Will the real EMT's please Stand

[JPINFV]

The fire department is dispatched to every 911 call. To the best of my knowledge, there is no way to cancel them, and with short response times, they often beat the BLS ambulance to the scene anyways.

On the other hand, anyone can call an interfacility transport company for ambulance transport. Since there is no regulation in OC or LA for chief complaints that must be refereed to 911 (Riverside County has an entire list of chief complaints that IFT companies are not allowed to transport and instead must direct to AMR for paramedic transport), a BLS ambulance will be dispatched and it is up to the basics on board to determine if paramedics are needed, and if so, if the nearest hospital is closer transport time wise than a paramedic response.

[KAThomas]

JP...Is a fire paramedic dispatched to every call, or do you have the option to transport without them clearing you..I'm just curious, and may have missed it somewhere else.

I can tell you that it has been my exp that the medics have to clear BLS units. I work the 911 for a large portion of LA. JP is right... I have seen some of the most unenthusiastic medics ever. Some are great but it's such a mixed bag.

JP I had an exp that I brought to the "Company" (who asked me how it was my problem)... get this, we pull up on scene and there is a squad with a single medic in it. No matter what, we were going BLS and despite the fact the hospital is well within tolerance and there are no apparent life threats (there was never a plan on Fire's part to ALS the pt from the onset).

[ccmedoc]

I've ended up running transports following calls where the fire department refused to let their private ambulance crew transport a patient to a hospital outside of the closest.

I was just wondering how, if the fire dept. clear you basic, can they dictate where you go.

Do they contract with hospitals, or are they just pushing you around.?

Isn't it up to the patient????

[JPINFV]

I was just wondering how, if the fire dept. clear you basic, can they dictate where you go.

Do they contract with hospitals, or are they just pushing you around.?

Isn't it up to the patient????

I have never worked for a 911 company. I was in the second ambulance that responded to the call and the one that actually transported the patient. From what we were told by a staff member and family member on scene was the medics cleared the patient for BLS and told the staff that, 'since they didn't like their private ambulance crew leaving the area [note: the Orange County in this area is essentially one contiguous suburban city and the prefered destination was not 20 minutes away] , the patient either goes to the nearest hospital or they need to call someone else.' The company that provides 911 ambulance service to that city, ironically enough, also does IFT transports.

By protocol, patients have the right to determine their own transport destination provided it isn't too far (20 minutes) AND they are stable enough to go the extra distance. Whether the patient is being transported by basics or medics is irrelevant.

[ccmedoc]

I'm not trying to argue here but, can you call the hospital or medical control hospital and get permission to go further if the patient desires?

I'll leave it alone now..I was just curious how you guys worked..sounds messed up!

[reaper]

I guess so... the idea here is that complacency breeds an environment that hurts all the good people to the point of forcing them away from what I consider to be an honorable and upstanding job & profession. First on shouldn't be first to wait... I gave oral glucose to a patient who had a BS of 27 by a family members Accucheck, pt meets the criteria... the Engine is waiting for the Squad... why? I did my job AVPU V/S ABC's O2 & Gluc... medics get a BS of 58... push D50 = b/s 157 package and were gone...

How many of my "peers" would wait... along with the 5 EMT/FF from the engine and watch the coma?

This may be why? You gave Oral Glucose to a "coma" pt with a BGL of 27 mg/dl.???

If this is the case, I would rather you wait till ALS shows up. Just talk politics with the family or something! :shock:

[JPINFV]

JP I had an exp that I brought to the "Company" (who asked me how it was my problem)... get this, we pull up on scene and there is a squad with a single medic in it. No matter what, we were going BLS and despite the fact the hospital is well within tolerance and there are no apparent life threats (there was never a plan on Fire's part to ALS the pt from the onset).

Meh, I've heard stories through the grape vine about basics arriving to a 911 call and finding their patient sitting on the curb with a paramedic PCR taped to their chest.

[Dustdevil]

I'm not sure what prompted Boolance's inappropriate outburst. Although the title of this thread doesn't make any sense to me, the original post itself is -- as JPINFV confirms -- an accurate reflection of the conventional wisdom in Southern Kalifornia.

And that really is the bottom line. SoKal sucks for EMS, in every conceivable respect. Garbage in = garbage out. If you want different results, you're going to have to pack your bags and move out of Kalifornia altogether, because it will never, ever in our lifetime change.

Sorry to be the bearer of bad news, but the good news is, the rest of the United States is not even remotely similar to Southern Kalifornia.

Of course, I say EMS in general gets better when you leave Kalifornia, but EMTs really don't. It's still just a three week first aid course that is appropriate only for first responders. They still don't have any business on an emergency ambulance. But you will at least find them respected as capable first responders.

[JPINFV]

I'm not trying to argue here but, can you call the hospital or medical control hospital and get permission to go further if the patient desires?

I'll leave it alone now..I was just curious how you guys worked..sounds messed up!

Working interfacility, I could honestly not care less which hospital the patient requests to go to (within reason, of course, and 20 minutes is more than reasonable. The patient I was talking about was transported to their hospital of choice). To be honest, you can cover a good amount of ground and reach a lot of hospitals in 20 minutes from most places. The 20 minutes is just an estimate, not really a hard limit. Thus it's more up to the paramedic than anything else.

[DwayneEMTP]

Oh great, just what we need another tool bag on EMT city....

-5 for violating Wendy's Law.

You don't like this thinking, so your best idea is to litter the thread with your idiotic insult?

You've been a member what...two weeks and have decided that you know the City needs and what it doesn’t? Give me a break.

He showed you the respect of taking the time to carefully prepare his post and make it easy to read, you should have done the same. Like a grownup.

When I opened this post the first thing I noticed what that it was actually more than two sentences long and in paragraphs! As I read, I found it pretty well written and that it very clearly described an opinion that many basics share, complete with outstanding descriptions of their frustrations and good list of what I believe to be their misunderstandings and misconceptions, from a poster with very few posts.

I would like to think we've talked this subject to death, but it keeps rising, so obviously it needs to be talked about some more. I for one choose to talk about it with someone that is able to spell, and express their arguments clearly.

Statements like the one you made above may make you giggle and feel clever, but they make you look ignorant and childish. You couldn't even be bothered to present an opinion with it...?

Good OP on a much discussed, abused and overworked topic.

On another note...OP, a search would have led you to many relevant conversations that relate to your original post.

Dwayne

Note: Must have been posting the same time as you Dust...No intention of being redundant, but am not going to delete it after taking half an hour to type it... :wink: