# Harris county emergency corps



## CTMD (Apr 1, 2016)

Hey all, 

I was wondering if anyone could give me any information on what it is like working for HCEC? Station quality, call volume, pay, overall opinions of the place etc. How long does it take to promote up to in charge if you are already a medic?


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## STXmedic (Apr 2, 2016)

Send @Wes a PM.


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## CTMD (Apr 2, 2016)

Is there a minimum amount of posts you have to post before getting to PM?  I didn't see that option but I'm kinda new to this lol


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## TransportJockey (Apr 2, 2016)

Ten posts I believe. I can speak of overall opinions from outside agencies. They're a good, aggressive service, one that is very well established and not going anywhere anytime soon. They have also drunk their own Kool-Aid


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## CTMD (Apr 3, 2016)

TransportJockey said:


> Ten posts I believe. I can speak of overall opinions from outside agencies. They're a good, aggressive service, one that is very well established and not going anywhere anytime soon. They have also drunk their own Kool-Aid


Cool thank you! Is the area that they cover pretty rural or not so much? How is it living there? Cost of living, Safety, recreation activities? Also does anyone know how they would compare to MCHD or Cypress Creek EMS?


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## TransportJockey (Apr 3, 2016)

CTMD said:


> Cool thank you! Is the area that they cover pretty rural or not so much? How is it living there? Cost of living, Safety, recreation activities? Also does anyone know how they would compare to MCHD or Cypress Creek EMS?


Similar to MCHD. Dont know much about Cy Creek. From what i remember, their territory is pretty suburban. And i believeore populated than my entire county (Galveston). COL in the Houston metro isn't bad, and the no state income tax thing helps there. There's plenty to do out here within an hour or so of that area of Harris County.


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## CTMD (Apr 3, 2016)

TransportJockey said:


> Similar to MCHD. Dont know much about Cy Creek. From what i remember, their territory is pretty suburban. And i believeore populated than my entire county (Galveston). COL in the Houston metro isn't bad, and the no state income tax thing helps there. There's plenty to do out here within an hour or so of that area of Harris County.


Awesome thanks!


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## TransportJockey (Apr 3, 2016)

Just so you know we are looking for emts and medics in Galveston as well lol


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## CTMD (Apr 3, 2016)

TransportJockey said:


> Just so you know we are looking for emts and medics in Galveston as well lol


 I'm in San Bernardino Ca for medic school, might be a little premature too move lol I haven't heard much about Galeveston, can you tell me more about your service? I'm looking for an aggressive service/system with multiple treatment options and a large pharmacological toolbox. I can't stand being in a system that just carries the bare minimum to function as ALS 911. That's why I'm looking into Texas, it seems like the general Harris County area has a lot of advanced aggressive systems.


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## TransportJockey (Apr 3, 2016)

CTMD said:


> I'm in San Bernardino Ca for medic school, might be a little premature too move lol I haven't heard much about Galeveston, can you tell me more about your service? I'm looking for an aggressive service/system with multiple treatment options and a large pharmacological toolbox. I can't stand being in a system that just carries the bare minimum to function as ALS 911. That's why I'm looking into Texas, it seems like the general Harris County area has a lot of advanced aggressive systems.


I'll type up the full thing when i get to  computer lol. You would have several good options out this way.
Our protocols are found online. Google galveston ems, and they can be viewed from the front page anout half way down


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## CTMD (Apr 3, 2016)

TransportJockey said:


> I'll type up the full thing when i get to  computer lol. You would have several good options out this way.
> Our protocols are found online. Google galveston ems, and they can be viewed from the front page anout half way down


Ok cool, I'll take a look at them. What are the average transport times for those areas? HCEC MCHD and Galveston?


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## TransportJockey (Apr 4, 2016)

CTMD said:


> Ok cool, I'll take a look at them. What are the average transport times for those areas? HCEC MCHD and Galveston?


