# It's That Time, KCM1 Now Hiring



## FLMedic311 (Jan 18, 2018)

Please feel free to ask questions!


https://www.publicsafetytesting.com/

https://www.kingcounty.gov/…/emer…/medic-one/employment.aspx

King County Medic One employment - King County
King County Medic One (KCM1) is a county-operated EMS system that is the sole provider of pre-hospital 911 Advanced Life Support (ALS) in south King County.
Learn More
KINGCOUNTY.GOV


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## DrParasite (Jan 18, 2018)

1) what are the odds of getting hired if you aren't already a certified paramedic?  since they are going to send you through medic school again any way, does it really matter?

2) who handles ALS in north King County?

3) what is the failure rate?  meaning, how many people who get hired do not complete the initial training? how many do not complete their first year, or pass their FTO time?  

4) assuming you don't complete your first year there (for whatever reason), are their any other comparable places to work, within a reasonable (defining as 1 hour commute) distance?  I mean comparable pay rates, conditions, schedule, etc.

5) is the assessment completed in a one or two day process, or do out of towners have to fly to Seattle multiple times to get it done?

6) 8 hours in class, followed by 12 hours on a busy truck, followed by 8 hours in class sounds like a recipe for disaster, especially if they expect you to pay attention at all in class when you are exhausted.  do they commonly do this?

is KCM1 part of the county, or part of Seattle fire department?  the website makes it look like it's county based, but there are many references to Seattle fire department paramedic units.


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## RocketMedic (Jan 18, 2018)

Y all don't have field blood transfusions and work too much (24/48 right?)


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## NomadicMedic (Jan 18, 2018)

I know some of the answers to this, if I’m way off @FLMedic311 can set me straight. 

If you’re not a paramedic you still have a chance of getting hired. They’ll send you to school and teach you the King County way. They’ve hired EMTs and medics. I know a few guys who worked as a basic for years and then got hired at KCM1. 

 North King County is Seattle. Seattle Fire runs everything basically up to Snohomish County. Other fire departments like Bellevue, to the east, run ALS. Their paramedics would be called “Bellevue Fire Department Medic One”. Shoreline has their own medics, right?

 South King County is where King County Medic One runs. Renton, Kent, Auburn. If you look at a map you can see it.  They are not a fire  service, but they are the only paramedic service in king county that is not fire.


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## DrParasite (Jan 18, 2018)

NomadicMedic said:


> North King County is Seattle. Seattle Fire runs everything basically up to Snohomish County. Other fire departments like Bellevue, to the east, run ALS. Their paramedics would be called “Bellevue Fire Department Medic One”. Shoreline has their own medics, right?
> 
> South King County is where King County Medic One runs. Renton, Kent, Auburn. If you look at a map you can see it.  They are not a fire  service, but they are the only paramedic service in king county that is not fire.


So, are all the medic one's different?  different protocols, different pay and schedule, different medical directors?  hypothetically speaking, could i apply to KCM1 and then transfer to Seattle Fire medic 1?  or Bellevule fire medic 1?  or would I have to do all the training again?  is the pay the same at all the medic ones?  or are they all independently operated groups, who have the "medic one" name but that's all they have in common?


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## FLMedic311 (Jan 18, 2018)

RocketMedic said:


> Y all don't have field blood transfusions and work too much (24/48 right?)


No we all don't do blood transfusions and no we don't work 24/48.  We do work 24hr shifts, 102 shifts a year to be exact.  The schedule is 24on 24off 24on 5Days off with approx. 9 debit days per year


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## FLMedic311 (Jan 18, 2018)

DrParasite said:


> 1) what are the odds of getting hired if you aren't already a certified paramedic?  since they are going to send you through medic school again any way, does it really matter?
> 
> 2) who handles ALS in north King County?
> *exactly what Nomadicmedic said, The FDs like Seattle, Bellevue, Shoreline, Redmond*
> ...


