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New Castle County EMS


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It also often results in the inevitable problems of the treating agency looking for excuses to dump patients on the transporting service,

It's not an excuse if the patient doesn't require an ALS transport, plus it allows ALS resources to still be available and the patient still gets the needed transport to the hospital via BLS. I think everyone on this site can say that they are tierd of runing BS calls, and this system allows us to weed that out.

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Yes, I'm completely confident in the ability of LAFD's medic mill, "getting my license for a fire job" paramedic graduates to decide who needs a BLS taxi ride and who doesn't. Also, I plan on using a pack of komodo dragons to babysit my child. :rolleyes: :rolleyes: :rolleyes:

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Actually, one of the things Delaware does right is ALS...and no sales taxes.

In Delaware, ALS is regulated by the state. Under state law a qualified "ALS unit" must have two paramedics. Almost universally ALS care is provided by chase cars.

Some nice things about Delaware's system:

1) Almost exclusively ALS is provided by professional paramedics. No volunteers. It is provided by the three county systems.

2) Care is pretty progressive. Sussex County has every medic performing RSI with a comprehensive system in place to insure skills retention (OR time, etc). Hiring is extremely competitive.

3) There is little call dilution. Each county has maybe 6-8 ALS units that cover pretty decent sized areas. Providers get plenty of experience while serving in a semi-rural atmosphere (higher acuity, less BS).

4) State law requires all EMS units to have ventillators on board. If I remember correctly, it was originaly supposed to be some pandemic flu thing (I guess someone assumed there would be a need for field hospitals...?). Interestingly enough this has expanded to everyday clinical applications.

5) Pretty open drug boxes w/ regional protocols.

6) Paramedics do split (if one is following behind and another call comes out they go to that call), but they run cover units in a similar fashion to police officers. The idea is to have two paramedics on the call, or atleast severe calls.

7) Decent starting pay for the regions. County jobs, county retirement, good benefits.

I have two friends who worked in Delaware. One for Sussex and one for New Castle. Both said the systems were great and very oriented towards progressive ALS care. The one now works at a renowned flight service and credits his experience in NC with getting him that job.

Con: Delaware is boring.

Hope that helps.

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