Texas EMS

[vntramdc445]

I am looking to move out of Southern California and to Texas and wanted to get some info about how EMS is run in the state of Texas. I performed a search and could only find a little information.

Overall, how is the EMS system in Texas? Are you seperate from fire? (hopefully). Are the units run dual medic? How is the scope for paramedics in Texas? Does the system enable you to think on your feet? Also, how are the hospitals in the different counties?

Also, I am currently an EMT-B hopefully going to Paramedic School soon and I was wondering if it would be in my best interest to go to paramedic school in southern California or wait until i move to Texas to go to medic school.

If anyone has any info I would really appreciate that, or if they work in the state of Texas I would love the insight. Thanks in advance!

[Fox800]

Wow, that's a lot of questions. I will try to answer them one by one.

The EMS system in Texas varies greatly (duh). The quality of care fluctuates depending on where you are. We have urban systems that run their butts off and rural volunteer services that rarely turn a wheel.

The majority of EMS agencies are fire departments. With that said, there are a good number of third services and private companies that provide 911 response.

Texas is one of the states that allows a medical director to specify your "scope of practice", the state sets minimums but doesn't explicitly forbid other procedures. This can create gray areas where rural BLS/ILS providers are authorized to perform procedures that are typically reserved for paramedics. You'll find the standard assortment of paramedic procedures/medications, lots of services have protocols for RSI, the more progressive ones are inducing hypothermia for post-arrest patients, the really spoiled places have things like transport ventilators and IV pumps (cough MCHD EMS cough).

You'll find that the vast majority of paramedic ambulances are set up as medic/EMT or medic/EMT-I, it's truly a luxury to work in a system with medic/medic trucks with both paramedics cleared to the same level (I'm spoiled). The only agencies I know of off-hand that do this are Austin-Travis County EMS and Williamson County EMS. Most services don't wanna cough up the $ to pay for that.

As far as "thinking on your feet" goes, it really depends on the agency. The ones I've worked for give you the ability to think for yourself and apply our clinical "guidelines" as you see appropriate. Other agencies make you call for orders for practically everything.

Hospitals depend on the area you work in. Obviously, the closer you are to a major metropolitan area, the better your choices will be. Some rural agencies may be hours from a basic hospital. Texas does not have a true "trauma system" compared to other states.

This is just my opinion, but I'd recommend taking your paramedic course here in Texas. Doing it in California will instill that fire-based, kick-it-to-AMR, call-for-orders-for-everything EMS mentality. Here you'll have the opportunity to ride with some kickass third services and learn to think for yourself.

[spenac]

I would say the majority of 911 providers in Texas are not fire related but who cares.

As mentioned each service has a medical director that decides what is allowed. In my service we look like a pharmacy with all we carry. Yet other services have no pain meds even. So varys greatly.

Pay also varys greatly. My service which has no ties to fire pays nearly $20 an hour and you are paid all hours on duty. Many services seem to required either free or low paid standby hours so really you do not get the pay they advertise.

[paraloco]

ditto Fox800. We had an entire company from So.Cal come help us during Hurricane Rita. Not long after they went back home, some came back to stay. No calling for orders, no transfers in or out of town, much better pay than what they were getting. Our pay rates are not quite to 20/hour, but then it does not cost as much to live here as it does in Austin or Williamson County. Some places in Houston might make a little more. Its hard to find paramedics, so we hire basics and intermediates(a limited number) and train them up our way, and eventually we will be all paramedic again. Acadian offers 10k, sometimes 20k sign on bonuses depending what area you hire in for, but they have to call in for orders for some things. Some place to inquire about would be ATCEMS, Williamson County, Montgomery County, Harris County ESD1, Baytown EMS, (and maybe LaPorte, but their pay was on the low end last time I checked). Beaumont needs more paramedic applicants. The stack of basic and int. applications would kill you if it fell over on you.

[spenac]

Also, I am currently an EMT-B hopefully going to Paramedic School soon and I was wondering if it would be in my best interest to go to paramedic school in southern California or wait until i move to Texas to go to medic school.

Definitely come to Texas for your Paramedic studys. Will be easier than trying to change location later. At least thats what I think.

If you want rural life look in west Texas, many services paying in the $20 an hour range and in the $13 an hour range for basics. Cost of living is low as well.

[BushyFromOz]

As mentioned each service has a medical director that decides what is allowed. In my service we look like a pharmacy with all we carry. Yet other services have no pain meds even. So varys greatly.

You serious?? There places i yakee land where ambo's provide NO pain relief??

thats just inhumane

[CBEMT]

You serious?? There places i yakee land where ambo's provide NO pain relief??

thats just inhumane

Most of the private services where I am, including where I used to work, carry nothing for pain relief or even siezures. Optional meds= why spend the money?

[spenac]

You serious?? There places i yakee land where ambo's provide NO pain relief??

thats just inhumane

You got that right. It is cruel. Friend of mine got ran over broke his femur and tib/fib. They back boarded and hauled him to the hospital all with no pain meds. That was in a town with over 100,000 people and every ambulance has paramedics. He asked them for pain meds and they do not carry any. Apparently they a fire based service failed in some way in the past so their medical director took most meds away from them. Whats funny is another service that the same medical director is in charge of allows even more than my medical director, but that service is about the only one in Texas as bad off or worse as far as distance than my part time service is.

[BushyFromOz]

Most of the private services where I am, including where I used to work, carry nothing for pain relief or even siezures. Optional meds= why spend the money?

Dude, even our first responders have pain relief here :shock:

Wow, almost a reason not to visit yankeeland :?

[BushyFromOz]

Dude, even our first responders have pain relief here :shock:

Wow, almost a reason not to visit yankeeland :?

Spen, that made me feel physically sick what your friend went through. I remember when i fractured my R tib and tore all the miniscal cartiledge out of my knee, the swelling was pushing on one of the nerves in my leg - it was excrutiating. They gave me 10mg of morph and it did nothing for me. I said to the ambo's "if i hit you and act aggressive, will you midaz me?" The guy looked at me and siad "well you are a bit agitated"

5mg IM and was suddenly at peace with the world

Point is if they didn't have options then i would have been one unhappy punter, how does the public let this happen?? :?