Any MAST Ambulance workers?

[AMESEMT]

I was just curious if there are any paramedics/EMT's that work for MAST ambulance in KC on the board? I was thinking about going back to KC and was wondering what MAST is like and would you recommend it? I was also thinking about going to MAST for my paramedic internship. Any advice, thoughts, etc...would be great. Thanks!

AmesEMT

[Just Plain Ruff]

Off list if you will, I have a few friends there.

[AMESEMT]

What do they say about MAST?

[UnapprovedUses]

I was just curious if there are any paramedics/EMT's that work for MAST ambulance in KC on the board? I was thinking about going back to KC and was wondering what MAST is like and would you recommend it? I was also thinking about going to MAST for my paramedic internship. Any advice, thoughts, etc...would be great. Thanks!

AmesEMT

I work at MAST. I have nothing but positive things to say about the place. I've worked for other services, and while MAST isn't perfect, it is by far the best place yet. I'll give you a really long answer about it. I've been there for just over a year.

First, it's high volume. You sit in a truck for 8-12 hours per day. There are no stations. Your truck is your station. And you move around all the time. You do a lot of driving. You run a lot of calls. A 12 hour night shift might have between 4-10 calls. Your calls are not always very exciting. There's a lot of low-acuity things like 5 day old cat bites, just got arrested now I have chest pain, random intoxicated guy passed out in the weeds. You know the regulars. There are people that call 4 times a week. People you know by name.

But you also see a TON of crazy stuff. 8 person shootings, self-immolations, dissecting aortas, high speed car wrecks, tons of cardiac arrests, insane amounts of drug overdoses, and just about every medical problem you can imagine. You will see this in your first year.

Transport times are short. There's 3 level 1, and 5 level II trauma centers within a 20 minute drive. There's some 15-20 different hospitals you'll go to in the metro. You will not be spending a lot of time with patients unless they're a cardiac arrest patient. Most transport times are less than 15 minutes, I'd guess.

The expectations are quite high. The reality is that if you're not interested in being a great paramedic, MAST probably isn't the place for you. Coworkers expect a lot of each other. The local health department expects a lot of you. The ER docs and nurses expect a lot of you. People know who is mustard and who isn't. Reputation is very important. Without it, nobody will want to work with you and the hospitals will second guess you. You will have trouble getting orders from online medical control if you consistently screw up.

People also know that nobody is perfect. Mistakes are expected. But learning from mistakes is required. People that don't learn from mistakes don't stick around very long. People that are dangerous, irresponsible, or heartless won't find anyone to work with them and they'll be asked to consider new employment.

You work with one partner all the time. You can choose your partner, your shift, and it doesn't change more frequently than 6 months. There are people who have had the same partner for over a decade. Your partner is either your best friend or worst enemy. A bad partner will get you into trouble, and a good partner will keep you out of it. A good partner makes a 12 hour shift seem like 45 minutes.

You have tremendous autonomy. Refer to my paragraph about being a great paramedic. With great responsibility comes great expectations. You are given, by city ordinance, total control over a medical scene. Not the police, not fire, not anyone else but you. MAST and the City of Kansas City are fiercely protective of ensuring your ability to do your job without interference. Some services have supervisors showing up on every call to tell you how to do things. Not at MAST. It can be very intimidating when you're new. People look to you for all the answers and you're all alone. But you learn quickly that this is a blessing, not a curse. You will have more autonomy than at many other services. Especially as a paramedic because nobody else will have your level of training. My first week on my own, I was thrust into doing incident command on an 8 person car accident over a 2 block area with a 5 unit response. First time for me. It didn't go perfectly, but incident command is one of those things you'll pick up real quick at MAST. And you only learn it by doing it.

Management can be a bit stringent about following all the rules and regs. Particular with respect to your licenses. There is no leeway. You absolutely CANNOT forget to renew ANYTHING. From CPR to ACLS to ITLS or anything. You, by city ordinance, CANNOT work if your certifications are not valid. NREMT is an absolute must. People have lost their jobs over things like this. At the same time, I have found the supervisors and managers to be very interested in helping field crews do their jobs. I had car problems for two days and a field supervisor gave me a ride to and from work, no questions asked. If you have problems with a particular hospital or another agency, the supervisor can step in to remedy the problem so you're not taking the flak from them.

Generally when it comes to coworkers, it's a very congenial and fun environment. There's people for everyone. Some people are light hearted, some deathy serious about their job. Some playful, some somber. Some very straight and narrow, others wild. It's a big organization, so if you're new to the area, you will have no trouble finding people who can give you advice on where to live, or where to find childcare, get your car fixed, what ever. People really want to see you succeed, you just have to ask for help.

MAST runs EMT-B/Paramedic trucks with just a few exceptions. That means as a medic, you're doing all the patient care and writing all the charts. The EMT-B cannot run the call even if its a BLS patient. That's a rule according to the city. Protocol wise, you can view the protocols online. It's a public document.

http://www.kcmo.org/health.nsf/web/protocols?opendocument

Our protocols are very straightfoward. The cardiac arrest protocol is quite unique. Our cardiac arrest save rate is double or triple the national average. We only carry 20 drugs. We carry one IV fluid: LR. Everything is designed for simplicity.

A few highlights:

Only four things need online med control orders. Lasix for CHF. Bicarb for TCA OD. CaCl for calcium channel blocker OD, and morphine ONLY when it is used for CHF.

Some highlights of standing orders:

Unlimited NTG in chest pain. We have NTG paste, too. Morphine is standing orders on chest pain.

