EMS systems similar to Kern County

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Podag

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Hi sorry to intrude but I'm researching for cities and counties that are set up like Kern County/Bakersfield, where fire does not control EMS. Any input would be much appreciative.
 
Most of Texas.
 
Podag said:
Hi sorry to intrude but I'm researching for cities and counties that are set up like Kern County/Bakersfield, where fire does not control EMS. Any input would be much appreciative.
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If you're from here (California) and cannot afford to move out of state, the entire Central Valley from Kern County to at least Merced operates this way.

As the rest on here have already posted, if EMS is what you want to do, can afford to, and have nothing holding you back, move out of California.
 
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Lassen County/SEMSA


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In the Central California Emergency Medical Services Authority region, (CCEMSA) Tulare County, Kings County, Madera County, Fresno County all have the ambulance maintain scene control. Except for several fire agencies (a couple of whom transport their own), almost every fire department in that region is non transporting BLS, and the few non transporting ALS first responding agencies typically give over patient care to the ambulance immediately upon its arrival. This region has about 1.8 million people over 12,000 square miles, so it is not a small system by any means. Outside of the major population centers (LA area, the Bay Area, and San Diego) much of California is run that way and the ambulance paramedics run the show. This is especially true in the vast rural areas of California which are most prevalent in the central and northern parts of the state. Protocols in those areas are good for California standards and are all standing orders. (I am sure people in Texas laugh at that statement.)
 
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CentralCalEMT said:
In the Central California Emergency Medical Services Authority region, (CCEMSA) Tulare County, Kings County, Madera County, Fresno County all have the ambulance maintain scene control. Except for several fire agencies (a couple of whom transport their own), almost every fire department in that region is non transporting BLS, and the few non transporting ALS first responding agencies typically give over patient care to the ambulance immediately upon its arrival. This region has about 1.8 million people over 12,000 square miles, so it is not a small system by any means. Outside of the major population centers (LA area, the Bay Area, and San Diego) much of California is run that way and the ambulance paramedics run the show. This is especially true in the vast rural areas of California which are most prevalent in the central and northern parts of the state. Protocols in those areas are good for California standards and are all standing orders. (I am sure people in Texas laugh at that statement.)
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Actually, the functional parts of those protocols are essentially identical to vast swathes of Texas. Sure, some Texas rural agencies RSI and do surgical crikes once in a blue moon, but for the most part, the medicine is similar....monitor/IV access/fluid bolus/pain meds/antiemetics/benzos/breathing treatment. Sure, you're a lot more likely to run across a vent (simple or advanced) or a pump or something out of CA, but for the most part, the functional and common medicine is the same.
 
Podag said:
Hi sorry to intrude but I'm researching for cities and counties that are set up like Kern County/Bakersfield, where fire does not control EMS. Any input would be much appreciative.
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Do you mean areas where fire is BLS only? In counties like Riverside and San Bernardino, among many others, the fire department will respond with ALS engines, but they do not have transport ambulance. On scene, the private ambulance paramedic and the fire department paramedic have scene control together.

If you are looking for places in CA where fire is BLS only, you won't find many. Rural areas are often covered by Cal Fire, and they started putting medics on most of their engines 10 years ago.

You could also consider joining fire departments that have single-function medics. San Bernardino County Fire began staffing these on their ambulances a few years ago. SF has had single-functions medics for a long time.
 
zzyzx said:
In counties like Riverside and San Bernardino, among many others, the fire department will respond with ALS engines, but they do not have transport ambulance.
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Depends on where you're at in RVC. Stations 69, 67, 50, 71, 33, 55, 88, 86, and 80 all have ambulances staffed by ffpm's that transport. At some of of those stations listed above the engines will sometimes be staffed BLS, actually it's more often than none but we don't run with them in those cities.
 
zzyzx said:
Do you mean areas where fire is BLS only? In counties like Riverside and San Bernardino, among many others, the fire department will respond with ALS engines, but they do not have transport ambulance. On scene, the private ambulance paramedic and the fire department paramedic have scene control together.

If you are looking for places in CA where fire is BLS only, you won't find many. Rural areas are often covered by Cal Fire, and they started putting medics on most of their engines 10 years ago.

