Niftymedi911

You guys all need to go back to your roots with the attiudes about EMT's, where did every single medic come from? An EMT. Now, I'm not much for supporting EMT's to do ALS care, BLS is EMT's and ALS is Medics, No questions asked, but the bashing of EMT's is getting kind of worn out. Yes, we might not have the higher education levels that you guys might have, thats plain and simple. But EMT's wether you work for BLS or ALS provider are your partners, the people who should be watching your back, I cannot tell you how many times I've saved a medic's ass from write up or even worse injury resulting in loss of work. The EZ IO is ALS, I personally, believe the LMA should be BLS. If we can insert a Combitube which does more damage to an airway then a LMA does, then why not an LMA? Our medical director for my agency allows EMT's to insert LMA's with supervision in the field if the medic cannot intubate. He also allows us to start IV's in the field under medic supervision. The LMA is simply a slide into until it stops not forcing into the trachea. It's a secondary device, I though secondary device's were BLS? If you would like an updated copy of our medical protocol's let me know, the ones on our website are 2 years old, we are unveiling a revised protocol guidlines book, which includes the LMA, and administration of Lopressor we now carry on our trucks. I've also read on here some members' generalizing all EMT's. THAT IS BS!!! Just bc you have some really crappy EMT's does not mean they are all the f***ing same. Who knows, I might just be one of those anomalies who's actually an educated EMT and can do the skills efficently, apprioriately, and safe. I don't know.......

Hey Adam, how did you get the county emblem uploaded?? I tried to do it like 8 or 9 times and never got it to work?? And in refrence to your post. In my opinion the county definately needs to revamp its need / want / cost procedures.

What the hell did they do out in the middle of nowhere on a block of ice? We have 5 Gators, all are 6WD, 2 of the 5 are outfitted with platorm in the back which carries our Stryker MX-PRO stretcher, 2 medics, equipment. The Gator also has LED warning lights, lightbars and siren to move the crowd. We host one of the biggest night parades (Edison Festival of Lights) in the united states with over 100,000 people in attendance.

Lee County Public Safety utilizes the: Astro Motorola 800 Mhz Digital / Simulcasted / Trunked system. We have 24 tower sites throughout the county. Our radios aren't geared for interoperability between Fire-Rescue / Police / LCSO / EMS. We have our EMS-DIS channel which has only but all of 911 EMS traffic, we have 4 EMS tach channels and over 25 county-wide tach channels in which Fire- Rescue / Police / LCSO also have. We also have numerours federal and local government tach channels, as well as state wide Fire Hail / LEO Hail etc. Unless we are on a County-wide tach channel we cannot communicate between the different agencies. Which royall sucks ass when it comes to certain things. When asked, Lee Control ( Lee County Communications Call sign) says we are interoperable when we use the county-wide tach channels but will not allow EMS and fire radios to have the channel. As far as recpition, it sucks in buildings (even with the upgrade in reception available from Motorola factory for use in buidlings) and in the extreme rural areas of our county, otherwise, our radios work in both Charlotte County to the north and Collier County to the south. With 21 independent fire districts, 4 PD depts. 1 Sherrif's office numerous county public works agencies, it tends to get kinda hairy. Considering we only have 1 EMS dispatcher for 33 units 24 / 7 and 4 Fire - Rescue dispatchers, it does get kinda hairy at times. LCSO ( "Lee County" call sign) is the PPSAP and Fire / EMS ("Lee Control") is the SPSAP.

