# Best states to work in for EMS?



## MedicBender (Jul 16, 2011)

Hello everyone!

First off a brief introduction... I'm a newly certified EMT-P. I've been working as an EMT-B for around 4 years now in both 911 and transport settings, 2 years in Minnesota and 2 years in Maryland. 

I'm looking to branch out from Maryland. I'm a bit fed up with the system here and would like to move out west. 

I'm looking for a state/service with aggressive protocols and positive attitude toward EMS. The attitude in MD towards medics and EMS is general is fairly poor. 

So where should I begin looking? I've applied for temporary state licenses in NM and AZ, and I'm currently working on my CO license. 

Any help/comments/thoughts would be greatly appreciated. Thanks!


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## DrParasite (Jul 16, 2011)

Seattle Washington and Wake County NC always have positive reviews


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## TransportJockey (Jul 16, 2011)

Lots of good third service agencies in TX. NM is rather limited if you're not fire. And job prospects with the temp cert are non-existant. Most places will only hire you with the full NM cert. 
Here in NM I'd say best bet is try to get on with Lincoln County EMS (a Presbyterian Healthcare-run EMS service) or ABQ Ambulance (again, a Pres service)

CO has Denver Health Paramedics which are a highly thought of service, and if you're fire the Metro fire depts are great!


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## jjesusfreak01 (Jul 16, 2011)

DrParasite said:


> Seattle Washington and Wake County NC always have positive reviews


Wake's a cool place, but intense. Don't come here if you don't want progressive protocols, the best equipment, and a lot of responsibility. We don't call med control for permission, only forgiveness. You won't see a trauma every day, but the busy trucks run 6+ calls every twelve hours. We have more than the required amount of con-ed every year, and it consists of lectures, skills training, and occasional scenarios in the sim lab.

Working in the system you'll have the support of excellent district chiefs, a dedicated medical director, and you'll be joined on calls by firefighters mostly certified as EMTs who are excellent at giving basic medical care, taking vitals, and getting histories to make your job easier. I enjoy working in Wake County.


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## shfd739 (Jul 16, 2011)

I'll second Texas as good-great depending on the agency/service. My previous experience in Mississippi was positive but that varies by county/service/agency and their protocols. South Lousiana wouldn't be bad. Avoid Alabama- the statewide protocols are restrictive and it seems every time a step forward is made they take 2 steps back. 

That's all I have experience with. 
Sent from my electronic overbearing life controller


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## MrBrown (Jul 17, 2011)

Get a bunch of experience and come down here to become an Intensive Care Paramedic, duh


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## emtchick171 (Jul 17, 2011)

Personally I love north Carolina, we have a mix of it all...


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## MedicBender (Jul 17, 2011)

I've heard great things about Seattle, as well as Wake county. 

Does anyone have any recommendations for places to start looking in TX?

Transport Jockey, How do you like working in NM? I applied for my license there because I saw a few openings in ABQ.

Mr Brown, I would love to end up in NZ! I fully intend on venturing out in the world after I get some experience stateside. What is the process like for transferring to NZ?


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## TransportJockey (Jul 17, 2011)

MedicBender said:


> I've heard great things about Seattle, as well as Wake county.
> 
> Does anyone have any recommendations for places to start looking in TX?
> 
> ...



Montgomery County Hospital District, Beaumont City EMS, ATcEMS, Williamson County EMS, and Acadian (private service based out of LA) are all good places to look into for TX.
As for NM... it's ok. I'm actually looking to move back to TX to work, but that's a whole nother story. NM scope is pretty good, and we're treated pretty well here. I currently work rural 911 w/ a private service just south of ABQ. I bet the openings you saw were either AMR Alamogordo or Albuquerque Ambulance... Maybe Lincoln County EMS, right?  Our career EMS personnel in this state usually know what they're doing and are pretty good at it. EMS is such a small community in the state that the ones who don't know what the hell they're doing either get pushed out or stay volunteers.


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## MedicBender (Jul 17, 2011)

It was with ABQ Ambulance Services out of Presbyterian Health. Will the temp license hold any weight with them?


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## TransportJockey (Jul 17, 2011)

MedicBender said:


> It was with ABQ Ambulance Services out of Presbyterian Health. Will the temp license hold any weight with them?



Thought so. Bus has stopped hiring EMT-I/B at this time (which is fine since I like not just being an EVO), and are looking mainly at medics. As for the temp license issue... I really don't know. You might try calling them Monday morning and ask. I know when I was coming back to NM and had my temp EMT-I (I had to go the recip route since I let my NM EMT-B expire and I had my NREMT-I/85 and TX EMT-I, even though I got training in NM) no one would hire me on with the temp cert, I had to go take the state test and get my full cert before they would. But calling to double check is something I would recommend.


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## MedicBender (Jul 17, 2011)

Sounds good, I'll give them a call in the morning. I can justify flying/driving out there for an interview, but I'm not to sure if I can justify going out to just to test for my license for a job I don't have yet.


