colorado or washington d.c.

[gregoryjoel82]

I need ya'lls help. I'm an EMT-B in NC lookin to move this summer. Colorado and Washington D.C. are at the top of my lists. Where I go is solely dependent on the job and con-ed opportunities. Soooooo......what can ya tell me? I want to get into tactical med/trauma eventually, so I thought D.C. would be a good spot for eventual gov't jobs, good trauma centers, etc. Colorado seems to have a crap-ton more con-ed opps., WEMT opps., and I'm a sucker for the outdoors...So whoever's at either place, help me out...I'll be a NC state certified EMT-I by the time I move; want to have my NREMT-B by then too. Every job listing online is pretty much the same for every organization, so if ya got the skinny on any good companies to apply to, or avoid, that would be awesome.

Also, what can be said about workin in Austin, TX? aside from the many smokin' hot babes...

 

[ffemt8978]

Moved to appropriate forum.

 

[WarDance]

Where in CO?

 

[benkfd]

Colorado baby!!!!!!!!!

Jo,
My suggestion would be Colorado. Especially the Denver area. They have SEVERAL Level I and Level II trauma centers along with a few teaching hospitals that are EXCELLENT. I have family out there and one of my brothers is a EMT-B (starts EMT-P soon hopefully) with Rural-Metro. I will see if I can get some info for you about who to contact if you would be interested.

 

[benkfd]

Also I'm sure that war would be more than happy to help you

 

[jordanfstop]

A recent article in JEMS about changes to the FF/EMS structure in Washington, DC:

http://www.jems.com/news_and_articles/articles/jems/3401/from_worst_to_first.html

In contrast, another recent article, this time in Washingtonian Magazine, with a very different view.

http://www.washingtonian.com/articles/people/11153.html

 

[paramedicmike]

I want to get into tactical med/trauma eventually...

If this is really what you want, join the military. The Army, Air Force and Navy all have combat medic opportunities. And unless you've been living under a rock since 2001 (and I doubt you have), you've probably noticed something in the news about two wars currently ongoing in the middle east. Can't get much more tactical/trauma oriented than a battlefield.

...so I thought D.C. would be a good spot for eventual gov't jobs, good trauma centers...

Unless you want to work for DCFD, avoid DC. The department is currently a pretty lame excuse for an EMS provider, anyway.

Good luck.

 

[sir.shocksalot]

I think CO would be a good choice, although I might be biased .
CO has some very good protocols for EMTs, we can start IVs administer Narcan D50 IV and Narcan IN as well, along with all the usual EMT-B "meds" If you want to be a driver I would go with R/M, as their contract with Aurora is such that the Firemedic does all the "pt care" by himself and R/M just drives. Pridemark has a number of 911 contracts but expect to be stuck on a wheelchair cab for a long time and then promote to EMT. AMR isn't bad either, but again you will spend time on a wheelchair cab before promoting to an ambulance. AMR has 911 in Golden and Longmont, and partial 911 in Denver when Denver Health is out of vehicles. I can't really speak to Washington DC's EMS, but I believe it is done by the FD. You could try to get on a FD here and do TEMS with them, but its the same story in CO as it is everywhere else, 1 open FD position, and 200 applicants, at the very least. Good thing I have no desire to be a FF

 

[benkfd]

Sir's right about R/M Aurora, I have a brother that works for them and he started out on a w/c cab for a while but that's how you get your foot in the door. From what I understand though it's a good place to work. If interested in info on them let me know.
Ben

 

[frdude1000]

EMS in DC is Shi**y. DCFD has been sued multiple times this year and they have a bad track record. Also, their protocols suck bigtime. The pay is also very meager (not that ems is the most high paying job). I live in montgomery county, maryland, which is 10 minutes away from DC. Our Fire/Rescue system is great. We have many stations and new apparatus. It is a mix of career and volunteer personnel. The website is http://www.montgomerycountymd.gov/firtmpl.asp?url=/Content/FireRescue/Index.asp. It is right next to DC and is a nice suburban county to live in. We have a high call volume, too and assist DC when needed. PM me if you have any questions!

 

[Ridryder911]

Let's be truthful. It is very doubtful you will gain a very good position at any place with the EMT Basic level and no experience. Even more so, why is the emphasis on Level I trauma Centers? The only difference between Level I & Level II is research, not patient care.

I believe we teach too much "myths" in EMS. There are several good EMS in numerous states that provide excellent care that have aggressive patient care protocols that might not have a Level I in the neighborhood. As well, many of those places employ basic level EMT's as long as they pursue upwards to the Paramedic level. Let us clarify because a service has a high call volume, does not mean they are better in fact I have usually seen the later. Again, several have enough call volumes that meet any demands. In fact even many rural areas are now experiencing not burn out but worn out. Too many calls within a period of time.

Why don't we ask; if they have a full 24/7 heart cath lab? In reality, that type of service will interact more than the differential of a Level or Level II trauma center. Especially since there is very little differential in care of trauma, no matter where you are located.

My recommendation is to find a location that has an outstanding Paramedic program. First see if it Nationally Accredited, what is the end result such as Degree or certificate. Compare the number of graduates, their success (employment ratio, etc accredited institutions have this on file) and services surrounding this educational area.

You may find that you have written your ticket to work anywhere and not have to work up the ranks and waste of time.

Good luck,

R/r 911

 

[Veneficus]

Rid, while I have the highest respect for you and your opinions, I do find we have some disagreements from time to time.

