AMR in King County, WA

[NomadicMedic]

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.

 

[psyanotic]

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.

 

[Aidey]

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.

 

[medicsb]

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.

 

[psyanotic]

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.

 

[NomadicMedic]

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.

 

[medicsb]

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.

 

[Luno]

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.

 

[yowzer]

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.)

 

[KingCountyMedic]

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.

 

[NomadicMedic]

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.

 

[KingCountyMedic]

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.

 

[NomadicMedic]

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.