*NO, other then we all go to training at Haborview together, and Seattle FD is who you ride with during training.*


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## FLMedic311 (Jan 18, 2018)

DrParasite said:


> So, are all the medic one's different?  different protocols, different pay and schedule, different medical directors?  hypothetically speaking, could i apply to KCM1 and then transfer to Seattle Fire medic 1?  or Bellevule fire medic 1?  or would I have to do all the training again?  is the pay the same at all the medic ones?  or are they all independently operated groups, who have the "medic one" name but that's all they have in common?


Yes we are all different, no you could not simple lateral, although once you have completed training succesfully you would not need to complete it again should you apply and get hired somewhere else in the county.  What we all have in common is that we graduate from Dr. Copass's "Medic One" Training Program.  That is what it "means" to truly be Medic One, but when you are here you will see other Depts Bite on the name because there is no way to trademark it


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## FLMedic311 (Jan 18, 2018)

NomadicMedic said:


> I know some of the answers to this, if I’m way off @FLMedic311 can set me straight.
> 
> If you’re not a paramedic you still have a chance of getting hired. They’ll send you to school and teach you the King County way. They’ve hired EMTs and medics. I know a few guys who worked as a basic for years and then got hired at KCM1.
> 
> ...


NAILED IT!  I will just add that over the past few years we have hired 5 prior medics and 4EMTs, so bottom line is best candidate gets hired


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## CALEMT (Jan 18, 2018)

Go through medic school again? Yeah, no thanks.


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## RocketMedic (Jan 18, 2018)

What's so special about this "Copassmedic"?


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## VentMonkey (Jan 18, 2018)

How about we don’t pull the ruler out quite yet? Dude was just telling people that they’re accepting apps. 

I’m not completely sold on redoing paramedic school myself, but I certainly get them wanting to ingrain _their_ culture. It’s not for all of us clearly, but then again it clearly still appeals to enough people that they’ve yet to change their policies //shrugs//

@FLMedic311 I may have missed the answer that @DrParasite asked, but what exactly is their attrition rate for those who get hired on through their first year?


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## FLMedic311 (Jan 18, 2018)

@VentMonkey First and foremost Thanks.  I am most definitely not here to brag, we have out shortcomings and there are plenty of other amazing programs out there!  But if you think that ours could be right for you, I would be happy to help answer questions and clarify things for you! 
 Regarding Attrition rate I am not 100% sure but I know it is fairly low, If I had to put a number to it I would _*Guess*_ 3-5% .  One of the primary goals in hiring is trying to make sure that who they hire won't wash out because when that happens it quickly becomes a huge burden on the dept.  With that said, getting hired is not a guarantee to completion


RocketMedic said:


> What's so special about this "Copassmedic"?



As prior stated in my comment it is Dr. Copass.  He is one of the founders and was the director of the Medic One Program of HMC


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## Thatoneguy1313 (Jan 18, 2018)

Is the 3 years experience a hard requirement? I know it probably is, but sitting at 2 years I figure may as well ask.


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## FLMedic311 (Jan 18, 2018)

Thatoneguy1313 said:


> Is the 3 years experience a hard requirement? I know it probably is, but sitting at 2 years I figure may as well ask.


Yes


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## PotatoMedic (Jan 18, 2018)

Thatoneguy1313 said:


> Is the 3 years experience a hard requirement? I know it probably is, but sitting at 2 years I figure may as well ask.


Quite hard.  If it is not three years by application end date no luck.  Knew a guy who was a day off and was rejected.  ONE day.  Not saying it is a good or bad thing.  Just that it is a hard requirement.  If I had the orange book to study I probably would apply.


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## NomadicMedic (Jan 18, 2018)

They do turn out some good medics. There’s nothing else that quite compares to their education. 

I find it interesting tht many of the services who call themselves Medic One don’t hire Harborview medics. Like Mason County, Gig Harbor and Key Pen. They actually wear a “Medic One” patch. Surprised the Medic One foundation hasn’t found a way to squash that.


