KCM1 Now Hiring

[Summit]

Fair question! I can say that the current emphasis is on IO first, some reasons that they are preformed in the field could include poor performance of IO and the lack of IV access in a critically ill Pt. Also the need for extended duration of a vasopressor "Levophed" without IV access (anecdotally they are not as effective IO).
We use the Arrow kit via seldinger technique (same used in the ER) with sterile technique. Yes we do have a quota of 2 per year or remediation.
I also agree and I think I would find a Vent very usefully, alas that is not something we have been able to obtain as of yet

Anecdotally you think that norepi is less effective in an IO? You would use a failed IO as your justification to start a CIV in the field instead of another IO despite the well documented complication from CIV starts in suboptimal/substerile conditions with providers who start a whopping 2 CIVs per year? Would you also delay transport for this?

What percentage of your medics get two CIV field starts and what percent remediate?

 

[EpiEMS]

So I am currently employed here at KCM1 in the 3rd month of my FTO period

Thanks for your great reply - very informative!

I wanted to inquire: What has been your sense of the nature of your interaction with the medical control physicians? Do you find that you have to call them more often than you'd like, or is it not much of a burden? My understanding is that you must call before you perform most (all?) ALS procedures. Is that correct?

 

[DrParasite]

Going back to school, that was well known for being not only intense but not afraid to send people they didn't think were cutting it home packing. Now just over a year later I can easily say that it was more then worth it! School had it's challenges, but the learning and clinical opportunity were second to none.

Do you know what percentage of their new hires don't pass the reeducation process? and how many graduates of the reeducation process don't complete their FTO time?

 

[ExpatMedic0]

Interesting, I am sure it's a great place to work. However, coincidentally I have my bachelor's in paramedicine from Central Washington University. From my understanding unless you take CWU's program on campus, all other accredited paramedic programs are accepted at the same amount of transfer credit as a " advanced standing" policy. This is regardless if they exceed the national standard. So in that regard, any NREMT paramedic from a nationally accredited program will get the same amount of transfer credit, unless you took seperately classified and accredited college credits in separate subject matter. For example, a full anatomy class for college credit as part of your program. Otherwise it's all vocational training at most universities. Not to steal your thunder, I am sure it's a stellar agency with great pay and a good reputation

 

[FLMedic311]

Anecdotally you think that norepi is less effective in an IO? You would use a failed IO as your justification to start a CIV in the field instead of another IO despite the well documented complication from CIV starts in suboptimal/substerile conditions with providers who start a whopping 2 CIVs per year? Would you also delay transport for this?

What percentage of your medics get two CIV field starts and what percent remediate?

I am going to start with I fully respect your opinion on this matter, and have nothing against your thoughts on CIV access. With that said I am not going to try and sway your opinion or defend our current practice.

Thanks for your great reply - very informative!

I wanted to inquire: What has been your sense of the nature of your interaction with the medical control physicians? Do you find that you have to call them more often than you'd like, or is it not much of a burden? My understanding is that you must call before you perform most (all?) ALS procedures. Is that correct?

To be honest I only have my last job as a FF/PM in Florida to compare too and I do not feel it is much different. We have standing orders in which we operate under and they cover most all things you can think you may need to do in an emergent situation. There are few times in which we are calling for "Orders" and most of those times it is warranted do to it being a complex Pt. The "mother may I" system is not in place here and I think the thoughts behind it mostly stem from what you have to do in school while with SFDM1. So no it is not a burden at all!

Do you know what percentage of their new hires don't pass the reeducation process? and how many graduates of the reeducation process don't complete their FTO time?

I can't honestly say I know and exact # but it sounds like it does not happen often as the hiring process itself is set up pretty well with regard to hiring canidates that are going to be successful in school and a good fit for KCM!

 

[Amberlamps916]

Outside of the USA we're told Medic One is the "best" of the USA, particularly due to their very high survival from cardiac arrest.

Does anybody know if it is true in regards to the "rest" of what they do; considering cardiac arrest is like 1% of workload.

Medic One is always looked upon as the gold standard for cardiac arrest survival but for some reason, other systems with relatively high survival rates are rarely mentioned.

For example, Santa Barbara County in California (go figure) has very high sudden cardiac arrest survival rates, 52% as of 2015 (file uploaded for verification).

This can be attributed to bystander cpr programs, a strong emphasis on resuscitation, pit-crew cpr, and county AED programs.

