# AMR in King County, WA



## RanchoEMT (Mar 23, 2012)

So im in Seattle currently and I've noticed AMR has been going by the hotel code3, whats this all about??? I thought Medic One was the primary ALS Ambulance for all of King Co., WA??? (saw a Medic One Ambulance blocked by one of the FF's personal trucks in the fire station bay, thought maybe they're striking or something...) any input?? I would love to transfer if AMR is running 911 in seattle!


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## STXmedic (Mar 23, 2012)

I would assume code to an contracted facility. That, or transporting code.


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## RanchoEMT (Mar 23, 2012)

Im right by Pike Market in the city, and they've gone by maybe 3 times a night and shutdown a block or so away, im assuming OnScene. Unless they're going balls out to post...


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## NomadicMedic (Mar 23, 2012)

AMR in Seattle is the BLS transport contractor for Seattle. They respond priority to every ambulance request to meet the response time requirement.


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## medicsb (Mar 23, 2012)

Also, Seattle is covered by only 7 medic units.  2 of them are stationed at Harborview medical center, so whatever ambulance you saw was probably not one of the 7.  There are, I think, 4 "aid cars", which are SFDs BLS ambulances.


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## NomadicMedic (Mar 23, 2012)

Yes, but Seattle Fire aid cars do not, as a rule, transport BLS patients.


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## Luno (Mar 23, 2012)

AMR Seattle provides BLS TXPT for Seattle FD, and responds priority because that is what is negotiated in their contract with Seattle FD, NOT because of the patient's needs...


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## NomadicMedic (Mar 23, 2012)

Luno said:


> AMR Seattle provides BLS TXPT for Seattle FD, and responds priority because that is what is negotiated in their contract with Seattle FD, NOT because of the patient's needs...



Just like TriMed in Kent and Bellevue… Who cares if they kill someone because they're going priority to a stubbed toe.


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## RanchoEMT (Mar 25, 2012)

If u have to be on the FD to be a paramedic in Seattle how do u get experience as such, prior to getting hired???


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## NomadicMedic (Mar 25, 2012)

RanchoEMT said:


> If u have to be on the FD to be a paramedic in Seattle how do u get experience as such, prior to getting hired???



You work BLS for AMR, TriMed or Rural/Metro.


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## RanchoEMT (Mar 25, 2012)

n7lxi said:


> You work BLS for AMR, TriMed or Rural/Metro.



So if i moved to seattle with 4 years experience as an EMT, 2 of which are on a 911 ALS unit with a medic id have more experience than almost all ambulance EMT's in seattle?


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## NomadicMedic (Mar 25, 2012)

Yep. EMTs for private BLS in King County are at the bottom of the heap. You're basically a stretcher fetcher and the fire department EMTs gofer. (and they get more respect then you do as an EMT). For most, a BLS job in Seattle or the surrounding area is simply a stepping stone, a spot to get your EMT card before a fire job. You should do a little research on how EMS in King County works before you get all excited. 

If you work as a medic for Medic One, it's an outstanding place. If you work for a private, it's ... Well, let's just say its not good. 

There are a zillion other places I'd recommend over King County.


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## RanchoEMT (Mar 25, 2012)

n7lxi said:


> Yep. EMTs for private BLS in King County are at the bottom of the heap. You're basically a stretcher fetcher and the fire department EMTs gofer. (and they get more respect then you do as an EMT). For most, a BLS job in Seattle or the surrounding area is simply a stepping stone, a spot to get your EMT card before a fire job. You should do a little research on how EMS in King County works before you get all excited.
> 
> If you work as a medic for Medic One, it's an outstanding place. If you work for a private, it's ... Well, let's just say its not good.
> 
> There are a zillion other places I'd recommend over King County.



By all means, recommend them.