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## ethomas4 (Jan 18, 2018)

I just moved to Seattle. I am curious, what is AMR´s role in EMS up here? I have seen both Medic One units and AMR units arrive to same call. Thanks


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## NomadicMedic (Jan 18, 2018)

ethomas4 said:


> I just moved to Seattle. I am curious, what is AMR´s role in EMS up here? I have seen both Medic One units and AMR units arrive to same call. Thanks



BLS transport and LOTS of IFT.


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## RocketMedic (Jan 19, 2018)

Basically, if it's not acute enough to justify paramedic transport and intervention, AMR gets it.

What criteria does M1 have for ALS assessment and transport?


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## PotatoMedic (Jan 19, 2018)

RocketMedic said:


> Basically, if it's not acute enough to justify paramedic transport and intervention, AMR gets it.
> 
> What criteria does M1 have for ALS assessment and transport?


Usually actively dieing and before bed time.  I can't count on both hands how many times I've take "oh that isn't a stemi" to the ER as a bls provider because the senior medic wanted to go back to bed.  Or even new onset seizure.  Or status asthma.  Does "Turfing Tony" still work for ya?


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## NomadicMedic (Jan 19, 2018)

PotatoMedic said:


> Usually actively dieing and before bed time.  I can't count on both hands how many times I've take "oh that isn't a stemi" to the ER as a bls provider because the senior medic wanted to go back to bed.  Or even new onset seizure.  Or status asthma.  Does "Turfing Tony" still work for ya?



Hahahaha. The legend lives on.


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## EpiEMS (Jan 19, 2018)

PotatoMedic said:


> I can't count on both hands how many times I've take "oh that isn't a stemi" to the ER as a bls provider because the senior medic wanted to go back to bed. Or even new onset seizure. Or status asthma.



Geez. And the AMR medical director is OK with this?


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## PotatoMedic (Jan 19, 2018)

EpiEMS said:


> Geez. And the AMR medical director is OK with this?


The county medical director, who is the over all medical director, is fine with it as they are the kcmo medical director.  The AMR or xyz ambulance medical director has to play by the county medical directors rules.  And honestly they are just there to catch a paycheck and don't really provide over site.


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## RocketMedic (Jan 20, 2018)

"Just drive fast"?


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## KingCountyMedic (Jan 25, 2018)

I see all the usual folks that can't pass our testing process are still here.


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## NomadicMedic (Jan 26, 2018)




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## StCEMT (Jan 26, 2018)

KingCountyMedic said:


> I see all the usual folks that can't pass our testing process are still here.


Can't fail a test I have no interest in taking.


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## RocketMedic (Jan 26, 2018)

KingCountyMedic said:


> I see all the usual folks that can't pass our testing process are still here.



Why would I want to regress professionally?


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## medichopeful (Jan 26, 2018)

RocketMedic said:


> Why would I want to regress professionally?



Because you could work for KING COUNTY!  You would be a god to all other lowly EMS providers.

You could even place central lines in the field, and you wouldn't have to worry about such trivialities as "sterility."


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## DrParasite (Jan 26, 2018)

KingCountyMedic said:


> I see all the usual folks that can't pass our testing process are still here.


I can honestly say that nothing that I have read here or online makes me want to uproot my family, move to the west coast, where the cost of living is 50% higher compared to my current location (and still higher than when I lived in Jersey), for a job that if it doesn't work out (for one reason or another), I'm totally screwed there because there are no comparable jobs in the area for me to work at.  

Oh, and the whole class for 8 hours, than busy 12 hour clinical in the city, followed by another 8 hours of class firmly supports my decision.  Well, than and I couldn't handle the pay cut.  

So yeah, thanks for your two cents on this topic, and enjoy drinking the koolaid


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## NomadicMedic (Jan 26, 2018)

You all know my take on KCM1. Its certainly not for everyone, but if you live in western Washington, it’s the place to be a medic. 

If you don’t know any better or have been working for a lousy private, KCM1 is nirvana. 

