Tired of crappy EMT-B EMSA wages

[towheadedmule]

I have had just over a thousand transports in the last year, and probably only 6 of those were pt who would have benefited from RSI. Three were within 3 minutes of the hospital and ODs. Two were OD with a transport of about 7 minutes. Both were nasally intubated with assistance from Versed. One was an CVA pt who I had in the hospital 18 minutes from the time of the CALL to 911. And just for you Rid, that was with a fullest assessment that needed to be done, 2 IVs and scoop and run.

Would I like RSI, yes. We have some areas that have 25-30 minutes transports to the nearest hospital in perfect conditions. I don't know how many intubations we performed last month, but a banner month in transports by setting a record. Over 4000 transports. Successful intubation rate was 91% in the eastern division.

Anecdotal evidence though.

R

[Ridryder 911]

Sorry you feel that is the "fullest assessment" or patients do not need a secure airway. Thus the reason some EMSA medics have to be re-trained. The reasons some employers "cringe" when they see EMSA as a past employer.

Part of the problem is so many are installed into that the "EMSA" way is the only way. Many never realizing what emergency medicine is all about. I don't care if the patient was in the drive way of St. Francis they deserve an airway. Anything less is negligible.

Again, they do have a lot of great medics, so that is why I try to avoid generalization. Unfortunately, many only think inside the box and the current protocols and methodology does not promote anything but to follow protocols and not think .

I do wonder how one receives a call, performs any real assessment, follow a protocol of an IV, ECG, and then e-PCR that one has to complete before going back into service in less than 30 minutes? If one is running nearly two calls an hour. I know most in the Central area is allowed 20 minutes before going back into service to ensure medusa is complete and unit cleaned and the central area makes more responses. Even with this allotment there always remains a shortage, and they have placed sign on bonuses as well as now attempting to pay for EMT's to go to Paramedic school. Albeit, it is still controversial of the programs they maybe considering and the pay off or penalty is extreme if they choose to do so.

Again, let me emphasize there is a lot of good but there is many areas to improve alike anywhere else. Part of the problem though is most assume "it is the best!" because they have never worked anywhere else or have came from a service that was worse. Many cities that are using EMSA are now beginning and planning to start their own EMS services. Tired of the costs, response time, and care provided. I do believe this will cause a problem as well. EMSA has continued to ask both cities (Tulsa & OKC) for millions of dollars to maintain costs. Hence the reason the thoughts and discussion of placing EMS into the FD.

Personally, I would hate to see such a decision be made to place into the FD, in either cities. I would like to see better management techniques and better, broader education for the medics. Even if responding over one call per hour, it has scientifically demonstrated that mental stress and focused attention drastically drops and unsafe measures increases. Is this the best for the patient or staff? No.

Personally, I recommend EMSA for those that want a lot of experience in a short period of time. I do always recommend one not to spend more than one to two years, for many reasons that I won't go into. Longevity is not one of their better aspects.

R/r 911

[towheadedmule]

Sorry you feel that is the "fullest assessment" or patients do not need a secure airway. Thus the reason some EMSA medics have to be re-trained. The reasons some employers "cringe" when they see EMSA as a past employer.

Part of the problem is so many are installed into that the "EMSA" way is the only way. Many never realizing what emergency medicine is all about. I don't care if the patient was in the drive way of St. Francis they deserve an airway. Anything less is negligible.

Again, they do have a lot of great medics, so that is why I try to avoid generalization. Unfortunately, many only think inside the box and the current protocols and methodology does not promote anything but to follow protocols and not think .

I do wonder how one receives a call, performs any real assessment, follow a protocol of an IV, ECG, and then e-PCR that one has to complete before going back into service in less than 30 minutes? If one is running nearly two calls an hour. I know most in the Central area is allowed 20 minutes before going back into service to ensure medusa is complete and unit cleaned and the central area makes more responses. Even with this allotment there always remains a shortage, and they have placed sign on bonuses as well as now attempting to pay for EMT's to go to Paramedic school. Albeit, it is still controversial of the programs they maybe considering and the pay off or penalty is extreme if they choose to do so.

Again, let me emphasize there is a lot of good but there is many areas to improve alike anywhere else. Part of the problem though is most assume "it is the best!" because they have never worked anywhere else or have came from a service that was worse. Many cities that are using EMSA are now beginning and planning to start their own EMS services. Tired of the costs, response time, and care provided. I do believe this will cause a problem as well. EMSA has continued to ask both cities (Tulsa & OKC) for millions of dollars to maintain costs. Hence the reason the thoughts and discussion of placing EMS into the FD.

Personally, I would hate to see such a decision be made to place into the FD, in either cities. I would like to see better management techniques and better, broader education for the medics. Even if responding over one call per hour, it has scientifically demonstrated that mental stress and focused attention drastically drops and unsafe measures increases. Is this the best for the patient or staff? No.

Personally, I recommend EMSA for those that want a lot of experience in a short period of time. I do always recommend one not to spend more than one to two years, for many reasons that I won't go into. Longevity is not one of their better aspects.

R/r 911

LMAO!!!

Aphasic, pressure sky high, blown pupils, diaphorectic, family reports ongoing weakness and dizziness for one week, oh,,,,and unresponsive, good pulse ox and cap, ECG good. '

maybe I should have sat onscene and done the CSS and MSS. Pulled a comprehensive HX from the family?

Or Maybe take her the hospital.

We find that transfer medics frequently have to be retrained to realize what an emergency is and what to do about it.

Is EMSA the best. No. Could things be better. Yes. Our protocols generally work for us. And I have tubed in the bay at St John's and St Francis. If you read the literature beyond JEMS and EMSresponder you'll find that many physicians want to pull RSI from the scope of practice of paramedics due to atrocious intubation rates nationally. Our MD wants us to have rates similar to anesthesiologists in the OR before he will consider RSI.

We ask for money because medicare and medicaid do not like to pay. And if you think those extra monies tack onto water bills are going to go away if Fire takes over, how laughable.

The EMTs that want to goto paramedic school are screened and are volunteers, unlike many Fire medics that were ''forced'' to goto school. I'll take a volunteer any day over a draftee.

Rant off