or the fire departments provide paramedic response and a contracted private company provides 2 EMTs and an ambulance. The fire department always responds with lights and sirens, the private company rarely responds with lights and sirens. As such, you'll normally arrive on scene after paramedics and you'll generally be a gurney pusher for the paramedics. This is ignoring, of course, how insanely restrictive Orange County is in terms of protocol and policy. 

However, given the fact that there are no private company paramedics outside of Mercy Air, if you're working IFT you'll get plenty of patients from nursing homes and assisted living facilities being transported to the emergency department. Normally, but not always, they will be relatively stable, albeit almost always have significant and multiple chronic diseases. Unlike 911, you will always show up first at the nursing home. Hence, Orange County is bizzaro world where IFT provides a better experience than 911 in terms of medical patients.


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## bradford (Oct 19, 2010)

JPINFV-

I do agree that MOST of OC EMS for EMT-B is run that way, but not all. I was fortunate enough to work for a privately contracted ambulance company that worked directly with OCFA. Meaning that I was in the OCFA ambulance stationed in the OCFA firehouse and would arrive on scene-code 3-at the same time as, and many times before, the ALS engine. I know (first hand) that most of Orange County BLS is limited to IFTs, but please don't paint all of OC with such a broad stroke. I cut my teeth in EMS in Orange County and wouldn't trade that experience for the world. 

I know you are a medical student and are far and away more knowledgeable than I, and it seems from your posts that you have spent a fair amount of time working in the area, but please don't make such assumptions and accusations that (seemingly) deride or otherwise discount EMT work in Orange County.

 I can say for certain that I was not, as you so eloquently put it, "a gurney pusher." I actually got to use my training and do full patient assessments, use an AED, perform CPR, and C-spine patients,  many times before ALS arrival. I think that my experience working as such a lowly, gurney-pushing EMT in Orange County really helped me in paramedic school. 

I am really not trying to start a flame war, and I can appreciate many of the points you are trying to make, but I am pretty offended with what you had to say about BLS EMS in Orange County. In the future, please refrain from commenting on a subject you have strong feelings about, yet don't fully understand. 

I am sorry if I read too deep into your comment and took it for more than it was worth.

By the way, I do agree on the part about learning a lot from IFTs. I learned more about kidney disease during dialysis transports than I could have ever imagined.


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## JPINFV (Oct 19, 2010)

Oh, I know about Orange County as I worked for Lynch for 2 years during undergrad and did my EMT class ride along with Care. 2 calls in 8 hours, did a second ride along, 2 calls in 8 hours. Arrived 1st on only 1 call, and responded code only once on another call. Similarly, there's a lot to learn from IFTs besides renal issues because, unfortunately for the patient, so many "skilled" nursing facilities refuse to call 911 when their patient is in dire straights. So, even though their patient has acute pulmonary edema secondary to CHF, or pulled out their central catheter, was status post surgery and threw a clot leading to marked unilateral hypoprofusion beneath the elbow, or is now complaining of chest pain (among other serious complaints, sometimes frighteningly often), please don't assume that the only experience IFT gets in OC is going to or from Davita, Gambro, or RAI. Similarly, please don't assume that I don't know how OC is set up just because I'm currently a medical student. I'll admit that I might have been a little harsh with "just gurney pushers," however there's a big difference between doing an assessment and initiating care when paramedics aren't coming unless you request them and doing an assessment and initiating care either immediately before or under the watchful eye of a paramedic. 


Oh, and OCFA? Was that Doctors or Medix before Medix went full retard with their lawsuit (don't bite the hand that feeds you)?


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## bradford (Oct 19, 2010)

JPINFV-
Again, the condescending attitude is unwarrented. You assume that because you worked for 2 years on a transporting ambulance that you are the ultimate authority of Orange County EMS. I worked for 2 years on a 911 ambulance and don't claim to have nearly the knowledge of the OC-911 inner-workings that you have. 
No, it wasn't just waiting for ALS engines to decide what to do. We were treated as equals and educated by the OCFA firefighters to think and act appropriately (within protocols and guidelines). I read your posts about how you're a second or third year medical student and think you must know a lot, but in reality it seems you know very little of the goings-on in Orange County field EMS. 
And no, I didn't work for Doctor's, Medix, or Care. Want to guess again? 
You know all of Orange County EMS, I am sure you can figure it out. 
Once again, not trying to be a smart ***, just defending all of us gurney-pushers in Orange County


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## JPINFV (Oct 19, 2010)

Well, I picked Doctors and Medix because they have or had, respectively, most of the OCFA contracts. Care runs Seal Beach, which is OCFA and Emergency runs an OCFA. However, to the best of my knowledge none of those companies runs OCFA ambulances. Similarly, Americare has a handful of outer area contracts and I'm assuming that they do to. 

However, the majority of 911 ambulance service is not provided as you described it. The vast majority of it is private companies providing service in ambulances with the company's, not OCFA's, livery out of the company's (normally motels or hotels for the 24 hour units) facilities or posting location. As such, the concept of being stationed at the fire station and responding along side, in contrast to being in addition to, the fire department is definitely not a standard situation.


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## bradford (Oct 19, 2010)

JPINFV- 
You are absolutely right that most of Orange County isn't run that way and re-reading my posts I came off as a jerk, so I apologize for that. I was trying to illustrate that not all California EMTs run IFTs and I somehow ended up in a p*ssing contest with you. I was actually trying to be sarcastic but it is tough to convey any emotion on an internet forum.
I have been away from Orange County EMS for a little over a year now and I know a lot changes with so many companies competing for contracts, so I have no idea who runs what city. 
I know it is rare to run 911 in CA as an EMT, but it does happen. I was trying to give the OP a little hope and use my experience as an example. 
Again, sorry for the pompous remarks in my earlier posts


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## Ewok Jerky (Oct 19, 2010)

AMR runs EMT/Medic Rigs for 911 in Contra Costa, Yolo, Placer, Sacramento, and San Joaquin Counties and, I think Stanislaus County.

Enlo is a private ambulance that runs in Yuba County, I think.

I can't remember who but Im pretty sure Solano County has private 911 response.

There are lots of EMTs working ALS 911 in Northern California, I think open positions are hard to come by though.


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