the 100% directionless thread

[CCCSD]

Stuck in Denver because of the storm. Got out to try and remove some of the 8in of snow on my windshield and stepped on a ziploc baggie that had been left on the door step to my truck. Couldn't see it because it was also completely buried under the 8in of snow. Somebody left me a bag of homemade jerky. Hoping it was a fellow employee and not some random nut job.

Human or animal...?

 

[Aprz]

I agree 100%, it doesn't. But I would say that it is better than working for AMR anywhere. HEMS, sure I can see that, especially if you love the medicine. Im looking into TX at a couple 3rd service options if the wife will be down. That being said, the benefits/retirement, at least for me with 4 kids, are worth it.

Obviously not a flight paramedic so I may be wrong. This is just what I've research. In California, a lot of flight paramedics have the same limited scope of practice that ground paramedics have. After removing pediatric intubation from the California paramedic scope of practice, there was talk about expanding the scope of practice for flight paramedics and making it state wide, but that hasn't happened yet. The flight paramedic scope of practice still depends on the local EMS agency, and if the local EMS agency didn't write anything specific for the flight paramedic (seems like most haven't), you are just a ground paramedic working on a helicopter. You're just changing the vehicle you work in. Typically, you get paid less, still require >3 years experience, still require things like FP-C so they can meet CAMTS requirement. :/

California Flight Paramedics to Receive New Scope of Practice

In San Francisco this past Tuesday, the California EMS advisory groups EMDAC and EMSAAC gathered for their final quarterly meeting of 2017. EMDAC is comprised of Medical Directors and oversees the …

caparamedic.org

The day started off with a rare, closed door meeting between the EMDAC and EMSAAC bodies, as state leadership looks to address the Flight Paramedic scope of practice in the wake of EMDAC’s decision to revoke pediatric intubation from paramedics last September. At that meeting, a presentation by San Diego Fire-Rescue Associate Medical Director Joelle Donofrio prompted the group to red line pediatric endotracheal intubation from the optional scope of practice for California Paramedics after voicing serious concerns in that Paramedics were not safely using the skill.

Medical Directors representing state aeromedical providers are now scrambling to create an exemption for their Flight Paramedics. They argue these teams, most often a Registered Nurse and Paramedic, must work dynamically in the treatment of pediatric patients, and that it is vital for paramedics to participate in the induction and intubation care often utilized in aeromedical cases. Interestingly, significant data of current pediatric intubation is being requested of all aeromedical providers as a part of the decision. This contrasts the decision to remove pediatric intubation which utilized historical studies but no current data.

^This was just talk with no change. I hope I didn't break any copyright data or whatever for quoting two paragraphs. I always forget the exact rule. Sorry. :/

 

[jgmedic]

Obviously not a flight paramedic so I may be wrong. This is just what I've research. In California, a lot of flight paramedics have the same limited scope of practice that ground paramedics have. After removing pediatric intubation from the California paramedic scope of practice, there was talk about expanding the scope of practice for flight paramedics and making it state wide, but that hasn't happened yet. The flight paramedic scope of practice still depends on the local EMS agency, and if the local EMS agency didn't write anything specific for the flight paramedic (seems like most haven't), you are just a ground paramedic working on a helicopter. You're just changing the vehicle you work in. Typically, you get paid less, still require >3 years experience, still require things like FP-C so they can meet CAMTS requirement. :/

California Flight Paramedics to Receive New Scope of Practice

In San Francisco this past Tuesday, the California EMS advisory groups EMDAC and EMSAAC gathered for their final quarterly meeting of 2017. EMDAC is comprised of Medical Directors and oversees the …

caparamedic.org

^This was just talk with no change. I hope I didn't break any copyright data or whatever for quoting two paragraphs. I always forget the exact rule. Sorry. :/

In San Diego they can still intubate kids. The scope is much higher what I can do on the ground. Depending on the FD you work for, the pay for HEMS can be better(probably not in NorCal), though the benefits and retirement are not close. I was just saying, I can understand if you're the rare FF who loves EMS more than Fire, I can understand leaving for HEMS, I just could never see leaving for AMR.

