# Double paramedic



## lakersmedic (Jun 13, 2011)

Can anyone list some county or private EMS agencies that run with 2 paramedics?  I am having a hard time finding this anywhere. I have been a medic for 3 years......I know double med is a lost art these days. I was jst wondering if there were any places that did it still.  Thanks!


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## TransportJockey (Jun 13, 2011)

Albuquerque Fire Dept
Austin Travis County EMS 
Williamson County EMS

Those are three off the top of my head that run dual medic busses

EDIT: Denver Health Paramedics is an almost all medic agency as well, so they run double medic


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## rmabrey (Jun 13, 2011)

Evansville AMR does, but only to pair up a newly certified medic for a while


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## HotelCo (Jun 13, 2011)

All ALS ambulances in Oakland County, Michigan are required to be staffed by two paramedics to be considered ALS. Anything else is BLS. 


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## firecoins (Jun 13, 2011)

FDNY and any 911 ALS bus in NYC


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## terrible one (Jun 13, 2011)

Every 911 municipal ambulance in LA and OC counties are required to be dual staffed


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## NomadicMedic (Jun 13, 2011)

Sussex County Delaware is only ALS, and all dual medic trucks.


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## usalsfyre (Jun 13, 2011)

TransportJockey said:


> Albuquerque Fire Dept
> Austin Travis County EMS
> Williamson County EMS
> 
> ...



Montgomery County Hospital District as well (with a few exceptions) and possibly Cypress Creek EMS (Flight-LP can confirm this).


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## Anjel (Jun 13, 2011)

HotelCo said:


> All ALS ambulances in Oakland County, Michigan are required to be staffed by two paramedics to be considered ALS. Anything else is BLS.
> 
> 
> Sent from my iPhone using Tapatalk



unfortunately


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## usalsfyre (Jun 13, 2011)

Just remembered City of Alexandria, VA is mostly double medic (FD run but single role providers), Boston EMS is double medic, and I believe all ALS units in NYC are double medic. And possibly Galveston County Texas...but I'm not sure on that one.


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## TransportJockey (Jun 13, 2011)

usalsfyre said:


> Just remembered City of Alexandria, VA is mostly double medic (FD run but single role providers), Boston EMS is double medic, and I believe all ALS units in NYC are double medic. And possibly Galveston County Texas...but I'm not sure on that one.



I forgot about Galveston County. They are. I found that out when I was job hunting last summer


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## STXmedic (Jun 13, 2011)

San Antonio Fire and Schertz EMS both do around here


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## Akulahawk (Jun 13, 2011)

Santa Cruz County, California certainly used to be, and may yet still be, for 911 ambulance units.


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## bigbaldguy (Jun 14, 2011)

usalsfyre said:


> Montgomery County Hospital District as well (with a few exceptions) and possibly Cypress Creek EMS (Flight-LP can confirm this).



Cypress creek runs one basic and one medic on their trucks. Only time I've seen a double patched truck is when they've run a P class through and can't slot them into a ICP right away.


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## jgmedic (Jun 14, 2011)

Akulahawk said:


> Santa Cruz County, California certainly used to be, and may yet still be, for 911 ambulance units.



I believe it still is. I would love to transfer up there but cost of living is prohibitive, to the OP all LA County ALS 911 ambulances (RA's) have to be dual medic.


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## tyler500e (Jun 19, 2011)

Johnson County Med-Act of Johnson County Kansas.  All paramedics, no EMT's or EMT-I/D.


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## MrBrown (Jun 19, 2011)

Oh god that reminds Brown, Kansas still has EMT-Defibrillator, um, how 1980s 

Here in NZ two Intensive Care Paramedics in an ambulance is unheard of, Brown knows it is common in some jurisdictions in Australia.


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## boingo (Jun 19, 2011)

Boston, King Co. Washington, Pittsburgh.


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## nemedic (Jun 19, 2011)

As a few have already noted, Boston EMS runs dual medic. Also most, if not all of the FD staffed ambulances in eastern MA are dual medic IIRC. For 911, the privates generally run dual medic, but that is probably due to the 911 contracts calling for dual medic trucks. For transfer trucks, mostly split into P/P and B/B trucks, but I know my company has a few P/B transfer trucks in rotation. 


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## emtpche (Jun 19, 2011)

Santa Cruz county is still dual medic.  One of the last to still run that setup in the Bay Area.  Let me ask this.  Does having two medics make on the unit make for a better system?