It's interesting to see Medic One's cardiac arrest survival rates but I'd like to see statistics on patients where treatments are performed in the Medic One system utilizing methods most providers in America can't use.

 

[FLMedic311]

Interesting, I am sure it's a great place to work. However, coincidentally I have my bachelor's in paramedicine from Central Washington University. From my understanding unless you take CWU's program on campus, all other accredited paramedic programs are accepted at the same amount of transfer credit as a " advanced standing" policy. This is regardless if they exceed the national standard. So in that regard, any NREMT paramedic from a nationally accredited program will get the same amount of transfer credit, unless you took seperately classified and accredited college credits in separate subject matter. For example, a full anatomy class for college credit as part of your program. Otherwise it's all vocational training at most universities. Not to steal your thunder, I am sure it's a stellar agency with great pay and a good reputation

This could very well be true! I honestly do not no the fine details. As far as my thunder, admittedly it is just my opinion and it is not to say this is without a doubt the best place to be a medic in the world. I just think it is!

 

[VentMonkey]

admittedly it is just my opinion and it is not to say this is without a doubt the best place to be a medic in the world. I just think it is!

Undoubtedly disputable.

 

[SpecialK]

It's interesting to see Medic One's cardiac arrest survival rates but I'd like to see statistics on patients where treatments are performed in the Medic One system utilizing methods most providers in America can't use.

CPR and defibrillation are not available to most American ambulance personnel?

That's the only two things which have ever been proven to increase survival.

IV drugs, mechanical CPR, endotracheal intubation, pre-hospital hypothermia: absolutely none of them have shown a positive impact on survival.

 

[VentMonkey]

CPR and defibrillation are not available to most American ambulance personnel?

That's the only two things which have ever been proven to increase survival.

IV drugs, mechanical CPR, endotracheal intubation, pre-hospital hypothermia: absolutely none of them have shown a positive impact on survival.

I think he was referring to things such as central line placement, which also has zero benefits, particularly in an urban-EMS environment; to answer your question, yes early CPR and defibrillation is readily available here.

Some cities, such as Seattle, do a phenomenal job at educating the public and supplying them with the training and equipment (public access defibrillators), thereby improving their overal OHCA survival rates.

 

[EpiEMS]

To be honest I only have my last job as a FF/PM in Florida to compare too and I do not feel it is much different. We have standing orders in which we operate under and they cover most all things you can think you may need to do in an emergent situation. There are few times in which we are calling for "Orders" and most of those times it is warranted do to it being a complex Pt. The "mother may I" system is not in place here and I think the thoughts behind it mostly stem from what you have to do in school while with SFDM1. So no it is not a burden at all!

Ok, that makes sense. I think I saw the "mother may I" in a slide deck for SFD MedicOne. So do you have to call for orders, say, for procedures like IOs or ETI?

It's interesting to see Medic One's cardiac arrest survival rates but I'd like to see statistics on patients where treatments are performed in the Medic One system utilizing methods most providers in America can't use.

This is a really good point!

CPR and defibrillation are not available to most American ambulance personnel?

That's the only two things which have ever been proven to increase survival.

IV drugs, mechanical CPR, endotracheal intubation, pre-hospital hypothermia: absolutely none of them have shown a positive impact on survival.

Well, maybe not in LA County...but yes, they are widely available - I think there is still an attitudinal adjustment needed in American EMS, where we tend to think more is better, even when the evidence is just not there (especially for neurologically intact survival and cost per QALY).

 

[FLMedic311]

Ok, that makes sense. I think I saw the "mother may I" in a slide deck for SFD MedicOne. So do you have to call for orders, say, for procedures like IOs or ETI?

No, most emergent procedures you would not. Situations like if you wanted to use Procaine for a SVT, or Metoprolol during a STEMI.

 

[EpiEMS]

No, most emergent procedures you would not. Situations like if you wanted to use Procaine for a SVT, or Metoprolol during a STEMI.

Gotcha, thanks. I really appreciate your helpful answers on this - very interesting to learn about this system!

 

[Bullets]

Not convoluted at all.

From their testing process, requirements, and vacancies I'd say it's easier to become a contractor overseas than to get juiced in at King County Medic One.
Seems like a tough sell, but then again, they are clearly looking for the best of the best...
... 6 months with an FTO... Then 6 more on probation. Plus retraining as a paramedic.

Plus you have to not screw up anything for nearly 2 years or risk it all being a wash. Tough sell, as I said. Maybe I'll go for USAF Pararescueman instead. Seems easier

I was told i should apply, but with all this, its just easier to go be a PA. Do you even get an AS on the way out with all this work?

