# Paramedic Openings in Tulare County



## CentralCalEMT (Feb 5, 2017)

As most people know, Hall and American have multiple paramedic openings. Both are excellent companies to work for. However, some people do not have the ability to move to start working 12s in a metro system. For those people who are unable to move, there is one other option in the county just north of Kern County. At least one Tulare County provider (Imperial Ambulance out of Porterville) is currently offering out of area medics who come work for them a compressed work schedule consisting of fixed days  of the week stacked back to back. For example, one week a medic would work a 48 Monday/Tuesday and the next week a 72 Monday/Tuesday/Wednesday. That ensures that out of the area paramedics only need to commute to work one time a week and gives alternating 4 and 5 day weekends. While the drive is 2 1/2 hours or so from LA, if it is only once a week it is more doable. Tulare County is a busy system with the same types of calls and same chance to get good experience as the larger systems to the north and south of it. Tulare County is part of the CCEMSA system so the protocols are the exact same as Fresno American and similar to Kern County. While Tulare County is a smaller system and often overlooked in comparison to the larger systems, it remains a viable option for commuting paramedics.


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## Jim37F (Feb 5, 2017)

I'm def one of those LA guys whose not in a position to move yet and is very intrigued with that schedule. Hows the call volume, i.e. 3-4 calls ea day or 20? Do you guys run dual medic, 1&1 (EMT and Medic) ALS, dual EMT, a combo? What kind of rigs are you in? Ford E series vans, Transit or Sprinter vans, F350/Dodge Ram Mods? Is the hourly pay enough to support a full tank of gas each way coming from LA?


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## VentMonkey (Feb 5, 2017)

CentralCalEMT said:


> At least one Tulare County provider (Imperial Ambulance out of Porterville) is currently offering out of area medics who come work for them a compressed work schedule consisting of fixed days  of the week stacked back to back.





Jim37F said:


> I'm def one of those LA guys whose not in a position to move yet and is very intrigued with that schedule. Hows the call volume, i.e. 3-4 calls ea day or 20? Do you guys run dual medic, 1&1 (EMT and Medic) ALS, dual EMT, a combo? What kind of rigs are you in? Ford E series vans, Transit or Sprinter vans, F350/Dodge Ram Mods? Is the hourly pay enough to support a full tank of gas each way coming from LA?


I'll do the neighborly thing here and add this:
http://imperialambulance.com/


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## CentralCalEMT (Feb 6, 2017)

Jim37F said:


> I'm def one of those LA guys whose not in a position to move yet and is very intrigued with that schedule. Hows the call volume, i.e. 3-4 calls ea day or 20? Do you guys run dual medic, 1&1 (EMT and Medic) ALS, dual EMT, a combo? What kind of rigs are you in? Ford E series vans, Transit or Sprinter vans, F350/Dodge Ram Mods? Is the hourly pay enough to support a full tank of gas each way coming from LA?



The call volume is moderate. You will average 8 or so per unit in a 24 if you are at our main post which has 3 ALS 24 hour units.  We also have a slow post with 1 24 hour unit which runs 4 calls on a busy day. That post is rotated between all medics so every medic gets a chance to work the slow post on a regular basis. The usual is 1&1 staffing although there are dual medic shifts from time to time. Fire is BLS only in our coverage area and some of their people aren't even EMTs. We have E series vans along with two Transit vans. The hourly pay should be enough to support a full tank. We currently have two employees who commute from LA and we used to have one who commuted from Sacramento and they seem to not have any issues. Shift change is at 0800 so it's not too early. The area covered is huge. Transport times range from 5 minutes in town to 2 hours from some remote mountain areas. We have 1 community hospital in our area but our nearest trauma and STEMI center is at least 30 miles away so those are extended transport times. We also have an air ambulance based in the county. Right now there are several medic spots open. I don't think there are any EMT spots open, but they do open up from time to time.


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## VentMonkey (Feb 6, 2017)

SkyLife has a base in Tulare Co. now?