Your called for a 10-18X non(L&S) transfer, you go up get report load the p/t up who is stable, and he turns to look at you and says I don't feel so good, I'm not gonna make it to the other hospital. Sure enough he codes IN THE ELEVATOR, on the way down to the ER. He coded into V-fib and then after the first shock went asystole, never got him back, he died in that hospital 5 minutes away from his bed. Another, when you hear "Medic 1 respond Unknown Distress, 123 Easy St. Response Echo" you get the call on your MDC, the dispatch info on your MDC looks like this: 80 Y/O F U U (Unknow Breathing status / Unknown Alert status) Caller statement: "She stinks". Response: 9E1. Poss Signal 7. LCSO enroute for access. You go 10-97, and you take one foot out the door into a cloud of decomp smell. Another, "Medic 18, respond signal 4, Chiquita and Veterans, Response Echo." MDC shows : Unknown Age Unknown Breathing Status Unknown Alert Status Transportation Accidents: Unknown Number of Patients, Unknown Injuries, Unknown Hazards, Priority Mechanism A-G (High Mechanism) Caller Statement: "A school bus just flipped over in front of me" Response 29E1. Update: LCSO / PD enroute. Update: FD responding 2 engines 1 heavy recue. Update: Off-duty medic on scene advising over 10 p/t's at this time. "Medic 2, Medic 22, Medic 14, Medic 24 respond 2nd, 3rd, 4th, and 5th units to signal 4, Chiquita and Veterans, Response Echo, All units be adised Medic 18 is primary unit and is establishing Veterans Command. All units enroute to Veterans Command, untilize County-Wide Tach 2. Controller Alpha Foxtrot breaking for 10-33 (911 traffic) on Tach 2, all LCEMS units utilize EMS-1" I had that one about this time last year. Over 15 p/t's including 3 Trauma Alerts (Priority 1 Trauma) were transported, 2 by Helicopter, 14 by ground. It was awsome to see the communiction that went on. We arrived on scene and went 98(completed assignment) within 41 mintues of dispatch. LCEMS ALL THE WAY!

Hey Ruff its all good, I could see myself saying the same thing if I read a post like that. I am also sorry for the whole FL mix up thing, I was told that it was the state. But ideally it is actually the medical director who has the authority. Now, someone said this: It's easy to think you're the best when you have never seen another way. You know your probably right, I have worked in various cities private and 3rd service. For example Rural/Metro in Orlando, FL AMR in Miami, FL Manatee County EMS, Sarasota County, FL and a private agency in NJ. In those this is the most progressive agency in FL out of working in the different areas. So I might not have seen it any other way, but I wouldn't want it any other way, to be honest, I'm very happy working for LCEMS. www.lee-ems.com/ems/default.htm That's our agencies website

Boy aren't I the fire starter??? LOL BLS Provider can : Insert Large bore IV's in both AC's running wide open with Ringer's ( oh wait a minute but thats an ALS medication right? Don't just exclude the narcotic's if your gonna be pissy about MS then you might as well be pissy about Ringer's or NS.) ---- You are wrong there - in the US starting an IV Is a ALS intervention - don't tell me that down in Ft. Myers you can start iv's?? We're not being pissy just about the MS, we are pointing out the fact that it's out of the EMT's scope of practice to do anything that is considered ALS We'd be making as big a deal if it was a IV start or a manual defib also. It also revolves around the fact that the medic lied and falsified his report. Saying he did something ALS when his EMT actually did it. You really need to re-read what some of us are pointing out. Look it up, the state of Florida legally allows EMT-B's to start IV's in the field. They do not honor EMT-I so they make it up to us by combining the different qualifications on Basic and Intermediate. And it can be legally documented in the PCR that I started an IV in the field. I've started countless IV's in the field. Believe it or not I've saved my medic's ass quite a few times bc they couldn't get the stick and the p/t needed one and I got like a 22 in the the rt hand with the smallest vein I've ever had to try after. As the manual defib part, all of our monitors are manual and AED compliant, but our agency also offers a 12 lead course in cardiology for EMT's who just as a CEU would like to take the course. I elected to take this. So yes I cannot per protocol manual defib, but I do have a step a head of most of the EMT's here. As in reguards to my attitude, you couldn't tell obvisiously the sracasticness in my post. ( As with nothing but words on a screen) I was being only sarcastic about the whole ALS / BLS thing except for the large bore IV's that I can do. I just like sturring the shit up and I had an open opportunity, you guys left it wide open. Anyway, if you want to go even further read our medical protocols. We are one of the most prograssive systems medically. We can't say # 1 but we pretty damn close!!!! Our medical director loves us. He said to me the other day, he'll be behind me with whatever treatment modality I choose as long as I can produce evidence that it was in the p/t's best interest of their outcome. But it is the truth about being burned, I have had many issues b/c I'm young and they think that they can get away with it. But I do not tolerate it. That instance happened about 2 weeks ago during a cold speel and the lady needed a little help. I was cool for about 10 minutes and then I told her to get the hell back here and do your job. Of course I got my hands slapped by a Duty officer for having the attitude I do with her in front of the p/t, but I got my point accrossed. But yes to tell you the truth, the whole priority 3 ans 2 thing happens a lot down here. And believe it or not there is also (some)instances where medics make priority 3's, 2's.

