fire/ems integration.....your opinion???

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DWemt28

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Hello. Right now im in my emt-b training and i plan on starting paramedic training next year. However I'm facing a problem. Where I live, in order to be a paramedic, you must be a firefighter. Only emt-b's roll in the ambulance. I've got nothing against fire medics. They sure are great at what they do (emergency is one of my favorite shows!) but I just don't think that firefighting is my line of work. What do you think? Do you believe in ALS fire and BLS ambulances?
 
Well everyone has an opinion on this can of worms so I won't delve too far into it. However my question is, where do you live? and why are only EMTs on the ambulance? Here FD run ambulances are still run with at least 1 Paramedic on board. The only BLS ambulances are run by private companies for hospital/Nursing home transfers.
 
I'm from orange county, CA. All of the firemen/paramedics are either on engines or non-transporting medic units (most of the time, engines). A lot of the cities each contract a private ambulance service to cover all transport, both emergency and non-emergency. The firemen will usually hop in the ambulance if the patient requires als on the way in, making that fire unit unavailable. I have no idea why there is only EMTs on ambulances
 
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Here in colorado Aurora fire has something similar but it is still an ALS response from the private company, just the private company medic sits there and twiddles his thumbs. I think its a horrible idea, paramedics belong on an ambulance regardless if its Fire/EMS or just EMS on their own. The firemedics don't organize or stock the ambulances they transport patients in, so they have potentially no idea where anything is on the ambulance. Medics should know where everything is on every ambulance they get into. We are supposed to be professionals and how professional does it look when the medic is staring at the cabinets going "uhhhh" *steps off soap box*
 
You do have a point, but like I said, the FD pretty much as all of the same equipment that is on a BLS rig, and more advanced equipment that isn't on the ambulance. They just take it with them if they have to hop in on an ALS transport. You are right because only the EMTs of that rig know the ambulance best.
 
DWparamedic said:
You do have a point, but like I said, the FD pretty much as all of the same equipment that is on a BLS rig, and more advanced equipment that isn't on the ambulance. They just take it with them if they have to hop in on an ALS transport. You are right because only the EMTs of that rig know the ambulance best.
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Yes, it is the same in LA county as well. You are free to go to Paramedic school, and obtain your licenses, but as far as working 911 calls as a paramedic in OC or LA, you will have to become a firefighter. You may work ALS interfacility transports as a medic on OC, but that is not for everyone. I suggest you look into moving down to San Diego County or to Riverside, where the private paramedics are 911 first in. Additionally, Santa Barbara, Ventura, San Luis Obispo, and Kern counties have private paramedics running 911.
 
What part of california are you from? What provider do you work for?
 
daedalus said:
You may work ALS interfacility transports as a medic on OC, but that is not for everyone. I suggest you look into moving down to San Diego County or to Riverside, where the private paramedics are 911 first in. Additionally, Santa Barbara, Ventura, San Luis Obispo, and Kern counties have private paramedics running 911.
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Hey, Daedalus, add San Bernardino county in there.

BTW, DW, there is no problem with working in one county and living in another. As for why the only paramedics are fire/medics in LA/Orange counties, well, that's cause fire has a BIG lobby...

/me works in LA County, on a 911 BLS rig, but live in San Bernardino County, and, for the win, carries a Riverside County EMSA cert.
 
daedalus said:
You may work ALS interfacility transports as a medic on OC, but that is not for everyone.
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Actually, no. I have never seen a private company paramedic in Orange County (well, ok, I've seen AMR Riverside at UCI Med Center a few times, but they aren't from OC). The CCT transports done by Lynch were done with RTs and/or RNs supplementing the basics on the ambulance and every CCT team I've seen from Care was an RN transport.
 
sir.shocksalot said:
Here in colorado Aurora fire has something similar but it is still an ALS response from the private company, just the private company medic sits there and twiddles his thumbs.
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I like how Littleton and other places like Arvada and Denver work it.

For everyone else's knowledge, Littleton: fire department has a nationally recognized EMS program - all firefighters are EMT-Bs, and they have ALS ambulances as well as several non-transport apparatus staffed with medics. Their responses are supplemented by an ALS/BLS private. It seems to work pretty nicely. It gets ALS care to people fast. If I'm having an emergency that requires ALS, I'd rather have an engine show up with a medic there to stabilize me while the ambulance is en route, rather than just wait for the ambulance. I am biased though. I work with them a lot.

In Denver all firefighters are EMT-Bs. They do not transport but supplement the response of hospital-based Denver Health Paramedic Division, which has tiered BLS -> ALS response. So you might have BLS there working for a little before the ALS gets there, especially in Denver because the EMS is stretched to (and often beyond) it's capacity.
 
JPINFV said:
Actually, no. I have never seen a private company paramedic in Orange County (well, ok, I've seen AMR Riverside at UCI Med Center a few times, but they aren't from OC). The CCT transports done by Lynch were done with RTs and/or RNs supplementing the basics on the ambulance and every CCT team I've seen from Care was an RN transport.
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rumors now are saying that care will start hiring emt-paramedics in the near future, which is why I'm still thinking about going to paramedic school. But still I don't know for sure what is going to happen
 
...but will those paramedics be in Orange County or LA County?
 
