# LA county ALS accreditation.



## socalmedic (Feb 20, 2011)

ok, first off you can all call me a hypocrite, I have applied for and been offered a Job as an IFT paramedic in LA countyh34r:. I know I swore never to do this, but the money is getting kinda tight and i cant afford to keep driving the way I am just to be employed elsewhere, for less money. 

anywho, my question to the LA medics is what is what will make my accreditation quicker. my employer says that they have to give me a letter to take to EMS and sit through some 8 hour class then take a test. they say then you just wait for your card from the county. I ask this because i get a rather sizable raise when this gets in so i want to make this happen as quickly as possible. They are telling me that i can work on a dual medic rig untill i get my county card but i wont get single medic pay until this happens.

are there any other protocols i need to know other than These. and the 800 policys?


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## thegreypilgrim (Feb 20, 2011)

All I can say is I hope you know what you're getting yourself into. I honestly would try exhausting every other opportunity before going through with this. Have you looked into ED-tech jobs in the area? Seriously man...LA County IFT will take years off your life.

There's really nothing you can do to speed the process up, unfortunately. Make sure, however, that the accreditation class you have to sit in for includes the WMD & terrorism modules because you need that as well.

You're also going to want to know the 500 series. Especially Ref. 517 for your purposes. Know that one like the back of your hand to keep yourself out of trouble. Good luck.


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## socalmedic (Feb 20, 2011)

I know that this will be a less than optimal job, but i cant keep working on EMT pay. I am determined to finish school and this company is very good about working with my schedule. I know that this is not 911 and i know that this will not be the most exciting job. based on  what the medic coordinator told me in the interview, i will most likely not have to administer drugs. it is usual just als transfer from urgent care to the ER down the block. ohwell, i still have my PT 911 job so i can still play like a real medic...


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## thegreypilgrim (Feb 20, 2011)

It's not just the lack of excitement and unchallenging nature of it. The job is just a world of nonsense. Hopefully you got picked up by a decent company like PRN, but everywhere else is just a joke. Every day is a game to see if your 15-year EMT supervisor (with no formal education or precious little actual experience) tries to write you up for having not having exactly 50 4x4's while simultaneously forcing you to go in service despite having missing/expired medications; dispatchers too lazy to talk to one another or look at their giant monitor with AVL showing all their units resulting in you getting sent on some nonsensical call across the county with 15 minutes left on your shift when there are plenty of other closer units; running calls out of shady urgent cares and convolescent homes that should've been 911 activations but have been handled as non-emergent leaving you behind the ball with your EMT partner who's done nothing but drive since getting out of school to help you run an emergent case. At this point you get to experience the wonder and awe of calling base as an IFT medic....that's an experience you just have to see for yourself, I just can't describe the frustration of it.


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## socalmedic (Feb 20, 2011)

nope not PRN, honestly i did not know that they had a good reputation as an als provider. for that matter i didnt even know they had medics.  the company seams good, they definitely made it quite clear that i was to call 911 for any unstable patient, not to scoop and run. of the few urgent cares that they have the station is either in the same parking lot or in the same block, apparently they have a contracted 5 min response time. i still have yet to experience the LA call-in. I am just waiting for the opportunity to say "sweatheart put the doc on", i am sure that will go over well.


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## JPINFV (Feb 20, 2011)

socalmedic said:


> I am just waiting for the opportunity to say "sweatheart put the doc on", i am sure that will go over well.



:beerchug:


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## thegreypilgrim (Feb 20, 2011)

socalmedic said:


> the company seams good, they definitely made it quite clear that i was to call 911 for any unstable patient, not to scoop and run.


 Well, you take your transport time vs. fire's ETA into account and go from there. Most of the FD personnel have no idea about Ref. 517 and don't understand that if a patient has an emergent condition they have to respond even if they're found in a health facility if the private ambulance ETA to the hospital exceeds their response time. Try explaining that to some FD Captain once they arrive. It's not fun. 



> of the few urgent cares that they have the station is either in the same parking lot or in the same block, apparently they have a contracted 5 min response time. i still have yet to experience the LA call-in. I am just waiting for the opportunity to say "sweatheart put the doc on", i am sure that will go over well.


 Lolz. Let me know how it goes. The last time I called base and asked to speak to the doc I got 15 minutes of silence...we were at our destination by the time the MICN came back on the line with the base physician's orders.


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## JPINFV (Feb 20, 2011)

Reading 517: II.A.2.c (emergency condition for patient in health care facility) makes me wonder if there's a need for a paramedic to call 911 for a response. It's a "best interest" judgement call and not spelled out as "ETA." Is it in the best interest of the patient for a fire department response if the IFT paramedic can provide appropraite care with the man power present? 

I think II.A.2.b is a bigger issue, but that's a company and dispatch center issue, not a field provider issue. In general IFT ambulances shouldn't be on those calls, but how the system is supposed to work and how it does is often very different.


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## socalmedic (Feb 20, 2011)

i will report back in a month, hopefully i will have moved to colorado by july.


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## thegreypilgrim (Feb 20, 2011)

JPINFV said:


> Reading 517: II.A.2.c (emergency condition for patient in health care facility) makes me wonder if there's a need for a paramedic to call 911 for a response. It's a "best interest" judgement call and not spelled out as "ETA." Is it in the best interest of the patient for a fire department response if the IFT paramedic can provide appropraite care with the man power present?


I think it's just poor authorship on their part. The intent behind it is more than likely ETA's given how similar issues are spelled out in 808. Gotta love the ambiguities of LA EMS' policies. 



> I think II.A.2.b is a bigger issue, but that's a company and dispatch center issue, not a field provider issue. In general IFT ambulances shouldn't be on those calls, but how the system is supposed to work and how it does is often very different.


Indeed, this is the far more common problem. I can't even count how many times I've had to call our dispatch to tell them we shouldn't respond to urgent cares & con homes for STEMI, Stroke, "altered" (when they're still altered), etc. patients and that the facility just has to call 911. Gotten into several arguments with the dispatch supervisor over that kind of thing.


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## terrible one (Feb 21, 2011)

Welcome back brother! haha. 
I swear I said the same thing "I'm never going back to LA EMS!" haha and here I am after working a year in a great EMS system with progressive ALS protocols as the number one medic on-scene now I am stuck doing IFTs all day! 

as greypilgrim said it will suck the life out of you! haha. the pay is good though and they are working with my school schedule, I have been here almost 5 months now and have done 2 base call ins. OMG what a joke they are!!!!! Biggest waste of time in my life, I honestly have no idea how actual ALS providers get anything done, I was on-hold for about 10-15min with a stable pt. ridculous.... By the time you actually get through and explain who you are, the situation, and the pt you could have had your patient at the hospital, admitted, and treatment started. oh well it is what it is. I'll hopefully be getting out of the black hole that is LA EMS by the summer. but we'll see. 

good luck


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## looker (Feb 21, 2011)

thegreypilgrim said:


> Well, you take your transport time vs. fire's ETA into account and go from there. Most of the FD personnel have no idea about Ref. 517 and don't understand that if a patient has an emergent condition they have to respond even if they're found in a health facility if the private ambulance ETA to the hospital exceeds their response time. Try explaining that to some FD Captain once they arrive. It's not fun.
> 
> Lolz. Let me know how it goes. The last time I called base and asked to speak to the doc I got 15 minutes of silence...we were at our destination by the time the MICN came back on the line with the base physician's orders.



If it happens in LA just tell them to take it up with LADOT if they got a problem.


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