KCM1 Video

[Fish]

http://vimeo.com/60817271

Our new recruit video, we test every year.

Well put together Recruitment video, thank you for sharing.....

 

[Ecgg]

Envy is probably to blame. When talking about desirable EMS employers, very few places are mentioned. KCMO is consistently one of them. If the worst they can get dinged for is gloves and cardiac arrest save criteria, then they're doing better than pretty much everyone else. Just sayin'

The EMS workplace can be a cut throat, back stabbing place. I'm seeing some of the same behavior patterns when people try to nit pick and deride (as said previously, there's a more proper way to question the video's content) a system that's probably #1 single role EMS employer in the country to work for, if not at least in the top 5.

It's certainly envy no doubt.

Directly from: http://www.publicsafetytesting.com/agency/view/list/
King County Medic One PARAMEDIC Requirements:
High School Grad/ GED
EMT Certification EMT or Paramedic certification
Paramedic Certification EMT or Paramedic certification
Prior EMT Experience Required Minimum of 3 year’s experience as EMT or Paramedic working in a urban / rural prehospital care delivery system. Twelve consecutive months of that experience must be with one agency
Salary Information
$15.19 per hour, + Overtime. (Approximately $50,000 anually during training)
$28.51 (2448 hrs per year) upon certification (2010 CBA Rates)

All I see is the same old GED, EMT or P card, and years on the job as the primary criteria for hire. Following that you go through their 10 month boot camp with “no extracurricular activities” and “70 hour a week” where you follow instruction “keep your mouth shut” and do the grunt work (we all went through medic school rotations and sadly you will not be one of the “residents” in the ER) while getting an EMT Basic salary and hey they want “people to make a career commitment” because we want people who lack formal education to do things our way period. Here is a video of us looking cool and all tactical with our bullet proof vests because that is paramount for progressive patient care while putting central lines without any care for sepsis just because we are allowed, they will get taken out anyway upon admission. Remember we will treat the patient exactly as an Emergency Physician will, with my GED and 10 month boot camp training.


I believe all the questions asked were legitimate questions. I would still like to see a proper response instead of “this forum is rude” and “sterile technique is not always possible” shall not be a deterrent from our progressive practices of field central line placement.

What is the formal college education level of your paramedics?

Why delay transport for placement of a central line while using questionable sterility methods? What was the goal on establishing said placement?

With only 8 medic units in service does everyone who needs ALS care receive it? Or on a busy day you get what you get?

 

[46Young]

It's certainly envy no doubt.

Directly from: http://www.publicsafetytesting.com/agency/view/list/
King County Medic One PARAMEDIC Requirements:
High School Grad/ GED
EMT Certification EMT or Paramedic certification
Paramedic Certification EMT or Paramedic certification
Prior EMT Experience Required Minimum of 3 year’s experience as EMT or Paramedic working in a urban / rural prehospital care delivery system. Twelve consecutive months of that experience must be with one agency
Salary Information
$15.19 per hour, + Overtime. (Approximately $50,000 anually during training)
$28.51 (2448 hrs per year) upon certification (2010 CBA Rates)

All I see is the same old GED, EMT or P card, and years on the job as the primary criteria for hire. Following that you go through their 10 month boot camp with “no extracurricular activities” and “70 hour a week” where you follow instruction “keep your mouth shut” and do the grunt work (we all went through medic school rotations and sadly you will not be one of the “residents” in the ER) while getting an EMT Basic salary and hey they want “people to make a career commitment” because we want people who lack formal education to do things our way period. Here is a video of us looking cool and all tactical with our bullet proof vests because that is paramount for progressive patient care while putting central lines without any care for sepsis just because we are allowed, they will get taken out anyway upon admission. Remember we will treat the patient exactly as an Emergency Physician will, with my GED and 10 month boot camp training.


I believe all the questions asked were legitimate questions. I would still like to see a proper response instead of “this forum is rude” and “sterile technique is not always possible” shall not be a deterrent from our progressive practices of field central line placement.

What is the formal college education level of your paramedics?

Why delay transport for placement of a central line while using questionable sterility methods? What was the goal on establishing said placement?

With only 8 medic units in service does everyone who needs ALS care receive it? Or on a busy day you get what you get?

So, KCM1 is basically like any other third service tiered system, except that they pay well, have a lengthy internship process, and play up their skills and abilities.


I'm beginning to see what everyone else sees. Those are excellent questions you've asked, and I hope to see a proper response.