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## Tigger (Jun 19, 2011)

nemedic said:


> As a few have already noted, Boston EMS runs dual medic. Also most, if not all of the FD staffed ambulances in eastern MA are dual medic IIRC. For 911, the privates generally run dual medic, but that is probably due to the 911 contracts calling for dual medic trucks. For transfer trucks, mostly split into P/P and B/B trucks, but I know my company has a few P/B transfer trucks in rotation.
> 
> 
> Sent from my iPhone using Tapatalk



This may be changing in some areas now that the state is allowing PB tucks without a waiver. That said, the double medic staffing will probably remain for the municipal providers since they already have their staffing set up to be dual medic.


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## SeanEddy (Jun 19, 2011)

AMR Ventura, Parker County (Texas)


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## NomadicMedic (Jun 19, 2011)

Actually, I found that every ALS truck in Delaware must be dual medic, as per law, two paramedics must be dispatched to every ALS call.


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## Flight-LP (Jun 19, 2011)

bigbaldguy said:


> Cypress creek runs one basic and one medic on their trucks. Only time I've seen a double patched truck is when they've run a P class through and can't slot them into a ICP right away.



A few years back, when they had significantly higher standards than they do now, Cypress Creek did run double P trucks quite a bit. Now that they put the Paramedic graduates straight into In-Charge training (one of the downfalls in their reputation and level of service IMHO), that has decreased. 

MCHD stopped hiring EMT-B's years ago in an effort to go all ALS (EMT-I's and P's). Now they are looking more at newer P's to put in the attendant role to increase their level of service. They really push their Intermediate's to finish Paramedic school, and even go as far as paying for the education throught their in-house program.

Both are still top notch programs, just one has lost some of it's "old school" reputation luster.


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## bigbaldguy (Jun 19, 2011)

Flight-LP said:


> A few years back, when they had significantly higher standards than they do now, Cypress Creek did run double P trucks quite a bit. Now that they put the Paramedic graduates straight into In-Charge training (one of the downfalls in their reputation and level of service IMHO), that has decreased.
> 
> MCHD stopped hiring EMT-B's years ago in an effort to go all ALS (EMT-I's and P's). Now they are looking more at newer P's to put in the attendant role to increase their level of service. They really push their Intermediate's to finish Paramedic school, and even go as far as paying for the education throught their in-house program.
> 
> Both are still top notch programs, just one has lost some of it's "old school" reputation luster.



Oh snap! Lol


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## TransportJockey (Jun 19, 2011)

Flight-LP said:


> A few years back, when they had significantly higher standards than they do now, Cypress Creek did run double P trucks quite a bit. Now that they put the Paramedic graduates straight into In-Charge training (one of the downfalls in their reputation and level of service IMHO), that has decreased.
> 
> MCHD stopped hiring EMT-B's years ago in an effort to go all ALS (EMT-I's and P's). Now they are looking more at newer P's to put in the attendant role to increase their level of service. They really push their Intermediate's to finish Paramedic school, and even go as far as paying for the education throught their in-house program.
> 
> Both are still top notch programs, just one has lost some of it's "old school" reputation luster.



MCHD just moved up on my list of places to apply at in the near future... I want out of NM worse than ever, and that would be kinda nice to work towards


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## nemedic (Jun 19, 2011)

Tigger said:


> This may be changing in some areas now that the state is allowing PB tucks without a waiver. That said, the double medic staffing will probably remain for the municipal providers since they already have their staffing set up to be dual medic.



For the muni departments, the staffing will almost surely remain dual medic( either through the FDs requiring everyone gets their p card, or the contracts for the privates that do 911 mandating P/P. At my company, which may or may not be a private with an easy majority of the 911 contracts north of Boston, the idea was floated to run P/B, and was shot down by every city it was offered to. And I heard from family I have in a local FD that my company has one of their 911 contracts in that the company offered to double the amount of dedicated trucks ( which equals the same amount of dedicated medics, just spread out a bit), and the city still turned it down. 


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## MassEMT-B (Jun 19, 2011)

nemedic said:


> For the muni departments, the staffing will almost surely remain dual medic( either through the FDs requiring everyone gets their p card, or the contracts for the privates that do 911 mandating P/P. At my company, which may or may not be a private with an easy majority of the 911 contracts north of Boston, the idea was floated to run P/B, and was shot down by every city it was offered to. And I heard from family I have in a local FD that my company has one of their 911 contracts in that the company offered to double the amount of dedicated trucks ( which equals the same amount of dedicated medics, just spread out a bit), and the city still turned it down.
> 
> 
> Sent from my iPhone using Tapatalk



Which is funny because the city would have all medic providers doing the care rather than some of the basic trucks they have that run 911.


