Interested in becoming a Paramedic in So. Cal.

[paraloco]

this sounds crazy. The firemonkey medics treat, then call a private to transport? Does the private then have to document everything the fireguys did? I know of tiered systems where a paramedic responder makes the determination if the patient requires paramedic level care, and rides in if the answer is yes. This sounds like they just turf the patient after they've played for a bit. tell me if I'm wrong

[CBEMT]

this sounds crazy. The firemonkey medics treat, then call a private to transport?

In those systems, what usually happens is Fire dispatches an engine, then calls the private to dispatch an ambulance while they're on the way.

In the even more asinine systems, the ambulance crew is required to wait outside the house until the FD crew is ready for the stretcher. 9/10 times all interventions are done prior to that point regardless of transport priority.

[zzyzx]

Dust, the way things work in SD City is that there are fire medics on each engine and a paramedic and an EMT on the Rural Metro ambulances. They respond to call together, and then the Rural Metro paramedic takes the patient to the hospital. The Fire Department used to have its own ambulances, but no more.

In the rest of SD County, most of the fire departments have medics on the engines, and some also have their own ambulances and transport themselves. A few are still BLS. In Chula Vista, AMR has the contract, and they have dual medics on their ambulances.

[AnthonyM83]

ZZ, who is the main medical provider in SD? Is it the ambulance and then fire engine comes to help or is it an ALS fire engine and they then transfer care to the private ambulance?

ParaLoco (and others asking about S. Cali EMS),

In Los Angeles County, FD is the main EMS provider everywhere. There's a few cities that have their own city FD with FD ambulances, such as Los Angeles City itself, Manhattan Beach, Santa Monica. Most other city's contact the LA County FD for fire and thus medical services (they come as a package).

LA county dispatch receives the call and it's concurrently sent to both FD and private ambulance service dispatch computers, who's dispatchers then dispatch their crews. In our area ambulance and FD arrive within 1 -2 minutes of each other on the vast majority of calls (FD has advantage of receiving call straight to their station computer and on the radio, so they get it immediately. Ambulance gets it in dispatch, dispatch needs to read what area it's in, speed dial the appropriate crew quarters, answer in two rings usually, then they get ready and go to rig).

Anyway, each call gets a dual paramedic squad (two FF/Medics in pickup truck-like thing), a fire station (usually just an engine, but sometimes an engine AND ladder truck) usually 4-5 FFs, and an ambulance (I believe five companies partake in the county 911 contract, but only one does 1EMT/1Medic...other 4 are BLS except for their IFT medic rigs that also respond to 911 calls).

If engine is there first, they can cancel the medic squad (I don't THINK they need to have a medic on the engine crew to do this...I've seen crews without any patches do it, but sometimes they don't wear their medic patches) or ambulance. Squad can cancel engine or ambulance. Usually everyone arrives around the same time, though. Ambulance can ONLY be canceled by FD, not by patient, themselves, PD, unable to locate, etc.

Either squad medic or engine medic does assessment, call base for almost everything (due to protocols), then decide to "ship it BLS" or "go for a ride" with the patient in the ambulance. All kinds of things get shipped BLS, either by medics lying on their run sheet, bad patient assessments/interviews, or technicalities on their protocols.

When one crew was once told to do ALS follow-up to hospital 11 month old who fell off his high chair and was "disoriented" (for age) for a couple minutes after (not crying until a couple minutes later), they were aghast. They asked under which criteria and base told them "Judgement". After they hung up, they kept repeating "judgement!? Since when is that criteria?" . . . that left ME aghast. (Only reason they called based in first place instead of just shipping it BLS is that mother wanted to self transport..any patient under 1yro needs base contact for that). . . . so if you're wondering one of the reasons why LA protocols are so limited, the above is an example why.

Anyway, the FD then hands us a carbon copy of their run sheet for us and one for the receiving hospital. We then do a continuation PCR which is usually just VS boxes and "Patient condition/changes during transfer" and a bunch of lines. If it's someone who should have gone ALS, I use that include all the stuff FD left out like "Positive LOC, Blood in Vomit, SOB, clonic-tonic seizure, pain rating, OPQRST, pertinent medical hx, and other details". It's also good practice for writing PCRs. FD PCRs are usually limited to 1 to 3 sentences and 1-3 pertinent negatives and VS.

