flight-lp

Problems I see............... A) People are willing to do this job for free, so why would they want to pay you............. Many services are not satisfied with the current state of EMS education (god I don't blame them!) C) Many private services have no interest in who they get to staff their trucks, as long as they get paid. Private, for profit systems are businesses first and foremost. D) Pension??? What the hell is that????

It's amazing how a thread can just go to hell overnight! Sorry, but I hate it when people come in with assumptions that they know everything about everyone's scope of practice. So admin, bear with me for a moment, but I think clarification is in order............... FF523 - I have seen a lot of scary things that facilities do. Fortunately, I do not see a high incidence of BLS or non critical care educated ALS units taking IABP's, LVAD's, ECMO's etc......... But, I have also not seen any nurses being involved with an IABP transfer solely for the reasoning of the balloon pumps presence. For one, a Perfusionist is responsible for the pump, not a nurse. I have also performed many IABP transports, by both air and ground, as a Paramedic without the services of a Nurse or a Perfusionist. Only one ever experienced a technical issue (Internal electrical overload causing a complete system failure). Trouble shooting was simple, there was nothing that could be done. The machine's power supply and battery were disconnected and the patient appropriately monitored. So a nurse is not necessarily "the golden standard", ground, air, ship, whatever the mode of transport may be. Despite what your particular experiences and beliefs may be, some Paramedics do operate at an advanced level of practice. Deal with it and stop making accusations that you cannot personal substantiate. Just because it doesn't happen in your world doesn't mean it can be done in ours. BTW-"Pimped"???????? Not really following you on that one, but I also didn't understand it when my 12 year neice said it either.........................

Lee Counties' numbers are based off of a 56 hour work week, as Nifty previously stated. Add the built in OT of 32 hours per check x 26 pay periods and his numbers are pretty close.................

You actually had a great idea in your first post. Austin / Travis County is a wonderful service, all ALS, you can start as a Paramedic instead of that "work as an EMT for a year crap", they have good protocols for all levels, and career advancement is very realistic (special ops, rescue, flight). Cost of living outside of Austin city limits isn't bad and starting pay is some of the highest in the state. The best part is you don't have to be a fire monkey to earn that decent rate! Clubs, young people, 6th street.........................enough said! Check it out......... http://www.atcems.org/ www.atcemsea.org

This is without a doubt the most profound statements my eyes have ever seen........... +5 to you Rid, very well stated and true to the core! I too believe the future of EMS to be an interesting ride. However my ride is soon to end as i will be departing into the world of aviation fulltime. Honestly, I am not going to look back when I'm gone, I believe I have given what I could with the resources that I had at my disposal. I've saved some, I've lost some. I've had appreciation given for "a job well done" and I've been chastised for some that could not be saved. But after 15 years, the only thing I have to show are the lines on my face and the bags under my eyes. I do within my heart a feeling of self satisfaction and pride, but those will not help my back and neck in the morning and neither will provide for my retirement. Plus I am tired of noob's telling me that this "is how we were taught it" and listening with deaf ears when asked to think outside of the box or realize that some with experience might know a more efficient way. I've had enough of slapping c-collars on every fall, a NRB on every patient who says they "can't breathe", and asking "why can't I --insert something an EMT shouldn't be doing at their barely trained level here--?" Time to move on to something that will ensure a future for my family......................... And that sure to hell isn't EMS!

Ditto, nothing there that I need or want.................... (Except maybe a nurse or two!)

Actually the $600,000 figure is for the one and only EMS agency. Fire is taxed separately at a rate up to $.10/$100. I can understand your frustration with money issues, but it sounds like your experiences were within departments with little or no budget savvy knowledge. Regardless of your revenue, an annual budget should be in place for operating costs, including payroll. Bills shouldn't be late, and there are many proactive methods to prevent such a thing. Having to lose money to "get it immediately" is not good business, period. Enough said from me, good luck with your new business, I hope it brings you the return you are looking for.............................