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## CALEMT (Feb 7, 2017)

Generally Tulare Co. is a slow county (my experience). My experience has been... well... very rural Tulare Co. Like a hour and a half away from Porterville way up in the sticks. Back when I was in Tulare AMR still had P-ville and Imperial was... I forget... but I've talked to some of the imperial guys when I would work a different station and they seemed happy there. The 48 and 72 defiantly makes it appealing for someone that commutes. Just a reference I live in the Coachella Valley and commuted to my station (Tyler Creek/ California Hot Springs) which was 300 miles from my driveway to the driveway of the station. I would get up at 0220 and leave at 0330 and get to the station around 0730. In the morning it took generally 4-4 1/2 hours cause no traffic. Driving back took about 5-5 1/2 hours cause traffic. Granted my commute was 10-210-5-99-65-mtn rd 56. I would compare it to driving to Visalia for time. P-ville would be about another 20 minutes from my turn off at Ducor. Not a bad commute from LACo for a decent paying job for a decent shift IMO.


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## CentralCalEMT (Feb 7, 2017)

VentMonkey said:


> SkyLife has a base in Tulare Co. now?



Skylife 3 is now based out of the Visalia airport. That was the bird that went down last year near the Kern/Tulare county line.


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## VentMonkey (Feb 7, 2017)

CentralCalEMT said:


> Skylife 3 is now based out of the Visalia airport. That was the bird that went down last year near the Kern/Tulare county line.


Yes I am familiar with this, but was under the impression they were based out of Hanford.


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## CentralCalEMT (Feb 7, 2017)

VentMonkey said:


> Yes I am familiar with this, but was under the impression they were based out of Hanford.



They used to be, but were moved to Tulare County since we use them in the mountains more often than Kings County used them.


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## VentMonkey (Feb 7, 2017)

CentralCalEMT said:


> They used to be, but were moved to Tulare County since we use them in the mountains more often than Kings County used them.


They're no longer seasonal either I take it? We get the blue moon auto launches up that way. Posey comes to mind off the bat, but there are occasional Tulare Co. MA launch requests.


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## CentralCalEMT (Feb 7, 2017)

VentMonkey said:


> They're no longer seasonal either I take it? We get the blue moon auto launches up that way. Posey comes to mind off the bat, but there are occasional Tulare Co. MA launch requests.


 
Yeah they are year round. Fresno has 2 and we have 1. If all three are unavailable we will call Medivac 1. I have also requested them before in far south Tulare County when my helo was coming from Fresno since Medivac 1 is way closer to us at that point.


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## CALEMT (Feb 7, 2017)

VentMonkey said:


> Posey



Wow thats a good driv.... flight for you guys from Bakersfield I'm guessing is where you're stationed at Vent? I know when I was up in that area we had a preplan to have KCFD launch one of their birds from... oh let me think here... Glennville? I could be wrong though.


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## VentMonkey (Feb 7, 2017)

CentralCalEMT said:


> Yeah they are year round. Fresno has 2 and we have 1. If all three are unavailable we will call Medivac 1. I have also requested them before in far south Tulare County when my helo was coming from Fresno since Medivac 1 is way closer to us at that point.


Do you guys do launch requests, auto launches, stand-bys or any of the above depending on the calls EMD code?


CALEMT said:


> Wow thats a good driv.... flight for you guys from Bakersfield I'm guessing is where you're stationed at Vent? I know when I was up in that area we had a preplan to have KCFD launch one of their birds from... oh let me think here... Glennville? I could be wrong though.


Lol, pretty good memory, CAL. Yes, Glennville is closer to the Tulare Co. border and they often get dispatched before, or simultaneously with the Tulare units.

If they get dispatched first, depending on the nature of the call---medical or trauma---they ask for us on standby. Those guys are pretty good up that way, and on it.

Yes, we're based out of the Bakersfield International Airport, or Meadows Field. Flight time off the top of my head is about ~20 minutes, maybe a bit more. Considering we backfill for Mercy Air when they're out and those flight times can be in the 30's, it's not that bad at all.


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## CALEMT (Feb 7, 2017)

VentMonkey said:


> Lol, pretty good memory, CAL.



Had to man, I was the first due engine to Kern Co haha. I though they had a bird out of Glennville. Wasn't sure if it was Glennville or Kernville, but I knew it was one of the other. When we would get the 1 medical aid every 2 weeks or so it was a toss up on the ground ambulance. TCFD was pretty good about letting us (CAL FIRE) know who was responding and from where. My side of the shift I never had a helicopter on the initial dispatch for a medic aid or a trauma. I just knew if **** went down we would launch KCFD's chopper and land it at one of the predetermined LZ's.


