Williamson County EMS is Hiring

RocketMedic

Earl of the Wheeled Chair
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Looks amazing, but 24/48s?
 

aquabear

World's Okayest Paramedic
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Looks amazing, but 24/48s?
Our busiest truck averages 9 calls a shift, so 24/48s are doable and admin looks at moving/adding resources once a unit gets close to 10 calls a shift.

We also have three demand trucks, two work 12hr shifts and one works 10.5hrs x four times a week.
 

DrParasite

The fire extinguisher is not just for show
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all ambulances are 2 paramedics only? any EMT positions?

what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?
 

TransportJockey

Forum Chief
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all ambulances are 2 paramedics only? any EMT positions?

what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?
I know it's an all paramedic agency, with no EMT positions in the field

Hmmm.. One of Cyn's relatives told her that she needs to move to Round Rock, and we both like the Hill country area... Hmmm....
 

RocketMedic

Earl of the Wheeled Chair
4,370
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Our busiest truck averages 9 calls a shift, so 24/48s are doable and admin looks at moving/adding resources once a unit gets close to 10 calls a shift.

We also have three demand trucks, two work 12hr shifts and one works 10.5hrs x four times a week.
It's not the UHUs as much as it is the thought of going back to 33% of your life at work from ~25% for the same pay, same job. I like 24/72 for slower/rural agencies, and I really really really really like the 12-hour peak truck write-my-own-schedule thing I've got going on here. It literally took a disaster to make me work overnight lol.
 

Tigger

Dodges Pucks
Community Leader
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It's not the UHUs as much as it is the thought of going back to 33% of your life at work from ~25% for the same pay, same job. I like 24/72 for slower/rural agencies, and I really really really really like the 12-hour peak truck write-my-own-schedule thing I've got going on here. It literally took a disaster to make me work overnight lol.
If only 24/72 didn't require four shifts of people to make it work.
 

DrParasite

The fire extinguisher is not just for show
4,813
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What that is true, 24/72 use the same level of manpower an 12 hour shifts covering the same schedule.

One of the biggest drawbacks to 24/48 (from what I hear, I have never worked them) is you always feel like you are either recovering from work or getting ready for work; you don't get that extra do to be completely off.
I know it's an all paramedic agency, with no EMT positions in the field
so doesn't that mean the medics end up treating a whole lot of non-ALS needing patients? leading to the issue of skills degradation, because they just don't get to see enough sick patients to maintain the high levels of competency? Wasn't this one of the documented issues with an all ALS system?
 

aquabear

World's Okayest Paramedic
119
75
28
all ambulances are 2 paramedics only? any EMT positions?

what is the ratio of ALS calls (calls requiring ALS interventions) vs BLS ones?
Every truck is dual paramedic, and almost all of our Admin and Clinical Practices staff are credentialed paramedics too. That level of care allows us to have a great scope of care because we have a minimum of two highly trained providers on every scene. We don’t need permission from a supervisor or contact OLMC to do things like DSI/RSI, surgical cric, pericardiocentesis, hang pressors etc.

I don’t really keep track of a “BLS vs ALS” ratio to be honest. The “ratio” does change from truck to truck, but everyone still gets sick patients.

so doesn't that mean the medics end up treating a whole lot of non-ALS needing patients? leading to the issue of skills degradation, because they just don't get to see enough sick patients to maintain the high levels of competency? Wasn't this one of the documented issues with an all ALS system?
The first step we do to make sure we maintain high levels of competency is to hire the right people. Once they pass our rigerous hiring process, they have to pass our academy and credentialing process, which can take up to a year.

Our medics stay sharp with daily peer to peer chart reviews, Senior Medical Officer KPI chart reviews and Station Lieutenant operational chart reviews. These chart reviews allow us to quickly identify problems (individual and system wide) and work toward resolving them.