Example ALS transport - $1,000 15% fee to lender - $150 Loss after 100 claims - $15,000 --OR-- You could keep your $15,000 --PLUS-- get tax money to infuse into your budget. Take the $.03/$100 taxation which is common here in the Houston area. For example, if you have 20,000 people in your county / city / whatever and the average home is $100,000 (low ball figure), then their tax would be $30 per year. There is no reason in the world why someone cannot pay $30 / year if they own a home. Take your total from all 20,000 residents and you now have a budget of $600,000. Not too shabby........................ Beats losing 15%...........................

Here is an interesting article concerning factoring................. http://www.allbusiness.com/business-financ...e/260966-1.html

I would caution using terms such as "human ATM machine" and "unlimited funds. They are a little misleading.............. Factoring is not the miracle answer. Especially in a rural environment. In fact, I personally view it as another financial venture out to make a quick buck. Why would you pay someone to get today what you could have in less than 3 months? Most of these agencies charge up to 10 % and require a repay within 90 days. If your current billing practice does not allow for a less than 90 day return, then factoring is going to cause you even more problems as you will then not have the funds to repay. AND THEIR LATE FEES AND PENALTIES ARE OUTRAGEOUS! A quality and efficient billing company can generate a better return, for less money, with less risk and liability. A pose another question for you......... How are you going to pay back the advance when you have a higher percentage of uninsured, underinsured, or government assisted (M-care / M-caid) patients in a rural environment? It is prohibited by Congress to factor Medicare or Medicaid payments. The lenders get around this by taking assignment of the rights of payment (very risky and has the potential for M-care and M-caid to deny your agency any future claims as you are no longer taking primary assignment). Some states do not even allow this to occur. I strongly urge any agency to retain the services of legal council to determine whether or not your state regulation allows this. In short and summation, there are too many "shady" individuals out there trying this and people are bound to get burned.... Please do not take this personally Janmarie, I in no way mean to implicate or insinuate your intentions, but this is not an answer for all............. I still hold solid the belief that funding can and should be generated through community taxation. There is no reason whatsoever why EMS services should be free. Generate some funds from your community, then pay your medics. Show the community the level of professionalism that you can offer them through solid tax funding, paid professional employees instead of unhappy volunteers who devalue themselves and, as an old wise man recently stated , devalue their service. Tax funds are predictable and solid, no risk is required, and it will also help generate some "cushion" funds in the case of the uninsured / underinsured. Tax 'em, period end of story.

Horrible advise :shock: DISCLAIMER - Do not attempt unless you place no value on your extremities or your career! The release on the side of both the ferno and stryker were designed to lower the stretcher with one attendant (without a patient!), not as a primary means of lifting. There is not a safe position to place your hands without worrying about losing some fingers and that particular handle's locking mechanism is not designed to withstand this type of use. Get some extra help and do it right... OR................... Get a Stryker Power Pro. Simplicity with the push of a button...............Can lift up to 750lbs....

It probably won't happen in our life time Rid...................... All of this aggravation, whackerism, and stupidity is self induced by EMS personnel "thinking". We dug our own grave and very few are willing to listen to a way out. Its sad really, partially the reason why I got out................................... These guys are just flat out fu%*&@! stupid. The should be criminally charged with negligence. If I ever overloaded my plane and experienced and accident or incident, I would immediately lose my license and be fined, could possibly see some jail time. Why shouldn't these back woods ignorant morans??????

