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emtbyker

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    Tulsa, OK

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  1. I hope you're not saying that I have very little EMS experience. I've worked in two of the larger systems in the country and worked in several urban ERs (and one smaller EMS system). As for SSM, I agree that it has problems, but, from a deployment angle what would work better for busy urban EMS? Staff up 24-hour stations like fire, everywhere? SFFD tried it and they're moving towards 12-hour shifts now. It looks like in the end they will move to SSM. How do you meet sub-10 minute response times? Saying that you don't need to respond that fast doesn't cut it. Also how do you cost effectively blanket an urban area with enough trucks to handle volume without being able to move them? I'm not trying to sit here and say SSM is the be all end all. I just haven't seen anyone in this string of posts (and others) say what would be better. There any many Fire based EMS systems in the country that have moved away from station based EMS to SSM or brought a private service into or back intro their response area. PLEASE... point me at some web site that has a study that shows a really workable, proven, model for urban EMS response. I'll be completely honest. I worked as an executive in the computer industry before I came to EMS. Unlike many field medics I do think about the bottomline. To sum up my opinion (and it's just that), SSM is often misused. In smaller urban or urban/rural systems the difference in number of trucks needed is maybe 10%-20% (in many cases another 2-3 trucks would mean no need for SSM). But, to move off SSM in a system like EMSA Tulsa wouldn't we really be faced with needing to add more like close to 50%-100%? Even then, you might still run into response time issues. Willing to be educated... --- Nancy
  2. There's a lot of EMS agencies doing SSM. As for Fire. It seems like it would be kinda nasty moving entire engine companies around all over the place. Moving one rig and a couple of folks around is easier. Fire response times increase when there are multiple incidents in the same area. Make that three+ and everything goes to pot! The good news, multiple fire incidents don't happen in the same areas with the incredible regularity that multiple EMS incidents do. Case in point: Riggs Station 31 (Atwater, CA) has SSM stats that show that when one call goes down there's a high likelyhood that another will go down shortly thereafter before the next station can meet response times. It's spooky but it's true. So Riggs tries to keep two Riggs at the station, even though they may go hours without a call. When one happens, another very, very, often does. EMSA uses System Status stats to change the posting model to meet historic load requirments. As for stress on the crews... At Riggs where I used to work they mixed SSM and 24-hour stations and it's a major nightmare. Getting toned up at 0200 because the status dropped and you needed to go cover a post along the side of a highway for 5 hours. Now, take SSM and mixed it with HPEMS & 12-hour shifts it makes sense. It works for AMR ALCO. It works here too. Sure, we get crazy busy sometimes, at the moment more often then not. Even though I've been here only a couple of months, and my street time at this point is limited, there's a rhythm to it. Sometimes you get into a posting loop, but most of the time you run about a call an hour. EMSA East gives us 20 minute drop times and with the Medusa Tablets it isn't hard to make that. I'd much rather run 12 calls in 12 hours then 10 in 24 hours. Back problems? We're often not in the trucks enough to worry about it! I like to run calls, always have. I was wrecked during most of my 24-hour shifts at Riggs. The 12-hour shifts sucked because they were either near or after a 24-hour shift. Sure, I'm still a tater, but I'm already happy with my choice to come to work here. EMSA East is something special. I left California to come here. We're staffing up to increase the number of trucks on the street too. P+ really seems to take retention seriously and they know that staffing up is key to doing that. I finished that academy last week. There's a reason why EMSA folks have an attitude, we're trained well and given great equipment and protocols to get our jobs done. The academy was kind of like Paramedic graduate school. It wasn't as much about following protocols, we did that in the first 2 weeks. It was about thinking, feeling and knowing what to do. I thanked the folks that put it together. I think that every service that uses 12-lead and ETCO2 cap should be trained the way we are. Of the paramedics I know that have 12-lead in their protocols I know very few that really know how to read them and don't just read the top. Before everyone jumps down my throat I know there's a lot of folks out there that know how to really read 12-leads, but how many services in the US really take the time to train their folks on 12-lead and ETCO2 cap. A handful at best. EMSA is one of that handful. --- Nancy
  3. :x My not so humble opinion on the patch... The gold patch with the rocker has always been that cool thing I will get at the end of the trails of becoming a paramedic. None of the services I worked for used them so, I wouldn't get to wear it. Then... I come to work for EMSA and we wear the registry patches. COOL! What happens? I get here and find out they changed the damn patch, and, guess what, my academy is the first to get the new ones and I'm the first person to get the new ones. The 8 of use folks coming into Tulsa are like the 'one of these things is not like the others' from Sesame Street. The gold is brighter and it just looks like something is missing without the rocker. The almost universal feeling here is unhappy about it. People are saving their patches from old uniforms, etc... I have my one old patch that came with my registry packet. Poo. --- Nancy
  4. [/font:207bb23200] I just started the current academy here in Tulsa, OK. last Monday. 6 weeks (five to go), tough stuff. You hit the ground running. One week and your first of three cracks at passing a 50 for basics or 150 for medics question protocol and procedure exam (80% passing). I have to recert ACLS, AMCLS, PHTLS, PEPP, etc... They have a strong emphasis on making us into "EMSAmedics". They did an incredible amount of work to move me from California. Pay here is the same as for mid-paid CA services. That mean based on the cost of living it's pretty good. Adjusted for cost of living it is like high-paid CA private (which means AMR metro agencies in California). I'm *very* impressed with the management, the staff, etc... I came out and rode along and talked to people before deciding to move here. The total bonus for Tulsa is $4700 ($3500 OK + $1200 Tulsa) You get $1000 for bringing someone in. I've worked in Alameda, CA AMR and Merced, CA Riggs and seen the protocols and equipment of a lot of services and talked to a lot of people. - EMSA East (Tulsa) Employees almost universally love working here - We have almost all brand new AEV Type I Rigs with Fully Loaded LP12s (ECO2, Auto BP, 12-lead) - We carry vents and CPAP - We have what I consider excellent protocols I don't know anything about the Western Division (OKC) accept that Baptist has a hyperbaric chamber. (that's an academy joke) But they may be every bit as cool as East is. Yes, I almost do feel like I drank some Kool-Aid at some point. --- Nancy
  5. Hey All, I teach ACLS and I've run into something that I hear is pretty normal. During a recert class I challenged my students to think during the megacode skill station. Some of the nurses were upset that I made them think and didn't just tell them what to do and give them their certs. When I talked to a medic friend of mine she said "Of course, it's just recert, no one wants to think, they just want their cert." What the hell? Am I supposed to turn out students that don't know their stuff? --- Nancy
  6. In a few weeks I will be interning in East San Jose, CA. That's pretty damn urban! --- Nancy
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