Standing order morphine in qualifying patients for "isolated extremity trauma" e.g. sprains, strains, hips, etc. 2 mg q 5 min max 10 titrated to pain relief, LOC and vitals. Nothing outrageous, but until recently we had to call for orders.

Very generous seizure protocol. Have the option of intranasal versed for both pediatrics and adults. Works *extremely* well. Can do up to 10 mg valium on standing orders either IV, or PR.

CPAP is coming in two weeks.

Technical info about MAST:

We have a very good and forward-thinking medical director. We use brand new Zoll M series monitors with NIBP, 12-lead, capnography (for intubated patients only). We have disposable fibreoptic laryngoscope blades.

We're moving to an entirely electronic charting system. Tablet PCs. I think this is a Q1 2007 goal.

We have GPS-based ambulance tracking and routing. It's not perfect, but we have not missed a response time target in over 2 years. And we have some very tight response times -- 9 minutes MAX from the time the call was received. That leaves, realistically, a 7 minute drive time for the highest priority calls. I love it, but a lot of the old-timers prefer the map book and knowledge way. KC is a big area, so it takes a while to learn the streets. We cover almost 500 square miles.

Very neat standby event options. MAST is the only ambulance service that can be used in KCMO. Venues have to have a standby unit for big crowds. The new Sprint Arena brings a lot of famous concerts to the area. The KC Royals and Cheifs all have standby crews on the field and in the stands. Even as a brand new person, you have just as much shot at doing a Chiefs game as a 25 year person.

We're upgrading all our ambulances, slowly. We have a fleet that is now about 50/50 older Braun ambulances and a newer type. The "service truck" style. Those are our red and white ones you may see pictures of or if you have seen the show "Paramedics" when MAST was on that show.

The newer ambulances are Type III AEV Trauma Hawk units. They have an impossible to miss LED light package that is absolutely blindingly brilliant, about the loudest siren I've ever heard short of a Q. Some people love the air horn. Our trucks still have air horns. I'm not really into it, but it has a place. There's a ton of room in the patient care compartment.

Some HR-type info:

MAST is a Union shop. We're represented by the IAFF. Very sensitive political issue and I will not comment on it since there's a lot of pro and anti union sentiment on this board. I'm not going to comment on that except to say that I am comfortable with my job benefits and security. Our pay scale is published online. As if the cost of health insurance. Starting pay for a new medic is $16.82/hr. Your health insurance is fantastic. Premiums are $22/month for single coverage.

Uniforms are paid for. You get your CEUs paid for. By that I mean the class is free, and you get paid to attend. They teach about 60 classes/month that you can pick from. If you start as an EMT, you can go to the MAST paramedic program free.

Good 401k benefits. MAST will simply give you 8% into a 401k. That is not a matched contribution. That's a gift. The vesting schedule is online, too.

It's based on a 42 hour week. So you will have 2 hours of OT each week.

You get a lunch break. An actual lunch break. 40 minutes where you can relax and have a meal. You still might get a call on lunch, but it's rare since your lunch is usually covered by another unit.

The vast majority of shifts will end on time. In the past year, I think I've only been late getting off about 6 times. And it wasn't more than 30 minutes.

--

Long and short: There's a ton of services in the KCMO metro. Not everyone will be happy at MAST. I recommend shopping around to find a good fit. You can look at Overland Park Fire Department, which hires medics. Johnson County Med-Act -- well-respected service I think. They have very nice protocols. Raytown EMS. North Kansas City Fire Department. Belton Fire. AMR in Independence. Gladstone Fire. Grandview Fire. Lee's Summit Fire. Bonner Springs Fire. NRAD EMS. Kansas City Kansas Fire.

If it is "fire" in the name, you will likely need to have FFI and FFII certifications prior to applying. Not always, but likely. The exception is KCK Fire. Being a medic is enough to get in the door, as they'll train you.

So - I love my job. I love where I work, and I love coming to work. It's the best job I've ever had and I don't regret anything about it. That said, not everyone feels at home at MAST and I can understand that. No matter your experience, if you love urban EMS, want to run a variety of calls, and do it with tremendous autonomy, and like being challenged daily, this is the place for you. In an average day, you can find yourself walking into a $4 million dollar home at the start of the shift, transport, then run a call in the most dangerous and economically depressed part of town two hours later. How can you beat that?

[AMESEMT]

UnapprovedUses,

Thank you very much for the response, a long and detailed response. I am originally from KC and grew up seeing MAST ambulances frequently. I am starting medic school in 2 weeks and have to give my top 3 choices on where I would like to do my field internship. MAST is the first. From what I have heard, like you said, MAST is busy and I would get a wide variety of calls and a great learning experience. You answered quite a few of my questions about how MAST works on what goes on. Thanks again for the extremely detailed response! I look forward to doing my field internship with MAST and maybe I might be paired with you!

Ames

[Dustdevil]

Great post, UU. Welcome aboard!

Does mast run transfers too, or EMS only?

[spenac]

Whats the logic behind LR over NS? My new service only has NS, reason being some drugs should not be given with LR. Just curious. Welcome to the site.

Are you management in disguise? :wink:

[EMT City Administrator]

I hope our promo poster is in every station.. or attached to every paycheck. :wink:

[Dustdevil]

I hope our promo poster is in every station.. or attached to every paycheck. :wink:

And anybody lucky enough to work in a non-union shop should send dues to EMTcity every month instead of union dues.

[speedygodzilla]

Great post, UU. Welcome aboard!

Does mast run transfers too, or EMS only?

They run transfers too. I believe this is due to a contract with the city that they are the only allow ambulance service in Kansas City, MO.