I assume that they will just assist the fire medics, and yes, care only serves orange and la county
 
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JPINFV said:
Actually, no. I have never seen a private company paramedic in Orange County (well, ok, I've seen AMR Riverside at UCI Med Center a few times, but they aren't from OC). The CCT transports done by Lynch were done with RTs and/or RNs supplementing the basics on the ambulance and every CCT team I've seen from Care was an RN transport.
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Ah! Than we can prove that there is no real need for ALS interfacility transport!!
 
LucidResq said:
I like how Littleton and other places like Arvada and Denver work it.

For everyone else's knowledge, Littleton: fire department has a nationally recognized EMS program - all firefighters are EMT-Bs, and they have ALS ambulances as well as several non-transport apparatus staffed with medics. Their responses are supplemented by an ALS/BLS private. It seems to work pretty nicely. It gets ALS care to people fast. If I'm having an emergency that requires ALS, I'd rather have an engine show up with a medic there to stabilize me while the ambulance is en route, rather than just wait for the ambulance. I am biased though. I work with them a lot.

In Denver all firefighters are EMT-Bs. They do not transport but supplement the response of hospital-based Denver Health Paramedic Division, which has tiered BLS -> ALS response. So you might have BLS there working for a little before the ALS gets there, especially in Denver because the EMS is stretched to (and often beyond) it's capacity.
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Does an engine drive faster than an ambulance?:rolleyes:
 
daedalus said:
Ah! Than we can prove that there is no real need for ALS interfacility transport!!
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Shhhh! ALS IFT in my area pays 15/hr as oppose to 911 at 12/hr. ALS IFT is needed. It is, it is!!! I need the money for paying back student loans after I pass Medic!! >:[
 
DWparamedic said:
Does an engine drive faster than an ambulance?:rolleyes:
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There are more engines than ambulances. Depending on where you are and where the private ambulances are posting, an engine could easily have a faster response time than an ambulance. I saw it happen all the time on ride-alongs with both the private ambulance company and the FD.
 
DWparamedic said:
I assume that they will just assist the fire medics, and yes, care serves orange and la county
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I'm well aware that Care has 911 contracts in both Orange County and LA County. That doesn't necessarily mean, though, that if they hire paramedics that the paramedics will be working in Orange County. Besides, what's there to help with? A 911 call in OC is like a circus rolling into town (I just love the fact that OCFA in Irvine dispatches their own engine and an ambulance to a call but still has Doctors to transport for them) with the fire engines being clown cars. There's already too many providers on scene and any difficult questions will be sent to medical control anyways (anything worse than a sneeze requires the medics to contact med control and give a full report over the radio).

Little story to illustrate the above. I had an incident when I was working as an EMT at Wild Rivers where a young girl was assisted to first aid by her parents after bumping her head coming down a kiddy slide. Patient's A/Ox1 (name, didn't know location, purpose, time) and extremely lethargic. 911 contacted immediately (I don't screw around with altered patients in a non-transport role). Long story short by the time fire arrived the girl had improved to A/Ox4 and just dazed. Fire's response was a battalion chief (who was "in the area"), a "paramedic assessment unit" (read engine), another unit which had paramedics on it (canceled en route, probably a fire department ambulance), and Doctors ambulance (private). That's 4 vehicles responding to an incident that should have required, at most, 2.
 
JPINFV said:
I'm well aware that Care has 911 contracts in both Orange County and LA County. That doesn't necessarily mean, though, that if they hire paramedics that the paramedics will be working in Orange County. Besides, what's there to help with? A 911 call in OC is like a circus rolling into town (I just love the fact that OCFA in Irvine dispatches their own engine and an ambulance to a call but still has Doctors to transport for them) with the fire engines being clown cars. There's already too many providers on scene and any difficult questions will be sent to medical control anyways (anything worse than a sneeze requires the medics to contact med control and give a full report over the radio).

Little story to illustrate the above. I had an incident when I was working as an EMT at Wild Rivers where a young girl was assisted to first aid by her parents after bumping her head coming down a kiddy slide. Patient's A/Ox1 (name, didn't know location, purpose, time) and extremely lethargic. 911 contacted immediately (I don't screw around with altered patients in a non-transport role). Long story short by the time fire arrived the girl had improved to A/Ox4 and just dazed. Fire's response was a battalion chief (who was "in the area"), a "paramedic assessment unit" (read engine), another unit which had paramedics on it (canceled en route, probably a fire department ambulance), and Doctors ambulance (private). That's 4 vehicles responding to an incident that should have required, at most, 2.
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Like I said I'm not even sure if they are even going to start hiring paramedics, let alone figure out what county to put them in. Haha yeah you are right about O.C. paramedic responses. They use EVERYBODY on most medical calls :P
 
JP I find it soooooo soooo odd that OCFD has red ambulances with a gurney that are just paramedic squads! They cannot transport! WTF!?
 
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