# Orange County and SE LA County - Paramedic Private Ambulance



## pmedic1104 (Jun 9, 2020)

I am moving to somewhere near Anaheim and was looking at company choices. I was wondering what are the highest paying companies for a medic? I am totally okay doing all IFT transports, and would be interested in companies that have critical care transports as well.


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## NPO (Jun 9, 2020)

As a paramedic your only option is IFT unless you join a fire department. Most if not all of the companies that have paramedics will also have Critical Care Transport, but it will be done by Nurses, not paramedics.

Care is the largest provider that has medics. Does that mean they're the best? I'm not sure.


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## DesertMedic66 (Jun 9, 2020)

NPO said:


> As a paramedic your only option is IFT unless you join a fire department. Most if not all of the companies that have paramedics will also have Critical Care Transport, but it will be done by Nurses, not paramedics.
> 
> Care is the largest provider that has medics. Does that mean they're the best? I'm not sure.


Lynch does have a single city contract for 911 paramedic responses in the OC area.


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## NPO (Jun 9, 2020)

DesertMedic66 said:


> Lynch does have a single city contract for 911 paramedic responses in the OC area.


Thank you for correcting me. I was not aware. Looks like OC is catching up with the rest of the civilized world.


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## jgmedic (Jun 9, 2020)

We'll see how long that lasts.


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## Jn1232th (Jun 10, 2020)

I currently work at lynch as a medic. 911 starts July 1st  which there taking very seriously actually but chances of getting on 911 side right now are slim. Currently I’m on IFT side which is actually not bad at all. 80% of our calls are skilled nursing or board and cares to ER. I say 1/2 time it’s BLS but other half are legit medical issues. This week alone I ran a stroke, TIA, hyperglycemic of 600 and symptomatic Brady in the 40’s. It’s standing orders as well so base contact is never made.  We do run mutual aid as well typically with Huntington Beach when they are busy.  IFT wise it really depends on day. Can be monitor transfer for insurance reasons, or a re-triage for stroke/stemi/trauma. Some medics are vent certified through an additional course and all medics are trained on pumps which are nice ( mostly just monitor though. No titration). 
As for LA/OC companies I feel it’s the best but pay really depends on experience. Some places do pay well ($30 hour) but typically are just monitor transfers from what I’m told by crews.


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## Jn1232th (Jun 10, 2020)

“Very seriously “ sounds weird. What I meant is there trying to make it as smooth as a start as possible and the main person taking over it is doing best to make it top notch. I’m hoping it goes good but we are getting alotttttt of hate


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## NPO (Jun 10, 2020)

Jn1232th said:


> I’m hoping it goes good but we are getting alotttttt of hate



I can understand that. Allowing private paramedics to run 911 calls is groundbreaking, cutting edge stuff.


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## Jn1232th (Jun 10, 2020)

Must be haha I thought It was just what 90% of country did 🤷🏼‍♂️


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## Rano Pano (Jun 10, 2020)

Jn1232th said:


> Must be haha I thought It was just what 90% of country did 🤷🏼‍♂️


Out of curiosity how have they been preparing their medics to be ready by July 1st? How are they decided who will be assigned to those trucks? I’d imagine some of the more seasoned people haven’t done 911 in some time.


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## Jn1232th (Jun 10, 2020)

Rano Pano said:


> Out of curiosity how have they been preparing their medics to be ready by July 1st? How are they decided who will be assigned to those trucks? I’d imagine some of the more seasoned people haven’t done 911 in some time.



pretty much the 12 people going over work 911 for AMR Previously within past year or fire agencies as well ( morongo Fire/la Habra heights/ etc) . Everyone starting has at least 3 years experience in 911 setting. They’ve been training for past few weeks on radios/scenarios/ and with the new fire department on mci and active shooter drills.


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## Jn1232th (Jun 10, 2020)

They were pretty picky on the selection process to make sure it’s a smooth start and to show that crews have the experience they stated they had in the proposal last year.


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## DesertMedic66 (Jun 10, 2020)

I know there are some very experienced medics who work for them who have ~10 years of 911 experience each. The first few shifts may take some adjustment but they (the medics I know) will be quick to adapt. 

