678 Responding

Just as a sidenote, New Jersey does not allow volunteers to be ALS providers, correct? I thought I read that when looking into reciprocity with NJ.

Correct, there are MANY BLS volunteer providers, but all ALS must be PAID and HOSPITAL based. No if ands or buts.

Asysin, I can relate 10000% to this, as I live in Southern NJ, not the shore, but close enough. Where I live there is only ONE, yes people only ONE ALS service in the county with roughly 6 units on the road at a time, serving approx 510,000 people everyday. Now this might not seem like a lot of people, but add 2 major cities, and many towns spread across a decent area, then this presents a problem. All too often we have had ALS units come in from the next county over to cover all the ones already tied up. The system is ass backwards, as only a hospital is allowed to run a MICU program, and you are only allowed to petition to start a program, as Asysin noted with the help from a politician.

This state, for some reason, has a grudge against pre-hospital providers, ever since the start of EMS in the state. EMTs in certain places make way more than medics do, and they wonder why there is such a hardship in finding medics to staff the trucks.

As for the volunteer squads, even though I am a member of a volunteer squad on the side for "shits and giggles", I am beginning to wonder the value of them. Time after time, I hear an "All Call" get toned out, or even 2 squads at a time, because after all, one of the two will respond. This scares me, as 8+ minutes before a squad can even respond let alone arrive on location with BLS services to work a code. Its a sad situation, the state is corrupt from the bottom up. The law makers and politicians don't care about what service people are getting, only what the hospital monopolies are making and what they can shove in their pockets from the lobbyists.

I'm sorry, but this is a PERFECT example of how NOT to run an EMS system, unless that is if you don't care about your citizens and rather rake in the profits from your own monopoly without competition and unfair rules and regulations

Your point is lost. Perhaps you aren't familiar with the terminology though. An ACP is an ALS paramedic. And, as was well explained, it takes an advanced provider longer because he's doing more than taking a pulse, respirations, and blood pressure before transporting. When you have nothing to offer the patient, then yes, you need to get off the scene. But an ACP will in many cases be providing on-scene treatment to the patient instead of making him wait through a ride to the hospital before receiving any care. After all, that is what we are there for. If that takes half an hour, so be it. It still beats waiting until they're seen by a busy ER doctor.

I understand an ACP is an ALS provider, but they arent doctors. There are only so many things you can do on location until you start inventing them. Want a portable lab while you're at it?? There has NEVER been a medical call where I have spent 30+ minutes on scene with ALS personnel. If you can give me a breakdown of an assessment that would take 30+ minutes, that'd be great, because I cant think of many things that should take that long. Any and all ALS I have worked with expect the patient to be on the way to the truck within 10 -15 minutes. You can perform all the assessments you want in the field if there is "nothing seriously wrong", but you know what, if they sit in the ER waiting, they're going to wait anyway until a doctor can get to them and do the same thing over. Sorry, but we assess and treat, not diagnose. Again Lith, this isn't a personal attack or anything, I'm just trying to find justification in it. I'm not the only one that seems that this is a little odd.

If you think you're unsure sometimes as a PCP, just wait til you make the jump to ACP. My average scene time as a PCP was 16 minutes, as an ACP its closer to 25 or 30. Your assessment skills will become more enhanced over time and you'll be sure to leave no stone unturned.

peace

25 - 30 minutes ON SCENE!? HOLY *$%& Batman!! How long does it take to do an assessment. Not trying to bash your style, but I feel that's kind of long. I mean, if someone is having an obvious MI or even unobvious like this case, collect med info, allergies, basic questions, V/S, load and go, continue your assessment and treatment on the way. Even if I spent that much time on a scene as a BLS provider, the medics would CHEW ME UP, as I would anyone else in their position. The only way I can justify spending that much time on a location would be if i had mechanical trouble (stretcher, vehicle) or arguing with the PT to go to the hospital. Like I said, not trying to bash, but just trying to make a point.

In Camden County, NJ we use VHF with a repeater system for Fire and EMS, with separate frequencies for dispatching and operations. Police are on UHF frequencies split up into 4 different frequencies. VHF and UHF is the way to go, as 800 MHz in this area is impossible to get and would be way to expensive to change over.

Where at in NJ are you? Im in southern NJ, and there are many squad down here that would allow you to ride along, and "test the waters." If you want a way to search for local squads, look at the Dept. of Health website, everyone is in there. If you dont have any luck, send me a message, ill see what I can do.

I actually work for Exceptional Medical Transport. We have a BLS and SCT transport system out of West Berlin, NJ, and the 911 system in Atlantic City is also operated by our company. In order to work on the AC shift, you have to work in Berlin for a while until there is an opening. ALS is actually provided by AtlantiCare (Based out of Atlantic CIty Medical Center). Philadelphia EMS is provided by Philly FD, which provides both BLS and ALS services. They're always looking for people. Any other questions, just ask.

My FD does not require us to wear badges on duty. If we're running EMS, we only need to wear a duty shirt and a pair of BDU's. As for special occasions, we have Class B uniforms that all have badges on them. You know, the eagle shield badge. But this is only when we have something going on. Badges do "UP" the profesional image of a department, when used when appropriate, thus we do not recommend using class B's while on EMS duty. (Makes you look like a LEO).

Theyre currently pushing legislation to allow Basics to use LMA's in NJ. Just takes forever to go through. Theyre pretty much dumby proof.

In NJ , we can administer albuterol only if its the patient's prescribed, same goes for epi. However they just approved a bill to allow us to carry epi with us and administer it without prescription, we're just waiting for protocols now.

I was just wondering, how much do you guys charge to respond to a call? I know my squad charges $500 each time we're toned out, and the medics, well, they're just as bad as doctors. Lets hear it!

off the top of my head there are about 3 EMT guys in our squad including me, and more gals than i can even think of. It doesnt bother me, I can work well with em all no matter who it is. Thats all thats important, right?

Well, we had 6 seizures in one night with a full moon. Im 100% a believer. haha

Medics around here are starting to use nasal Narcan rather than starting a line. Learn something new everyday.

I think the whole "certification" vs. "Licensed" issue has to be fixed too. It would allow EMS to be considered more advanced and protected if NR could possibly start pushing for licesure rather than certification. Not only would this give EMT's a more professional look, but no doublty increase quality of care with training. I dont know how it works in other states, but where i'm at in NJ you can either A.) Get your associates degree in Paramedicine or B.) Get a certificate of Paramedicine if you already have a degree already rather than going through the whole spiel. So, if you can get a college degree to be Paramedic and be considered "Certified" and get a college degree to be a RN and be "Licensed", why is Paramedicine excluded from this group? I think its very badly skewed. In my opinion this should be for all levels; Basics, Intermediates, and Paramedics, though I think First Responder should stay the way it is as usually people that are first responders are more or less your fire fighters and police officers that are not interested in making this a "career path" but rather be able to sustain someone and monitor them until EMS can arrive. Just my two cents. Like i said before, and ill say it again. Protocols and education should be standardized throughout the whole country, rather than have one level of care being provided in one state, while over the river you're more likely to survive because advanced care is more readily available.

This is when I say, "County, 678 request FD for lift assist" hahaha.. if me, my partner, and the PD on scene cant do it, then we call FD.

Dont let her starve to death. There are better ways to have someone go. Shes merely existing, not living.