 

[Aprz]

Edit: Rant that probably isn't appropriate online.

 

[ffemt8978]

Human or animal...?

Hoping animal but haven't tried any yet.

 

[Jim37F]

Your fire medics sound even worse than the ones I worked with in LA Co, and that's saying something.

But thats sounds more like they don't want to be Paramedics, and only did so because that's the only way their ALS dept will hire them, or only way they can get promoted/get a pay bump enough to actually live on in the Bay area, etc

I doubt if they left their Dept for better opportunities they'd even consider any ambulance based transport agency that wasn't an FD, even an air ambulance. Even if someway somehow your local AMR shop payed more.

 

[Aprz]

Your fire medics sound even worse than the ones I worked with in LA Co, and that's saying something.

But thats sounds more like they don't want to be Paramedics, and only did so because that's the only way their ALS dept will hire them, or only way they can get promoted/get a pay bump enough to actually live on in the Bay area, etc

I doubt if they left their Dept for better opportunities they'd even consider any ambulance based transport agency that wasn't an FD, even an air ambulance. Even if someway somehow your local AMR shop payed more.

I deleted my rant in case anyone wonders who he is replying to.

 

[CCCSD]

I have run into plenty of “medics” who only got that cert to punch the ticket to be hired...

 

[DesertMedic66]

Obviously not a flight paramedic so I may be wrong. This is just what I've research. In California, a lot of flight paramedics have the same limited scope of practice that ground paramedics have. After removing pediatric intubation from the California paramedic scope of practice, there was talk about expanding the scope of practice for flight paramedics and making it state wide, but that hasn't happened yet. The flight paramedic scope of practice still depends on the local EMS agency, and if the local EMS agency didn't write anything specific for the flight paramedic (seems like most haven't), you are just a ground paramedic working on a helicopter. You're just changing the vehicle you work in. Typically, you get paid less, still require >3 years experience, still require things like FP-C so they can meet CAMTS requirement. :/

California Flight Paramedics to Receive New Scope of Practice

In San Francisco this past Tuesday, the California EMS advisory groups EMDAC and EMSAAC gathered for their final quarterly meeting of 2017. EMDAC is comprised of Medical Directors and oversees the …

caparamedic.org

^This was just talk with no change. I hope I didn't break any copyright data or whatever for quoting two paragraphs. I always forget the exact rule. Sorry. :/

It’s a cluster right now in CA regarding flight medics. Last I heard there were 15 counties that have the expanded scope with a dozen more looking very deeply into it.

Even if you are in a county the doesn’t have the expanded scope doesn’t mean you won’t be around and assisting with more aggressive/advanced prehospital care.

Sure I can’t technically give antibiotics however I can create a care plan with my nurse partner that includes antibiotic administration.

Sure I am not technically allowed to make any changes on the ventilator however I can direct my nurse partner to make any changes that I deem necessary.

 

[Jim37F]

So a landslide washed out basically the only road in and out of Kauai's North Shore, so they have Air Ambulances on standby for all 911 patient transport from there

Medevac services on stand-by for Kaua'i's north shore residents

www.kitv.com

 

[GMCmedic]

It’s a cluster right now in CA regarding flight medics. Last I heard there were 15 counties that have the expanded scope with a dozen more looking very deeply into it.

Even if you are in a county the doesn’t have the expanded scope doesn’t mean you won’t be around and assisting with more aggressive/advanced prehospital care.

Sure I can’t technically give antibiotics however I can create a care plan with my nurse partner that includes antibiotic administration.

Sure I am not technically allowed to make any changes on the ventilator however I can direct my nurse partner to make any changes that I deem necessary.

That's annoying. Only differences between Medic and RN here are I cannot bolus Propofol and I can't initiate blood, but I can maintain it.

 

[DesertMedic66]

That's annoying. Only differences between Medic and RN here are I cannot bolus Propofol and I can't initiate blood, but I can maintain it.