If you want to be a fairly autonomous single role medic, make a good salary and have a decent retirement, KCM1 is a good choice. 

Are there other places? Yes. Is KCM1 still a good place to work? Yes. Let’s not all crap on the help wanted post. I’d think anyone who’s planning to test there will have done their due diligence.


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## RocketMedic (Feb 7, 2018)

Relevant:

https://em.uw.edu/sites/em.uw.edu/files/7 Paramedic Orientation - Edits 7.pdf

So they are literally "mother-may-I" on everything....if it's not traumatic shock or CA, it's a medical control.

_*LAME.*_

Meanwhile, us Texan, New Mexicans, Pennsylvanianites, and even Californians are doing relevant things to help people without even thinking of asking permission in a lot of cases....


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## Bullets (Feb 7, 2018)

RocketMedic said:


> Relevant:
> 
> https://em.uw.edu/sites/em.uw.edu/files/7 Paramedic Orientation - Edits 7.pdf
> 
> ...


They have to call medical control for Aspirin and Nitro? Wooof


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## CALEMT (Feb 7, 2018)

Bullets said:


> They have to call medical control for Aspirin and Nitro? Wooof



I would find that surprising if this is in-fact the case.


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## Gurby (Feb 7, 2018)

RocketMedic said:


> Relevant:
> 
> https://em.uw.edu/sites/em.uw.edu/files/7 Paramedic Orientation - Edits 7.pdf



"The Medics and their patients deserve to be greeted by a physician, a nurse, an empty bed, and other necessary resources like RT."


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## PotatoMedic (Feb 7, 2018)

CALEMT said:


> I would find that surprising if this is in-fact the case.


Good news!  You won't be surprised!  Most of the medics I knew would treat then call the doc to tell them what they did.  Also note that PDF was for Seattle medic one who has a tighter leash.


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## CALEMT (Feb 7, 2018)

PotatoMedic said:


> Good news!  You won't be surprised!  Most of the medics I knew would treat then call the doc to tell them what they did.  Also note that PDF was for Seattle medic one who has a tighter leash.



Ok lol. I was thinking holy crap and I thought CA was bad. At least I can give meds on standing orders.


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## FLMedic311 (Feb 7, 2018)

RocketMedic said:


> Relevant:
> 
> https://em.uw.edu/sites/em.uw.edu/files/7 Paramedic Orientation - Edits 7.pdf
> 
> ...



Wow, you couldn't be more incorrect on this.. I have zero issues with people who are critical of my system.  As I have and will continue to say, we are not perfect.  But what is truly   _*LAME*_   is your incessant need to make negative statements with little to no bases.  If you have a question, or are unsure about something ask!  I have made it more then clear that I am happy to clarify anything to anyone to the best of my ability.  But your disparaging comments are not only unwanted they are are unwarranted.


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## RocketMedic (Feb 7, 2018)

Well, that's from Medic One...what is the real standard?


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## medichopeful (Feb 8, 2018)

FLMedic311 said:


> Wow, you couldn't be more incorrect on this.. I have zero issues with people who are critical of my system.  As I have and will continue to say, we are not perfect.  But what is truly   _*LAME*_   is your incessant need to make negative statements with little to no bases.  If you have a question, or are unsure about something ask!  I have made it more then clear that I am happy to clarify anything to anyone to the best of my ability.  But your disparaging comments are not only unwanted they are are unwarranted.



I'm legitimately curious.  Can you walk me through how a call would go for a patient who broke their ankle, and is hemodynamically stable?  I'm talking about just a brief overview, including treatment before medcon, talking to medcon, after medcon, etc.


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## EpiEMS (Feb 8, 2018)

medichopeful said:


> Can you walk me through how a call would go for a patient who broke their ankle, and is hemodynamically stable?



Based on what I've heard, they'd BLS that 

But yeah, this is a valid question - medics are on scene, no BLS unit available, how do they handle this? Do they really have to call medical direction?


