# SoCal protocols



## palmm (May 16, 2012)

Any info on the protocols there or access to the different county protocols within SoCal.


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## DesertMedic66 (May 16, 2012)

Where abouts in SoCal? Up in the LA/OC area? Riverside/San bernardino area? Or far south in the San Diego area?


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## jgmedic (May 16, 2012)

Look on each county's EMS website.

San Diego
Los Angeles
Riverside(REMS)
San Bernardino(ICEMA)
Imperial


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## marshmallow22 (May 16, 2012)

Yeah, LA and Orange Counties are by far the worse, about 30 years behind the rest of the country (and I'm serious too), and Ventura County is not far behind them.  VERY limited scope of practice, and if you can believe it, they're still required to make contact and speak with an MICN for further orders/report.  ICEMA and Riverside aren't bad (very limited MICN communication), their scope is fairly greaer than LA/Orange counties, but as compared to most parts of the country, they too are not as progressive.  If you ever attend an EMS convention/seminar I'd keep it to yourself that you work in CA.


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## palmm (May 16, 2012)

Wow, that sucks


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## socalmedic (May 16, 2012)

marshmallow22 said:


> Yeah, LA and Orange Counties are by far the worse, about 30 years behind the rest of the country (and I'm serious too), and Ventura County is not far behind them.  VERY limited scope of practice, and if you can believe it, they're still required to make contact and speak with an MICN for further orders/report.  ICEMA and Riverside aren't bad (very limited MICN communication), their scope is fairly greaer than LA/Orange counties, but as compared to most parts of the country, they too are not as progressive.  If you ever attend an EMS convention/seminar I'd keep it to yourself that you work in CA.



hmmm, I wonder how much experience you actually have or if you are even a medic.

while ICEMA is considered the "best" or "most liberal" protocols to work under that dosnt necessarily mean they are the most current. there is nothing good about a 300 page protocol manual.

Riverside used to be great, however they are becoming more and more limited due to med-errors. easy fix, dont screw up and you wont loose peds intubation and pressors...

Ventura is actually very liberal if you read into it, I only have to call in to the base if my patient does not respond to my treatment. if they respond they are a limited contact or protocol run. in the last year i have only called for orders a handful of times, 10 tops. and the MICNs always agree with us, I have never been denied an order. further more our protocols are all evidence based medicine, its not they are restricted, but that the are proven treatments with research to back them up.(yes i am a medic in ventura county)

LA and orange county are lost causes.


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## marshmallow22 (May 16, 2012)

Ventura medic: the fact that you still are REQUIRED to make contact and speak with a nurse says it all.  You still have no peds intubation, you don't have a hypothermic protocol, and you are still required in most cases to ask for an order for pain meds, in which a NURSE can deny you the order.  Your county just recently designated 2 trauma centers.  Up to the last few years you guys didn't even have a one.  Do you even have a designated pediatric receiving yet?  Even LA County has pediatric specific facilities.


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## marshmallow22 (May 16, 2012)

Oh yeah, I forgot you also play the "we were on scene first" political game with the VCFD medics (assuming you're on the ambulance).


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## socalmedic (May 16, 2012)

marshmallow22 said:


> Ventura medic: the fact that you still are REQUIRED to make contact and speak with a nurse says it all.  You still have no peds intubation, you don't have a hypothermic protocol, and you are still required in most cases to ask for an order for pain meds, in which a NURSE can deny you the order.  Your county just recently designated 2 trauma centers.  Up to the last few years you guys didn't even have a one.  Do you even have a designated pediatric receiving yet?  Even LA County has pediatric specific facilities.



I assume you where talking to me... not ventura medic (he is someone else); we do have peds intubation (above 8 years old), we dont want hypothermia (prehospital hypothermia has no evidence of being beneficial over ER hypothermia), I dont need an order for pain meds or even have to make base contact, a nurse will NEVER deny an order (she will get a doctor), yes our trauma system is up and running we have less than 1 million people how many trauma centers do we need? LA county has EDAPs because they found that their hospitals where not appropriately managing pediatrics, our hospitals are doing just fine with the kidos. any more corrections to your statements that you would like me to make?

by the way, you never did answer my question, are you even a paramedic?