You could also consider joining fire departments that have single-function medics. San Bernardino County Fire began staffing these on their ambulances a few years ago. SF has had single-functions medics for a long time.
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Again, most of Central California has BLS fire departments. Cal Fire's presence isn't as heavy here, either; they seem more rampant on the coast, in the Inland Empire, and further up north, though I am sure they're around the Central Valley sporadically. In fact, to my knowledge Tulare County went from contracting with Cal Fire (then CDF) to establishing their own fire department, albeit probably underfunded.

If your (op) heart really is in staying in California and practicing prehospital medicine alongside BLS fire departments, this seems to be the part of California where it's most prevalent. The two major departments in the county I work in are full time, paid departments, as are many in Central California, who don't appear to be in any rush to cross train the FF's anytime soon.

Overall, it works out quite well. They show up first, render basic life support, hand off care, and/ or ride in if needed. Most everyone plays nice, and is happy with their designated roles in this particular system/ setting.
 
VentMonkey said:
In fact, to my knowledge Tulare County went from contracting with Cal Fire (then CDF) to establishing their own fire department, albeit probably underfunded.
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This info is true, however it happened back around 05 I believe. Tulare county staffs engines with 1 company officer and the firefighters are paid call. So pretty much theres just one dude at the fire station. Meanwhile Cal Fire TUU (Tulare) is BLS staffed 3-0 (2 ff's 1 co) at 2 engine houses and 4-0 (3 ff's 1 co) at single engine houses. I'm pretty sure the vast majority of Tulare Co. FD is BLS. Tulare Co. is way underfunded as opposed to Cal Fire and in my opinion it would be better to contract with either Cal Fire again, or start a fire protection district with the adjoining cities (Porterville, Visalia, etc).

A little of topic this was, however Tulare Co. is similar to Kern Co. in the sense of fire is BLS and the ALS ambulance has scene/patient control when they arrive on scene.
 
CALEMT said:
This info is true, however it happened back around 05 I believe. Tulare county staffs engines with 1 company officer and the firefighters are paid call. So pretty much theres just one dude at the fire station. Meanwhile Cal Fire TUU (Tulare) is BLS staffed 3-0 (2 ff's 1 co) at 2 engine houses and 4-0 (3 ff's 1 co) at single engine houses. I'm pretty sure the vast majority of Tulare Co. FD is BLS. Tulare Co. is way underfunded as opposed to Cal Fire and in my opinion it would be better to contract with either Cal Fire again, or start a fire protection district with the adjoining cities (Porterville, Visalia, etc).

A little of topic this was, however Tulare Co. is similar to Kern Co. in the sense of fire is BLS and the ALS ambulance has scene/patient control when they arrive on scene.
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They were transitioning from the CDF name to Cal Fire when I went through internship.

I still like calling then CDF, to me it's funny.

Ahhh, the little things...
 
VentMonkey said:
They were transitioning from the CDF name to Cal Fire when I went through internship.

I still like calling then CDF, to me it's funny.

Ahhh, the little things...
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Haha its still during dispatches "respond on CDF command __" The official name is California Department of Forestry and Fire Protection/ CAL FIRE. My oh my what a mouth full haha.

Also in regards to the OP in Tulare Co. and adjoining counties. The state fire engines (type 3 or wild land engines if you're not familiar) can be staffed with a ffpm thats a seasonal firefighter. If thats the case the engine will be a paramedic assessment engine. Assessment being the key word as the medic has no toys to play with, yes it does have a medic but it still acts as a BLS engine with paramedic assessment's if that makes any sense at all.
 
CALEMT said:
Assessment being the key word as the medic has no toys to play with, yes it does have a medic but it still acts as a BLS engine with paramedic assessment's if that makes any sense at all.
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Pointless, IMO lol. I may catch more flack for this, but this is why, where, when an AEMT assessment engine may serve its purpose.

Do all things needed until you exceed your scope, and the paramedic transporting ambulance arrives. Follow in if needed, or not, but perhaps an IV, fluids, first line meds within their respective scope, and any immediate defibrillation can be performed, if or when at all needed.

