Perfect EMS

[NREMT-Basic]

Maybe I am just new enough to EMS or am out of the loop but I have never heard of reponders being stationed at hotels. This sounds a little..well..bizarre to me. I have however, run into lots of volly services so far where responders have ambulances at their homes. We have a volly service just north of me in fact where this is the case. While Dust has a point that many vollys may not live in their district (though in IL i believe they have to) it also seems that it would save time going out and getting in the ambulance parked at your residence than having to drive to the station, get the ambulance and then go to the call.

I am sure there are plenty of things in my post here that will get me blasted my Dust but then it is the little things that make my life complete.

[Timmy]

Well i found it bizarre as well, don’t get my wrong it would have advantages and when you think about it, it seems like a logical idea but it would end up being a tad expensive.

Our ambulance stations are geographically positions for best response times and access ect.

(wow that sounds really stupid)

If you wana have a look at were my states ambulance stations are positioned:

http://www.rav.vic.gov.au/images/area_offices.gif

[Dustdevil]

Whoops I forgot American EMS isn’t government funded… Sorry. :oops:

Forgot? Where did you ever get that idea in the first place? It is wrong.

During normal working hours, Friday and Saturday nights, there is a crew of 2 with a Merc at the ambulance station ready to roll. With 1 on standby.

Out of hours, one medic takes home the Merc and the other takes there first response sedan, when there’s a call out they both respond to the scene.

If there’s an incident involving a lot of patients then everyone gets called in and they have a spare GMC at the station.

Talk about your under-funding! Sounds like a nightmare right there.

I do have an ambulance at my house; it lives in our barn lol… It’s a first aid unit.

There’s only 3 volunteers in my division and we have 2 ambulances so we take them home so we don’t have to use our won fuel.

Forgive me if I am mistaken, but you're not in EMS, are you? If not, when and where you park your ambulances would't really be relevant to this comparison.

[Niftymedi911]

Well to be hontest with everyone I must live in and work for the closest to perfect EMS agency in the USA. Our little corner of Earth doesn't allow Fire/rescue to trasnport. We are 100% publicly and governmentally funded by the county's general fund. Our new budget for this fiscal year is 42 million dollars. Lee county EMS has 30 24 hr trucks and 3 12 hr trucks. All of our trucks are Extended Cab Freightliners built by American LaFrance. So no more Ford's or Vans !!!!!! They are very roomy! We are primary 911 response as well as handle all interfacility transfers, we are in the process of starting our own transfer divison which handle nothing but transfers so that allows the other 30 trucks we have to be primary 911 response. We have an average response time of 8 minutes anywhere in the county. We have 2 helicopters for critical care transports as well as first response to our barrier islands which have no land acess. We are a third service governement ALS transport service, the only one in Lee County. Fire/rescue responds a rescue truck with us to all of our calls. We minimally staff an amublance with 1 EMT and 1 Medic. The busiest trucks carry 2 medics and 1 emt. We work 24 hrs on and 48 off rotation with 3 shifts A,B, and C. We also have 12 hr trucks during peak times of the day to help manage transfers and primary 911. We have many programs in place that were firsts in EMS. We currently operate the first EC-145 helicopter that was built and relased in North America. We have cutting edge medical protocols which allow EMT's to start Iv's in the field as well as watch hep locks and watch lines with clear fuild hanging. this is largly based on the fact that the state of Florida does not honor EMT-I licenses so they make up for it allowing EMT-B's to do it. We also have a very progressive RSI program we call CAM (Crash Airway Management) which allows us to use Etomidate, Succ's and a diprivan drip in the field to intubate a p/t with a difficult airway. Waveform Capnography was just introduced into our system. We use Zoll M series monitors with NIBP, O2 Sat, 12 lead ECG, Waveform Capnography, Pacing, and cardioversion capabilities. We have a total electronic PCR reports system in place using what are called Hammerhead Tablet computers. We use a CAD system with GPS, we have laptops in our trucks in which our calls come through there eliminating too much radio traffic. We also have a maaping system on the laptops which plots the shortest path to an emergency call. the GPS allows dispatch to dispatch the closest unit to a call. We utilize medical priority dispatching. We are now this year unveling a dual response system between BLS and ALS units. We will have 5 12 hr BLS trucks starting to run the BLS calls here in the county. So no more ALS units responding to BLS calls. You are awarded increases for evey cert you obtain and maintain. The county will hire employees who do not have AS degrees but tend to lean towards having a degree. Any management position must have a minimum of a Bachler's degree. Our agency has the full support of the County Comissioners. The agnecy was bought from a private agency in 1972 to provide transport. We currrently have close to 400 employees staffing a total at any given time 33 ambulances 24 hrs a day 7 days a week. We also have one of the country's biggest health systems in Lee county, Lee Memorial Health System. The system is comprised of 6 hospitals throughout lee county. They hold currently a Level 2 trauma center based out of Lee Memorial Hospital which is the only trauma center between Tampa and Miami on the west coast. Our pay is in the process of being updated. We belong to a bargaining union the local 1826 IAFF union which fights for our rights and fair pay amungst the fire districts. We currently are hiring EMT's base salary is 34,425 a year and Paramedics are starting at 49,625 a year. But those numbers will be changing as of November, our union is introducing a pay plan based of years of service. Starting pay for new employees: EMT 38,475 a year Paramedic 52,843 a year. employee's top out after 13 years of service EMT's maximum base is 49,312 a year and Paramedic's maximum base is $74,890. We also have in services and we also train our own through our training department. We are currently on track to start our very own accredited Paramedic Adacemy in February. We also have great potential when it comes to OT. There is no limit on the amount of OT you work. Like for instance I'm an EMT thats been with the county for a year my base is 34,425 but because of my OT I work which is close to a 100 hrs a pay period I'm almost to 50,000 this year. We have a great benefits package which includes 100% paid medical, dental, vision, long term disability, short term disability, as well as a 250,000 life insurance policy. We have paid Vacation and Sick leave. We are also included in the Florida Retirement System which after 6 years you are vested. The county pays your retirement fund. After working for 20 years you have the option of contiuning in whats called the DROP plan which is more money paid into your account. Or retire after 20 years of service. I enjoy working for Lee County EMS, now given there are drawbacks to every agency like the shortages in medics and emts we have which brings the level of OT up but in all we have a niche which is kinda hard to find these days.