Puff, puff, pass my friend, puff, puff, pass...................... :twisted: :wink:

:shock: $915 :shock: I am sooooo going to hell! see y'all there! :twisted:

Yea, what he said............ Definately take CCEMT-P first. Better yet, check out this new offering, http://www.emsacademy.us/EMS/Critical+Care.../CICP+MICP.aspx This is what CCEMT-P should have evolved into but didn't. AWESOME course!!! Mike is one of the best in the industry....... The FP-C exam is a bitch, plain and simple. To sit for it without the basic core knowledge of critical care medicine is a complete waste of your money, time, and integrity. I only say that because if you are going to carry yourself as a "certified Flight Paramedic" then you need to know a hell of a lot more than what you will find on the test, or you are of no benefit to the patients who are truly placing their lives in your hands. Unfortunately, too many helo agencies are taking stock in the FP-C exam being the "golden certification" to truly evaluate your critical care knowledge and capabilities. It is a test, nothing more. You will find that if you truly have the knowledge and the drive to undertake a critical care career, then most reputable organizations can see beyond those little letters behind your name. Good luck in your endeavours.............. AK - FP-C is 4 years and a C.E. recert is now available.......... http://www.certifiedflightparamedic.org/cf...l%20by%20CE.pdf

First and foremost, Dr. Bledsoe, welcome to the city, its always a pleasure to hear your views associated with misutilization, especially in the over populated regions of Texas. As a Texas flight medic and a Commercial Pilot, I too am greatly saddened by the current state of HEMS. Yes governmental, or even to some extent, hospital based systems are safer and better equipped. They are also usually more effectively managed. The sad part is that most of them are based where they do not need to be, in the urban environment. Inter-metro area critical care transports can and should be transported by ground with appropriately staffed teams. It is the underserved rural areas that truly benefit from HEMS. However, the majority of these rural areas settle for what they can get. For instance, one company in particular (no names mentioned, but Dr. B and Rid can probably figure it out pretty quick) serves only rural areas. But they do so in under powered, single engine, VFR, non GPS, 20-30 year old helicopters with 20,000+ hours on the air frame. In some cases when fully loaded, a ground ambulance is faster than the helicopter! Unfortunately, I believe it is a problem is an irrepairable one until the FAA and NTSB intervene. IFR aircraft or even dual pilot is not the answer, it will just cause further issues and will not decrease the current accident or mortality rate. Allowing pilots to enter actual IMC conditions off of published airways down to ground level (outside of an airport with a published instrument approach) is unsafe, period. Approach controls and ARTCC's do not have the time nor resources to safely track an IFR medical helicopter. Plus, what happens when a pilot goes to shoot an instrument approach into the hospital helipad and finds that he is still in IMC at his minimum descent altitude? He now has to go to an airport, shoot another approach, then wait for an ambulance to arrive to transport. The only true need for HEMS is now lost; TIME............It is the basis of civilian air medical services. Its not about what the crew is or can do, its how much time can they save for the patient. The feds need to get involved. They need to stop the uneeded growth and corporate greed. Fortunately, courtesy of managed healthcare and federal cutbacks, most air medical reimbursements will be reduced if not cut completely off in the near future, thus forcing many services out of business. Just like most things in this world, it ain't what it used to be! I seriously doubt it will get better....

Words well spoken! I for one would not hesitate to perform it, possibly even before she arrested based on sound conclusive evidence that she was decompensating from her effusion. I am truly surprised at the number of ALS responses that wouldn't due to lack of knowledge about the procedure vs. not having a specific protocol for it. Has this procedure been lost by the wayside? I realize that AHA no longer emphasizes it, but is it not covered in Paramedic school or in continuing education?

I have never been in a situation that I had to have an unlicensed and undereducated EMT partner perform an ALS intervention. A proficent medic knows how to prioritize and delegate. As previously stated the Medic should have been addressing the pain management aspect while the EMT was bandaging, splinting, etc (although based on the arterial issue, pain control shouldn't have even been a priority at the time, more about that down below)......... Yes, and that is why I have another Paramedic or a nurse as a partner.......... You are absolutely correct, I did misquote you and I humbly apologize for doing so............. ABC - C standing for circulation, i.e. bleeding control. Why was this medic already into secondary interventions when the bleeding wasn't even under control? That is a basic day 1 EMT course assessment pearl, yet the issue here is about who pushed the Morphine???????? Actually the exact opposite. The reality is that the medic did not appropriately manage the patients care as previously mentioned................ This is why failed airway adjuncts were invented, 3 attempts then Combitube or LMA. Placed properly, they will provide a more patent and less damged airway than allowing a gung-ho EMT lacerate someones vocal cords! You cannot allow a patients suffering to emotionally alter your care. It causes people to rush, miss pertinant items, and cause errors in care. This being a perfect example. You are right, I wasn't there, had I been, this would not have occured. Plain and simple! I hope your friend learns something from this experience.................