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## DrParasite (Feb 8, 2018)

FLMedic311 said:


> Wow, you couldn't be more incorrect on this.. I have zero issues with people who are critical of my system.  As I have and will continue to say, we are not perfect.  But what is truly   _*LAME*_   is your incessant need to make negative statements with little to no *bases.*


IDK.... providing documentation from the website from the University of Washington's Department of Emergency Medicine that clearly provides information about Seattle/King County Paramedics from the doctor's point of view is a pretty strong support for a claim.....

It's like me saying Medic One paramedics have to call for everything; that's a baseless statement.  But if I show the protocol from Medic one, or from their medical director's training program, which clearly say medics need to call a doc to give a drug, than it's not so baseless.

If anything, I think your response saying that his claim (which may or may not be true) is incorrect is pretty baseless..... Can you provide any support to your (currently) baseless claim, such as by posting a link of the MedicOne protocols that state when a paramedic is supposed to call the doc?  something like this (http://www.emsonline.net/assets/EMTPatientCareProtocols2012.pdf), but preferably from the paramedic level and more recent than 2012


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## FLMedic311 (Feb 8, 2018)

RocketMedic said:


> Well, that's from Medic One...what is the real standard?



That is from Seattle Medic One.  If you don't understand the difference, there are plenty of other posts explaining this..



DrParasite said:


> IDK.... providing documentation from the website from the University of Washington's Department of Emergency Medicine that clearly provides information about Seattle/King County Paramedics from the doctor's point of view is a pretty strong base.....
> 
> It's like me saying Medic One paramedics have to call for everything; that's a baseless statement.  But if I show the protocol from Medic one, or from their medical director's training program, which clearly say medics need to call a doc to give a drug, than it's not so baseless.
> 
> If anything, I think your response saying that his claim (which may or may not be true) is incorrect is pretty baseless..... Can you provide any support to your (currently) baseless claim, such as by posting a link of the MedicOne protocols that state when a paramedic is supposed to call the doc?  something like this (http://www.emsonline.net/assets/EMTPatientCareProtocols2012.pdf), but preferably from the paramedic level and more recent than 2012



No it is not.  It is out of context. 
I work here, I take time out of my personal life to try clarify what it means to be a part of this organization from the eyes of someone who has done it and recently for that matter.  I would say that is the definition of bases.




EpiEMS said:


> Based on what I've heard, they'd BLS that
> 
> But yeah, this is a valid question - medics are on scene, no BLS unit available, how do they handle this? Do they really have to call medical direction?



@medichopeful @EpiEMS Yes, we would likely BLS that..  There is always a BLS unit available, whether it would be FD, AMR or Trimed.  That is not to say there is no circumstances in which that person could/would be transported by a medic,  Most situations that require a MD contact prior to Tx are Conscious sedation and the use of anti-arrhythmic in a otherwise stable arrhythmia  i.e.  Diltiazem to Afib RVR with stable vitals.


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## medichopeful (Feb 8, 2018)

Thanks for the response. Would discomfort/pain be one of the reason that it would be ALS? In other words, how does pain management play into these calls?

I have zero interest in working for KCMO for a variety of reasons, but I'm curious how the system handles some things.


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## RocketMedic (Feb 9, 2018)

Is symptom relief and pain management not a thing in King County? Kidney stones, etc?


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## DrParasite (Feb 9, 2018)

FLMedic311 said:


> No it is not.  It is out of context.
> I work here, I take time out of my personal life to try clarify what it means to be a part of this organization from the eyes of someone who has done it and recently for that matter.  I would say that is the definition of bases.


1) please explain how it's taken out of context.

2) we have only your word that you actually work there.  I would say I work there too, and both claims have the same validity.  it's the nature of the online forum.  Your claim that you have done it and done it recently has the similar amount of validity.  Did you do it?  maybe?  maybe not? I wasn't looking over your shoulder, so I can't say for sure (and no one else can too).

