Atlantic City EMS

[678 Responding]

Ok here is my take on this all.

New Jersey actually has something good going on here. Hospital based ALS is the way to go. If you look at it closely, their main objective (besides the absurd bill) is to provide maximum patient care Some of these municipal run ALS programs have nothing but politics and tax money in mind. With hospitals you get quality training, quality assurance, top notch equipment, and less of the politics/tax BS going on. Why fix something if it isn't broke. Only about 10-20% of calls are TRULY ALS treats. I'm not talking ALS DISPATCH, but treat.

For example: BLS and ALS get dispatched to a residence for whatever reason, BLS arrives, does an assessment and decides ALS is NOT appropriate and to be recalled. This is the way the system is to work. BLS gets on location, does initial assessment, decides whether to keep ALS, if they aren't needed, they recall the medics and make them available for the next call. There are a lot of ALS dispatches, but only a few are legitimate treats. Where I live here in Camden County, I can have 3 different medic units at my house in about 6-7 minutes or less (provided they were all available). There is absolutely no need for every municipality in NJ to run an ALS program since it isn't tax effective and the quality of care is less than that of the current system. I know if I were the patient I'd feel more comfortable hearing "I'm one of the paramedics from the hospital" rather than XYZ fire department.

As for Intermediates, I have to disagree with everyone here. In New Jersey there is no need for Intermediate level. Once again, if the patient is in need of drugs, advanced airway management, and EKG monitoring, you should have Paramedics in the first place. The Basic provider level does just that, provide basic care. If they need more advanced care they call for paramedics. So you get a patient, its a legit BLS patient, you as an intermediate decide to start a line and hang some fluids. Did you do anything to immediately make that patient any better than what the Basic couldn't have done, after all, it was a legit BLS call. No. If they needed the more advanced care, get a medic.

These fire departments that want to start ALS care in NJ, its never ever ever going to happen. This would be a regress in standards. Cherry Hill lives in a fantasy world.

But what is interesting in NJ is that if a Medic is running on a BLS ambulance and they get a call with ALS, and they transport with ALS, as long as the Medic that staffs the BLS ambulance also works for the same hospital as a medic as the ALS crew, its up to the ALS crews discretion, but the Medic on the BLS truck is allowed to treat as a paramedic. This is because he/shee is covered by their medical director. Now if they were from a different hospital, it wouldn't be allowed. Pretty wild.

[ambman142]

Finally someone who gets it! I am in complete agreement with you on hospital based ALS versus municipal based. I have been saying that the hospital based system was the way to go all along. First let me restate the fact that a hospital based system is better able to provide Medical Direction, Quality Assurance/ Education, Pharmacological Rotation, and Skill Retention/ Competency. I As for EMT-Intermediates, I personally think that if a EMT-B/D is competent enough to attaining a EMT- Intermediate level of certification, then it wouldn't be detrimental for the patient to receive that level of care. Although, I agree that it will never happen again in New Jersey, it does work in other states. As I explained the 3 county Pilot Program was a way to provide at least a ILS level of care to patients that only had a BLS level of care accessible. This was due to the fact that an ALS CN was awarded with a population based criteria. This is not the case anymore and ALS is available for every resident in the State of New Jersey. I do have to respond to you comment that If you have a legitimate BLS patient, that starting a IV & running fluids was not providing any greater patient care than a EMT-Basic. You are right in that statement. but they can provide a greater level of care to patients that require more care than the EMT-Basic can provide. In fact let me remind you that we are all EMT-Basics first & foremost, and build on that certification to the ALS level. The fact is, a EMT-Intermediate can start a IV & run fluids and provide limited pharmacological intervention, when ALS is unavailable. They can also better assist the paramedic, when they arrive, due to a broader Scope of Practice than a EMT-Basic. Yes, a basic provider does provide basic care and a intermediate provider provides intermediate care, and a advanced provider provides advanced care. No one was saying that a EMT-B provide intermediate care. The statement that was made was that an EMT-Basic that was competent enough to attain EMT-Intermediate certification, provide intermediate care. This works in other states, why not in New Jersey.

[FireGuard69]

BACK on topic....

I just ogt my background check infor from Exceptional. Hopefully I will have more info to share soon!

[678 Responding]

BACK on topic....

I just ogt my background check infor from Exceptional. Hopefully I will have more info to share soon!

I work for Exceptional, anything you want to know? Oh, hope you have no points on your license, because there is a good chance they won't even allow you to drive a truck if you do.

[FireGuard69]

678...sorry, i didnt even see you responded!

I got hired for AC EMS, my physical is this monday, and should *SHOULD* be on first shift the 15th

im stoked as hell!

Even though I do mostly 911 for Mutual Aid Emergency Services for Somers Point, AC EMS is the place to go to get experience

[678 Responding]

Cool, glad you got it. I'm going to tell you that most of the calls you are going to get are BS with the occasional stabbing and shooting. So you're pretty much a taxi ride since the hospital is in such close proximity that you really don't get to do much before you're pulling up to the ER. Good luck and have fun.

[FireGuard69]

Yea, thats what I had pretty much heard, but its gotta be better then Somers Points 1 or 2 calls a day, and I want to be damn good at BLS before I go to Medic School

[678 Responding]

I think you're in luck, because AtlantiCare I believe is heading up a new Medic program, so you wouldnt have to go all the way to Blackwood (where I am) which is a hike, or even philly for that matter.

[FireGuard69]

THAT would be pretty cool

[scratrat]

First, I apologize to anyone I might offend. This is a late reply, because I just now found the blog.

Whoever it was looking for a job, stay away from Atlanticare. They will only make you miserable. They became another MONOC, you're just a number to them now. You would hate it there.

About the hospital based two tier system.....it sucks. And here's why. Having first hand knowledge, I cannot tell you the number of times we were on scene where we didn't need to be, and a call would go out right down the street. You couldn't take it because you are already commited. The next available medic unit is 15-20 minutes away. How is this a good system? It does not work. Yes, only 20% of dispatches are actually ALS calls, but most of the time BLS couldn't recognize this, especially since there is very little QA on an EMT level. "Well, since you're here you can evaluate", was the reply most often by EMTs'. Well that's effective. Let me hold your hand why the cardiac arrest goes to the hospital without medics on board. A system that works is 1 medic 1 emt. You are always guarenteed an ALS response to every call. You no longer have the problem of "ALS unavailable".

As far as EMT-I's go, not in Jersey. I've seen too many EMT's with 10+ years experience who can't even operate a BVM correctly and you want me to trust tht person with a laryngoscope? I don't think so!

Sorry, I just had to vent that.....I feel better now