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## VentMonkey (Feb 7, 2017)

CALEMT said:


> I just knew if **** went down we would launch KCFD's chopper and land it at one of the predetermined LZ's.


KCFD's, and KCSO's helicopters are hoist rescues only. With the exception of perhaps large-scale wild land fires, they're BLS-level in county for us and rendezvous with us or MA if the patient requires medical transportation to the hospital via air.

They do have medics on them from time to time, but don't function in county as such. They even have purtty cardiac monitors, etc. The KCFD helicopter is based out of Keene, in between Tehachapi and Bakersfield.

To put the thread back on topic, for those interested in this type of exposure as a paramedic or EMT, these are the areas to do it in. They're not infrequent, and definitely something I wasn't used to with "inner-city" EMS.


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## CALEMT (Feb 7, 2017)

VentMonkey said:


> They're not infrequent; definitely something I wasn't used to with "inner-city" EMS.



Very cowboy EMS in the more rural parts. Which was cool. Great experience as a EMT cause I was the highest medical authority (depending on what ambulance was responding). This thread is making me miss the central valley...


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## CentralCalEMT (Feb 7, 2017)

VentMonkey said:


> Do you guys do launch requests, auto launches, stand-bys or any of the above depending on the calls EMD code?`
> 
> Lol, pretty good memory, CAL. Yes, Glennville is closer to the Tulare Co. border and they often get dispatched before, or simultaneously with the Tulare units.
> 
> ...



We have auto launch based on EMD Code or other information dispatch receives. County Fire, CalFire, CHP or any other agency is also free to request a helicopter if necessary.

I wholeheartedly agree with what VentMonkey said. This is an excellent area to get experience in. I enjoy long transport times and the wide variety of calls that we get. I did my EMT time in LA County and had no idea this area existed until I went to paramedic school in Bakersfield.

I now wish I had come up here a lot earlier. I think because Central California has a reputation as a boring, or redneck or poor part of California, it keeps a lot of people down south. However, with 48 and 72 hour shifts, the commute is doable. And if someone does decide to move up here, what it does have to offer is anything that someone who loves the outdoors could want. The Sequoia National Forest is literally in your backyard in Tulare County. My coverage area, once you are outside the town we are based in, has multiple giant sequoia groves, a lake, rivers, and tons of mountain wilderness. We have year round fishing, hiking, hunting, camping, etc.


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## CentralCalEMT (Feb 10, 2017)

CALEMT said:


> Very cowboy EMS in the more rural parts. Which was cool. Great experience as a EMT cause I was the highest medical authority (depending on what ambulance was responding). This thread is making me miss the central valley...



I assume you worked TUU? Those stations have been auto responding on a lot more than they used to. It's a huge help with county fire being so understaffed.


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## CALEMT (Feb 10, 2017)

CentralCalEMT said:


> It's a huge help with county fire being so understaffed.



Don't get me started on TCFD. Staffing 1 man engines is not a better way to do things.


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## Jim37F (Feb 10, 2017)

CALEMT said:


> Don't get me started on TCFD. Staffing 1 man engines is not a better way to do things.


Dafuq?? How on earth do you run any calls as a single man engine??


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## CALEMT (Feb 10, 2017)

Jim37F said:


> Dafuq?? How on earth do you run any calls as a single man engine??



PCF's

Edit: Which is useless because you can't go interior on a fire because of the 2 in 2 out rule. It makes no sense, where I was the Tulare county fire station was only sometimes staffed. The captain would only work like 8 hour or 12 hour shifts on certain days of the week. Which I understand since its rural as hell, but when the station is supplemented by 1 PCF that may or may not respond then sometimes TCFD won't even respond to their own calls in their own area. In Tulare county CAL FIRE covers the SRA (state response area), the Feds cover the FRA (federal response area), county covers LRA (local response area), and the city depts cover the cities. 100% of the calls in my area we would respond mutual aid for TCFD. The vegetation fire that we IA'd (initial attack) it was us (4 man engine, 1 capt. 3 ff's) and TCFD which the capt. was on a 24 surprisingly. 5 people for a visitation fire with a moderate rate of spread. Oh and the next in engine was 45 minutes out. 5 acres total with 1 building lost. That fire could've been 5 acres with no loss of property had the county staffed engines with at least one more paid person.