This is why we have a "shortage" of medics. This whole forum reaks of the "Paramedic God" attitude. What is the difference between ALS and BLS in a trauma scenario? The ALS provider can watch a heart monitor and push medications. BLS Provider can : Insert Large bore IV's in both AC's running wide open with Ringer's ( oh wait a minute but thats an ALS medication right? Don't just exclude the narcotic's if your gonna be pissy about MS then you might as well be pissy about Ringer's or NS.) Airway Adjuncts and/or suctioning the airway in case of respiratory failure or compromise Use BVM to ventilate p/t. Splinting and immoblization in life threating and non life threating instances Rapid GCS assessments Shock and Hemmorage Control Can apply an AED in instances of trauma arrest, in which pretty much the only thing in a trauma arrest your gonna give is the fluid challenge, normally the p/t is asystole to try and fix why the heart is not beating. Unless it's V-Fib or V-tech pulseless, then it's your current ACLS protocol, which is ALS (watching the montior for heart rythm and giving ALS medications) The most important thing a trauma p/t needs is what? Rapid transport to a facility with the necessary surgeons are on staff awaiting p/t arrival. ( aka Golden Hour) But I bet in instance's where you state in your report that you administered NS or LR at the aprropriate rate with an appropriate size IV but in reality the EMT (BLS) spiked it, aligator clipped it to the IV hub and let it rip while you (ALS) were trying to maintain airway, while fire was boarding the p/t. (OMG, thats lying on a run report). Stop with the God attitude it's making the rest of us sick over here. (puking noises) Everyone does it one way or another. For you to deny that you've seen it or let it happen just means your too niave to have a real open mind. Kudos to Dust, should it happen no. Does it happen, Yes. But to deny it when in stances a medic could be busy with something else, Shame on you. But don't sit there and bitch about when that EMT that sits right next to you and watches your back and life to make sure you go home at the end of your shift is in charge of a 80 y/o with "flu" like symptoms, who could use NS or LR to perk up b/c of dehydration, her sat's are boarderline and she has some junk in the lower bases (possible pneumonia) but you don't want to treat her and you leave it to him to treat the p/t. While you sit up front and drive blaring the radio at 0330 AM on a Sunday morning sipping a nice hot cup of Joe and it's 28 degrees outside.

The medic obviously trusted the EMT. It's technically not allowed all ALS drug are supposed to be administered by the medic. But if the medic on the truck trusts you, you have a good working relationship together, he double checks the 5 right's of the medications prior to administration, and keeps the best intrest of the p/t in his mind as well as you. There should no cause for conern. Now if the medic just opensly gives you the med without checking it etc, then I would say there's a problem. Not only that, but what technically are we EMT's? We handle priority 3's with BLS care we are in charge of getting our medics to and from the scene safely, we are also the paramedic's assistant. That's why EMT's and medics work together. Believe it or not I would take any experienced EMT over a second medic on the truck any day. Sometimes medics get used to riding in the back and sledom drive, thus an EMT with experience is technically worth more b/c of the driving experience. Believe it or not it has saved me more then twice, having an EMT that can drive.

