EMS dreams crushed!

CentralCalEMT said:
LA County, you get on scene and are an IFT company and it is an actual emergency, you are supposed to call 911 and let them handle it and not even use your skills. Let that sink in....an AMBULANCE calling 911 for another ambulance since you are not part of the 911 system.
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Not true.......... if you are a private als unit you are allowed to provide care but not allowed to transport unless dual paramedic.

BLS any private may provide care AND may transport depending on if you are closer to the mar than als arrival or may request an als intercept. When I worked ift I use to do it ALL the time. Remember if you don't assist that's neglect and would love to see that held up in court "I have the training but im forbidden" ive been in LA county ems for 15 years.


LA county will get better. All the Armenian/russian companys are getting shut down and going bye bye. With the stricter medicare/medical laws your gonna see alot less of these dialysis taxis running around.
 
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You also have the option in LA county, per protocol, to transport if ETA to the hospital is less than the ETA for paramedics.
 
I never said neglect the patient. You can always assess and treat the patient until the 911 provider gets there; i was referring to transport and treatment enroute to the hospital. However when people decide whether the MAR is closer than ALS, most people only consider travel time to the hospital. It takes time to load the patient. Most of the time, especially if the call is in a SNF, in the time you get report if you can even locate a nurse, take vitals, (you can determine if the complaint is ALS the moment you get it), load the patient, etc, ALS could be there. That is especially important with patients that might need a specialty center. I was a supervisor for a BLS company in LA, and know plenty of occasions wher an EMT played super EMT and rushed a patient to the closest hospital that was not equipped for the patient because they did not want to wait a couple of minutes for ALS. What good does that do the patient other than delay their care as they wait for a transfer? EMS providers need to think and not just rush around. You and I both know that the system there, with 0 interoperability of radio systems is not even set up for an intercept, and I never heard of anyone actually doing that. So yes, there are rare occasions where a BLS IFT unit can function as actual EMS, but the fact that the actual opportunity comes with so many strings attached that shows the fact that the system is deeply flawed.

Consider this scenario: You arrive on scene at a SNF and find a patient complaining of chest pain. They facility and patient's MD want the patient transported to a hospital 10 minutes away where the MD has admitting privileges, and the patient's records are. There is a closer hospital 4 minutes away with an ED. ALS is 5 minutes away. This scenario plays out daily in LA and in a system flooded with hospitals and ALS is not uncommin. By protocol, yes you can transport the patient to the closer hospital because ALS is further out. What good does that do? They patient is at a hospital, where his primary care MD can not admit him. They hospital is not familiar with the patient. The patient's care is thus delayed while the hospital plays catch up trying to go through the packet from the SNF figuring out what the patient needs. They do not have his prior EKGs to look for changes in. They have to start from scratch. Is that in the patient's best interest? ALS down there is rarely more than 5 minutes away, and while their scope is small, they can at least run a 12 lead and take the patient to the requested facility. Yes you would be within protocol transporting to the closer facility. However, in EMS just because we can do something does not mean we should.
 
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Oh, and I agree that the time to determine ETA and, if needed, call paramedics is the time that the EMT first realizes that the patient needs ALS.
 
coco county is the same way. Unless that ETA of 911 ALS is over like 10 minutes and the hospital is close, they want you to call for 911 ALS. Even if I was an IFT medic...it sounds dumb but thats just the way the protocol is written
 
JBLS14 said:
Managers, supervisors, owners....etc. all driving beautiful cars, luxury homes, excellent cars. Thanks to the EMTS ($10.00) IM SICK OF IT!!!! why do emts still work for pennies. all the hard work, all night studying for NREMT, finals, quizzes, test ,paying for EMT school. all for nothing. this is a situation that needs to be stopped. we emts work hard 12hr shift, 24, 36, 72...5150 pts, this is crazy where so under paid.


WHEN IS THIS ALL GONNA CHANGE!!!
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None of the things listed cry "give me money." One semester as a part time student=not much money. A few tests at an eighth grade reading level=not very hard. Working shift work=the rest of the blue collar world.

What were you expecting? I feel underpaid when I am doing my administrative role at work. Writing grants, policies, letters, etc required an actual formalized education that I worked hard to obtain and spent a fair bit of money on. But the actual run of the mill EMS work? I make what I should, considering the time I have invested in those responsibilities.
 
I had a CPR save on one day and met one of the most incredible men I have ever met on a simple dialysis transfer. I get to help my brothers on my wildland fire crew when they get dinged up. You can't give me any better pay than that. Be in this job for your patients and the family we serve. Stay grounded in why we are in this line of duty and don't get so caught up in what other folks have or how much they make. I've seen some great medics lose focus and compromise good care when dissatisfaction with pay and/or conditions burned ém out'. Stay true to your duty and it will all balance out.
 
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