# Progressive EMS states



## NightHealer865 (Dec 18, 2016)

Hello, 
I am currently in paramedic school and am wanting some options on progressive EMS states to get started in as a brand new paramedic. I am currently in TN practicing as an AEMT but am looking for a change of scenery as a medic. I'd love to live near a coast line but I'll live anywhere. I'm mostly like for places with progressive protocols that I can make a 20+ year career with. I will come out of school with NREMT-P if all goes well. 
Thanks! 


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## NomadicMedic (Dec 18, 2016)

Delaware. Texas. 

There are plenty of others, but those are top of mind.


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## DrParasite (Dec 18, 2016)

what do you define as progressive?


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## Brady Farley (Dec 18, 2016)

Programs with aggressive patient treatment protocols, states that allow Paramedics to be aggressive. States on the front life of ems progression with research and development.


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## NomadicMedic (Dec 18, 2016)

Brady Farley said:


> Programs with aggressive patient treatment protocols, states that allow Paramedics to be aggressive. States on the front life of ems progression with research and development.
> 
> 
> Sent from my iPhone using Tapatalk



How do you define aggressive?


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## NightHealer865 (Dec 18, 2016)

I generally mean a good scope of practice and systems with pretty decent protocols. Not having to call for orders for anything other than BLS interventions would be nice. Ultimately, I'll be looking for a place to start my career as a paramedic that will mold me into a confident paramedic. 


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## twistedMP (Dec 18, 2016)

King county Washington is the first one that comes to mind 


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## VentMonkey (Dec 18, 2016)

twistedMP said:


> King county Washington is the first one that comes to mind


You know what? If I had grown up in the PNW, I am almost certain I would feel the same, and would have dropped my application as a tech to get in on the world renowned Harborview education.

How about NOT California, OP. The PNW (both Oregon, and Washington) has some decent protocols and I am sure if you looked hard enough, services (note: NOT JUST KCM1).

Also OP, understand just because you have a whole slew of awesome tricks in your bag does not mean you will use them, nor is it a measure of the level of paramedic you are, or aren't.

I am a born and bread Angelino who grew up as a tech around the notoriously lazy LACoFD squads, but even with their reputation and limited scope, saw a couple of them whom til this day I would emulate, and or learned from.

The guy who made sure all of his patients he BLS-d got a full work up and when asked why he didn't "roll hot" with every ALS follow up replied "Why? Are they dying?" comes to mind.


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## EpiEMS (Dec 18, 2016)

Definitely not California (Kern County cult aside )!

I'd stick to Texas, or maybe somewhere affiliated with or with good ties to a university health system.

As far as places to make a career, what about Pittsburgh? Or perhaps Delaware's fine fly paramedic systems? Another group of systems that comes to mind is North Carolina's several county based systems.


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## VentMonkey (Dec 18, 2016)

EpiEMS said:


> Definitely not California (Kern County *and all* )!
> 
> I'd stick to Texas, or maybe somewhere affiliated with or with good ties to a university health system.
> 
> As far as places to make a career, what about Pittsburgh? Or perhaps Delaware's fine fly paramedic systems? Another group of systems that comes to mind is North Carolina's several county based systems.


Fixed it for ya'.


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## EpiEMS (Dec 18, 2016)

VentMonkey said:


> Fixed it for ya'.



Haha, I thought some folks were bullish on Kern?


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## VentMonkey (Dec 18, 2016)

EpiEMS said:


> Haha, I thought some folks were bullish on Kern?


Define bullish?


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## EpiEMS (Dec 18, 2016)

VentMonkey said:


> Define bullish?



Well, relative to the rest of California, people tend to think it's (a little bit) better, that's really all...I suppose


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## VentMonkey (Dec 18, 2016)

EpiEMS said:


> Well, relative to the rest of California, people tend to think it's (a little bit) better, that's really all...I suppose


Fair enough, I just can't clump any part of California into a "progressive systems" thread.


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## akflightmedic (Dec 19, 2016)

I thought parts of FL were very progressive and aggressive....when I moved there from SC. But then I went to AK and found even more progressive and aggressiveness. 

I think it is all relative to what you know personally and then needs to be defined by more parameters so you get exactly what you seek. This country is wide open from "Mother May I" the most basic intervention to "Do Whatever it Takes" and here are the tools and EBM to support it. Then once you find the system you like and it could be either extreme or something in between...you then need to decide what state. Decide rural, urban, or both. Private or government...The defining list goes on and on....which is one of the reasons I always loved this business!!


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## akflightmedic (Dec 19, 2016)

Because I have moved a LOT in my life and career, I do find a lot of insular thinking in many areas. Basically, those who only know that system in that area, they think the entire rest of the country is exactly like they are. And if you tell them different, you are met with disbelief and resistance. 

Why just the other day (here in Maine) I bumped into a paramedic of a rural area who just finished his Community Paramedic Certificate. He proceeded to tell me how he is the first one in this area and that the state is also the first in the nation to do this program...I just said "ok, that's cool". I mean nearly two years ago I was assisting a local college in FL put together their Community Paramedic DEGREE program...but hey...to each his own. (Many programs pre-date that one as well, just using it as an example of insular thinking).


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## Milla3P (Dec 19, 2016)

DEmedic said:


> How do you define aggressive?



A lot of yelling. 
I prefer my paramedics to be passive-aggressive.


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## Milla3P (Dec 19, 2016)

RI is making a major upgrade in their protocols in a couple of months. Adding a fistful of procedures and meds and taking med control pretty much out of the equation for Ps. But then you'd have to live in Rhode Island.


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## akflightmedic (Dec 19, 2016)

Is RI still a state? I was unsure, I mean they took away Pluto's planetary status, thought I heard something similar regarding RI.


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## NightHealer865 (Dec 19, 2016)

akflightmedic said:


> I thought parts of FL were very progressive and aggressive....when I moved there from SC. But then I went to AK and found even more progressive and aggressiveness.
> 
> I think it is all relative to what you know personally and then needs to be defined by more parameters so you get exactly what you seek. This country is wide open from "Mother May I" the most basic intervention to "Do Whatever it Takes" and here are the tools and EBM to support it. Then once you find the system you like and it could be either extreme or something in between...you then need to decide what state. Decide rural, urban, or both. Private or government...The defining list goes on and on....which is one of the reasons I always loved this business!!



I was looking at Florida and North Carolina but was seeing what all options were available. Thanks 


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## aquabear (Dec 19, 2016)

Everything's bigger (like your scope of practice) in Texas.


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## AtlasFlyer (Dec 20, 2016)

Marion Co, Indiana (city of Indy).


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## VentMonkey (Dec 20, 2016)

AtlasFlyer said:


> Marion Co, Indiana (city of Indy).


Was this formerly Wishard a handful of years ago?


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## Operations Guy (Dec 21, 2016)

Alaska or Texas. Not California. Alot of Texas is county third system running duel medic. No state scope. Set by medical director so it's pretty broad and allows for provider critical thinking vs. a mother may I system like California.


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## AtlasFlyer (Dec 21, 2016)

VentMonkey said:


> Was this formerly Wishard a handful of years ago?



yes


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