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## VentMonkey (Feb 10, 2017)

Jim37F said:


> Dafuq?? How on earth do you run any calls as a single man engine??


Welcome to the Central Valley, Jimbo. KCFD at minimum does have 2 man engines, but they're a full time career department, and we're talking about some tiny townships that hardly notice when the engine is out, and/ or moved up to cover or back fill another areas engine out on drills or training. Tulare Co. though? Whole different ballgame re: their "county" fire department.


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## gonefishing (Feb 11, 2017)

Jim37F said:


> Dafuq?? How on earth do you run any calls as a single man engine??


It's a different world outside of LA County.  You don't need 8 fireman and 2 emts and 2 paramedics for back pain 
When you get out into those little rural towns like the great Vent said, you hardly notice the fire department moves.  I do know one of the houses in Tulare only had a 3 man crew.  Got a tshirt from them a while back.  I wanderd over to chit chat while I was at a wake which happened to be next door.  Very humble down to earth people.  It was a great change from some of big city fires personalities.

Sent from my SM-G920P using Tapatalk


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## CentralCalEMT (Feb 11, 2017)

gonefishing said:


> It's a different world outside of LA County.  You don't need 8 fireman and 2 emts and 2 paramedics for back pain
> When you get out into those little rural towns like the great Vent said, you hardly notice the fire department moves.  I do know one of the houses in Tulare only had a 3 man crew.  Got a tshirt from them a while back.  I wanderd over to chit chat while I was at a wake which happened to be next door.  Very humble down to earth people.  It was a great change from some of big city fires personalities.
> 
> Sent from my SM-G920P using Tapatalk



The calls go so much smoother when there are not too many people on scene. For instance, Porterville sends a 2 person BLS staffed patrol to most medical calls. The two firefighters and two people on the ambulance are more than enough for probably 95% of all calls. If the call comes out as a cardiac arrest, MVA, or something like that, then the engine responds automatically. The other interesting thing about that is there is no captain on the patrol so the medic clearly has scene control and there is no confusion about that. All the firefighters I work with are completely down to earth, helpful, and are on a first name basis with us.


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## CALEMT (Feb 11, 2017)

CentralCalEMT said:


> Porterville



I liked the guys from Porterville city. We finished out our new hire academy at their training facility. They were nice enough to let us use it.


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## VentMonkey (Feb 11, 2017)

I applied to Visalia fire once on the down low. I never actually made it to the in person interviews though. My "maybe-be-an-engine-paramedic" idea had all but fizzled out by then.


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## gonefishing (Feb 11, 2017)

VentMonkey said:


> I applied to Visalia fire once on the down low. I never actually made it to the in person interviews though. My "maybe-be-an-engine-paramedic" idea had all but fizzled out by then.


You're better as a guardian angel.  Good to know if somebodys butts in a bind they can call upon you to float down from the heavens and swoop them away. 

Sent from my SM-G920P using Tapatalk


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## VentMonkey (Feb 11, 2017)

gonefishing said:


> You're better as a guardian angel.  Good to know if somebodys butts in a bind they can call upon you to float down from the heavens and swoop them away.


Bro, really??? C'maaan???!!!


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## gonefishing (Feb 11, 2017)

VentMonkey said:


> Bro, really??? C'maaan???!!!


Hey, gotta keep your ego high like the elevations lol

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## VentMonkey (Feb 11, 2017)

gonefishing said:


> Hey, gotta keep your ego high like the elevations


Anything I find worth bragging about is hardly within the confines of my job description.

Back to Tulare Co. related topics:

@CentralCalEMT what can you tell us about the systems dispatch itself? I was (once) told that the companies rotate 911 calls. Is this in fact, or was it ever true?