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## marshmallow22 (May 16, 2012)

Yes, I am a paramedic.  Are you actually reading what you are typing?  Once again, how do you like knowing that you are one of ony a FEW systems in the country that still has MICN's?  Secondly, the pint I was making in reference to your lac of trauma centers wasn't aimed at your population, but rather the progressiveness of your system as a whole.  And lastly, you need to update your research.  When ROSC is obtained in the field it IS proven that immediate cooling IS beneficial.  Then again, you guys probably still laod your full arrests and perform CPR in the back of a moving ambulance so you really never obtain ROSC on scene.  Oh, and now answer my question... how do you like standing there with your gurney and waiting for VCFD to turn over the patient to you?  That is, if they do not decide to follow up with their squad.  After all, THEY are the public safety provider, not you.


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## socalmedic (May 16, 2012)

first off, EVERY system in California has MICNs they must as Title 22 requires it. secondly AHA has only shown that it is beneficial to cool within 4 hours of ROSC, making pre-hospital cooling not necessary. Thirdly, we have a great relationship with VCFD never once have i waited for report. when I show up if there is a VCFD medic on scene (about 50% of the time) I get an immediate report and transfer of care. never has the medic engine or squad not turned over care. sounds like you are bitter about something, did your nurse wife cheat on you with a fire medic? that was rhetorical, as I will not be responding to any more of your comments until you prove that you have something to bring to this community.


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## marshmallow22 (May 16, 2012)

Exactly... California.  That is why I stated earlier that if you are ever at an EMS convention/seminar just keep it to yourself that you are from CA.  And as far as VCFD turning over care, they are not required to do so.  If they choose to ride in, they can.  However, it does make your "fire/private" partnership more efficient when they decide not to ride in, but again, it's their choice.  In the eyes of the public though, they are the paramedics, and you're the ambulance driver.  Sorry, but it is what it is.


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## terrible one (May 17, 2012)

While SoCal EMS is far from perfect marshmellow, you are very misguided on the way it works in Ventura County. VNC (not VCFD, that would be Ventura City FD which does not have any squads) or any other county department rarely rides in with AMR or Lifeline Ambulance. Maybe go on a ride out in the county before making such speculations.
Also Pre-Hospital hypothermia has shown NO benefits over in hospital hypothermia. Check your sources again.


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## marshmallow22 (May 17, 2012)

Ok VNC, not that it makes a difference to state the point.  And yes, I know Ventura City Fire also has medic engines.  It's nice to see you realize the shortcomings of EMS in CA though.

 If a VNC engine or squad medic, or a VCFD engine medic decides to ride in, you have no choice but to let them, particularly if they arrive on scene first (which they almost always do) since AMR has cut many of their ambulances in the county.  I think it's great that in this economy your company will sell you down the river so VNC can keep adding medics to their engines.  In case you didn't know, the goal of VNC is to have a medic on every piece of apparatus, and AMR will make sure they attain that goal.  

As it stands, you do not assume patient care until the patient is on your gurney, and until that happens, just hang back and let the public safety agency handle the call (unless you arrive 1st, which we both know rarely happens).


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## terrible one (May 17, 2012)

VNC 9 medic units out of 31
VCFD 7 medic engines
OFD 8 BLS engines
SPFD 2 BLS engines
FLM 1 engine (sometimes ALS sometimes BLS)

The fire departments in Ventura county are majority BLS  
And yes they can ride in when they want, but that rarely happens. As in less than 10% of the time. I'm not sure why you keep stating that? The fire departments and ambulance providers in Ventura Co have one of the best relationships in the entire state.
Also I don't work for any of the ambulance company in Ventura Co.


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## ShotMedic (May 21, 2012)

at least when paramedics in LA/OC/SD counties get off work we can hit the beach and soak in the sun, surf, and eat amazing mexican food.


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## AnthonyM83 (May 25, 2012)

Marshmellow, you're reaching hard and it's embarrassing to watch. No claims about the quality of CA EMS have been made. You also painted an inaccurate picture of the state of EMS in Ventura (the fact SoCalMedic drew your fire doesn't absolve you of responsibility to post good info). 

Without their comebacks, you would have left readers with a much different picture.

So, 17 ALS engines in the county could ride in if they wanted to? *Yawn*

Also, remember SoCal's (cocky) claim about his county was in comparison to other SoCal counties...your reply went all crazy on statewide things...


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