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## psyanotic (Mar 25, 2012)

*King County*

He's right about King County, it's definitely an interesting animal and unfortunately, private ambulance EMT's are at the bottom rung. I work for Tri-Med right now but have a ton of friends that work for AMR, it's pretty much the same. You'll rarely beat fire to scene, you typically just arrive on scene, load them up and try to get your demographic info before you get to the hospital. Not too much "patient care" going on (although you can definitely increase your patient care if you focus more on that and leave your dreaded report for later).

And while it's true that you don't receive as much respect as medics or fire, it's all dependent on your attitude on scene. If you've worked in an area for a little while and have established a good rapport with fd and pd, they treat you very well.

Pierce County (just south of King) is required to staff all ambulances with one basic and one medic, so that might be a better place to work if that's what you're going for.

Also, if your goal is to get on with medic one (difference between King County M1 and the different fire department M1's), the majority of people that actually get hired are already paramedics. For KCM1, you're not a FF/Medic, just a medic. That's probably the route you would want to go since the other medics are FF's and are required to work for their department for 3-5 years before they can apply for medic one.


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## NomadicMedic (Mar 25, 2012)

Not exactly right. Even if you're already a medic, and have been for years, if you get hired at King County Medic One, the only non fire single role paramedic service in the county, you'll still attend a year of paramedic school at Harborview so they can teach you how to be a KING COUNTY medic. 

KCM1 is a great service. Just ask them, they'll tell you. A mentor of mine summed up it best, "They write their own press releases. The problem is, they read 'em and believe them, too."



And while I had a great relationship with the fire crew on my shift, in my first due, I would often have to work with fire monkeys who treated me, and the patients with little respect, if not outright disdain. I complained about several firefighters in Burien and North Highline and was told to "keep quiet if I wanted to keep my job". 

Yeah, I didn't need to be a stretcher fetcher that badly. 

It's a lousy place. Unfortunatly, King County is famous for doing a great job resuscitating VF arrests and that's what overshadows the poor care in the rest of the system.


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## Aidey (Mar 25, 2012)

n7lxi said:


> KCM1 is a great service. Just ask them, they'll tell you.



:rofl::rofl::rofl:






n7lxi said:


> Unfortunatly, King County is famous for doing a great job resuscitating VF arrests and that's what overshadows the poor care in the rest of the system.



Their fame is a perfect example of how statistics can be played with to make them show what you want them to show. Narrow the parameters enough and of course you are going to get a 50% save rate. 

Granted, Seattle does have a higher percentage of lay people trained in CPR and public access to defibrillators but KCM1 can only take so much credit for that.


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## psyanotic (Mar 25, 2012)

n7lxi said:


> Not exactly right. Even if you're already a medic, and have been for years, if you get hired at King County Medic One, the only non fire single role paramedic service in the county, you'll still attend a year of paramedic school at Harborview so they can teach you how to be a KING COUNTY medic.



Right, what I was saying though is that the majority of the people who get hired have ALREADY been working as paramedics. Of course they need to go through Medic One's program, but my point is that there's some pretty tough competition to get accepted, given that the test is at a BLS level and the majority of successful applicants are ALS providers.



n7lxi said:


> It's a lousy place. Unfortunatly, King County is famous for doing a great job resuscitating VF arrests and that's what overshadows the poor care in the rest of the system.


Haha not just FAMOUS, but OBSESSED. Have you guys heard about the new ALPS study? It starts in Seattle on Tuesday. Now if you go into cardiac arrest, you might get amiodarone, you might get lidocaine, or you might get a placebo (saline). They're trying to find out which, if any, are most effective for patients (cardiac arrest to discharge, not just to the hospital). Scary.


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## RanchoEMT (Mar 25, 2012)

psyanotic said:


> difference between King County M1 and the different fire department M1's


More detail, PLEASE!!! and TY


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## RanchoEMT (Mar 25, 2012)

Also, this is for anyone, how is the pay in and around Seattle for EMS including FF? (Been getting mixed answers from the search)

AMR EMT SEATTLE-$_____/hr.
other Private company Medic SEATTLE-$_____/hr.
FD FF SEATTLE-$_____/hr.
FD Medic SEATTLE-$_____/hr.
EMT's around SEATTLE area-$_____/hr.
Medics around SEATTLE area-$_____/hr.