Short and sweet, the EMT should not have pushed the Morphine. If any remote complication would have presented, all the patient would have to do is point his finger at who gave it, and voila, both certifications gone with the wind. While the act of a EMT who is not educated in pharmacology pushing a narcotic analgesic does bother me, the bigger issue here lies with false documentation and the fact that the crew "freaked out". If I was the pt. and I saw my EMS providers "wigging", I would have very little faith in their performance. This medic, feeling hurried by the pts. screams, lost effective control of this emergency. Calmness and composure, 2 essentials for a proficient medic................. Of course the whole legal issue of lying on a run record may also ruin their day............ Two thumbs down to both members of that crew! [-X

Is that what this is all about, getting free CEU's?!?!?!?!? Medicare and most state Medicaid programs REQUIRE patient billing if they are to reimburse. The agressivness of that billing is subject to individual discretion, but if your not billing the patient, then Medicare shouldn't be paying you a penny. My organization is a 503 non profit organization. We bill and we receive tax funding from our community. Our budget is just over 5 million per year, which is almost equally split between the two revenue sources. Due to our ability to generate income, we can also have the nice things that others have described including free CEU's. It costs less than $200 to obtain CEU's for recertification. Now figure the average BLS with no intervention transport. Runs around $500. You do the math.............. Granted, Jersey has some strange laws, but this one may take the cake.

Yea, heaven forbid they have to actually pay for healthcare.................... This topic makes me sick. If you offer a service, there is absoulutely nothing wrong with billing appropriately for it. Too many people demand a quality EMS service, but refuse to pay for it. Yet they pay for their trash and sewer services and don't bitch about them. We humans are a wierd species! I say let them not pay for it, let your funding go to s^#t, and then close your doors. Guarantee the first loved one in your county that dies from a lack of EMS will get you some more funding and one less family that will whine and complain about paying for it. Sad, but true................. I do have a question though. Why the big deal about being "not for profit" or "non-profit"? Just curious.............

Quote of the week!!!!

:shock: :shock:

The money......... The retirement........... The satisfaction that I am making my community a better place............ Being associated with a professional career............. The high educational standards............. The free drugs!!!!!!! (God, i've got to lay off the dope!)

www.ccems.com CPAP, RSI, I/O, Pain Management - Yes Progressive system - In my mind absolutely. To me progressiveness has little to do with what cool things you can do or how many drugs you carry. I believe that progressiveness involves a system that is consistant with its mission and care, provides longevity and stability to both its employees and the community, and one that upholds itself to the highest most professional standards possible. My system has been in place for over 30 years as the same entity, operating with the same mission. We have never "privatized", we never have been forced to do non-emergent transfers to maintain our budget (and thus reducing our availibility to our citizens), yet we still have all of the goodies. A frontline fleet that is less than 2 years old, quality diagnostic and treatment equipment, excellent support and equipment availability for our 1st responders, a superb quality improvement program that involves all parties from our doc on down to the EMT, and CE opportunity paid for by the company. Our field support from the supervisors and management is top notch. Both our operations manager and our medical director routinely respond with the medic unit. Benefits are excellent and most are paid for by the company. Pay is commensuate with the local COL and is negotiable. We currently run MICU only, however as our district is the largest ESD in Texas, we are having to grow with the times and are considering a tiered system. Employment information is available on the website, PM me if you have any additional questions.