The patient is considered the FD's patient the whole time, though, as soon as it's time to go, they basically just say "OK, load 'em up guys" and they walk out. Of course, there are some very good fire crews, captains, and medic squadies who are exceptions.

[jwraider]

Mike best of luck to you thought you might be interested in what I'm doing as I was in your exact spot this time last year in San Diego.

I want to be a FF because of what they stand for for me (integrity,courage,compassion and more) and after learning that many FFs in CA need to be medics now I've decided to do both. My background is in computers and I've really enjoyed the medical field / education so far. I don't see these as 2 seperate careers or jobs but that's a whole other argument =)

Anyway 1 year ago I was living in San Diego and was looking at all the same options you are and this is what I did:

1) Attended an accelerated EMT-B course in December in San Jose. Prior to the course I had met with several fire personal and ems personel to prepare myself for the commitmant I was undertaking. One of them gave me an EMT-b textbook which I studied for several mnths on my own before entering the accelerated course. I gained confidence before entering school that I could understand the information and could get alot out of an accelerated or "immersion" style program.

2) Looking at the states many paramedic programs I settled on Santa Rosa Junior college (I have family in the area). The course requires pre-reqs of Anatomy and ECG classes which I took in the spring semester. When you look into different programs remember that not all of them offer the same things. My course has great relationships with local agencies for clinical time and internships while other schools don't. My school requires us to wear a uniform and participate with integrity and a high degree of professionalism which I think is great.

3) I worked (still do casually while attending medic school) on a BLS interfacility ambulance during the spring and summer (about 700 hours). I feel that you do need SOME experience whether it's 911 or interfacility for you to fall back on. There are a 1000 things about an ambualance that you will pick up easily just by working on one that you won't have to worry about as a new medic.

Someone posted that EMTs should have X amount of years of 911 experience before becoming a medic. Well I'm not sure how easy that is to do considering FDs handle so much of the 911 call volume (so RM / AMR might be the only option). But I'm VERY thankful for the time I spent doing interfacility. I'm not saying it's "better" but there are several EMTs in my program who went directly to 911 EMT work who do not have the 100s of hours I do in the back of an ambulance with a patient 1 on 1.

At the same time I'm not very experienced in watching how a medic runs a call and actual BLS treatments (inserting airway adjuncts, CPR) but my point is having one or the other gives you something to build on.

Good luck to you feel free to PM me if you need any help I have a step by step plan for achieving my goal here in the state of CA.

Personally I will jump at any opportunity to serve as a FF/medic where I am now or back in SoCal. I'm not worried about the $$ per say (I do want to support a family someday) but for example the starting pay for a FF/medic up here is in the 70-85k range while I believe SD is closer to 45-50k. There are some great opportunities outside of So Cal so keep your options open !

[jwraider]

whoops I forgot something..

One other thing I didn't hear from FF personal in So-cal was the opportunity to volunteer. Here in Sonoma county there are many volunteer departments. If you have that opportunity it's a great way to gain experience and actually serve a community now as a FF. Some VFD will require you to do a community college fire academy first and some provide their own training. It gives you the option of approaching the fire side first as well and then going onto medic school.

The north county san diego fire academy is really an academy for medics to do and enter a hiring pool for the area FDs (if I recall correctly).

[AnthonyM83]

There are volunteer opportunities here, but still very competitive because everyone wants to volunteer. But I have heard guys at work who either volunteer or are reserves (not sure if it's volunteer or not, don't know that much about fire stuff)

[prettyone]

Say speaking of Southern Cali...Jw, and/or Anthony M83, Saddleback versus Golden West college for the EMT program??

Need advise,,,ty much.

[AnthonyM83]

Don't really know either...I've heard Saddleback mentioned a few times, though....but don't know about the quality.

[TheOldGuy]

I think you are on the right course. I have had a lot of students that did the B-EMT and went right into the Paramedic course without working the road. I discourage this for a few reasons. The main reason is that you get a lot of time and money invested in an education, for a profession that you may decide isn't what you want. Get your Basic, work the road and then decide if this is for you.

If you have a goal of being a firefighter, you will need the EMS certifications for a lot of Fire Departments so they go hand in hand. Still, see if this is what you really want and can handle. You don't want to spend a couple of years in training and several thousand dollars to find out that you weren't cut out for this or that you really don't like.