 

[SandpitMedic]

I was told i should apply, but with all this, its just easier to go be a PA. Do you even get an AS on the way out with all this work?

I wouldn't quite say it's easier to be a PA, yet it does seem highly competitive.
Great question- about the degree. I ASSume you would since it's a university program. However, what if you already have your AAS in EMS? What if you already have a BS in EMS?

Take one step backwards to take two forward? Sounds like some heavy personal decision making processes. Is it worth MAYBE getting hired to jump through all the hoops if you've already jumped through other hoops Such as academic, EMS, reciprocity, FPC/CCT, relocation, etc. just to be a paramedic in King County.

Not a swipe at "still" paramedics, but you'd think one would prefer career advancement over transferring "slightly up" or even "slightly down" if you're a practicing FP-C or CCT medic. Again, a personal choice and personal perspective.

For me, it's simply not worth it at this stage in my life. If I were early 20's I would attempt it. Late 20's... Not for me. I'd rather work on PA or Med school. What they offer to me is not worth wasting 2 years of education & probation that could otherwise be spent pursuing higher education, and career & life advancement.

 

[EpiEMS]

I was told i should apply, but with all this, its just easier to go be a PA. Do you even get an AS on the way out with all this work?

If this is still accurate, I don't think you do. However, it seems like they provide 88 college credit hours, and they have an agreement to transfer those credits to Pitt for their bachelors' program.

Becoming a PA is definitely more academic work, especially if you don't have the prereqs -- and also because that's two years of graduate school versus circa 10 months of paramedic school.

 

[SandpitMedic]

I can see it as both a pro and a con. A huge pro if you're an EMT basic. Also, a pro if you want to spend the rest of your life living in Seattle working at medic 1. Another pro that the training is paid and it's probably pretty good training, at the very least its 2-3 times more hours than a standard paramedic program so we all could probably stand to learn something and refresh on things regardless of our provider level. A con is it is a very intense year worth of training. For comparison, 40 hours a week times 52 weeks equals 2,080 hours a year. 3000 hours is much more than a fulltime job and thus the salary offered for training is not very good when analyzed from an hourly perspective. Secondly the 3000 hour program is vocational training, it is not recognized any more than any other 1300 hour paramedic program if you ever leave the small bubble of Seattle. It also does not result in any type of degree or transferable credits toward a degree more than a standard paramedic program does. Another con is if you're already an experienced provider and a paramedic with a degree who is willing to go through something like this there are other options. For example, PA school is also a 1-year intense classroom program, followed by 1 year of clinical... and your salary and working hours are better than even Medic 1. Just playing the devils advocate a bit...

This. I should have read the entire thread before my previous post. I concur with you 100%

Inshallah!

 

[RocketMedic]

This would be a pretty substantial clinical downgrade from what I do now. Having to call in for pain management and stuff....it's not terrible, but it's not exactly a lot of trust placed in the medics either.

 

[FLMedic311]

Take one step backwards to take two forward? Sounds like some heavy personal decision making processes. Is it worth MAYBE getting hired to jump through all the hoops if you've already jumped through other hoops Such as academic, EMS, reciprocity, FPC/CCT, relocation, etc. just to be a paramedic in King County.

So I am 33y/o with two kids, I have my FP-C and was a practicing flight paramedic with a great set of protocols! I do not feel I have taken a step backwards at all. Once again, I appreciate this may not true for others. Honestly though, I am a bit surprised about the thought of going back to school to equate to being a step backwards..

Having to call in for pain management and stuff..... not exactly a lot of trust placed in the medics either.

So I feel like I failed to paint a good picture on our ability to act and our relationships with our MDs. I don't know how I could word it better without having to answer to every possible situation, all I can say is that we have a great deal of autonomy, trust and relations with/from not only or MPDs but our receiving physicians as well.

BTW, thank you all for the great reception, I really appreciate all you have been able to provide to EMS as a whole through these forums. I have been reading through and there is a lot of great stuff on here and hope to try and contribute. I just want to say that I get that KCM1 is just one of many wonderful EMS systems, that I would also be fortunate (if I was ever able) to be part of as well. And that list grows more and more day by day. I do not wish to try and sway all the opinions on our dept and/or our practices, I simply would like to minimize rhetoric and give the fair opinion of someone who is there. Thanks again so very much for your excellent questions and curiosities, and I encourage you to keep them coming! Thanks Again!

 

[FLMedic311]