I guess I can ad KCM1 to the list of single role EMS providers that value experience over education. Seriously, this is supposed to be a premier agency, and they only require a GED, certs, and some experience? $50k/yr @ 70 hours/week (as stated on the video) for ten months of training? Whenever someone blames the fire service for retarding efforts to increase educational requirements, I counter that every other delivery model is also to blame. Surely a department as desirable as KCM1 could require a degree to have their application considered, and still have no shortage of applicants, no? Instead, I could start work as an EMT, do a six month medic mill, do two more years as a medic, and be qualified to apply with KCM1. When the top EMS employers take people with just a GED and a cert, it's no wonder why we're not getting anywhere with the education issue.

KCM1 has a tiered system that allows medics to see only sick patients (relatively rare outside of NY/NJ). That's good. They pay well. I hope that they have a pension. They have a decent scope of practice. Other than that, I don't see how they're superior to anyone else.

 

[46Young]

I have some questions:

What positions are available besides field EMS transport? How many of these opprtunities are available? Are there ample opprtunites to get off the road as you get older?

What is the average call volume per ALS unit? I think that the video said 14,000 calls divided over 65 medics. 2448 hours a year is a 47 hour workweek. That would be four calls a week for each medic, on either 4 12's a week, or two 24's a week. Does that sound right? Edit: (Actually, based on the hiring info, 14,000 calls over eight units is just under 5 calls a day per unit)

Could we see a coply of KCM1 guidelines? Let us judge how progressive these guidelines are compared to other systems, and if the options are necessary.

My county has 1.08 million residents spread over 395 sq miles (2749/Sq mile). We have 41 transport units, which are all ALS (15 are dual medic). What are the population stats and ambulance deployment (both BLS and ALS) for KCM1's coverage area?

 

[NomadicMedic]

There are some things about KCM1 that are great. The education is way beyond any other paramedic program. Because its held at Harborview, medic interns have a great opportunity to practice the skills that we all know are lacking in other programs. Namely intubation. Medics come out of that program with far more than the standard 10 live tubes.

There are also research opportunities, if you're into that sort of thing.

In reality, it's a just a system that's above average in some areas, below in others, has passionate employees and a really good PR department.


Many of us could take lessons on how our system is presented to others.

 

[KingCountyMedic]

We do 24 hour shifts. 1 on, 1 off, 1 on, followed by 5 days off. We have "debit days" which are used to cover vacation. We have 4 platoons, each shift has a MSO (Bat Chief) along with our Chief and 4 other day time MSO's that oversee training/hiring/operations etc. Each shift has an acting MSO that fills in for the shift MSO and then we have FTO's. So there are some promotional opportunities. We do have very good benefits and retirement. We are in the IAFF Union under our own local but we are not firefighters. We do carry bunker gear for car accidents and other operations were full protective gear is needed. We are all custom fitted and issued our own ballistic vests and we are required to wear them on all assault w/weapons calls. Our pension plan is LEOFF 2. Our pay is quite good and overtime is usually always available to those that want it. As far as education requirements yes you can get hired with a high school diploma/GED and an EMT card. Many of our people have multiple degrees, we have a ton of RN's that work here as well. Everything we do is overseen by some of the nations best Doctors, as far as our scope of practice and what we do in the field, everything is overseen by Physicians who are actively involved in running our program. Every patient we see is documented and the case is reviewed by our Docs. Our program was designed by a group of Doctors that wanted to save life. They wanted to see if they could train a firefighter to go out and operate as an extension of the ER Physician. We have a history that we are proud of and we love to go to work. If you are interested we test almost every year. Here's the rest:


http://www.kingcounty.gov/healthservices/health/ems/MedicOne.aspx

 

[RocketMedic]

We do 24 hour shifts. 1 on, 1 off, 1 on, followed by 5 days off. We have "debit days" which are used to cover vacation. We have 4 platoons, each shift has a MSO (Bat Chief) along with our Chief and 4 other day time MSO's that oversee training/hiring/operations etc. Each shift has an acting MSO that fills in for the shift MSO and then we have FTO's. So there are some promotional opportunities. We do have very good benefits and retirement. We are in the IAFF Union under our own local but we are not firefighters. We do carry bunker gear for car accidents and other operations were full protective gear is needed. We are all custom fitted and issued our own ballistic vests and we are required to wear them on all assault w/weapons calls. Our pension plan is LEOFF 2. Our pay is quite good and overtime is usually always available to those that want it. As far as education requirements yes you can get hired with a high school diploma/GED and an EMT card. Many of our people have multiple degrees, we have a ton of RN's that work here as well. Everything we do is overseen by some of the nations best Doctors, as far as our scope of practice and what we do in the field, everything is overseen by Physicians who are actively involved in running our program. Every patient we see is documented and the case is reviewed by our Docs. Our program was designed by a group of Doctors that wanted to save life. They wanted to see if they could train a firefighter to go out and operate as an extension of the ER Physician. We have a history that we are proud of and we love to go to work. If you are interested we test almost every year. Here's the rest:


