American Ambulance in Fresno

[gonefishing]

Now VentMonkey just flys to work! LOL

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[CALEMT]

Woof, no thanks. I hate SoCal traffic, don't miss it one bit. I vowed when I moved I would be within a reasonable drive to where I worked.

From where I lived in LA to where I had worked in Redlands should have taken me about an hour, but was easily 2-2 and a half hours each way. Never again...never again.

The 72hr shift made it worth it. Plus being a wildland firefighter I wouldn't be making that drive every week.

 

[VentMonkey]

Hey, I'm from SoCal, when haven't any of us ever been forced not to "fly to work" (We'll go ahead and keep this out of that CHP thread)?

 

[Jim37F]

Woof, no thanks. I hate SoCal traffic, don't miss it one bit. I vowed when I moved I would be within a reasonable drive to where I worked.

From where I lived in LA to where I had worked in Redlands should have taken me about an hour, but was easily 2-2 and a half hours each way. Never again...never again.

The 72hr shift made it worth it. Plus being a wildland firefighter I wouldn't be making that drive every week.

Yeah if Hall offered that same 48-72 schedule for new hires I'd be very interested lol Even with my FF interview and intent to try and go to an Academy this year I might find myself filling out an app..

 

[gonefishing]

Yeah if Hall offered that same 48-72 schedule for new hires I'd be very interested lol Even with my FF interview and intent to try and go to an Academy this year I might find myself filling out an app..

Gotta work 6 months metro before you get an outlying station and that can take a year or more. If they changed it up they would see an increase definitely. The problem being faced is how much PRN is offering/promising people. Nationally their is a paramedic shortage. What should be looked into is AEMT. It's the middle man and you can easily bridge someone to paramedic.

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[VentMonkey]

Gotta work 6 months metro before you get an outlying station and that can take a year or more.

Sigh, fish you know how I feel about rumors. The company rule has always been 90 days in metro Bakersfield. It can take longer depending on staffing/ needs in the outlyings.

Most people from "down south" try and bid, and/ or get to an East Kern shift most ricky tick since they allow the treasured KCFD 48 schedule and those outlyings are closer/ closest to SoCal area; definitely no guarantees and it can take up to, or more than 6 months...or not. Frazier Park is close too, but that ain't happening, especially for new EMT's.

 

[gonefishing]

Sigh, fish you know how I feel about rumors. The company rule has always been 90 days in metro Bakersfield. It can take longer depending on staffing/ needs in the outlyings.

Most people from "down south" try and bid, and/ or get to an East Kern shift most ricky tick since they allow the treasured KCFD 48 schedule and those outlyings are closer/ closest to to SoCal area; definitely no guarantees and it can take up to, or more than 6 months...or not. Frazier Park is close too, but that ain't happening, especially for new EMT's.

My mistake 90 days lol. I dunno why I put 6 months.

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[NPO]

.

. What should be looked into is AEMT. It's the middle man and you can easily bridge someone to paramedic.

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Our medical director is in favor of AEMT and had looked into implementing then. The problem is the way the law of the land is written, you can't use an AEMT to replace a paramedic, only supplement.


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[VentMonkey]

you can't use an AEMT to replace a paramedic, only supplement.

Tell this to every fire department ever utilizing "squads" and "RA's" in their systems south of Gorman.

 

[Handsome Robb]

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Our medical director is in favor of AEMT and had looked into implementing then. The problem is the way the law of the land is written, you can't use an AEMT to replace a paramedic, only supplement.


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Which is a good thing.

I worked as an EMT-I/AEMT/whatever you want to call them and it's definitely a useful certification level but it's far from a replacement for a Paramedic.


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[VentMonkey]

Which is a good thing.

I worked as an EMT-I/AEMT/whatever you want to call them and it's definitely a useful certification level but it's far from a replacement for a Paramedic.

In our county we're short paramedics now and oftentimes the fire department will ask their dispatch if the ambulance responding is an ALS or BLS unit.

I get that it's two different certification levels, a large gap in fundamental know how, but I can't help but wonder how it would affect their (the FD's) psyche knowing an "ILS" unit is en route instead of a BLS unit.

That says a lot to me, particularly that certain stations are still under the impression that an IV, limited meds, and maybe a monitor equal "life saving therapies" (bangs head on wall).

This is why to me it is fitting to just downgrade all of the fire-based paramedics in LA County to this cert level. It is how they practice and have been for decades. That, and they're a stones throw away from almost any hospital, and are realistically doing the patient a service as such more often than not.

 

[gonefishing]

.



Our medical director is in favor of AEMT and had looked into implementing then. The problem is the way the law of the land is written, you can't use an AEMT to replace a paramedic, only supplement.


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I never ment to use AEMT as a replacement but as a valuable resource due to large part of shortage of medics. An AEMT is the middle man and like VentMonkey stated, it would help the mental thinking of the FD. Why they should have any care or purpose in ems in the first place is beyond me. They are simple first responders and should only worry about assisting and nothing more.

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[VentMonkey]

I never ment to use AEMT as a replacement but as a valuable resource due to large part of shortage of medics. An AEMT is the middle man and like VentMonkey stated, it would help the mental thinking of the FD. Why they should have any care or purpose in ems in the first place is beyond me. They are simple first responders and should only worry about assisting and nothing more.

That's not exactly what I meant. ILS is a good fit in certain situations, but having a BLS ambulance, albeit a competent one, with the fire department to work alongside of, say a code, doesn't warrant ALS, or even ILS interventions when the ED is closer than any of those provider levels.