HCEC I'm not sure. MCHD can having short or relatively long just due to the area they cover. GAAA (galveston EMS) we have anywhere from 5 minutes to 45 minutes on the island, and the two county trucks we run are a minimum of 15-20 minutes to the nearest hospital.


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## TransportJockey (Apr 4, 2016)

CTMD said:


> I'm in San Bernardino Ca for medic school, might be a little premature too move lol I haven't heard much about Galeveston, can you tell me more about your service? I'm looking for an aggressive service/system with multiple treatment options and a large pharmacological toolbox. I can't stand being in a system that just carries the bare minimum to function as ALS 911. That's why I'm looking into Texas, it seems like the general Harris County area has a lot of advanced aggressive systems.


So in Harris County and the surrounding area you have a handful of good services, and then you have some ok ones, and then you have Acadian. 
In Houston itself you have HFD, which is the transporting 911 agency for the city of Houston. They run a tiered system, but you must go through the fire academy to work there. 
To the east you have Pasadena which is run by ETMC EMS, you have North Channel EMS, City of South Houston EMS, La Porte EMS. La Porte is a pretty well regarded system around here as well.
To the south you have League City EMS (city run third service in Galveston county), Webster Fire, Acadian, Friendswood EMS (third service hybrid system), Pearland (FD transporting system), Alvin (city EMS) and if you keep going you run into Galveston EMS and Lake Jackson EMS (both good choices), Clear Lake Emergency Medical Corps (No. Just no.), ****inson EMS (Fire based, but separate dept EMS agency)
To the west you have Ft Bend County EMS (county third service, which is well regarded and growing).
The the north you have MCHD EMS (Good hospital based service, covers all of Montgomery county), CyFair (well regarded red shirted service), HCEC (which you are looking at), and a couple others I can't remember.
This is not counting the small one and two truck 911 services scattered around. 

do NOT work at a small private company in Houston. It is the medicare fraud capital of the US.


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## CTMD (Apr 4, 2016)

TransportJockey said:


> So in Harris County and the surrounding area you have a handful of good services, and then you have some ok ones, and then you have Acadian.
> In Houston itself you have HFD, which is the transporting 911 agency for the city of Houston. They run a tiered system, but you must go through the fire academy to work there.
> To the east you have Pasadena which is run by ETMC EMS, you have North Channel EMS, City of South Houston EMS, La Porte EMS. La Porte is a pretty well regarded system around here as well.
> To the south you have League City EMS (city run third service in Galveston county), Webster Fire, Acadian, Friendswood EMS (third service hybrid system), Pearland (FD transporting system), Alvin (city EMS) and if you keep going you run into Galveston EMS and Lake Jackson EMS (both good choices), Clear Lake Emergency Medical Corps (No. Just no.), ****inson EMS (Fire based, but separate dept EMS agency)
> ...


Ok cool thank you for the detailed description of the services! In your opinion what services are the most aggressive/progressive with the best pay/working conditions?


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## RocKetamine (Apr 5, 2016)

Station quality: Very high compared to most services around. 
Call volume: around 25k a year. Typically 8-12 calls a shift. 
Pay: I believe medics start around $16 with no experience
Overall: It's a great company with an involved medical director. You can typically advance to in-charge within your first year of working there if you have a few years experience as a Paramedic. Can also work a lot of interesting events around Houston (anything at NRG, Toyota Center, BBVA Compass, Shell Houston Open, etc...)

The majority of the service is lower middle class/very poor with a few exceptions. Average transport time is less than 15 minutes in most cases. 

You can find HCEC, MCHD, and a few other Houston area services protocols if you download the PPP phone app.


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## aquabear (Apr 5, 2016)

If you aren't married to the Houston area, check out Williamson County EMS.