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## Jim37F (Feb 11, 2017)

gonefishing said:


> It's a different world outside of LA County. You don't need 8 fireman and 2 emts and 2 paramedics for back pain


I'm actually not too worried about that where half of those end up standing in the back once everyone is on scene 
	

	
	
		
		

		
		
	


	



But what about actual structure or wildland fire responses? That's what I'm worried about


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## CALEMT (Feb 11, 2017)

Jim37F said:


> But what about actual structure or wildland fire responses? That's what I'm worried about



Just sayin we kept a vegetation fire at 5 acres with 3 ff's and 1 capt. You can read my post at the top of the page for the details with TCFD.


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## CentralCalEMT (Feb 12, 2017)

VentMonkey said:


> Anything I find worth bragging about is hardly within the confines of my job description.
> 
> Back to Tulare Co. related topics:
> 
> @CentralCalEMT what can you tell us about the systems dispatch itself? I was (once) told that the companies rotate 911 calls. Is this in fact, or was it ever true?



I heard it was a long time ago, way before I worked there. I also heard the system was way slower back then too. Today the 4 companies have a shared dispatch center with borderless dispatch. The closest unit goes regardless of company to all emergency calls. We also have borderless post moves so if a city goes to level 0 a different company is automatically sent to cover.


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## VentMonkey (Feb 13, 2017)

Relevant Tulare Co. topic (and it looks like they do the dispatch for the county's ambulance companies?):

http://aavems.com/our-company/company-overview/

Also, they're completely separate from American Ambulance of Fresno/ Kings County's, though their logos are remarkably similar.


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## CentralCalEMT (Feb 15, 2017)

VentMonkey said:


> Relevant Tulare Co. topic (and it looks like they do the dispatch for the county's ambulance companies?):
> 
> http://aavems.com/our-company/company-overview/
> 
> Also, they're completely separate from American Ambulance of Fresno/ Kings County's, though their logos are remarkably similar.



Their website is somewhat confusing about dispatch. The countywide ambulance dispatch center (TCCAD) is actually a non profit organization. Each provider in Tulare County has a part in running it, but it is overall independent from any specific company to prevent a conflict of interest.

As a side note, beginning in March, Imperial is increasing starting pay to 17-17.50 per hour for new paramedics working the 2 on 5 off 3 on 4 off schedule, and offering a $4,000 sign on bonus. The base pay works out to over 62K per year to start making them competitive with most other companies. The increased call volume in the areas Imperial took over when AMR left resulted in those increases in pay.


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## USHmedic (Feb 15, 2018)

Does anyone know if Imperial ambulance is still hiring?


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## toyskater86 (Feb 18, 2018)

i ran a full arrest while at Delano Amb doing mutual aid in Tulare County, the Tulare CO fire engine first on scene was a single man engine...he was doing cpr for about 20 minutes by himself...He said it was a normal occurrence to have single man engines..


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## Jim37F (Feb 18, 2018)

toyskater86 said:


> i ran a full arrest while at Delano Amb doing mutual aid in Tulare County, the Tulare CO fire engine first on scene was a single man engine...he was doing cpr for about 20 minutes by himself...He said it was a normal occurrence to have single man engines..


that's just...scary

 Seriously, not just CPR but how do you run any call effectively and safely single man?? Especially fire calls, unless it's the smallest of spot fires you can't do anything single man engine....


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## CALEMT (Feb 18, 2018)

It’s single man engines supplemented by PCF’s and volunteers.


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## DrParasite (Feb 19, 2018)

Jim37F said:


> Seriously, not just CPR but how do you run any call effectively and safely single man?? Especially fire calls, unless it's the smallest of spot fires you can't do anything single man engine....


Lets be realistic: most call for the FD are medical assists.  Most medical calls can be handled by 2 people..... I've ran several solo in a QRV.  Not ideal, but doable.  Hopefully if you are at a cardiac arrest, you have requested a mutual aid company to assist you.

Currently we run a 3 man crew, so if it's an EMS call, two guys take the QRV, and if a second medical call comes in, the captain takes the brush truck solo.  You still have the ambulance responding, so it's not like help isn't coming, provided you know what you are doing for those 10 minutes.

Fire calls are a different story altogether. Hard to do much with just one person; however, you can give a sizeup, call for assistance, wrap a hydrant, stretch a line, charge the line, and by then hopefully a volunteer/POC FF shows up, or your next due engine is arriving. 

But at least the truck is guaranteed to get out, vs having 0 men on shift, where you might not get a driver for the truck.


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