http://www.kingcounty.gov/healthservices/health/ems/MedicOne.aspx

Everyone charts all of their patients, its how we get paid. Claiming that as a hiring incentive is like saying "sky is blue here too".

Everyone has doctors as medical directors, although most are not as involved as yours seem to be. Every paramedic out there work s to some extent as an extension of the ER.

What is your actual scope of practice?

 

[KingCountyMedic]

Everyone charts all of their patients, its how we get paid. Claiming that as a hiring incentive is like saying "sky is blue here too".

Everyone has doctors as medical directors, although most are not as involved as yours seem to be. Every paramedic out there work s to some extent as an extension of the ER.

What is your actual scope of practice?

http://www.kingcounty.gov/healthservices/health/ems/MedicOne.aspx

 

[RocketMedic]

http://www.kingcounty.gov/healthservices/health/ems/MedicOne.aspx

I see that you are allowed to perform several nonstandard surgical procedures, but no CPAP or BiPap? What about cath lab activations? C spine clearance? What is KCM1s policy on pain mangement and relief of nausea?

What sort of calls are you dispatched on? What is your working relationship with local FD and private ambulances?

How many of these surgical skills are performed in your system? What are your ETI rates?

How are errors managed? Clinical errors?

 

[PotatoMedic]

Claiming that as a hiring incentive is like saying "sky is blue here too".

Just so you know it is not. Constantly gray. If we see blue we know something has gone wrong!

 

[KingCountyMedic]

I see that you are allowed to perform several nonstandard surgical procedures, but no CPAP or BiPap? What about cath lab activations? C spine clearance? What is KCM1s policy on pain mangement and relief of nausea?

No CPAP or BIPAP yet, ongoing discussion amongst provider groups and physicians. KCM1 is a part of a much larger county wide EMS system, everyone has to agree to using it but probably coming soon. Pain and nausea are treated if it is a ALS patient requiring our involvement. We carry MS, Versed, Ativan and Zofran and Promethazine for nausea. We activate cath lab from the field on confirmed STEMI, we have the ability to transmit 12 leads with our LP15, often times we bypass the ED and go straight to the cath lab. As far as clearing c-spine not something we really do or see, I don't go to all MVC's just the bad ones.

What sort of calls are you dispatched on? What is your working relationship with local FD and private ambulances?

Chest pain with risk factors (age, type, radiation of pain, SOB, diaphoresis, cardiac history, HTN, diabetes etc.) resp distress, decreased LOC, status seizures, any overdose with depressed resp or decreased LOC, shootings, stabbings, high speed heavy mech MVC's, a lot of other, basically people that sound sick our dispatch guidelines are out there someplace would have to hunt for 'em.

We get along great with our fire departments, we train most of them and many of them come work for us. Any firefighter in the IAFF with LEOFF 2 can transfer all their pension when they come work here and join our local. As far as the private ambulance we get along with them very well for the most part. We hire quite a few private ambulance EMT's and Paramedics (over 10 years private myself) we recruit heavily from private ambulance.

How many of these surgical skills are performed in your system? What are your ETI rates?

I think we end up with 5-6 surgical airways a year. We have to train every two years on surgical airway lab. Our overall ETI success rate is 99.5% with a first pass success rate of 78% We have the iGel rescue airway device for failed intubation as well as the surgical options but usually tough tubes are managed with the eschmann cath. I love that thing. One of our Medical Directors is one of the Chief Anesthesiologists at Harborview Medical Center.

How are errors managed? Clinical errors?

Probably the same way most places handle them. Peer review, MSO review, Physician review. You will get a meeting with the MSO and the Medical Director and it can go a number of ways including documentation, counseling, medical probation, being sent back to Paramedic Training, having the Doctor ride with you or suspension/termination/prosecution if it's bad enough.