In short, the cert level shouldn't matter theoretically, assuming the providers working the call are all competent, capable, and confident in their skillset.

Is this reality? Well...

Why they should have any care or purpose in ems in the first place is beyond me. They are simple first responders and should only worry about assisting and nothing more.

This here is a piss poor mentality, fish. We're all a team, calling them "simple first responders" does nothing to promote a professional mindset, nor does it promote a environment conducive to a seamless team approach.

We need them to be efficient at what they do...BLS level care. We all know how far those skills vs. ALS care goes in terms of necessity in a code. Prompting them, encouraging them, and guiding them is the mark of a good clinician.

Think, where do doctors often stand in a code? Back, that's where. Once you learn how to properly orchestrate your symphony efficiently, cert levels hardly matter. Let's leave the egos at the door, yeah?

Oh, and once you're to the point as a medic that you have realized how limited you are with what you can do in an arrest to change the outcome, you'll have seen one too many codes. That's a general rant. Reaper Racers have zero effect on God's Will.

 

[gonefishing]

That's not exactly what I meant. ILS is a good fit in certain situations, but having a BLS ambulance, albeit a competent one, with the fire department to work alongside of, say a code, doesn't warrant ALS, or even ILS interventions when the ED is closer than any of those provider levels.

In short, the cert level shouldn't matter theoretically, assuming the providers working the call are all competent, capable, and confident in their skillset.

Is this reality? Well...

This here is a piss poor mentality, fish. We're all a team, calling them "simple first responders" does nothing to promote a professional mindset, nor does it promote a environment conducive to a seamless team approach.

We need them to be efficient at what they do...BLS level care. We all know how far those skills vs. ALS care goes in terms of necessity in a code. Prompting them, encouraging them, and guiding them is the mark of a good clinician.

Think, where do doctors often stand in a code? Back, that's where. Once you learn how to properly orchestrate your symphony efficiently, cert levels hardly matter. Let's leave the egos at the door, yeah?

Oh, and once you're to the point as a medic that you have realized how limited you are with what you can do in an arrest to change the outcome, you'll have seen one too many codes. That's a general rant. Reaper Racers have zero effect on God's Will.

Agreed.

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[CALEMT]

Well I'll stir the pot. Studies show that BLS intervention is better than ALS intervention. Ex. better patient outcomes after release from the hospital.

 

[VentMonkey]

Well I'll stir the pot. Studies show that BLS intervention is better than ALS intervention. Ex. better patient outcomes after release from the hospital.

Lol, hardly a pot to stir, CAL. It's a well-known and proven fact IMO, and many others on here agree as well. My point was:

"Try telling that to some of our fyreMEN."

 

[gonefishing]

Lol, hardly a pot to stir, CAL. It's a well-known and proven fact IMO, and many others on here agree as well. My point was:

"Try telling that to some of our fyreMEN."

Which is kind of the point I was trying to make. The longer you stand around with the patient not getting a full effective treatment you can than instead load the patient and boogie or arrange a meet up with a higher level provider or maybe that hospitals only 5 minutes away vs your als resource of 10.

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[CALEMT]

Lol, hardly a pot to stir, CAL. It's a well-known and proven fact IMO, and many others on here agree as well. My point was:

"Try telling that to some of our fyreMEN."

Well I can't give a solid opinion since I've worked both sides and am planning on working in the fire dept. But in my opinion keep the engines staffed regularly with 1 paramedic. The ambulance staffed b/p. That way you don't have to many chiefs and not enough Indians. I'm all for someone putting their 2 cents in when it relates to the benefit of the patient... when its between 2 paramedics and not 3, 4+. Then you have the top dog A+ personalties that we all have. While BLS interventions are proven beneficial, the knowledge and understanding the physiology and pathophysiology behind whats going on it far better IMO.

 

[VentMonkey]

Right, so in summary-

I wished that our first responders were more focused in general on being excellent BLS providers instead trying to usurp an EMT or paramedic, and carry on about why every engine should be ALS.

Clearly, this is a broadened statement as most are happy to help, and do intend on providing the care within their scope as correctly as possible. It's the ones who blindly take the level of provider and the skills that they can provide as the line to draw when it comes to positive patient outcomes.

This is by no means reflective of EBM, which in turn no way reflects medical professionalism, but without further digressing this has merely been my observations of past events.

Misconstrued notions of the effectiveness of scope of practices is by no means new to this field, it's just sad that's our "measure" of necessity...still. The longer I do this the more I realize I can do so much more with words, and pencil (keypad) pushing.

 

[gonefishing]

Right, so in summary-

I wished that our first responders were more focused in general on being excellent BLS providers instead trying to usurp an EMT or paramedic, and carry on about why every engine should be ALS.

Clearly, this is a broadened statement as most are happy to help, and do intend on providing the care within their scope as correctly as possible. It's the ones who blindly take the level of provider and the skills that they can provide as the line to draw when it comes to positive patient outcomes.

This is by no means reflective of EBM, which in turn no way reflects medical professionalism, but without further digressing this has merely been my observations of past events.

Misconstrued notions of the effectiveness of scope of practices is by no means new to this field, it's just sad that's our "measure" of necessity...still. The longer I do this the more I realize I can do so much more with words, and pencil (keypad) pushing.

^^^^^^^^^THIS^^^^^^^^^^^^^^^^

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