It’s really going to be interesting to where where this ends up. If Lynch is successful in providing the ALS 911 services, I wonder how many other OC cities will bail on OCFA and instead go with a BLS fire department and ALS private ambulance model. 

In my county we also had a city bail on the contracted state fire agency and create a BLS city department with private ALS ambulance. At first there was a lot of thought that it would fail but so far after 2 years I haven’t heard much about issues with it.


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## jgmedic (Jun 10, 2020)

DesertMedic66 said:


> I know there are some very experienced medics who work for them who have ~10 years of 911 experience each. The first few shifts may take some adjustment but they (the medics I know) will be quick to adapt.
> 
> It’s really going to be interesting to where where this ends up. If Lynch is successful in providing the ALS 911 services, I wonder how many other OC cities will bail on OCFA and instead go with a BLS fire department and ALS private ambulance model.
> 
> In my county we also had a city bail on the contracted state fire agency and create a BLS city department with private ALS ambulance. At first there was a lot of thought that it would fail but so far after 2 years I haven’t heard much about issues with it.



Difference with them is that AMR has always been ALS in that city. That FD is a revolving door with no retirement, garbage pay, and piss-poor leadership.


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## DesertMedic66 (Jun 10, 2020)

jgmedic said:


> Difference with them is that AMR has always been ALS in that city. That FD is a revolving door with no retirement, garbage pay, and piss-poor leadership.


That may be so but they still have no issues with staffing, no major complaints from the city or county, and are still getting new equipment (they just added a new brush unit to the department). I also haven’t heard any major complaints from the AMR side.


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## RocketMedic (Jun 10, 2020)

DesertMedic66 said:


> I know there are some very experienced medics who work for them who have ~10 years of 911 experience each. The first few shifts may take some adjustment but they (the medics I know) will be quick to adapt.
> 
> It’s really going to be interesting to where where this ends up. If Lynch is successful in providing the ALS 911 services, I wonder how many other OC cities will bail on OCFA and instead go with a BLS fire department and ALS private ambulance model.
> 
> In my county we also had a city bail on the contracted state fire agency and create a BLS city department with private ALS ambulance. At first there was a lot of thought that it would fail but so far after 2 years I haven’t heard much about issues with it.


In Riverside County?


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## DesertMedic66 (Jun 10, 2020)

RenegadeRiker said:


> In Riverside County?


Yeah. Calimesa, CA.


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## RocketMedic (Jun 10, 2020)

I wish Lynch the best on this adventure.


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## jgmedic (Jun 10, 2020)

Cali was a ****show before they went to their own dept. The city didnt want to pay for a medic on the engine, so they went to a non-union, BLS dept managed by a guy who ran another fire agency into the ground. Their pay is laughable, benefits not on par with any public safety agency. They wanted to keep their 2-0 staffed Cal Fire engine, the county said no, all engines needed to be 3-0 with a medic.


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## pmedic1104 (Jun 23, 2020)

Jn1232th said:


> I currently work at lynch as a medic.... Some places do pay well ($30 hour) but typically are just monitor transfers from what I’m told by crews.



How much does Lynch pay? And which are the companies that go up to $30/hr? Also which are the companies that do vents/pumps? Even if it is a nurse running things I would be interested in companies that do critical care transport as well. Really just looking for a short list of best companies when it comes to pay, not interested in 911 at the moment.


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## Jim37F (Jun 23, 2020)

pmedic1104 said:


> Even if it is a nurse running things I would be interested in companies that do critical care transport as well.


I can't answer your other questions, but I will say that unless things have changed (and it has been many moons since I was working on a PRN Ambulance CCT unit), but from what I saw and experienced, LA/OC private ambulance CCT units are 1 Nurse, and 2 EMTs, not medics


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## NPO (Jun 23, 2020)

Jim37F said:


> I can't answer your other questions, but I will say that unless things have changed (and it has been many moons since I was working on a PRN Ambulance CCT unit), but from what I saw and experienced, LA/OC private ambulance CCT units are 1 Nurse, and 2 EMTs, not medics


Yep. Same for me, but this was many more moons ago at Bowers. It was 2 EMTs plus an RN, RT or MD. Never a medic.