 

[RocketMedic]

Just so you know it is not. Constantly gray. If we see blue we know something has gone wrong!

Touche...it is seattle i reckon.

 

[RocketMedic]

fair enough...why no power cots?

 

[BandageBrigade]

Lets see...I saw plenty of ineffective manual compressions, gastric distension, questionable invasive venous access, old equipment lacking power cots and autopulses, a tiered system discussing how low-priority calls are turfed with no further discussion of them and an educational system that seems to be first-rate until you realize that it boils down to thirty-five years of tradition unimpeded by progress.

Why would I move there?

AHA recommends against device such as the autopulse.. why would they want it? I also hate power cots. Heavy and slow. Give me a manual stryker any day.

 

[KingCountyMedic]

fair enough...why no power cots?

That could fall under the "40 years of tradition unimpeded by progress" category. We have looked at many models and the majority have not wanted them due to weight and other factors. Our new rigs that we will be getting by the end of the year will have power cots with power loading. We are going to the new International Terrastar rig which is a huge rig so we'll have more room for more stuff like power loading cots and transport vents if we go that route. We don't go in for a lot of new gadgets just because they advertise in JEMS and have lots of reps throwing note pads and coffee cups at us. At the top of our medical food chain are some very smart, very old school Physicians and for us to use something or change the way we operate it has to really show a benefit. Not everyone is in agreement both in and outside of our community but that's the way it goes sometimes.

I hate Ferno cots, been a Stryker fan forever and would love power cots and they are coming

 

[RocketMedic]

AHA recommends against device such as the autopulse.. why would they want it? I also hate power cots. Heavy and slow. Give me a manual stryker any day.

So you prefer manual compressions?

Any oposition to cot weight goes away when I can move 500 pound Manatees with my thumb.

 

[RocketMedic]

That could fall under the "40 years of tradition unimpeded by progress" category. We have looked at many models and the majority have not wanted them due to weight and other factors. Our new rigs that we will be getting by the end of the year will have power cots with power loading. We are going to the new International Terrastar rig which is a huge rig so we'll have more room for more stuff like power loading cots and transport vents if we go that route. We don't go in for a lot of new gadgets just because they advertise in JEMS and have lots of reps throwing note pads and coffee cups at us. At the top of our medical food chain are some very smart, very old school Physicians and for us to use something or change the way we operate it has to really show a benefit. Not everyone is in agreement both in and outside of our community but that's the way it goes sometimes.

I hate Ferno cots, been a Stryker fan forever and would love power cots and they are coming

Welcome to 2007. Power cots rock.

 

[KingCountyMedic]

So you prefer manual compressions?

Any oposition to cot weight goes away when I can move 500 pound Manatees with my thumb.

Manual compressions all day, we switch out every cycle and shoot for >90% compression fractions and we get the numbers back on how we did.

For our large patients we use special Bariatric Ambulances from our private partners. They have a lot of them equipped with cranes and all kinds of stuff.

 

[Christopher]

Welcome to 2007. Power cots rock.

I dislike the power cots...far heavier when taking it into/out of homes and heavier when loading a patient.

Nicer when raising is about all it has on the normal ones.

Also the Autopulse has not been shown to be superior than CCC, and our fire depts do a pretty good job. The LUCAS apparently might be, but I think the honest answer is once you have good compression fractions a mechanical CPR device only wins in the rare case you'd like to transport a working arrest. I saw a paper from Dana Yost which showed it took quite a long time to get setup a lot.

If I were to beat up KCM1 for being outdated, it would be for not having CPAP; if that rumor is still true.

 

[46Young]

I dislike the power cots...far heavier when taking it into/out of homes and heavier when loading a patient.

Nicer when raising is about all it has on the normal ones.

Also the Autopulse has not been shown to be superior than CCC, and our fire depts do a pretty good job. The LUCAS apparently might be, but I think the honest answer is once you have good compression fractions a mechanical CPR device only wins in the rare case you'd like to transport a working arrest. I saw a paper from Dana Yost which showed it took quite a long time to get setup a lot.

If I were to beat up KCM1 for being outdated, it would be for not having CPAP; if that rumor is still true.

The power cot does not need to go in the house; we have the Reeves and a stair chair. The power cot can also be loaded into the ambulance with one person on each handle, which negates the weight disadvantage by cutting the weight in half.

Of course, if the FD responds on each call, you're not lifting the patient either, so then it doesn't make a difference