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## STXmedic (Mar 25, 2012)

psyanotic said:


> Haha not just FAMOUS, but OBSESSED. Have you guys heard about the new ALPS study? It starts in Seattle on Tuesday. Now if you go into cardiac arrest, you might get amiodarone, you might get lidocaine, or you might get a placebo (saline). They're trying to find out which, if any, are most effective for patients (cardiac arrest to discharge, not just to the hospital). Scary.


Why is that scary? That is absolutely a needed study. Props to them for stepping up and going through with it. I look forward to the results. I wonder if the area hospitals are going to be onboard as well, for those patients that go back into arrest at the hospital/icu.


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## NomadicMedic (Mar 25, 2012)

PoeticInjustice said:


> Why is that scary? That is absolutely a needed study. Props to them for stepping up and going through with it. I look forward to the results. I wonder if the area hospitals are going to be onboard as well, for those patients that go back into arrest at the hospital/icu.



Agreed. That's part of the ROC study and I think it's a great idea. They've been talking about doing that study for a while, back when I was there I spoke with a couple of medical directors and they had expressed great interest in comparing amiodarone to lidocaine. I am a little surprised that they added a placebo…

And yes it is rather difficult to get hired as a Medic One paramedic candidate. However, I would encourage anyone who wants a great education to test for entry into the program. You'll become a very well educated paramedic, make a ton of money, and be burnt out in five years. That was not for me. 

In the interest of disclosure, I was not a King County paramedic. I did work BLS King County and worked as a medic in several other counties in Washington. I also never tested to become a King County paramedic, simply wasn't interested.


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## psyanotic (Mar 25, 2012)

*king county*

Well I think it's wise to do a study between the two since they're both antiarrhythmics, but having the saline in there, which I understand is necessary for a controlled study, just seems somewhat... unfair? I don't know, just my thoughts. It's FDA approved and going to be conducted concurrently in 10 major cities in the US.


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## Aidey (Mar 25, 2012)

They probably approved it since there is little evidence showing they are beneficial. If during the study one or the other is shown to have a significant affect they can and will stop the study early on ethical grounds.


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## medicsb (Mar 25, 2012)

psyanotic said:


> Well I think it's wise to do a study between the two since they're both antiarrhythmics, but having the saline in there, which I understand is necessary for a controlled study, just seems somewhat... unfair? I don't know, just my thoughts. It's FDA approved and going to be conducted concurrently in 10 major cities in the US.



They're not determining which antiarrhythmic works better than the other, they're determining if they work any better than nothing at all and only if one or both is better than nothing will they maybe determine which is best.  They're doing this because there is sufficient clinical equipoise to do so.

FYI, the FDA doesn't approve studies, an Institutional Review Board (IRB) does.


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## psyanotic (Mar 25, 2012)

*lol*

Lol sorry, I'm bad with acronyms.

Thanks though, I'll know who to sue if I ever die from getting the wrong drug.


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## NomadicMedic (Mar 26, 2012)

psyanotic said:


> Lol sorry, I'm bad with acronyms.
> 
> Thanks though, I'll know who to sue if I ever die from getting the wrong drug.



If you've got an issue with it, call Udub and request your red "opt out of the study" bracelet.


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## medicsb (Mar 26, 2012)

psyanotic said:


> Lol sorry, I'm bad with acronyms.
> 
> Thanks though, I'll know who to sue if I ever die from getting the wrong drug.



I don't think zombies can sue.  But you could try to eat their brains, I suppose.


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## Luno (Mar 26, 2012)

psyanotic said:


> I work for Tri-Med right now but have a ton of friends that work for AMR, it's pretty much the same. You'll rarely beat fire to scene, you typically just arrive on scene, load them up and try to get your demographic info before you get to the hospital. Not too much "patient care" going on (although you can definitely increase your patient care if you focus more on that and leave your dreaded report for later).