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## Jn1232th (Jun 23, 2020)

At lynch we all get trained on pumps, but we don’t titrate. So far most calls that have pumps tend to be heparin drips that we set to hospitals pre set rate. As for vent calls, we do use ventilators but does require additional class that they have periodically. Typically those calls are medic/medic or occasionally medic/EMT. I think there is normally two vent units on per day


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## DesertMedic66 (Jun 23, 2020)

Jn1232th said:


> At lynch we all get trained on pumps, but we don’t titrate. So far most calls that have pumps tend to be heparin drips that we set to hospitals pre set rate. As for vent calls, we do use ventilators but does require additional class that they have periodically. Typically those calls are medic/medic or occasionally medic/EMT. I think there is normally two vent units on per day


For your vented patients are you guys transporting patients who need sedation infusions (Versed, Propofol, etc) or the long term SNF patients who don’t need any sort of sedation?


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## Jn1232th (Jun 23, 2020)

DesertMedic66 said:


> For your vented patients are you guys transporting patients who need sedation infusions (Versed, Propofol, etc) or the long term SNF patients who don’t need any sort of sedation?



really depends. Typically it’s more of the SNF patient. They do transport Re-triage type calls as well with RSI on board. as for sedation we can transport benzodiazepine infusions. No propofol or paralytics. Then if needed can give verses for sedation In standing orders


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## Mitchellmvhs (Jun 28, 2020)

I work for Doctors Ambulance in OC, we’re owned by AMR but we only do CCT with nurses. Only time I’ve had medics on board were 911, but they were fire or I had a medic and RN for a covid transport, but they were a flight team when we picked up PT from airport


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## wtferick (Jul 14, 2020)

Jn1232th said:


> I currently work at lynch as a medic. 911 starts July 1st  which there taking very seriously actually but chances of getting on 911 side right now are slim. Currently I’m on IFT side which is actually not bad at all. 80% of our calls are skilled nursing or board and cares to ER. I say 1/2 time it’s BLS but other half are legit medical issues. This week alone I ran a stroke, TIA, hyperglycemic of 600 and symptomatic Brady in the 40’s. It’s standing orders as well so base contact is never made.  We do run mutual aid as well typically with Huntington Beach when they are busy.  IFT wise it really depends on day. Can be monitor transfer for insurance reasons, or a re-triage for stroke/stemi/trauma. Some medics are vent certified through an additional course and all medics are trained on pumps which are nice ( mostly just monitor though. No titration).
> As for LA/OC companies I feel it’s the best but pay really depends on experience. Some places do pay well ($30 hour) but typically are just monitor transfers from what I’m told by crews.


My ER loves using Lynch ALS! Lol You guys being able to transport TPA and not “needing” a nurse on board is such a time saver. Lynch>OCFA


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## Jn1232th (Jul 15, 2020)

wtferick said:


> My ER loves using Lynch ALS! Lol You guys being able to transport TPA and not “needing” a nurse on board is such a time saver. Lynch>OCFA



Oh I bet! Haha I have yet to have a TPA drip but always seemed Counter productive when I will see fire show up for a re triage and have to discontinue a drip of any sorts other than saline.


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## NPO (Jul 15, 2020)

wtferick said:


> My ER loves using Lynch ALS! Lol You guys being able to transport TPA and not “needing” a nurse on board is such a time saver. Lynch>OCFA


I'm surprised they let them do TPA since it's not in the state scope of practice. I'm assuming there's a stipulation that if it's on a pump and "set it and forget it" then it doesn't require a nurse?


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## Jn1232th (Jul 15, 2020)

NPO said:


> I'm surprised they let them do TPA since it's not in the state scope of practice. I'm assuming there's a stipulation that if it's on a pump and "set it and forget it" then it doesn't require a nurse?



basically. We can’t titrate it or anything like that. Just set to pre set rate at sending ER and discontinue if any complications pop up


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## wtferick (Jul 15, 2020)

Jn1232th said:


> Oh I bet! Haha I have yet to have a TPA drip but always seemed Counter productive when I will see fire show up for a re triage and have to discontinue a drip of any sorts other than saline.