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## bigbaldguy (Jun 21, 2011)

I just want to point out that having dual medics on the truck doesn't necessarily equate to better care. Scope of practice and actual competency are not necessarily the same thing. I have been on a couple of crews where a seasoned basic or intermediate was basically operating by proxy through the junior medic they were riding with. Just saying.


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## Handsome Rob (Jun 21, 2011)

jgmedic said:


> I believe it still is. I would love to transfer up there but cost of living is prohibitive, to the OP all LA County ALS 911 ambulances (RA's) have to be dual medic.



Only municipal. Private can be 1:1.

sent from my mobile command center. or phone. whatever.


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## medicsb (Jun 21, 2011)

New Jersey (all of it)
Delaware (all of it).
Worcester EMS (aka UMass Memorial Hospital EMS) in MA.
Saint's Paramedics (Greater Lowell EMS) in Lowell, Ma
Pittsburgh EMS
Delaware County Memorial Hospital in Upper Darby, Pa

The Philadelphia Fire Dept. ALS ambulances are supposed to be dual medic, but they run a lot of "limited MICs" due to staffing issues.


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## usalsfyre (Jun 21, 2011)

bigbaldguy said:


> I just want to point out that having dual medics on the truck doesn't necessarily equate to better care. Scope of practice and actual competency are not necessarily the same thing. I have been on a couple of crews where a seasoned basic or intermediate was basically operating by proxy through the junior medic they were riding with. Just saying.



Yes and no. An experinced medic can probably opperate as well with a basic level partner as a medic partner. What you lose however, is a mentor (beyond the minimum competency assured by an FTO) for newer medics and someone to bounce ideas off of. I have benefitted many times from another medic being available. However, it's not a make or break deal, and many systems opperate effectively with a P/B configuration. If I had my choice though, I'd staff dual medic trucks.


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## sirengirl (Jun 21, 2011)

Sarasota County (the one south of where I live, and where I plan on working) is currently an ALS system with P/B staffing, however I hear a lot of talk that they're transitioning to P/P staffing and have been filtering their EMT-Bs through medic school. That being said, they're also fire/EMS so I guess within the next 10 years the entire county should be entirely Fire/Medic personnel. 

Hillsborough County where I volunteer is also Fire/EMS but I'm not entirely sure if they're P/P, all I know is when you call them, you get 3 paramedics and 2 designated firefighters, minimum. I swear I've been on a call with 6 of their people. Station party, I guess.

The county I live in, Manatee, I believe is P/B but is not fire/EMS. They do have BLS volunteer trucks that are the same as the ones I work in Hillsborough. There are only 2 counties around me that I've heard of that even recognize EMT-I.


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## Tigger (Jun 21, 2011)

nemedic said:


> For the muni departments, the staffing will almost surely remain dual medic( either through the FDs requiring everyone gets their p card, or the contracts for the privates that do 911 mandating P/P. At my company, which may or may not be a private with an easy majority of the 911 contracts north of Boston, the idea was floated to run P/B, and was shot down by every city it was offered to. And I heard from family I have in a local FD that my company has one of their 911 contracts in that the company offered to double the amount of dedicated trucks ( which equals the same amount of dedicated medics, just spread out a bit), and the city still turned it down.
> 
> 
> Sent from my iPhone using Tapatalk



I haven't heard of many Fire Depts. forcing anyone to get their medic after hire, but no doubt that most new hires in the suburbs are almost exclusively medics. Nonetheless, the PB configuration helps many FDs get a backup ambulance out the door that can provide ALS when they were previously having to call for mutual aid.


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## EMTswag (Jul 3, 2011)

Most hospitals in NJ run dual medic trucks, but only a couple run dual medic ambulances. most are SUV-meet-up-with-bls system.


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## NomadicMedic (Jul 3, 2011)

EMTswag said:


> Most hospitals in NJ run dual medic trucks, but only a couple run dual medic ambulances. most are SUV-meet-up-with-bls system.



Delaware is all Medic Response Units (think squad 51) that meet up with the fire department BLS transport units.


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## feldy (Jul 3, 2011)

medicsb said:


> New Jersey (all of it)
> Delaware (all of it).
> Worcester EMS (aka UMass Memorial Hospital EMS) in MA.
> Saint's Paramedics (Greater Lowell EMS) in Lowell, Ma
> ...



