So how does ALS work in California?

[NPO]

I'm somewhat curious about SoCal EMS lol. Do I really want to trade my Texas medicking for AMR-San Bernadino County or Hall or Liberty-Ridgecrest or something? I mean, I haven't called for orders in two years.

I mean, I grew up out there, and I do miss it. But I also like guns and freedom and no state taxes.

I only call for orders if I don't want to give a drug, but I'm supposed to, so I can say I called and they said no. I phrase it in such a way they know to say no.

 

[RocketMedic]

Can yall, hypothetically, use vents on 911 calls, or do you need an rn?

 

[DesertMedic66]

I only call for orders if I don't want to give a drug, but I'm supposed to, so I can say I called and they said no. I phrase it in such a way they know to say no.

We can just withhold the drug without calling haha

 

[DesertMedic66]

Can yall, hypothetically, use vents on 911 calls, or do you need an rn?

For Riverside and San Bernardino counties vents are only carried on CCT units who only run IFTs and are staffed with 2 EMTs and an RN.

 

[kev54]

I'm somewhat curious about SoCal EMS lol. Do I really want to trade my Texas medicking for AMR-San Bernadino County or Hall or Liberty-Ridgecrest or something? I mean, I haven't called for orders in two years.

I mean, I grew up out there, and I do miss it. But I also like guns and freedom and no state taxes.

Why not work for a company like Remote Medical International so you can live anywhere for most of the year?

 

[NPO]

We can just withhold the drug without calling haha

We can too, locally, but our QA is now doing some kind of state-level audit, so if I can get base to say no, my patient is excluded from the audit, meaning because I didn't give the 23 year old anxiety patient ASA, we won't get docked.

 

[RocketMedic]

For Riverside and San Bernardino counties vents are only carried on CCT units who only run IFTs and are staffed with 2 EMTs and an RN.

I'm guessing ALS transfers are pretty limited in CA?

 

[RocketMedic]

Why not work for a company like Remote Medical International so you can live anywhere for most of the year?

Eh, I like what I do and don't really want to travel a lot for work.

 

[NPO]

I'm guessing ALS transfers are pretty limited in CA?

What makes you say that? The majority of transfers here are BLS or ALS. We have one CCT unit which has an EMT, a Paramedic and an RN. The medic also has to be CCEMT-P or FP-C certified within 2 years.

 

[RocketMedic]

What makes you say that? The majority of transfers here are BLS or ALS. We have one CCT unit which has an EMT, a Paramedic and an RN. The medic also has to be CCEMT-P or FP-C certified within 2 years.

That's what I mean, I guess. Here in Texas, a lot of what y'all would call CCT (intubated, multiple drips, etc) is still a paramedic-level transfer. I've got CCEMT-P and am pondering taking FP-C, and I enjoy those calls, but I still like 911 more and I like being able to apply the knowledge and tools to both.

 

[NPO]

That's what I mean, I guess. Here in Texas, a lot of what y'all would call CCT (intubated, multiple drips, etc) is still a paramedic-level transfer. I've got CCEMT-P and am pondering taking FP-C, and I enjoy those calls, but I still like 911 more and I like being able to apply the knowledge and tools to both.

The only thing we don't do ALS is drips. We are allowed to take K+ (40meq), nitro, heparin, and blood. That's it. But we can take vents starting next month.

 

[RocketMedic]

We generally don't start putting on nurses in my neck of the swamps until there's balloon pumps, ECMO or some other treatment going on that's so far out of normal that it demands its own minder.

 

[RocketMedic]

The only thing we don't do ALS is drips. We are allowed to take K+ (40meq), nitro, heparin, and blood. That's it. But we can take vents starting next month.

I'm guessing propofol drips, ABX infusions, etc are excluded and still require an RN?

 

[NPO]

We generally don't start putting on nurses in my neck of the swamps until there's balloon pumps, ECMO or some other treatment going on that's so far out of normal that it demands its own minder.

It's kinda silly here, I told a hospital a heparin drip could go ALS. They were blown away. It still went CCT because they couldn't wrap their heads around it.

 

[NPO]

I'm guessing propofol drips, ABX infusions, etc are excluded and still require an RN?

Yes. Anything other than those I listed are not ALS in my County.

 

[DesertMedic66]

That's what I mean, I guess. Here in Texas, a lot of what y'all would call CCT (intubated, multiple drips, etc) is still a paramedic-level transfer. I've got CCEMT-P and am pondering taking FP-C, and I enjoy those calls, but I still like 911 more and I like being able to apply the knowledge and tools to both.

Generally speaking intubated patients are taken CCT unless the transport is short and the patient doesn't need to be kept on any drips. This is a list of the only things medics in Riverside county are able to transport:

So the vast majority of the ALS IFTs are cardiac monitor, O2, and IV.

 

[RocketMedic]

I don't think I'd be happy there. What about rural CA, like way up north or out east?

 

[EpiEMS]

We do the "superplug" here, which is two NPAs and an OPA. No one can prove its actually more effective than an OPA and proper positioning but I do as I am told and it makes intuitive sense I suppose.

The more the merrier. I take my guidance from Mr. Oto, and as he says:
If "you place a BLS airway, the only breathable passage you’re really guaranteed is the lumen enclosed by the device itself: the central hole or grooves. And that’s not very much room. Our goal isn’t to create a tiny breathing tube, it’s to maximize the amount of usable airway — we’d like to be able to ventilate through as large a diameter as possible. That means using everything we can."

It's NRB only. We place an EtCO2 cannula but no O2 source to it.

Gotcha. I figure the NC couldn't hurt, so I was curious.

I don't think I'd be happy there. What about rural CA, like way up north or out east?

Seems like there's wide variation in scope by county: http://www.emsa.ca.gov/Media/Default/PDF/ParamedicBasicSOPChart3-2013.pdf

 

[dutemplar]

I know more people looking to eject from Californistan for Texas than vice-versa...

 

[CTMD]

Can yall, hypothetically, use vents on 911 calls, or do you need an rn?

In San Bernardino County we can use transport vents for 911 scene calls. Almost all the transporting agencies except for AMR have them. (County Fire, Desert, MBA)