Exactly. Plus, OCFA screws up sending a patient with Stroke like symptoms BLS a lot of the times. It would just be embarrassing for that same crew to transport out again haha.


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## NPO (Jul 15, 2020)

Jn1232th said:


> basically. We can’t titrate it or anything like that. Just set to pre set rate at sending ER and discontinue if any complications pop up


I mean, that's essentially how TPA works anyway lol. 

We can take anything we want on a transfer, as long as the sending doctor okays it. Usually that means a pump, but we can push meds and titrate too. It's nice having the freedom, but I also kind of understand the other side of the coin. 

What I don't understand is why it took until 2020 to realize that private paramedics can maintain continuity of care for many patients without needing a fire helmet.


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## wtferick (Jul 15, 2020)

NPO said:


> I'm surprised they let them do TPA since it's not in the state scope of practice. I'm assuming there's a stipulation that if it's on a pump and "set it and forget it" then it doesn't require a nurse?


Pretty much. “Set it and forget it”


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## Mufasa556 (Jul 27, 2020)

Any update on how Lynch is doing with their 911 contract?

I’ve been rooting for them, but I’ve heard some bad things through the grapevine.


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## DesertMedic66 (Jul 27, 2020)

Mufasa556 said:


> Any update on how Lynch is doing with their 911 contract?
> 
> I’ve been rooting for them, but I’ve heard some bad things through the grapevine.


With how much slander OCFA has been passing around I wouldn’t trust anything that you heard “through the grapevine”.


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## Jn1232th (Jul 27, 2020)

Mufasa556 said:


> Any update on how Lynch is doing with their 911 contract?
> 
> I’ve been rooting for them, but I’ve heard some bad things through the grapevine.



so far so good! No issues with calls being ran. They got there first ROSC the other day From what supervisors told me. I believe only real issue is with uploading onto new servers and such but that’s just technical. 
call wise, all on scene times have been good and no issues with base contact or treatments.
The surrounding cities though have been not using us for mutual aid, even when needed.


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## Jn1232th (Jul 27, 2020)

DesertMedic66 said:


> With how much slander OCFA has been passing around I wouldn’t trust anything that you heard “through the grapevine”.



True, I’ve been hearing a lot of rumors that are not true regarding how it’s going. Still a lot of hate and a lot of people wanting it to fail


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## DesertMedic66 (Jul 27, 2020)

Jn1232th said:


> True, I’ve been hearing a lot of rumors that are not true regarding how it’s going. Still a lot of hate and a lot of people wanting it to fail


It’s the same story anytime any city decides to go away from the “normal”. Happened in Calimesa, happened in Victorville, and is happening out there. Never really understood the mentality of “I hope they fail”.


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## RocketMedic (Jul 27, 2020)

What changed in Victorville?


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## Rano Pano (Jul 27, 2020)

RenegadeRiker said:


> What changed in Victorville?


They changed from San Bernardino County Fire to Victorville City Fire early last year.


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## DesertMedic66 (Jul 27, 2020)

RenegadeRiker said:


> What changed in Victorville?





Rano Pano said:


> They changed from San Bernardino County Fire to Victorville City Fire early last year.


This. The city decided to go back to a city department instead of contracting with San Bernardino County Fire. During the transition the county Fire union did a lot of shady and illegal things that got them in some trouble. Those things included spraying 935 (their union number) in weed killer on the grass of one of the stations, loosening water lines so that walls would become water damaged, removing the batteries from all the smoke/CO2 detectors, removing the batteries from the clocks and setting them to 9:35. Leaving them a heavily damaged fire engine that was owned by the city but was supposed to be maintained by county and then swapping all the nice equipment (also city owned) on the engines out for heavily used/damaged equipment, so they would be in Engine 33 (I don’t know their unit numbers) but have a chainsaw from 53, circular saw from 45, extrication tools from 23, etc.


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