If you would like more information please go to our website : www.lee-ems.com/ems/default.htm

[Niftymedi911]

Oh yea by the way the 24 hr trucks are based around the county stationed within the 17 independent fire districts stations. In otherwords our stations are with the fire stations. We actually have bays for them too!!

[web:eda6c48e38]http://www.lee-ems.com/ems/photogallery/2005/05/vick/images/000794_JPG.jpg[/web:eda6c48e38]

[JPINFV]

^^

I got 1/4 through that chunk of text and wondered when the paragraph was going to end. Paragraphs are our friends. They like to be used.

[BEorP]

Were do you draw the line with education? There’s a difference between

paramedicine and medicine. It sounds like we all might as well be doctors to run around in an ambulance.

There's a difference between paramedicine and the first aid or standby medical coverage that you provide, but paramedicine is medicine. I don't mean to be disrespectful to you, but as Dust pointed out, you're not in EMS. Being a first responder or whatever you want to call yourself is not medicine... it's giving out band aids and giving oxygen to the people who are actually sick. I don't mean to bash your organization but I know that being a volunteer "medic" it can be easy to come under the false impression that you have seen and know a lot more than you actually have. For example, it seems that you are big on trauma with your motocross stuff... are you aware that most EMS calls are medical?

What would be the purpose in having a doctor on an ambulance? They are highly skilled and educated but they also know a lot more than they need to (e.g. there is not need to interpret an x-ray in the field right now). There's also EMT-Bs in the US who I would consider no more than ambulance drivers and maybe sometimes give them the credit of being medical technicians. So where do we draw the line? It's hard to say for sure but obviously somewhere in the middle. I think a good start is a four year degree with a large focus on patho to ever be able to call yourself a Paramedic and respond to my family's call for help.

[Niftymedi911]

EMT-B just a mere "driver"??? Yes, we dont have the training like medic's do but theres just no freaking reason to put us down.

Correct me if I'm wrong, but I thought that the most important treatment modality you could use on a p/t was BLS skills before ALS?

So BLS BEFORE ALS BABY!!!!!!!!

There are some great EMT's out there in the USA, and then there are not but for you to say that EMT's in general in the USA are just mere drivers, you can kiss my ass. I am a EMT-B in Fort Myers,FL and I sometimes do better at field sticks then some of my medics I work with. We have more if not the same responsibilities as medic's We have to get you to the scene, and to the hospital safe and in one piece.

Medic's just have cooler tools then we do. LOL

It takes a excellent EMT to become a good Paramedic.

[BEorP]

EMT-B just a mere "driver"??? Yes, we dont have the training like medic's do but theres just no freaking reason to put us down.

Correct me if I'm wrong, but I thought that the most important treatment modality you could use on a p/t was BLS skills before ALS?

So BLS BEFORE ALS BABY!!!!!!!!

I'm not putting you down because you lack the training of Paramedics... I'm not trying to put anyone down, I don't mean to make it personal... but this is just going back to the much discussed lack of education in some EMS systems. I don't think EMT-Ps have enough education either if that makes it any better.

I wouldn't disagree with BLS before ALS as long as it is educated BLS before ALS.

[Michael]

"This is like déjà vu all over again." ~ medical-education ethicist Yogi Berra (b.1925)