If I pick up a shift in AZ I can do anything my company allows. Company wide we don’t bolus propofol.

 

[Aprz]

It's funny because places I've been applying to ask if I am willing to move, I put no, but the more and more I look at it, the more I kinda do. I've just always lived in California. At the same time, the scope of practice between a California paramedic vs anywhere else paramedic vs flight paramedic is so great that I feel like I'd practically have to start as an EMT somewhere else. It's frustrating because I didn't want to become a flight paramedic just for my vehicle to change. Like that part is cool, but I wanted to do the medicine. Locally, there is a CCT-P that does have a decently expanded scope of practice. I am not really sure if that's how it was back when I was in an EMT, but looking at their protocol, it's actually not that bad. Just when I was an EMT there, the CCT-P units were very poorly utilized and underutilized. It got to the point that they were sending the CCT-P units to BLS calls because all they were doing was posting and doing nothing. I really do hope they expand the scope of practice for flight paramedics state wide eventually, but I'm not holding my breath. That article I posted is like 4 years old I think? Ridiculous. Oh well, the place I think I am probably gonna go to I hear has amazing training. After I get hired, if I get hired, and trained, I can reevaluate from there if I want to stay, move, do CCT-P, or something like that.

 

[Tigger]

In San Diego they can still intubate kids. The scope is much higher what I can do on the ground. Depending on the FD you work for, the pay for HEMS can be better(probably not in NorCal), though the benefits and retirement are not close. I was just saying, I can understand if you're the rare FF who loves EMS more than Fire, I can understand leaving for HEMS, I just could never see leaving for AMR.

This is why I work for an FD and not a flight service. Probably would make about the same (though not on 48s) at both places, but the hospital's retirements just don't compare to that of municipalities.

 

[Peak]

I’m mostly deterred by the not wanting to die in a crash over some patient that would have had the same outcome in a ground ambulance bit; and the part where I would have to take a pay cut.

 

[jgmedic]

Your fire medics sound even worse than the ones I worked with in LA Co, and that's saying something.

But thats sounds more like they don't want to be Paramedics, and only did so because that's the only way their ALS dept will hire them, or only way they can get promoted/get a pay bump enough to actually live on in the Bay area, etc

I doubt if they left their Dept for better opportunities they'd even consider any ambulance based transport agency that wasn't an FD, even an air ambulance. Even if someway somehow your local AMR shop payed more.

To me this is the biggest problem with FD based EMS, and IMO why if they dont transport there shouldnt be more than one medic on Fire apparatus. When I teach, I always ask if they're there just to get a badge. If you do not want to do EMS, then you should seek employment in an area where Fire is Fire and EMS is EMS. I try to instill in our probies the mentality that a huge majority of our job is EMS, and we should be devoting equal amounts of training between the two, and you should strive to be an excellent clinician as well as firefighter.

 

[Seirende]

If "play is the work of children," then I am supervising two very hardworking toddlers currently.

All I need is a couple hours babysitting the twins to remember that:
A. Time with children is the best thing this world has to offer
B. I am not ready to be a parent
I have the patience and love for it, just not the energy... maybe if we could adapt an insulin pump for caffeine. In the meantime, being an aunt is my favorite job ever.

 

[Jim37F]

Woot! Officially ended shift with a no hitter!! We were in service and available all day too. Did some driver sustain training (basically I drove the truck around for a couple hours in a combo area familiarization and keeping familiarity with just simply driving the larger/heavier than my own personal truck, truck lol)

Otherwise I cooked using both the pressure cooker and the Air fryer functions of my Ninja Foodi cooker lol, and that was the shift.

Just means when I show up tomorrow for overtime 24hr shift we're gonna get absolutely slammed I bet though

 

[NomadicMedic]

I ran my first ALS call since October yesterday. Like riding a bike.

 

[StCEMT]

Hoping the volunteers will come on tomorrow night. Thanks to them I slept from 2300-0600 last shift. I love having 3 days off after every shift, but I definitely miss night shift when I wake up 2 hours after I fell asleep.