Where is the best EMS system?

DPM said:
Specifically it was the reciprocity for me. I'm hoping to expand my scope, at it looks that a move to LAS would limit it further. I think I'm correct in thinking I wouldn't be able to start IV's or give any IV meds, intubate etc until I was an Advanced or Specialty Care paramedic.
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Many Paramedics in the UK no longer intubate. This is largely because they cannot maintain competency. Remember, in the UK, Paramedics are professionally registered with standards of competence set by the HCPC and the accountability is with the individual practitioner at the end of the day. The other reason is well, it doesn't really help and there is good evidence to show this. Indeed I think here we are only averaging about one intubation a month per Officer.

You can start an IV as a Paramedic and give some IV drugs yes.

Because of the professional HCPC registration you have very wide scope in what to do with patients and this seems quite nice; i.e. you are a registered professional who can exercise your own clinical judgement (and on the flip side are responsible for it). Australasia is slowly moving towards registration and it's at least one to two years away. While we have similar practices it would be nice to have some legal weight behind it.

I seriously investigated moving to London, and I have personally been to London a couple of times. It is an incredible world city with absolutely amazing things to do and see and that is not even considering the wider England, UK or Europe. Auckland is an up-and-coming world city but I think we are still five years away from truly being there. I'd go back to London in a microsecond, but I just do not want to move there to work.

If you are young and want some experience I can't see why you wouldn't go especially considering the LAS is actively seeking internationals?

Do a Google for the BBC series "Ambulance" and have a squiz; it's on some streaming site somewhere probably. It's three or four very recent episodes that will give you a bit of an insight.
 
SpecialK said:
If you are young and want some experience I can't see why you wouldn't go especially considering the LAS is actively seeking internationals?
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LAS, that's a great option! It'd be a great experience to live abroad, for sure!
 
DPM said:
So here is my question; where is the best EMS system in the USA? Seattle King Medic 1? Somewhere else? I'm looking for a busy system, that pays at least Ok, with good protocols.
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Define busy..... define pays at least OK, and define good protocols...

There is no system that is the best... Take London Ambulance: http://www.bbc.com/news/health-38077409 for everyone who says it's great, there is always another side of the coin.

If I was looking for an EMS career, I would look at agencies that offered the following: offers positions that doesn't involve me being on the ambulance, so when I get bored/hurt/sick of the ambulance, I can transfer to a different position and not have to change companies, an ability to retire and collect a pension, reasonable cost of living compared to my salary, either a 24/72 schedule or 12 hr shifts, without a frequent flip from days to nights, enough independence to do my job, but the resources are available should the situation require more help, and to have an agency culture of people who want to be there to do the job, not who are just there to collect a paycheck and are miserable but get paid too well to go elsewhere.

As I said, it all boils down to what you want, and if that particular agency is able to provide you with what you are looking for.
 
DrParasite said:
Define busy..... define pays at least OK, and define good protocols...

There is no system that is the best... Take London Ambulance: http://www.bbc.com/news/health-38077409 for everyone who says it's great, there is always another side of the coin.

If I was looking for an EMS career, I would look at agencies that offered the following: offers positions that doesn't involve me being on the ambulance, so when I get bored/hurt/sick of the ambulance, I can transfer to a different position and not have to change companies, an ability to retire and collect a pension, reasonable cost of living compared to my salary, either a 24/72 schedule or 12 hr shifts, without a frequent flip from days to nights, enough independence to do my job, but the resources are available should the situation require more help, and to have an agency culture of people who want to be there to do the job, not who are just there to collect a paycheck and are miserable but get paid too well to go elsewhere.

As I said, it all boils down to what you want, and if that particular agency is able to provide you with what you are looking for.
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Do you know of any systems that fulfil those criteria that you listed?
 
I'm surprised Williamson County EMS hasn't been thrown in this mix. Station based, dual Paramedic 911 service with good protocols, involved medical direction, 55k a year base salary, one of if not the outright best retirement plans in the nation and in a decent location.

Might not meet your definition of busy but not slow either.


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VentMonkey said:
So, my top picks would be one of these types of agencies---with SCEMS being at the top of my list---followed by a solid Texas-based EMS third service such as Wilco EMS. Denver Health (EMS) seems interesting as well.
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Handsome Robb said:
I'm surprised Williamson County EMS hasn't been thrown in this mix. Station based, dual Paramedic 911 service with good protocols, involved medical direction, 55k a year base salary, one of if not the outright best retirement plans in the nation and in a decent location.

Might not meet your definition of busy but not slow either.
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Ahem...;)
 
Seems like Texas has a relative profusion of good services -- is it a matter of flexibility for SOP? Or is it more related to local flexibility for organization? Or maybe...relatively low cost of living and a decent tax base for third services?
 
EpiEMS said:
Seems like Texas has a relative profusion of good services -- is it a matter of flexibility for SOP? Or is it more related to local flexibility for organization? Or maybe...relatively low cost of living and a decent tax base for third services?
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Delegated practice helps a lot. We can do anything our MD wants provided the can show we've been sufficiently educated for it.

Also we have a professional association in the Association for Texas EMS Professionals that lobbies for legislation supporting EMS.

No state income tax means more property taxes and what not which in turn provides more county/city tax base for third services if I understand it correctly as well.


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If you want busy, go to London. They average 5,000 calls to 999 per day and I think on average generate about 4,000 responses. This is for a population of say 8 million people. On average, for a population of 1.5 million we do about 500.
 
