Shady Companies In LA City

MusicMedic said:
looker im.really starting to be convinced you run one of these shady companies...
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So long as he has some people on staff who don't drink or smoke crack and have a valid DL51 to partner with, a forward thinking medical director who will let me practice at Intensive Care Paramedic level and not have to ring up to fart or stick in a drip I'm OK with it

What, Brown needs to diversify a little ok :D
 
terrible one said:
I bet your employees have a different take on that
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I never asked them and really do not make a difference to me. It can be called taxi, or anything else as long as i am making money that is all i really care about. I am pretty sure that taxi driver would love to have those red lights on top of the vehicle, i am sure his job would be so much easier :D
 
looker said:
I never asked them and really do not make a difference to me. It can be called taxi, or anything else as long as i am making money that is all i really care about. I am pretty sure that taxi driver would love to have those red lights on top of the vehicle, i am sure his job would be so much easier :D
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Too bad an IFT company should never use those red lights, either it's just another BS taxi transport or ALS should be called for a serious patient.
 
somePerson said:
Too bad an IFT company should never use those red lights, either it's just another BS taxi transport or ALS should be called for a serious patient.
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If you pick up a patient and his condition become unstable you need to rush that person to the hospital. What do you suggest BLS ambulance do, call 911? Red lights use is directly up to EMT and him/her only. In some city IFT responds to emergency to nursing homes with whom they have a contract. No need to call 911 when IFT can respond code 3.
 
looker said:
If you pick up a patient and his condition become unstable you need to rush that person to the hospital. What do you suggest BLS ambulance do, call 911? Red lights use is directly up to EMT and him/her only. In some city IFT responds to emergency to nursing homes with whom they have a contract. No need to call 911 when IFT can respond code 3.
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I forgot, my bad. BLS rigs that run IFT's all day can handle everything, there is no reason to call for ALS when the patient needs it, wouldn't want that CHFER to get some ALS treatment cause the :censored::censored::censored::censored:y SNIF decided to call a shady ift company to not get audited.

I
 
somePerson said:
I forgot, my bad. BLS rigs that run IFT's all day can handle everything, there is no reason to call for ALS when the patient needs it, wouldn't want that CHFER to get some ALS treatment cause the :censored::censored::censored::censored:y SNIF decided to call a shady ift company to not get audited.
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Without knowing where Looker's company is at, depending on the location, the situation is a little more nuanced than that. There's a big difference between deciding which patients gets a paramedic first response in a system with IFT ALS resources and where the choice is IFT BLS and 911 ALS. Some things that end up going BLS should never have been dispatched BLS, but should 911 be called every time a patient have abnormal electrolyte levels, regardless of how out of range it is? How about that patient with a history of seizures who had a seizure in the morning and is now being transported for evaluation 5 hours after the seizure and the patient is back to his normal state of being?
 
looker said:
If you pick up a patient and his condition become unstable you need to rush that person to the hospital. What do you suggest BLS ambulance do, call 911? Red lights use is directly up to EMT and him/her only. In some city IFT responds to emergency to nursing homes with whom they have a contract. No need to call 911 when IFT can respond code 3.
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Funny little quirks of various systems, but in Ontario, yes. IFT vehicles are not Ambulances under the law (even though retired Ambulances are the most popular vehicle choice for IFT companies) and are not able to display emerg lights, sound a siren or any of that Ambulance stuff EMS does. They must pull over and call 911. Nursing homes, MD offices, even hospital here cannot contact an IFT company for an emerg call. If the transfer is a stat, it must go through EMS or ORNGE (the provincial critical care/air ambulance service).
 
WolfmanHarris said:
Funny little quirks of various systems, but in Ontario, yes. IFT vehicles are not Ambulances under the law (even though retired Ambulances are the most popular vehicle choice for IFT companies) and are not able to display emerg lights, sound a siren or any of that Ambulance stuff EMS does. They must pull over and call 911. Nursing homes, MD offices, even hospital here cannot contact an IFT company for an emerg call. If the transfer is a stat, it must go through EMS or ORNGE (the provincial critical care/air ambulance service).
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What you talking about is called non-emergency medical transportation vehicles. They do not have emergency lights and generally are not staffed by an emt. Instead the requirement is that driver be first aid/cpr certified. During emergency the driver is required to dial 911.

Being that IFT company bls units are staffed by 2 emt's there is no reason why they should not be able to handle emergency runs. Understand that many IFT's company have 911 contract with local city's.
 
looker said:
Being that IFT company bls units are staffed by 2 emt's there is no reason why they should not be able to handle emergency runs. Understand that many IFT's company have 911 contract with local city's.
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Good IFT companys have 911 contracts with local cities to provide transport supervised by an ALS authority (usually an FD). The als first responder determine if the patient can be transported BLS or ALS.

It's the crappy companies that are encouraged to never call for ALS by their employer, even if the patient can benefit from ALS care. They wouldn't want to have an ALS unit take money away from them for the transport, god forbid you give up money for the sake of patient care.
 
somePerson said:
Good IFT companys have 911 contracts with local cities to provide transport supervised by an ALS authority (usually an FD). The als first responder determine if the patient can be transported BLS or ALS.