When and what channel is Code Blue on? Discovery at 6?

I have to second that BLS save, about 2 months ago, I was responding from out of zone to a call about 10 miles away. FD was on scene in 4 minutes, FD is BLS, they Combitube'd the p/t began CPR via the new guidelines, and then shcoked her twice after 4 minutes of CPR, UEA 10 minutes after dispatched, EMS ALS, We got on scene started 2 lines, contiued CPR, and approx 45 seconds after the lines were started, she came back with a pulse producing rythm, no medications were used!!!! That was a first. And when I mean first, I mean it, this FD is kinda a redneck style department if ya know what I mean. BLS, bear minimum on training, they wear their brother's bunker gear, the senior ones aren't the brightest. Most of the time I kid you not they'll just stand there until EMS gets there. So for FD to get this BLS save it was kinda funky, weird, awsome, and made a believer of the new guidelines out of me! The p/t walked out of the hospital 11 days after the incident.

Whatever happened to that TV show Paramedics on TLC? I used to watch it all the time, it was good to see the differences in services and geographical locations. I used to pick up a lot of the errors the medics or FF's would do. I wish it would come back, I think our agency would be a perfect episode with all the various medical and trauma calls we get. Believe it or not its most legitimate stuff. But everyonce and a while we'll get BS.

I know Lee County isn't in central FL, but Lee County EMS is hiring EMT's and medics, we're a 3rd service government operated ALS transport service. We handle all 911 traffic and 911 and non-911 interfacility transfers. We are the sole transport provider in Lee County. Here's our website: www.lee-ems.com/ems/default.htm EMT salary : $44,562 / yr starting Medic salary: $52,712 / yr starting I also have an ad posted in the classified section: http://www.emtcity.com/phpBB2/ads_item.php?id=63 Look forward to hearing from ya!

Yeah, I realized after I typed it that there was adifference, Lee County, FL is close to 600,000 year round residents and close to 800,000 during snowbird season. (Nov-Apr) I would never want to live in rural, I used to and was hit by a drunk driver, it took 16 minutes for fire to show up which called for a helo. EMS arrived at 34 minutes after dispatch, Then approx 45 minutes after the initial dispatch the helo showed up and 56 minutes later I was in the air on my way to the trauma center. I wasn't as bad as some people but I didnt make that "Golden Hour", if it was anymore life threatening then it was I would of been screwed, (not that it already was) Turns out after my accident I suffered bi-lateral tib/fib fractures to both left and right legs, a 6 inch laceration to the lumbar region of my back and head trauma with LOC. Ended up bitting a tube after I arrived for surgery to repair both legs. The good thing was that the agency I work for now is the one who transported me by air. We handle a 5 county area response with our choppers.

Hey it is not impossible!!!, my agency I work for is a County based 3rd service ALS transport service. We cover over 1,100 sq miles in Lee County with a response time of 9 minutes. We also have 2 helo's which have an average response time of 10 minutes anywhere in the county. We staff 30 ALS units 24/7 throughout the county. We also have 4 additional 12 hr trucks throughout the day. Most of our stations are housed with fire departments, but we also have 7 self standing EMS stations. It is not impossible to do this if you have an open mind to accomodate.

Down here in Fla our agency is doing the same thing when it comes to EMT's starting IV's in the field. I love it.