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## CTMD (Apr 5, 2016)

RocKetamine said:


> Station quality: Very high compared to most services around.
> Call volume: around 25k a year. Typically 8-12 calls a shift.
> Pay: I believe medics start around $16 with no experience
> Overall: It's a great company with an involved medical director. You can typically advance to in-charge within your first year of working there if you have a few years experience as a Paramedic. Can also work a lot of interesting events around Houston (anything at NRG, Toyota Center, BBVA Compass, Shell Houston Open, etc...)
> ...


Cool thanks for the info! Is there a minimum amount of time required to progress to IC or is it just that it takes awhile to gain the experience needed to be able to function competently at that level? I've read both of their protocols on the PPP app and that is what got me interested and considered moving to Houston. I like how MCHD has ultrasound and some other things but it seems like HCEC has a little more aggressive protocols with more of an offline medical direction mentality. 
So based on the service area is it safe to say that HCEC actually gets to dig into their protocols due to the patient population more often being sicker than most and relying on emergency medicine as their primary care provider?


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## CTMD (Apr 5, 2016)

aquabear said:


> If you aren't married to the Houston area, check out Williamson County EMS.


I haven't heard much about Williamson county.. Can you explain what makes it a good service?


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## RocKetamine (Apr 5, 2016)

CTMD said:


> Cool thanks for the info! Is there a minimum amount of time required to progress to IC or is it just that it takes awhile to gain the experience needed to be able to function competently at that level? I've read both of their protocols on the PPP app and that is what got me interested and considered moving to Houston. I like how MCHD has ultrasound and some other things but it seems like HCEC has a little more aggressive protocols with more of an offline medical direction mentality.
> So based on the service area is it safe to say that HCEC actually gets to dig into their protocols due to the patient population more often being sicker than most and relying on emergency medicine as their primary care provider?



There isn't a set time but you'll just have to wait until your in-charge partner, supervisor and the clinical department are confident in your abilities. Don't expect it in less than 6 months of hire. HCEC is pretty off line driven other than Ketamine usage and RSI which you can do if a supervisor is on scene and approves it. Ultrasound and pericardiocentesis are apparently in the works.

Just like with any service it all depends on where you are located. Some stations get more trauma, others medical. The trauma calls aren't as frequent as they were in the past. The county has cracked down on the area gangs making the shootings and stabbings far less common than 5+ years ago.

Also the schedule is probably the best around. You'll work two 24 hr shifts a week with 5 days off in a row.


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## aquabear (Apr 5, 2016)

CTMD said:


> I haven't heard much about Williamson county.. Can you explain what makes it a good service?


County run EMS system just north of Austin with good pay and a good TCDRS pension program. All of the trucks are based out of a station with no street corner posting. All stations are either in house with fire or in stand alone EMS stations. The county purchases the latest equipment including Wheeled Coach mods build on F-450's, King Vision VLs on every truck, Stryker power-pro gurneys, Philips Monitors, and Lucas 2's and vents on all commander vehicles.

Protocols are evidence based and updated yearly to reflect the most recent medical literature available. The medical director worked in the county as a paramedic before going to medical school, he is very pro-paramedic and works in a local ER. The scope of care is cutting edge and includes DSI for adults, RSI for peds with iGEL airways, ketamine for pain management refractory to fentanyl, dual sequential defibrillation, pericardiocentesis, and field STEMI and stroke activations.

Williamson County EMS also has a community health paramedic program, tactical medics, and a swift water rescue team.


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## aquabear (Apr 5, 2016)

But seriously, most 911 agencies in Texas are better than anything in California.