In MA, there are very few P/B trucks. Its usually P/P or B/B with a paramedic intercept. Saints paramedics (Greater Lowell P1/P100) and Greater Lawrence Paramedics (P2/P200) are non transporting ALS, they run in sprint cars and then 1 rides in with the ambulance.


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## slb862 (Jul 5, 2011)

St. Cloud, MN - dual medics


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## smurfe (Aug 26, 2011)

My department, East Baton Rouge City/Parish EMS is dual medic.


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## Fish (Aug 29, 2011)

Around Central Texas

Williamson County EMS
Austin-Travis County EMS
Fayette County EMS
Washington County EMS
Schertz EMS
MCHD EMS

And maybe a fire dept. or two


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## Flight-LP (Aug 29, 2011)

Washington County and Fayette County both staff their units with a Paramedic and an EMT-B/I. Neither is scheduled dual medic.

MCHD runs all ALS with either dual medics or a Paramedic / EMT-I.


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## Fish (Aug 29, 2011)

Flight-LP said:


> Washington County and Fayette County both staff their units with a Paramedic and an EMT-B/I. Neither is scheduled dual medic.
> 
> MCHD runs all ALS with either dual medics or a Paramedic / EMT-I.



True that, I got off on a tangent I guess


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## Handsome Robb (Aug 29, 2011)

Denver Health is dual medic I believe. If they aren't there yet, thats the direction they are working in.

To be allowed to respond to 911 calls in Washoe County, NV the truck has to be minimum I/P, most are mixed with a few P/P trucks rolling around.


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## kymedic25 (Feb 6, 2012)

rmabrey said:


> Evansville AMR does, but only to pair up a newly certified medic for a while



AMR Evansville does not run double paramedic.  Having worked there in the past, they run paramedic/EMT-B or AEMT.  Every now and then, you could be on a double medic truck if someone was working OT or a part time employee, but they do not generally run double medic trucks.

Jason


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## JeffDHMC (Feb 6, 2012)

Yes, DH is dual medic.


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## Handsome Robb (Feb 6, 2012)

JeffDHMC said:


> Yes, DH is dual medic.



DH is another place I would love to work. geez I'm gonna have to bust some *** at my current service to get that experience in.


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## Maine iac (Feb 7, 2012)

Just to clarify Boston EMS might run dual medic on their intercepts, but their primary response is a basic crew (from my understanding).


All trucks in Minneapolis are dual medic.


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## Handsome Robb (Feb 7, 2012)

Maine iac said:


> Just to clarify Boston EMS might run dual medic on their intercepts, but their primary response is a basic crew (from my understanding).
> 
> 
> All trucks in Minneapolis are dual medic.



That's how I understand it too. However from what I hear many of their BLS crews are actually medics, just operating as EMTs. 

They don't hire Medics from outside, only promote from within.


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## DesertMedic66 (Feb 7, 2012)

4 out of our 25+ rigs are duel medics out here in Palm Springs,CA. Only the medics with 10+ years at our company are able to get those rigs


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## MedicSchwanee (Feb 8, 2012)

Medstar EMS in Fort Worth has multiple levels of paramedics. You have to be a level 4 to be a primary paramedic on a 911 ALS unit. There is a Level 6 which is a CCEMT-P that works in the community health program, and then every two weeks they rotate to the truck. There is a level 3 paramedic that will work with a higher level paramedic on a 911 truck.


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## Fish (Feb 9, 2012)

TransportJockey said:


> Albuquerque Fire Dept
> Austin Travis County EMS
> Williamson County EMS
> 
> ...



Albuquerque Fire Dept? I thought a Hospital based service ran this area.


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## tssemt2010 (Feb 9, 2012)

Flight-LP said:


> A few years back, when they had significantly higher standards than they do now, Cypress Creek did run double P trucks quite a bit. Now that they put the Paramedic graduates straight into In-Charge training (one of the downfalls in their reputation and level of service IMHO), that has decreased.
> 
> MCHD stopped hiring EMT-B's years ago in an effort to go all ALS (EMT-I's and P's). Now they are looking more at newer P's to put in the attendant role to increase their level of service. They really push their Intermediate's to finish Paramedic school, and even go as far as paying for the education throught their in-house program.
> 
> Both are still top notch programs, just one has lost some of it's "old school" reputation luster.



i have been at cypress creek about a year and a half now and have never seen any of their paramedic graduates go straight to incharge training, their time spent as a P1 depends on how well they perform, most spend 6 months to a year as a p1 before they will consider sending you through your incharge training


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## Handsome Robb (Feb 9, 2012)

tssemt2010 said:


> i have been at cypress creek about a year and a half now and have never seen any of their paramedic graduates go straight to incharge training, their time spent as a P1 depends on how well they perform, most spend 6 months to a year as a p1 before they will consider sending you through your incharge training



When you say "incharge training" are you saying training them to become FTOs or going straight from school to FTO time as an attendant at the ALS level?

