Anyone know about Monroe County, FL EMS?

[AnthonyM83]

Just wondering if anyone was from that area or could tell me who runs the local EMS? Particularly Key West, but also the rest of the county. Is it Fire and privates? Who transports? Who provides ALS and BLS responses? Any idea of wages and job opportunities (I heard FL is a bit saturated with EMTs right now).

[VentMedic]

124 miles of narrow county property

3 hospitals (Miami is nearest trauma and NICU higher then Level 1-which is in Key West)

Monroe County EMS and FD

A few volunteer FD

Key West FD

AMR for the city of Key West

http://www.emsvillage.com/career_center/item.cfm?id=177

One scene/interfacilty Sheriff's medical(?) helicopter - Trauma Star (that forgot to get the interfacility contracts with the hospitals)

One private medical helicopter

Rescue Medical helicopter from Miami for the northern part of the county (in dispute with Monroe sheriff's)

Average salary $35k - $45k

Cost of living makes SF look reasonable.

www.keysso.net

http://monroecofl.virtualtownhall.net/Page...nnel/employment

http://www.keysnews.com/

www.keynoter.com

[AnthonyM83]

Thank you! That was very helpful.

Do you happen to know how Key West works? Is FD first responder who hands patient over to AMR medics or is AMR used mainly as a transport company using FD medics?

[VentMedic]

I honestly don't know the EMS arrangement but I think it is like the one in Oakland,CA with AMR. AMR also does the ALS "cath runs" to Miami for the hospitals via ground. That's a 2.5 hr trip each way. Sometimes they bring another AMR truck from Miami and sometimes they'll run an extra truck from KW.

Give AMR or KW FD a call. I'm sure they wouldn't mind hearing from someone off the island. It's got that neighborly small town feel with island Bubba politics.

AMR-Key West

1414 1st St

Key West, FL 33040

Phone: (305) 296-2401

[medic511]

I was a medic in Lower Keys for some time.

Key West Rescue is an AMR operation. They have 24 hour shifts, with many of the part time shifts filled in 12-hour blocks. I think they are still 8 am to 8am. They are licensed as ALS and serve only the city of Key West, which includes the island of Key West and the northern half of Stock Island (which is the part of the island with the Sheriff's Jail which serves the whole county, and ALF elder care facility, a nursing home with a dubious history IMHO, a couple of deluxe condos and a golf course, as well as the Lower Keys Medical Center hospital owned by HCA).

Usual staffing is two street trucks and one or two on-call inter-facility ground transport trucks. A typical shift will have three medics and one EMT as well as a Supervisor, who is always a medic and responds in a non-transport truck to critical calls or calls when both street trucks are already on calls. Medical Director is Dr Joe Nelson, who is the best. The Manager and Supervisors were always fair, fun, reasonable people while I was there. Protocols are liberal and include RSI. Transport times are very short.

First Response is provided by Key West City FD. Almost always (by now, probably always) there is an FD medic as well as several EMTs. Probably about half of the FD medics are also PT or FT medics for KWRescue, so pretty much everyone knows each other. I felt that the AMR operation was excellent, far above average, but I'm probably biased!

Down sides include no better than average pay and a LARGE unfunded homeless population and resulting relatively high number of transports to ER with patients who really need only a few hours in the drunk tank, but the jail (the only one in the entire, 125 mile long county!) refuses to take intoxicated prisoners, so the ER staff gets to baby sit them until sobriety returns and discharge to street is possible. Another down side is the limited availability of housing within Key West itself, and extremely high cost of housing anywhere in the Keys. Be very sure to carefully check this out before considering the Keys.

Pluses are part-town USA, excellent (if damp) weather, really laid back people, reefs (water quality is failing faster than the mortgage market however). Rescue also just recently moved into a great new facility, long past due as we had a slowly rotting single-wide trailer when I was there. One crew and supervisor sleep at there and the other crew sleeps at Fire Station 3.

Rescue and Monroe County FD provide mutual aid and cover each other from Big Coppitt Key (mile marker 10) to Stock Island.

