# Get Out of LA and California for that matter!



## Yetti (Jun 27, 2018)

So after trying out LA area I'm convinced it's the worst place i've ever seen. I want out! Advice to all, Leave now! this place is soul sucking madness!!!!!!!!!!!! and don't even get me started on  protocols and horible work place ambulace companies


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## DesertMedic66 (Jun 27, 2018)

Yetti said:


> So after trying out LA area I'm convinced it's the worst place i've ever seen. I want out! Advice to all, Leave now! this place is soul sucking madness!!!!!!!!!!!! and don't even get me started on  protocols and horrible moronic ambulace companies


The forum is well aware of how ****ty it is haha


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## Yetti (Jun 27, 2018)

It's really bad! I'm just trying to save others from making the mistake of working in ems/ ift in LA county.


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## PotatoMedic (Jun 27, 2018)

I hear Texas is good.


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## RocketMedic (Jun 27, 2018)

Mmm whole blood in a 911 environment and don't even remember how to call a nurse for orders...


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## PandaNin (Jun 27, 2018)

Lemme FIFY



> It's really bad! I'm just trying to save others from making the mistake of working in ems/ ift in LA county.


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## DrParasite (Jun 28, 2018)

RocketMedic said:


> Mmm whole blood in a 911 environment and don't even remember how to call a nurse for orders...


hmmmmm, whole blood in a 911 environment.... think of the possibilities....

and I can honestly say in 3 states I have never worked in a system where we had to call a nurse for order, it was always a doctor on the other end of the phone.

North Carolina is always looking for Paramedics.  And apparently so is Texas,


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## Yetti (Jun 28, 2018)

Bump!!!


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## mrhunt (Jun 30, 2018)

According to my Medic class though which is based out of LA County, They just had a Massive protocol revision which add's tons of standing orders and eliminates the mother may i For 911. 

Now granted 96% of everyone is still doing IFT, but at least LAFD is having more fun..... Lol.


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## CALEMT (Jun 30, 2018)

We just got TXA approved in Riverside Co. and from what my pal @DesertMedic66 has told me it sounds like were getting Ketamine approved too. So its not all bad.


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## DesertMedic66 (Jun 30, 2018)

CALEMT said:


> We just got TXA approved in Riverside Co. and from what my pal @DesertMedic66 has told me it sounds like were getting Ketamine approved too. So its not all bad.


TXA and Ketamine are approved at the state level as of July 1st so now it is up to each individual county on if they want to put it in their protocols.


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## RocketMedic (Jun 30, 2018)

Interesting. If only your pay would catch up...


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## TheComebacKid (Sep 11, 2018)

DesertMedic66 said:


> TXA and Ketamine are approved at the state level as of July 1st so now it is up to each individual county on if they want to put it in their protocols.



Im pretty sure ketamine is still in a pilot program for isolated extremity injury pain management in ICEMA only, I do not think it has been added to the state scope, same with TXA being pilot only. Do you have any site or link that can prove otherwise?


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## DesertMedic66 (Sep 11, 2018)

TheComebacKid said:


> Im pretty sure ketamine is still in a pilot program for isolated extremity injury pain management in ICEMA only, I do not think it has been added to the state scope, same with TXA being pilot only. Do you have any site or link that can prove otherwise?


TXA has been approved by the state. Ketamine is still in study in Riverside county (REMSA) and San Bernardino county (ICEMA). Ketamine can be used for any traumatic pain or burns regardless of location (ABD pain, chest pain, or extremity). 

TXA was approved a couple of months ago

http://remsa.us/documents/memos/20180629SystemAdvisoryTXALOSOP2018.pdf


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## RocketMedic (Sep 11, 2018)

Do you still have to call for orders for everything?


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## DesertMedic66 (Sep 12, 2018)

RocketMedic said:


> Do you still have to call for orders for everything?


Varies greatly by area and if you are ground or HEMS.


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## TheComebacKid (Sep 12, 2018)

DesertMedic66 said:


> TXA has been approved by the state. Ketamine is still in study in Riverside county (REMSA) and San Bernardino county (ICEMA). Ketamine can be used for any traumatic pain or burns regardless of location (ABD pain, chest pain, or extremity).
> 
> TXA was approved a couple of months ago
> 
> http://remsa.us/documents/memos/20180629SystemAdvisoryTXALOSOP2018.pdf



Ah okay, Cool!


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## bigbaldguy (Sep 13, 2018)

Come to Houston, you can't throw a rock round here without hitting an agency that's hiring. Some of them don't even suck


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## RocketMedic (Sep 14, 2018)

Lake Jackson, Clute, Angleton, Pearland FD, Fort Bend, HFD, Atascocita right now.


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## nwhitney (Sep 17, 2018)

I think we got a pretty damn good system in Multnomah County. Progressive protocols, good medical benefits, and our pay is solid especially after our recent union contract. We got our issues just like every private EMS agency.


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## NomadicMedic (Sep 17, 2018)

There are a zillion great places to work... and with the exception of Hall, none of them are in California.


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## CALEMT (Sep 17, 2018)

NomadicMedic said:


> none of them are in California.



Riverside and San Bernardino counties aren’t that bad protocol wise.


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## VentMonkey (Sep 17, 2018)

NomadicMedic said:


> and with the exception of Hall...


It’s certainly been a good place to, and for me. It has changesd a lot though, even before Mr. H’s passing.

My wife is still kicking around going back for her FNP once the girls are high school/ middle school age. Who knows what will happen at that point.

There are certainly those fair share of “too bad it’s not this state, or that country” moments, but the older I get quite literally the less I care where I practice.


CALEMT said:


> Riverside and San Bernardino counties aren’t that bad protocol wise.


Yeah, they’re not bad. I think many non-Californians lump things not known, or seen firsthand directly into what I like to refer to as the “Squad 51 Bucket”.

I literally cannot recall the last time I had to ask for permission to perform something within my protocols on a standard ground ambulance shift.


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## RocketMedic (Sep 17, 2018)

I just want to go somewhere where I can help make the operational changes necessary to provide great work and medicine


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## CALEMT (Sep 17, 2018)

RocketMedic said:


> I just want to go somewhere where I can help make the operational changes necessary to provide great work and medicine



Get a voice big enough that’s how we got TXA in our scope and how Ketamine is a trail study. Also sounds like we may be getting push dose epi here in the next protocol update in April 2019.


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## NomadicMedic (Sep 17, 2018)

RocketMedic said:


> I just want to go somewhere where I can help make the operational changes necessary to provide great work and medicine



You have to put your time in. Go get a job in a small system, build yourself, your leadership skillset and your resume and then go for it.


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## DrParasite (Sep 17, 2018)

NomadicMedic said:


> You have to put your time in. Go get a job in a small system, build yourself, your leadership skillset and your resume and then go for it.


I was going to say pretty much the same thing.  Get a job in a small system, and rise to a manager role.  then you can make some changes.  use that experience to pad your resume to take a similar role in a larger agency.  

do the same thing every 3-5 years; that seems to be a common trend, do what you can, than take a position with the larger agency.


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