3) the definition of base is typically an objective statement that is verifiable by a third party.  I can verify that the document provided is legitimate.  I can verify that it is, indeed, on an authentic server from UW.  Based on this, I have no reason to doubt it's accuracy.  Your claim that the document is inaccurate, without any supporting documentation, based solely on your opinion, has no base, because it isn't verifiable by a third party. 

4) I did ask for a copy of some KCM1 protocols (feel free to thank Chief Tait for me).  It looks like they operate similar to NJ; paramedics can do a whole of of standing order stuff, and then call the doc, who might say to do more, or might just say monitor and transport..  Although I was surprised to see you guys still put certain meds down the tube in a cardiac arrest......  Since I'm attaching the actual patient care guidelines, it's now no longer a baseless claim. 

I hope clearing up baseless vs solid base for you.


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## RocketMedic (Feb 9, 2018)

That's a surprisingly narrow band of standing orders.


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## NomadicMedic (Feb 9, 2018)

RocketMedic said:


> That's a surprisingly narrow band of standing orders.



So, the way it works is like this. The medic sees a patient, makes a field diagnosis, decides on a treatment plan and then calls the doc to present the patient and proposed treatment. The doc usually agrees, the medic treats the patient and transports to the hospital. 

@FLMedic311, am I right on this? There are few standing orders because the medic is expected to make contact, present the patient with proposed treatment and get approval. It's not exactly a "mother may i" system ... It's more like a "This is what I've got Doc. Do you agree?"


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## FLMedic311 (Feb 9, 2018)

medichopeful said:


> Thanks for the response. Would discomfort/pain be one of the reason that it would be ALS? In other words, how does pain management play into these calls?
> 
> I have zero interest in working for KCMO for a variety of reasons, but I'm curious how the system handles some things.





RocketMedic said:


> Is symptom relief and pain management not a thing in King County? Kidney stones, etc?




No problem,  Yes it can be, but it is at the discretion of the crew as to whether or not they are going to Tx for pain management.  Because ALS is treated as a limited resource, there are other considerations that have to be taken into account before making this decision.  We unfortunately do not have the ability to Tx for pain and allow BLS transport subsequent to that.


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## RocketMedic (Feb 9, 2018)

NomadicMedic said:


> So, the way it works is like this. The medic sees a patient, makes a field diagnosis, decides on a treatment plan and then calls the doc to present the patient and proposed treatment. The doc usually agrees, the medic treats the patient and transports to the hospital.
> 
> @FLMedic311, am I right on this? There are few standing orders because the medic is expected to make contact, present the patient with proposed treatment and get approval. It's not exactly a "mother may i" system ... It's more like a "This is what I've got Doc. Do you agree?"



But where is the vast majority of treatment in a system that is tiered and sends most people off BLS, if they ever see a medic?


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## RocketMedic (Feb 9, 2018)

FLMedic311 said:


> No problem,  Yes it can be, but it is at the discretion of the crew as to whether or not they are going to Tx for pain management.  Because ALS is treated as a limited resource, there are other considerations that have to be taken into account before making this decision.  We unfortunately do not have the ability to Tx for pain and allow BLS transport subsequent to that.


So basically, the quality of care provided is primarily determined not by the patients needs or wants, but by EMD and how compassionate the crew feels if they are actually assigned?

Like, in our system, every truck has a medic, so you're not actually saving time if you don't want to ALS something, and although discretion remains, you can't handwave "resources" to defend not doing something. There's really no reason not to manage pain if it can be done safely and effectively.


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## Bullets (Feb 9, 2018)

DrParasite said:


> 4) I did ask for a copy of some KCM1 protocols (feel free to thank Chief Tait for me).  It looks like they operate similar to NJ; paramedics can do a whole of of standing order stuff, and then call the doc, who might say to do more, or might just say monitor and transport..  Although I was surprised to see you guys still put certain meds down the tube in a cardiac arrest......  Since I'm attaching the actual patient care guidelines, it's now no longer a baseless claim.
> 
> I hope clearing up baseless vs solid base for you.