I'm starting to like Florida more and more :shock:

Lee County Emergency Medical Services Fort Myers, FL www.lee-ems.com/ems/deafult.htm Lee County Emergency Medical Services (EMS) is a Florida certified ground and rotor-wing Advanced Life Support Provider. Lee County Paramedics and EMTs provide care on-scene and during transport to the most appropriate medical facility. Lee County EMS covers more than 1,100 square miles with 30 ALS ambulances, two twin-engine helicopters, two ALS non-transport units, and on-call bicycle paramedics. Each ambulance consists minimally of a State-certified Paramedic and EMT. In 2005, Lee County EMS responded to 74,996 emergency calls and transported more than 1000 patients by air. Lee County's western border is composed of seventy five (75) barrier islands that dot Southwest Florida's gulf coast. Our Mission: To provide the highest quality out-of-hospital emergency medical care and transportation for the residents and visitors of Lee County, Florida. Our highly trained professionals use the best technology to meet the needs of those who require assistance. Lee County EMS has cutting edge medical protocols, including a agressive RSI program called CAM (Crash Airway Management). CAM is a advanced system to manage a failing airway due to trauma etc. We use in order Etomidate, Succ's at its appropriate dosage, and hang a Dripivan drip to keep p/t sedated. CPAP, and the EZ-IO modules has been in use for over 2 years, we have a very aggressive pain mangement protocol. All ambulances are minimally staffed of a State-certified Paramedic and EMT. LCEMS has currently 4 geographical sectors North, South, Cape, and West and each sector has 1 Paramedic Lt. Supervisor Pay: EMT's $39,803 >> $57,790 per yr // Paramedics $43,903 >> $72,512 per yr Hiring Process: All applicants are required to successfully complete the Lee County EMS New-Hire Assessment Center. This assessment process is broken down into four phases. PHYSICAL AGILITY: The physical agility requires individual proficiency with 10 push-ups, 10 sit-ups, 10 jumping jacks, 10 squat thrusts and carrying a drug bag or monitor/defibrillator up three flights of stairs. With a partner, applicants will be required to carry a boarded patient down three flights of stairs. Strap the patient to the board and wheel the patient to and load the patient into an ambulance. With a partner, applicants will be required to carry a boarded patient a distance of about 20 yards. Perform 2-person CPR for a designated time limit and return the boarded patient the about 20 yard distance. WRITTEN EXAM: A 100 question, general knowledge exam based on current state criteria for position applied. A 25 strip, ECG general knowledge exam for Paramedic applicants. EMT applicants must achieve a minimum passing score of 70%. Paramedic applicants must achieve a minimum passing score of 80%. PRACTICAL EXAM: A scenario based exam pertaining to the position for which applicant has applied. ORAL INTERVIEW: Applicants who have successfully completed all other phases shall be eligible to sit for the oral interview. The interview consists of general knowledge questions and situational scenarios, both operational and medical. All applicants must successfully complete each phase of the assessment in succession beginning with the physical agility test in order to continue with the assessment process. Results are tabulated and candidates are ranked in a comparative analysis. Thorough background and reference checks are completed to assure validity of application. All candidates must possess a current State of Florida Paramedic license or EMT certificate. (florida paramedic and emt reciprocity) prior to being offered a position. Beginning May 23, 2005, the Florida Department of Health offers the Florida paramedic exam in 12 locations across the state and also available throughout the United States and its possessions. When determining an appropriate testing site, use the Florida Department of Health and FLDOH-FLPMD – Florida Paramedic Exam as your selection options. Candidates within the specified ranking are offered employment, but still must complete a post-offer pre-employment health exam, drug testing and criminal background check prior to beginning work. This process may take several weeks. For information regarding certification, education requirements or programs, please see the following sites: State of Florida, Office of Emergency Medical Services and Edison College, Ft. Myers, Florida New employees must complete a two week, in-house Orientation Program in preparation for duty. New employees attend a 3 week, 8 hour/day Orientation Academy. This program allows the new employee to become familiar with the general equipment and operations they will be exposed to in their job. Sample Orientation topics include EVOC, HazMat, communications, BLS / ALS equipment review, and lifting / moving patients. Once the new employee has completed Orientation, they are assigned to a Field Training Officer and scheduled to ride as a third person on an ambulance, until they have completed the necessary objectives including understanding of the Lee County EMS medical guidelines to allow them to work alone as lead paramedic or EMT. Work Shifts: Lee County EMS currently has two (2) primary work shifts: 1. 24 hours on / 48 hours off work shift beginning at 0700 hours. 2. 12 hour work shift on a 3 days on / 2 days off, 2 days on / 3 days off in a rotation for 48 hours on one week and 36 hours the following week. Shift times are 2000-0700, 0930-2130 and 1030-2230. Representation In addition to being employees of Lee County, Lee County EMS EMTs, Paramedics, Pilots and Ambulance Maintenance Worker are represented by Local 1826 of the Southwest Florida Professional Firefighters and Paramedics.EMS Collective Bargaining Agreement To apply for a job with Lee County EMS, you can apply on-line or call 1-888-889-8799. Below is a copy of our medical protocols for your gander [web:f4fff115c8]http://internet.lee-ems.com/intranet/publications/documents/medical_guidelines.pdf[/web:f4fff115c8]