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## TransportJockey (Jul 17, 2011)

Yep, that was my thing... luckily I was working in west TX when I had to go to Test, and my parents still lived in NM, so I had an excuse to come back (plus going to visit The Girl too). 
If you're interested, here are the protocols that AAS falls under:
hsc.unm.edu/SOM/emsacad/docs/ems_protocols.pdf


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## MedicBender (Jul 17, 2011)

Thanks a ton! I've been digging through the net trying to find various state protocols. I stumbled on this site and it's one of the reasons I joined, tons of great info here


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## TransportJockey (Jul 17, 2011)

That there is. It should be noted that BernCo protocols are a bit more restrictive than elsewhere in the state, due to shorter transport times (for instance my minimum transport times on my ILS unit is 25-30 minutes, can go upwards of an hour to ANY hospital, ABQ transport times is usually a max of 10 minutes to a hospital).
State SOP is here:
http://nmems.org/NM_treatment_guidelines.shtml
http://nmems.org/practice_scope.shtml


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## MedicBender (Jul 17, 2011)

I'll start the reading tonight, I'm stuck on night shift till 0700 and my company has a no sleeping policy, so I might as well start reading up.


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## tom.watkins (Jul 17, 2011)

If you want to go back through paramedic school, then Seattle is for you! Otherwise, go anywhere but King County; there has always been and EMS iron curtain there and only Medic One (Harborviews) medics are allowed to play. I work in Yakima county, and while we aren't as busy as Seattle, we get plenty of calls, and enough "cool" stuff to keep our skill levels up.


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## NomadicMedic (Jul 18, 2011)

Seattle is an EMS wasteland. I also worked in Yakima and had a blast. I now am in Sussex County Delaware, at the medic dream job. Want to find out why? Google Sussex County EMS.


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## ArcticKat (Jul 18, 2011)

Ever consider Canada?


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## STXmedic (Jul 18, 2011)

n7lxi said:


> Seattle is an EMS wasteland. I also worked in Yakima and had a blast. I now am in Sussex County Delaware, at the medic dream job. Want to find out why? Google Sussex County EMS.



Lol that's awesome that you only have to ride with the transport on ALS calls  Seems like an awesome gig!


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## tom.watkins (Jul 18, 2011)

n7lxi said:


> Seattle is an EMS wasteland. I also worked in Yakima and had a blast. I now am in Sussex County Delaware, at the medic dream job. Want to find out why? Google Sussex County EMS.



Just read the website....it makes Yak look like a wasteland too! Good for you, man! You should send me a of your sprint vehicle.


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## MedicBender (Jul 18, 2011)

Sussex has an awesome reputation out here. The only thing I've heard about DE is it's a pretty big "mommy may I" state, but being a new medic that isn't necessarily a bad thing. I'm waiting on my packet from new castle county right now.


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## NomadicMedic (Jul 18, 2011)

The protocols are available on line. Not a lot of "mother may I" here.


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## cfd3091 (Jul 18, 2011)

Cabarrus County NC. Real busy, very progressive, and a great Medical Director.


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## TransportJockey (Jul 18, 2011)

cfd3091 said:


> Cabarrus County NC. Real busy, very progressive, and a great Medical Director.



They hiring currently? And will your service look at someone without NC cert?  (see my thread to NC EMTs)


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## firecoins (Jul 18, 2011)

the state of confusion is a great state to do EMS in. And its always hiring.


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## cfd3091 (Jul 18, 2011)

TransportJockey said:


> They hiring currently? And will your service look at someone without NC cert?  (see my thread to NC EMTs)


I don't work for them anymore I'm full time fire now but while I was there they did hire one from Florida.Check out the website.


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## cfd3091 (Jul 18, 2011)

cfd3091 said:


> I don't work for them anymore I'm full time fire now but while I was there they did hire one from Florida.Check out the website.


http://www.cabarruscounty.us/government/departments/ems/Pages/default.aspx
Had to have 5 posts for this here you go


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## NomadicMedic (Jul 19, 2011)

tom.watkins said:


> Just read the website....it makes Yak look like a wasteland too! Good for you, man! You should send me a of your sprint vehicle.



Yeah. It's pretty cool. And here's a pic of the truck.


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## NomadicMedic (Jul 24, 2011)

MedicBender said:


> Sussex has an awesome reputation out here. The only thing I've heard about DE is it's a pretty big "mommy may I" state, but being a new medic that isn't necessarily a bad thing. I'm waiting on my packet from new castle county right now.



I applied at New Castle too. Sussex seemed like a better fit for me.  if you're interested in the comparison, and why I chose Sussex, drop me a pm.


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## MrBrown (Jul 24, 2011)

Deleware is cool, they have RSI and POC lactate ... but no Ceftriaxone? :unsure:

We have ceftriaxone but no POG lactate but we do have RSI


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## NomadicMedic (Jul 24, 2011)

MrBrown said:


> Deleware is cool, they have RSI and POC lactate ... but no Ceftriaxone? :unsure:
> 
> We have ceftriaxone but no POG lactate but we do have RSI



Interesting. I don't know of any services in the states, off hand, that have prehospital ceftriaxone. I'd assume it's only for suspected meningococcal meningitis?


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## MrBrown (Jul 24, 2011)

n7lxi said:


> Interesting. I don't know of any services in the states, off hand, that have prehospital ceftriaxone. I'd assume it's only for suspected meningococcal meningitis?



Meningitis and sepsis


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## NomadicMedic (Jul 24, 2011)

Makes sense. I'll have to search for studies on prehospital antibiotics. It's practically unheard of here. (Although,  without searching, I'd guess that if anyone would have them it'd be either Wake or Austin/Travis.)


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