So where are the standing orders for like, every other thing a medic might come in contact with?


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## VentMonkey (Feb 9, 2018)

@FLMedic311 this is yours...





And so my post doesn’t get deleted, here’s to hoping the thread can stay moderately relevant  until 03/31, cheers.


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## Ensihoitaja (Feb 9, 2018)

NomadicMedic said:


> So, the way it works is like this. The medic sees a patient, makes a field diagnosis, decides on a treatment plan and then calls the doc to present the patient and proposed treatment. The doc usually agrees, the medic treats the patient and transports to the hospital.
> 
> @FLMedic311, am I right on this? There are few standing orders because the medic is expected to make contact, present the patient with proposed treatment and get approval. It's not exactly a "mother may i" system ... It's more like a "This is what I've got Doc. Do you agree?"



I have a friend that works for Seattle Fire and that's exactly how he described it to me.


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## chriscemt (Feb 10, 2018)

PotatoMedic said:


> The county medical director, who is the over all medical director, is fine with it as they are the kcmo medical director.  The AMR or xyz ambulance medical director has to play by the county medical directors rules.  And honestly they are just there to catch a paycheck and don't really provide over site.



Being in the Kansas City area, each reference to KC and KCMO is terribly confusing.  Carry on.


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## RocketMedic (Feb 10, 2018)

I'm still wondering how world-class prehospital medical care is consistently provided for most patients in a system where most calls don't even see a provider capable of providing meaningful interventions for their complaints, much less get transported by them.

@FLMedic311 , here's a few questions. What sort of response, treatment and transport should these patients expect from the KCM1 system? (Assume all vitals are stable)

A) 65 y/o hemodynamically-stable hip fracture, complaints of 10/10 pain and fracture, uncomplicated.
B) 25 y/o GSW to the hand, complaints of 10/10 pain, uncomplicated.
C) Adult asthma exacerbation, expiratory wheezing only, some relief from MDI, "I can't breathe well and I feel bad"
D) 70 y/o near-syncope
E) "Grandma's a little lethargic today"
F) 60 y/o chest pain with cough.
G) 70 y/o with chest pain.

Broadly, who gets medics, and who gets rides?


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## PotatoMedic (Feb 10, 2018)

RocketMedic said:


> I'm still wondering how world-class prehospital medical care is consistently provided for most patients in a system where most calls don't even see a provider capable of providing meaningful interventions for their complaints, much less get transported by them.
> 
> @FLMedic311 , here's a few questions. What sort of response, treatment and transport should these patients expect from the KCM1 system? (Assume all vitals are stable)
> 
> ...



Besides the gsw I can say I have transported all those patients as a bls provider in the kcmo system.  

To also be honest I have seen medics transport and treat all of those patients as well.  And to note just because I have transported a chest pain as a bls provider does not mean that the medics don't do it regularly.  The kcmo protocols are well... Lacking because they are trained and educated well.  They have a trauma protocol.  A cardiac arrest protocol and a do what you want just call the doc to clear it by them protocol.  They literally don't have a set protocol because they are trusted to diagnose and treat.  Yes they call the doc but honestly half the time they just do and then let the doc know what they did.  Honestly I don't like that a lot of patients that would benefit from ALS care go bls.  In fact a lot of patients that would mandate Als care in a lot of places go bls in king county.  But the providers are very knowledgeable and most do care.  They also are put in a limited resources situation.  And they will split crews to take two different ALS calls.  I remember a few times being at one scene with a medic unit when bad trauma came in.  I left my partner with one medic and the other medic grabbed the kits and told me to drive to the other call to take the second patient.  In the end both got ALS transports.  No system is perfect.  And I know kcmo is not perfect.  But it is also evolving.  I know with the new medical director some things are changing for the better.  But it takes time to change a culture.


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## emtgirl0959 (Apr 24, 2018)

Hello! Can you give an idea of what the hiring process/skills assessment is like?


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