Marathon (at mile marker 50) has its own FD based ALS EMS program and handles most intra-facility ground transports from Fisherman's Hospital. This program broke off from the County about two years ago and seems progressive. Usually a medic and EMT are partners.

Islamorado is also incorporated and provides EMS through it's FD.

Key Largo EMS is legally affiliated with the FD special service district but operates under its own management and has a very distant relationship with the FD. It has a somewhat unusual structure the full details of which I am not certain. Basically, ambulances respond with PT, paid medics and meet volunteer EMTs enroute or on-scene.

The rest of the county is served by Monroe County FD and the sole surviving truly volunteer FD, Sugarloaf. (www.sugarloafVFD.org) County EMS has one medic and one EMT per truck. The medic always treats the patient and the EMT always drives. Career fire service is relatively new in Monroe County although career EMS began in the mid 1980s. There have been growth and volunteer versus career issues but things seems to be working out more recently. I think that BC Boswell leads the EMS operation and he is extremely well-trained and I liked him.

I found Key West Rescue an enjoyable and good natured place to work. Anywhere in the Keys has a fairly large amount of trivial drama, but many places do.

If you have more questions, please feel free to ask or PM me.

[web]http://sugarloafvfd.org[/web]

[VentMedic]

Lower Keys Medical Center hospital owned by HCA

Lower Keys and Fishermen's Hospital (Marathon) are owned by HMA - Health Management Associates.

Mariners Hospital - Upper Keys is owned by Baptist.

AMR does almost all interfacility transports off the islands that does not go by Flight.

Except for HBO and transporting a "well baby" from Fishermen's to Key West's Level 1 nursery, there should be little reason to transport between hospital facilities within the Keys. However, in recent years, there have been a shortage of specialty physicians. This then leads to the problem of transporting broken bones to whatever hospital has ortho or whatever specialty.

Getting to the mainland for health care can be very expensive for the pt. The hospital in Key West is the largest and provides a fair amount of community hospital services. Fishermen's and Mariners are very small and offer a limited number of services. It truly is not the ideal place to live if you have serious health problems or expect a complicated pregnancy.

Throughout the Keys you will have serious trauma calls with head on collisions, boating propellar accidents, moped accidents (KW) and burns from boat/RV explosions.

Nursing homes are now almost extinct in the Keys since Marathon Manor closed.

Marathon's FD is now in a new building also since their old one was destroyed in Wilma.

There are Paramedics and EMTs that live 2 - 4 hours away due to the cost of living in the Keys.

It is relatively easy to get experience in the Keys as a Paramedic or a Sheriff's deputy while waiting for a chance to get on with a mainland department.

[VentMedic]

One more interesting KW news item: 8)

11 January 2008

New Medical Helicopter At Hospital

http://www.kwtn-blue.com/2008/01/new-medical-hel.html

LifeNet, a division of Air- Methods, the largest provider of medical helicopters in the world has contracted with Lower Keys Medical Center to make Key West a permanent base of medical flight operations. Air Methods oversees, partners and maintains more than 200 helicopters, surpassing the number of helicopters in the United States Coast Guard fleet.

On the hospitals helipad right now is the Eurocopter 135. These highly sophisticated medical helicopters become airborne intensive care units for transporting critically ill patients to medical facilities on the mainland. The EC 135 can carry up to 2 patients and up to 4 medical crewmembers at a time and can fly a total distance of 300 miles without refueling. The medical crews of these advanced high-flying air ambulances are the “best of the best.”

“We are very pleased to be able to offer our services and expedite transport for the Lower Keys community,” said Alana Scalia, Base Operations Supervisor for Key West. LifeNet/Air Methods are the only provider that requires all of its programs to be independently accredited by the Commission on Accreditation of Medical Transport Services (CAMTS).

Before being based in Key West, the copter used to take up to an hour to arrive from Miami. Now the crew can be on the helipad in minutes and ready to go on the approximately 50 minute flight to mainland medical facilities.

[AnthonyM83]

Thanks a lot for all that info guys! Just what I was looking for.