Personally I'd be heated if I graduated from school and still had to drive someone around constantly. It makes no sense to make a brand new medic a FTO but what is wrong with training them as an attendant and letting them lead on ALS calls? How else are you going to learn?


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## kymedic25 (Feb 9, 2012)

NVRob said:


> When you say "incharge training" are you saying training them to become FTOs or going straight from school to FTO time as an attendant at the ALS level?
> 
> Personally I'd be heated if I graduated from school and still had to drive someone around constantly. It makes no sense to make a brand new medic a FTO but what is wrong with training them as an attendant and letting them lead on ALS calls? How else are you going to learn?



"In Charge" in this area means literally that, you are in charge of the ambulance.  Since I am a double medic truck, someone needs to be responsible for everything that happens on the truck and that means me, the "In Charge".  We have P1 - Attendant Paramedics, can not ride without an IC, P2 - In Charge, P3 - In Charge that does not need to call for orders, FTO - Field Training Officer, and P4 - Relief Supervisors, Field Sups.

I am a P3/FTO.


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## BeachMedic (Feb 9, 2012)

jgmedic said:


> I believe it still is. I would love to transfer up there but cost of living is prohibitive, to the OP all LA County ALS 911 ambulances (RA's) have to be dual medic.



Just confirming that we are still dual-medic. And yes, it is expensive to live up here. The pay doesn't get too much better for privatized EMS though.

San Mateo AMR medics are probably the only ones in NorCal that have a better contract than us. (and those other counties in the AMR bargaining unit in the Bay)  Those medics make a ton of cash I hear.

Get on with SFFD (which is 1on1) and they probably make the most money in the Bay Area as single role paramedics. At least when you factor in starting salary/benefits.


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## Tigger (Feb 9, 2012)

NVRob said:


> That's how I understand it too. However from what I hear many of their BLS crews are actually medics, just operating as EMTs.
> 
> They don't hire Medics from outside, only promote from within.





Maine iac said:


> Just to clarify Boston EMS might run dual medic on their intercepts, but their primary response is a basic crew (from my understanding).



Not quite. Boston EMS runs 19 BLS ambulances (2 EMT-Bs) and 5 ALS ambulances (2 Paramedics) on average. Most calls get only a BLS truck on the initial dispatch, but depending on the EMD both ALS and BLS can get sent. If there are no BLS units left in the system sometimes they send just ALS or ask a private company to take it.

As stated BEMS does not hire medics, they promote from within. It be however, an exaggeration to say that most basics are medics working as basics. It happens, but most of the BLS trucks are staffed by EMTs. From time to time the city offers an internal medic class as well. Beyond that I'm not really sure how the promotional process works.


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## FreezerStL (Feb 10, 2012)

Almost all of the Fire Dept/Districts in St.Louis run Dual medic, as well as most Ambulance Districts.

It's rarer to see a place that runs Medic/EMT than dual Medic.


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## Commonsavage (Feb 10, 2012)

Fish said:


> Albuquerque Fire Dept? I thought a Hospital based service ran this area.



Bernalillo County/Albuquerque is a two-tier system with Albuquerque Ambulance Service(a division of Presbyterian Hospital).  In Albuquerque it's AFD and AAS. In the County it's BCFD and AAS.  In Rio Rancho, actually in Sandoval County, it's RRFD and AAS.


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## tssemt2010 (Feb 15, 2012)

NVRob said:


> When you say "incharge training" are you saying training them to become FTOs or going straight from school to FTO time as an attendant at the ALS level?
> 
> Personally I'd be heated if I graduated from school and still had to drive someone around constantly. It makes no sense to make a brand new medic a FTO but what is wrong with training them as an attendant and letting them lead on ALS calls? How else are you going to learn?



i mean you are the incharge, there are not many FTOs here, you have to work towards that, you can be an incharge without being an FTO

and while you are an "attendant" paramedic on the truck here when you graduate from paramedic school, you are put incharge of the calls, but you have that incharge medic to help you out so you gain experience and pretty quickly


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