No doubt our union Kick ASS!!!!

We have one CO2 Rattler and one Radiation Pager per truck.

The County and our Union the local 1826 chapter of the IAFF last week had just agreed last week on our new pay scale for the next 3 years. Lee County EMS pays the following: EMT's starting is $39,808 and maximum is $57,761 per year Paramedics starting is $43,903 and maximum is $72,512 per year We yearly get a 4.3% COLA increase on top of a 4% yearly raise across the board. Pay is negotiable based on yrs experience and maintained certifications. Exp: CCEMT-P, ACLS instructor, PALS instructor, ITLS instructor,BLS instructor, etc You get a maximum 10% increase in your salary for certifications but I think they're 2% each. Our main work shift are 24 hrs on / 48 hrs off We also have 3 12 hr peak time trucks which work a 12 hr rotation that I'm sure most of you are all aware of. OT is built into our schedule so most of the time you wont have to work. We are paid based on a 56 hr work week and we get 2 big checks with over 40 hrs of OT after working just our regualr schduled shifts for that pay period and one small check. OT is in abundace here and there is no limit to the amount of OT you can do. OT is paid at a rate of time and a half and mandatory OT is double time. Manadtory OT is based on a senority ladder that roates through everybody before it repeats itself. Like me I usually get mandatoried 1 every 2 years. We have full Benefits including 100% paid medical, dental, vision, short term, long term disability, pention in the Florida Retirement System, which means now you work 20 yrs and retire with a full pention. We also belong to a union the IAFF Local 1826 District 2 LCEMS union who continually negotiates with the county for better life here at LCEMS. We also have 2 helicopters, a brand new EC-145 and a BO-105. So for those of you who have flight cert, we are hiring flight medics!!!

We have class C HazMat suits with Masks, pappers, and filters on each of them. Our agency is in the process of issuing our Mark I kits this year. Our EMS Agency is also in the process of obtaining a class B cert for anyone intrested in obtaining a class B cert HazMat. All new hire employee's who complete our FTO academy completes class C hazMat training.

I carry the following: Portable Motorola XTS 3000 Radio with OEM Speaker Mic 2 pair Lg gloves Photo ID Badge with barcode on back to get into depots Nextel phone Shears Company supplied pen light EMS hat Copies of DL,and state certs with some cash 2 Pilot G2 Gel pens Truck Keys HammerHead XRT Tablet computer for completeing PCR's. All PCR's are electronical down here. Wal-mart special Wrist watch (God forebid you show up to work without a watch or a pen you'll get written up) I used to carry stethescope but after a really bad trauma and it getting caught in the door of the ambulance as we tried to load the p/t, that went out the window. Wal-mart special Wrist watch (God forebid you show up to work without a watch or a pen you'll get written up) In our extrication bags I have a helmet extrication coat , leather gloves, HazMat suit with mask and breathing equipment.

Hey Y'all which monitior do you guys think is the better one? Zoll M Series or Lifepack 12

Zolls are Far better then those lifepacks!!!!!