If you want more med, you need to be a more proactive crew and respond in a timely manner... especially if you work W of West Valley...  It isn't that difficult.


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## yowzer (Mar 27, 2012)

psyanotic said:


> And while it's true that you don't receive as much respect as medics or fire, it's all dependent on your attitude on scene.



Hah. I've heard one of the doctors in charge of the county's EMS program say that he wants all the local fire departments to do their own transport instead of calling big white taxis, er, private ambulances, to ensure good patient care. The lack of respect and second-class attitude starts at the top.  There are cases where individual fire and ambulance crews have better relationships, sure, but it's a rotten system in general when you're on an ambulance.

(I've had interactions with crews from lots of fire departments and all ambulance companies operating in the county. Some are good, most okay, some downright dangerous to their patients, with no one employer's emts, be it a fire department or private, taking the lead in any category.)


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## KingCountyMedic (Apr 6, 2012)

RanchoEMT said:


> If u have to be on the FD to be a paramedic in Seattle how do u get experience as such, prior to getting hired???



You have to work the Aid Car for 2-3 years at least to be considered for Paramedic Training in the SFD. And Seattle Aid Units DO transfer most of their patients as long as the patient goes to the hospital in the Aid Units first due response area. They have the option of using the contracted Ambulance, typically the guys that transport a lot are the guys trying to get into Paramedic Training.


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## NomadicMedic (Apr 7, 2012)

KingCountyMedic said:


> You have to work the Aid Car for 2-3 years at least to be considered for Paramedic Training in the SFD. And Seattle Aid Units DO transfer most of their patients as long as the patient goes to the hospital in the Aid Units first due response area. They have the option of using the contracted Ambulance, typically the guys that transport a lot are the guys trying to get into Paramedic Training.



Is that a new development? Every firefighter EMT I talked to at SFD told me they didn't transport unless it was absolutely necessary. And most of the south departments didn't have staffing to dedicate to transport rigs. For example, if Renton was down 2 guys, they didn't staff Aid 17, which meant that Aid 12 wouldn't be transporting. So, they ALWAYS used a private, as did everyone else down there, from Tukwila south. I know that Redmond and the guys over that way transport with their aid cars, however.


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## KingCountyMedic (Apr 7, 2012)

n7lxi said:


> Is that a new development? Every firefighter EMT I talked to at SFD told me they didn't transport unless it was absolutely necessary. And most of the south departments didn't have staffing to dedicate to transport rigs. For example, if Renton was down 2 guys, they didn't staff Aid 17, which meant that Aid 12 wouldn't be transporting. So, they ALWAYS used a private, as did everyone else down there, from Tukwila south. I know that Redmond and the guys over that way transport with their aid cars, however.



It varies year to year around the south end. We have had some departments change how they do business when they get new Chiefs trying to reinvent the wheel. Yes, staffing is a big one. The departments that have some of the fullest staffing never transport and some of the departments with very low staffing and very little $$$ will transport quite a bit. I like having aid units transport, makes you appreciate the private ambulance companies a bit more  Seattle Aid cars have always had the option of transporting but like I said the guys that transport are usually wanting to get into the program.

The Tri-Med and AMR crews in the south end are for the most part spectacular crews to work with. We hire quite a few of our Medics from Tri-Med and AMR. I worked at Shepard/AMR for years before going to Medic One. And by no means are the private guys the lowest on the food chain, we have a few folks that don't treat people nicely all the time just like anyplace on earth but I love my private bros and sisters and I always try to make sure they are part of the run. I will often take a private guy with me if I need a set of hands in the back. The Private EMT's I work with in King County are some of the best EMT's on the planet.


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## NomadicMedic (Apr 7, 2012)

While working BLS in King County, I did work with several great medics... But there were plenty who were obviously burnt out and just didn't want to be there.

"Turfin' Tony" anyone?

And to say that BLS private crews weren't at the bottom of the food chain is just not true. Burien, Skyway and North Highline are a few of the crews that treat private EMTs like dung, almost without exception.


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