Here are the requirements for level I and II centers from the American College of Surgeons.

http://www.facs.org/trauma/vrc1.html

http://www.facs.org/trauma/vrc2.html

In addition to research there is a criterion for number of surgical cases and patient admissions. Who is present at major resuscitations is also specified. It also states that in a level I an emergency physician must always be present in the ED and what other specific specialties must be in house. There are even requirements for specific ancillary services in house. In the level I, angiography and sonography must be available 24 hours a day, the level II has no such requirement. The level I also must have a surgical intensivist and the trauma surgeon has to maintain charge of patient care in the ICU. Those have large effects in patient care. Academic medical centers are also nothing to scoff at, it has been demonstrated that non academic centers fall into treatment ruts after about 10 years. This can also lead to substantial decline in patient care.

I understand that some states create their own criteria different from ACS. I am not sure if this is because they exceed or cannot meet the criteria. I have noticed there is a huge disparity in trauma care, not only between level I and level II centers but between level I centers based on things such as the personality of the head trauma surgeon, as well as public vs private institutions.

There is nothing wrong with an EMS professional with an interest in trauma. I have discovered it is quite a complex disease process. Far more so than the level that EMS treats it as. (The more I learn and become involved, the more I love it) The major trauma areas also have many ways EMS professionals can become involved. Though not at the EMT-B level.

A level I trauma center is not needed for most trauma patients, but when it is, nothing else will do.

 

[Ridryder911]

I am quite aware of the ACS standards again, stand by what I stated. There is really no significance in standards of a Level II and Level I only the research and professorship programs. Most level II have such services as you described and personally know in fact that some of the "so called required" are not really required but have to be available within reason. A loop hole that many are finding. In fact many studies have described the outcome to be no difference to even be better in Level II Centers.

As for as ACS accreditation, I will only offer they cannot always back up their reason(s) for criteria. Even the trauma center committee cannot explain differentiate why some of their criteria to be evaluated for Level I except for their own reasons. (that being, they are surgeons). For example: accompanied death in a vehicle. Do I like the ACS standards yes, but unrealistic in many areas. Again, most Trauma Center criteria has little to do with the trauma center itself; rather the system and trauma registry.

Although, I agree trauma care is exciting it is very limited in the emergency setting and truly is a surgical disease. In fact, little should be performed in the trauma bay and more with the OR theatre.

R/r 911

 

[Veneficus]

The fact that some have the services and others don't makes them exceptional centers, certainly not the norm for level IIs. I have seen one that has managed to find all the loopholes for accredidation and I wouldn't take a stray dog there. As I mentioned, even between level Is I have seen there is a noticable difference. All hospitals are not equal.

 

[Ridryder911]

. All hospitals are not equal.

That I will agree upon. I know of one ACS Level I that never (<5 days a month) that ever takes neuro patients yet still keep their accreditation level. Hmmm.. yeah I now wave validity to their process.

R/r 911

 

[LucidResq]

Hey OP:

The National Report Card on the State of Emergency Medicine (ACEP)

DC got a B-, and was ranked 2nd overall.

The District of Columbia also scores well with regard to Disaster Preparedness, as one would expect of the nation’s capital. The District has more ICU and burn unit beds, as well as more verified burn centers per 1 million people than any single state. The District also receives the highest level of federal funding in the country designated for disaster preparedness ($160.57 per capita). With regard to deployment of medical professionals, the District has medical strike teams or medical assistance teams and requires EMS and essential emergency department personnel to be compliant with the National Incident Management System (NIMS).

The Medical Liability Environment in the District of Columbia is not supportive of the medical community. The District ranks 50th with regard to the number of malpractice awards (8.0 per 100,000 people). In comparison, the average across the states was 2.4 awards per 100,000. The average amount for a malpractice award in the District is $366,131, compared with the average across the states of $285,218.

The District of Columbia gave a mixed performance with regard to the Quality and Patient Safety Environment. While the District demonstrates high rates of information technology use in hospitals, it ranks among the worst with regard to the percent of patients with acute myocardial infarction given PCI within 90 minutes of arrival (41 percent). In addition, there is no funding for quality improvement within the EMS system.

Aaaand now Colorado, who got a C+, and was ranked 13th overall.

Colorado leads the nation with regard to the Medical Liability Environment because it has implemented numerous reforms, including case certification by expert witnesses, requiring expert witnesses to be of the same specialty as the defendant, and ensuring that expert witnesses are licensed in the state.

Colorado also has some noteworthy successes in Disaster Preparedness. It is one of only two states to offer civil and criminal liability protections to health care workers during a disaster. Colorado also ranks fifth among the states reporting bed surge capacity, with 1,337 beds per 1 million people.

Colorado is lacking with regard to the Quality and Patient Safety Environment. The state does not provide funding for quality improvement of the Emergency Medical Services system or have a uniform system for providing pre-arrival instructions.

 

[phabib]

As a basic, the job market in Colorado is pretty horrible right now. In my IV class there are about 20 students, of them 5 have a job in the medical field.

The medic schools here are great in terms of hands on training and clinical time but there are limited spots and they all require a year of experience before applying.

Come here at your own risk.

 

[Summit]

As a basic, the job market in Colorado is pretty horrible right now. In my IV class there are about 20 students, of them 5 have a job in the medical field.

The medic schools here are great in terms of hands on training and clinical time but there are limited spots and they all require a year of experience before applying.

Come here at your own risk.

yep pretty much

there are a :censored::censored::censored::censored:ton of EMTs who do not work as EMTs because there are not jobs

 

[JeffDHMC]

I live and work in Denver, have for a long time. I vote DC.

 

[LucidResq]

As a basic, the job market in Colorado is pretty horrible right now. In my IV class there are about 20 students, of them 5 have a job in the medical field.

In general you're probably right but my friend who works for Rural Metro says they're pretty understaffed and desperate for basics...