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## TransportJockey (Apr 6, 2016)

aquabear said:


> County run EMS system just north of Austin with good pay and a good TCDRS pension program. All of the trucks are based out of a station with no street corner posting. All stations are either in house with fire or in stand alone EMS stations. The county purchases the latest equipment including Wheeled Coach mods build on F-450's, King Vision VLs on every truck, Stryker power-pro gurneys, Philips Monitors, and Lucas 2's and vents on all commander vehicles.
> 
> Protocols are evidence based and updated yearly to reflect the most recent medical literature available. The medical director worked in the county as a paramedic before going to medical school, he is very pro-paramedic and works in a local ER. The scope of care is cutting edge and includes DSI for adults, RSI for peds with iGEL airways, ketamine for pain management refractory to fentanyl, dual sequential defibrillation, pericardiocentesis, and field STEMI and stroke activations.
> 
> Williamson County EMS also has a community health paramedic program, tactical medics, and a swift water rescue team.


WilCo is a great service. If they had had open positions when i was looking to get back on a ground truck i likely would have wound up there instead of here...


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## CTMD (Apr 6, 2016)

RocKetamine said:


> There isn't a set time but you'll just have to wait until your in-charge partner, supervisor and the clinical department are confident in your abilities. Don't expect it in less than 6 months of hire. HCEC is pretty off line driven other than Ketamine usage and RSI which you can do if a supervisor is on scene and approves it. Ultrasound and pericardiocentesis are apparently in the works.
> 
> Just like with any service it all depends on where you are located. Some stations get more trauma, others medical. The trauma calls aren't as frequent as they were in the past. The county has cracked down on the area gangs making the shootings and stabbings far less common than 5+ years ago.
> 
> Also the schedule is probably the best around. You'll work two 24 hr shifts a week with 5 days off in a row.


Ok makes sense. I thought they already had pericardiocentesis? So when you call for a medical consult is it like calling a base hospital where you can only do what they say and can not even perform any standing orders without base consult? Or do you just call to ask for a certain drug or procedure and then carry on as usual? Is overtime pretty limited or generous?


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## CTMD (Apr 6, 2016)

aquabear said:


> But seriously, most 911 agencies in Texas are better than anything in California.


Oh I believe it. I'm applying to medical schools right now so I'm trying to figure out whether or not I want to work in california for about a year before moving on to med school or get experience in an aggressive 911 system somewhere else before I matriculate.


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## STXmedic (Apr 6, 2016)

CTMD said:


> Ok makes sense. I thought they already had pericardiocentesis? So when you call for a medical consult is it like calling a base hospital where you can only do what they say and can not even perform any standing orders without base consult? Or do you just call to ask for a certain drug or procedure and then carry on as usual?


I don't know anywhere in Texas that you have to call for everything you do. If you have to call, it's for specific things (RSI, Ketamine admin, etc). Then it's call for that procedure, and carry on. Where I'm at, our doc doesn't believe in calling, so everything is standing order.


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## RocKetamine (Apr 6, 2016)

CTMD said:


> Ok makes sense. I thought they already had pericardiocentesis? So when you call for a medical consult is it like calling a base hospital where you can only do what they say and can not even perform any standing orders without base consult? Or do you just call to ask for a certain drug or procedure and then carry on as usual? Is overtime pretty limited or generous?



It's in the guidelines but not in practice yet. Ned consult is a phone to either the medical director or one of two medical officers that are experienced Paramedics, just depends on who answers the phone. Currently you only need to call for Ketamine or RSI if a Supervisor isn't available.  

Also, there are LUCAS II devices, McGrath Video Laryngoscopes, and transport ventilators with CPAP/BiPAP capabilities. Also the trucks also have a liquid oxygen system instead of tanks.


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## CTMD (Apr 6, 2016)

Ok nice, yea in California it's so restricitve and whenever you make base you can no longer do anything without contacting base first. I'm kind of surprised that Ketamine is a consult order. Why is that?


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## RocKetamine (Apr 6, 2016)

CTMD said:


> Ok nice, yea in California it's so restricitve and whenever you make base you can no longer do anything without contacting base first. I'm kind of surprised that Ketamine is a consult order. Why is that?



I really have no idea.


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## CTMD (Apr 6, 2016)

RocKetamine said:


> I really have no idea.


Go figure. So do you work at HCEC or have you just had experiences with them?


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