Transfer of care has begun once the paramedic shows up, doesn't have to fool around with basic "intermediate" treatments, and can focus on the "advanced" prehospital care that needs to be provided, if at all.

Go team!:)
 
I believe they allow it in the sense of that ffpm whose a seasonal firefighter won't be a seasonal for long. Typically they get pickup as a permanent firefighter pretty quick. But I totally agree in the sense of having a AEMT of the state rides. The only constraint on why its strictly BLS is there isn't a whole lot of room to fit anything else medical wise. The type 3 engines are smaller than the type 1 (typical city engine) for the wild land therefore less room. Once you get everything required by the NFPA and CAL FIRE on the engine theres not a whole lot of room for anything extra.

In our medical compartment we had barely enough room for a "medical bag" (mainly trauma supplies) and the AED. To fit anything more than that you would need to ditch something that you can't get rid of (due to dept. policy or regulations) or get a bigger engine (which defeats the propose of smaller engines for wild land) its kind of a catch 22.

Also the method you've described will best work in rural counties such as Tulare, Fresno, Madera, Mariposa, and Merced to where you can be way out in the sticks like I was. It wouldn't really work in lets say Riverside Co. where the ALS ambulance is less than 5 minutes away. Up where we were in a perfect fantasy to where CAL FIRE was staffed with AEMT's with the tools to preform intermediate patient care it works. Cause for us the nearest ALS ambulance was out of Porterville which was about a 1hr 15min - 1hr 30min away.

Unfortunately like I mentioned above its ideal for rural counties but not particularly feasible due to the compartment space/ availability on the wild land engines. Plus then you're really limiting to AEMT's and above to whats primarily a wild land firefighting job. Yes CAL FIRE is a all risk dept. but the primary job for a seasonal firefighter is wild land fire suppression. Thats why the minimum requirement is 18 years old, thats literally the minimum requirement. If you outfitted every state schedule B ride with AEMT's or above then that narrows your applicant pool plus you now have to staff and equip every schedule B engine (I can't get a exact number but its gotta be around 500 engines). Its a great idea and I can see CAL FIRE eventually going to something along the lines of this, but for the time being I don't see anything changing with staffing and equipment on wild land engines.
 
Google search a map of the US and a good amount of the big cities have EMS as a third service run by the city or county. Central Texas has a few counties surrounding each other where EMS is a third service and has scene control (Austin / Travis County EMS, Williamson County EMS, Hays County EMS, to name a few in that area). Other notable ones across the US off the top of my head: King County Medic 1, Pittsburgh EMS, Boston EMS, a lot of counties in Florida, Wake County EMS in Raleigh NC is very progressive, Louisville, Denver, and I know I'm missing a lot. Wake County started induced hypothermia in the field, Austin - Travis County started Pit Crew CPR.
 
okayestEMT said:
Google search a map of the US and a good amount of the big cities have EMS as a third service run by the city or county. Central Texas has a few counties surrounding each other where EMS is a third service and has scene control (Austin / Travis County EMS, Williamson County EMS, Hays County EMS, to name a few in that area). Other notable ones across the US off the top of my head: King County Medic 1, Pittsburgh EMS, Boston EMS, a lot of counties in Florida, Wake County EMS in Raleigh NC is very progressive, Louisville, Denver, and I know I'm missing a lot. Wake County started induced hypothermia in the field, Austin - Travis County started Pit Crew CPR.
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If you've seen one EMS agency... you've seen one EMS agency. Not every third service has great culture. Amazing EMS agencies on paper might be an awful place to work. There are plenty of privates that also pay well, have progressive protocols and don't run you into the ground.

Narrow your search down to where you want to live, and then hopefully you'll find an agency that's got the culture you want to be part of.

And by the way, high performance CPR started in Seattle.
 
DEmedic said:
If you've seen one EMS agency... you've seen one EMS agency. Not every third service has great culture. Amazing EMS agencies on paper might be an awful place to work. There are plenty of privates that also pay well, have progressive protocols and don't run you into the ground.

Narrow your search down to where you want to live, and then hopefully you'll find an agency that's got the culture you want to be part of.

And by the way, high performance CPR started in Seattle.
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I was referring to "Pit Crew" CPR specifically.
 
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