Let me say that Qatar is certainly world-class and a very interesting system, particularly for experienced providers.
 
Handsome Robb said:
Delegated practice helps a lot. We can do anything our MD wants provided the can show we've been sufficiently educated for it.

Also we have a professional association in the Association for Texas EMS Professionals that lobbies for legislation supporting EMS.

No state income tax means more property taxes and what not which in turn provides more county/city tax base for third services if I understand it correctly as well.
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That third one is awfully appealing ;)

dutemplar said:
Let me say that Qatar is certainly world-class and a very interesting system, particularly for experienced providers.
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Do you have any suggested reading materials on Qatar's EMS system?
 
EpiEMS said:
That third one is awfully appealing ;)
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I've honestly never known anything else. You do make up for it in property taxes though if you're a homeowner. Average in my area ranges from 6-10k/year for a 200-350k home.



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Handsome Robb said:
I've honestly never known anything else. You do make up for it in property taxes though if you're a homeowner. Average in my area ranges from 6-10k/year for a 200-350k home.



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It's a nice little pay bump. Coming from NM, which has state income tax, to TX, which does not, was a nice little pay bump.

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I know i'm gonna get slaughtered for this, but where I work PDM is actually a really good place to work. I work at the Albany county sheriffs office EMS unit. Albany area is a great place to live, low taxes for being in NYS, there are taxes, but not bad! Pay is great 40k+ EMT 50k+ paramedic(i think, my CC-P partner is well above 50k, but he's also been here a long time).
An excerpt: "The Albany County Sheriff Office's EMS Division is actively seeking Paramedics and EMTs for part-time positions. This includes both County and non-County residents.
BENEFITS: EMTs = $14.05/hr, Paramedics = 21.29/hour, All 911 System, Paid Time Off, Longevity, Uniforms, Training, Monthly Scheduling, Paid Holidays"

few links to show a bit about. I also understand facebook is not a reliable source..
http://www.geocities.ws/45peter/NYalbanyCo.html
http://www.albanycounty.com/Government/Departments/CountySheriff/EmergencyMedicalServicesUnit.aspx
https://www.facebook.com/Albany-County-Sheriffs-Office-EMS-Division-143143805843470/
 
NysEms2117 said:
I know i'm gonna get slaughtered for this, but where I work PDM is actually a really good place to work. I work at the Albany county sheriffs office EMS unit. Albany area is a great place to live, low taxes for being in NYS, there are taxes, but not bad! Pay is great 40k+ EMT 50k+ paramedic(i think, my CC-P partner is well above 50k, but he's also been here a long time).
An excerpt: "The Albany County Sheriff Office's EMS Division is actively seeking Paramedics and EMTs for part-time positions. This includes both County and non-County residents.
BENEFITS: EMTs = $14.05/hr, Paramedics = 21.29/hour, All 911 System, Paid Time Off, Longevity, Uniforms, Training, Monthly Scheduling, Paid Holidays"
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wait a second... someone here is using that funky common core math..... 14.05 an hour doesn't come close to 40K a year for EMTs.....
 
DrParasite said:
wait a second... someone here is using that funky common core math..... 14.05 an hour doesn't come close to 40K a year for EMTs.....
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14.05 was based on an old model. As an EMT-B working on a CCT rig, im at ~$17+-10 cents. They also base that off of 40 hours a week due to the fact they are seeking "part time positions". However, they are hiring for both PT and FT.
 
NysEms2117 said:
Pay is great 40k+ EMT 50k+ paramedic(i think, my CC-P partner is well above 50k, but he's also been here a long time).
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We're talking about around ~2,850 hours a year for $40k as an EMT -- is that typical?
 
EpiEMS said:
We're talking about around ~2,850 hours a year for $40k as an EMT -- is that typical?
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no sir, 40 hours is what they are basing that on as said above. so generally 48 hrs a week is not "unreasonable". 8 hours at time and a half, lowers that down exponentially. if my mental math is right 40 hours a week is about 2100 hours. So i'd venture around 2150? It really is nothing super unrealistic, there are people that do full time EMT work there and are reserve sheriffs in the off time, and make 40k+ and still maintain a personal life.
 
EpiEMS said:
Do you have any suggested reading materials on Qatar's EMS system?
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https://www.hamad.qa/EN/Hospitals-and-services/Ambulance-Service/Pages/default.aspx
http://www.qscience.com/doi/abs/10.5339/jemtac.2016.icepq.106
http://www.emsworld.com/article/12032139/improving-prehospital-care-abroad
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3938867/
http://dohanews.co/qatar-motorists-to-get-alerts-on-the-radio-when-ambulance-approaches/
http://www.qatarisbooming.com/tags/ambulance-service
https://emergencytrauma.wordpress.com/
http://www.nhsq.info/app/media/1190
http://www.medichealth.com/early-warning-score-system-for-ambulance-service/
https://en.wikipedia.org/wiki/Healthcare_in_Qatar
https://www.esri.com/~/media/Files/Pdfs/library/brochures/pdfs/qatar-enters-a-new-era.pdf
http://nricafe.com/qatar-installs-new-devices-to-help-emergency-vehicles-cross-signals/
http://naedjournal.org/content/first-middle-east

Plus the usual JCI, etc...

..some older articles and studies. They are research and pretty aggressive in terms of equipment and science based upgrades.
 
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