It's the crappy companies that are encouraged to never call for ALS by their employer, even if the patient can benefit from ALS care. They wouldn't want to have an ALS unit take money away from them for the transport, god forbid you give up money for the sake of patient care.
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If BLS unit determine that it's quicker to transport patient to ER compare to waiting for ALS unit, i got no problem with unit transporting pt to the hospital. Unit on scene always the ones that make the call if ALS should be called or not.

If you think I would like the unit to play with patient care you are out of your mind. I currently have 5 million auto insurance, 3 million liability insurance and also 3 million umbrella. I am paying out of my *** already for insurance, i have no desire to have claim to happen and have my insurance double.
 
looker said:
If BLS unit determine that it's quicker to transport patient to ER compare to waiting for ALS unit, i got no problem with unit transporting pt to the hospital. Unit on scene always the ones that make the call if ALS should be called or not.

If you think I would like the unit to play with patient care you are out of your mind. I currently have 5 million auto insurance, 3 million liability insurance and also 3 million umbrella. I am paying out of my *** already for insurance, i have no desire to have claim to happen and have my insurance double.
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I'm guessing that's your coverage limits, not your premium.
 
somePerson said:
I forgot, my bad. BLS rigs that run IFT's all day can handle everything, there is no reason to call for ALS when the patient needs it, wouldn't want that CHFER to get some ALS treatment cause the :censored::censored::censored::censored:y SNIF decided to call a shady ift company to not get audited.

I
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If I need als during an ift I'm calling my boss. Our company has als providers and at least one is at the station most of the time. We also have per diem medics for scheduled transports of certain patient types. But since I'm new there and haven't done als calls there yet I do not know what makes them need a medic vs and emt for certain transports.
 
looker said:
What you talking about is called non-emergency medical transportation vehicles. They do not have emergency lights and generally are not staffed by an emt. Instead the requirement is that driver be first aid/cpr certified. During emergency the driver is required to dial 911.

Being that IFT company bls units are staffed by 2 emt's there is no reason why they should not be able to handle emergency runs. Understand that many IFT's company have 911 contract with local city's.
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I know what I'm talking about. Stable IFT's are primarily done that way here. They're staffed by FR or EMR trained staff, and looking at the EMT-B curriculum, is nearly equivalent staffing levels vs. PCP.

As for there being no reason for EMT-B's being equipped to handle emergency runs, I'll leave that be. It's been covered in many threads on education over the years.

I understand how the system works in the US. I was just providing contrast with our system where every area has a single EMS provider, and IFT is a separate industry.
 
WolfmanHarris said:
I know what I'm talking about. Stable IFT's are primarily done that way here. They're staffed by FR or EMR trained staff, and looking at the EMT-B curriculum, is nearly equivalent staffing levels vs. PCP.

As for there being no reason for EMT-B's being equipped to handle emergency runs, I'll leave that be. It's been covered in many threads on education over the years.

I understand how the system works in the US. I was just providing contrast with our system where every area has a single EMS provider, and IFT is a separate industry.
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The primary reason why EMS does IFT is because of insurance reasons. Medi-care(fed gov insurance) do not cover NEMT. They only cover EMS. Medi-cal(state health insurance) does cover NEMT but they pay crap and not everyone have it.
 
JPINFV said:
Sigh.

This is why every system should have a policy like Riverside County, CA has. Especially in systems where access to IFT ALS is limited.

http://www.rivcoems.org/downloads/downloads_memos/2009/BLS_Ambulance_Usage_Guidelines.pdf
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Yes this a good policy, esp. after certain BLS companies whose employees only take visual vitals have brought in critical patients with no interventions. However, in the city where I work, there is a con home in the parking lot of the local ED. On the one hand it is not a STEMI center, but the time it takes for one of our ALS units to respond, assess and txp, the patient could already be in the ED. On a side note, if the BLS unit is unsure, med control anyone? There has been some argument in RivCo regarding BLS ambos contacting for destination.
 
jgmedic said:
Yes this a good policy, esp. after certain BLS companies whose employees only take visual vitals have brought in critical patients with no interventions. However, in the city where I work, there is a con home in the parking lot of the local ED. On the one hand it is not a STEMI center, but the time it takes for one of our ALS units to respond, assess and txp, the patient could already be in the ED.
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The problem is that, if paramedic resources are readily available via the 911 system, there's absolutely zero reason for an IFT BLS unit to be dispatched to a chest pain call. A unit has to be dispatched before they can mess up an assessment. So, it isn't just about visual vitals. I would love to hear the reason why IFT BLS is more appropriate than 911 ALS when the dispatch complaint is, for example, "BP 80/50." Yes, I've been on that call and there's no justification I can think of for a BLS unit to be dispatched on that, or any of the other resp emergencies at SNFs that BLS IFT units are routinely sent to in So. California.


On a side note, if the BLS unit is unsure, med control anyone? There has been some argument in RivCo regarding BLS ambos contacting for destination.
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What about, say, Orange County, where BLS units do not have access to online medical control?
 
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