We also have quarterly mandatory CE classes, monthly mandatory Medic-CE courses, paid card classes and regular SMO station visits where they update field medics with patient care trends, SOC updates/clarifications and airway management skills verification. Our Clinical Practices staff also publish monthly statistics for the clinical metrics we track.

Additionally, every medic must take an annual skills, written, med math and 12 lead interpretation exam in order to remain credentialed.
 

RocketMedic

Earl of the Wheeled Chair
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The medicine is pretty advanced indeed. Do y'all have peak trucks?
 

Bullets

Forum Knucklehead
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surgical cric, pericardiocentesis
How often are you actually doing these procedures? I mean they are cool to say yoou can shove a needle in someones heart but are you actually using it?


RSI i dont think of as fancy, everyone around me does it. You still hang pressors? Around here its all push dose
 

aquabear

World's Okayest Paramedic
119
75
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How often are you actually doing these procedures? I mean they are cool to say yoou can shove a needle in someones heart but are you actually using it?


RSI i dont think of as fancy, everyone around me does it. You still hang pressors? Around here its all push dose
System wide I couldn’t give you exact stats on the two (pericardiocentesis and cric). I’ve personally performed a pericardiocentesis once this year. They are two tools in our tool box that I am glad to have.

We’re using push dose pressors in addition to hanging levophed, again all as standing orders.
 

RocketMedic

Earl of the Wheeled Chair
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How many days a week are these peak trucks, and do they get fought over?
 

Tigger

Dodges Pucks
Community Leader
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How often are you actually doing these procedures? I mean they are cool to say yoou can shove a needle in someones heart but are you actually using it?


RSI i dont think of as fancy, everyone around me does it. You still hang pressors? Around here its all push dose
Push dose pressors are designed to be a bridge. A bridge to hanging real vasopressor infusions. Continuing to bolus vasoactive medications for extended time periods is not good for patients. Use 10mcgs of Epi or dirty epi drips to get your patient through tough times, but they aren't and were never intended to be anything besides super short term measures. If your transport times are short it might not matter I guess.
 
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Bullets

Forum Knucklehead
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Push dose pressors are designed to be a bridge. A bridge to hanging real vasopressor infusions. Continuing to bolus vasoactive medications for extended time periods is not good for patients. Use 10mcgs of Epi or dirty epi drips to get your patient through tough times, but they aren't and were never intended to be anything besides super short term measures. If your transport times are short it might not matter I guess.
NJ, so yeah, transport times are like 5-15 minutes in my area. Only time we would have something long would be an offshore rescue which basically never get ALS until they hit land.
 

Tigger

Dodges Pucks
Community Leader
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NJ, so yeah, transport times are like 5-15 minutes in my area. Only time we would have something long would be an offshore rescue which basically never get ALS until they hit land.
Not to mention the time on scene. It's a little unfortunate that actually mixing infusions is no longer emphasized.
 

RocketMedic

Earl of the Wheeled Chair
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I made one this week...

Back on-topic, if I had to be sick or injured, I would way rather do it in WilCo than anywhere around there. For a lot of people, myself included, they're a very desirable operation. My only qualm with them is their schedule, and that's just because I'm all sorts of snowflake about 'work-life balance' and I really want to use my fancy book learning in more ways than to be the Ash Ketchum of EMS.
 

RocketMedic

Earl of the Wheeled Chair
4,370
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I'm only half-expert, but a lot of y'all from places like CA or NY or wherever with high taxes would find yourselves very pleasantly surprised by what an equivalent paycheck in Central Texas can get you. Austin's pricey, but there's a lot of nice places to live in the Central TX area that are both cultured and affordable.
 

Bullets

Forum Knucklehead
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I'm only half-expert, but a lot of y'all from places like CA or NY or wherever with high taxes would find yourselves very pleasantly surprised by what an equivalent paycheck in Central Texas can get you. Austin's pricey, but there's a lot of nice places to live in the Central TX area that are both cultured and affordable.
So whats a street medic making in Wilco
 
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