Atlantic City EMS

[FireGuard69]

After having worked at AC EMS for a while, I love it. I cant wait to get a Full time spot I would NOT reccommend it to a brand new EMT, however, I would also not reccomend it to anybody who doesnt have a good amount of 911 experience. It is a GREAT learning experience, but it is a tough gig to get used to.

[Dustdevil]

After having worked at AC EMS for a while, I love it. I cant wait to get a Full time spot I would NOT reccommend it to a brand new EMT, however, I would also not reccomend it to anybody who doesnt have a good amount of 911 experience. It is a GREAT learning experience, but it is a tough gig to get used to.

Sounds to me like you are saying that you don't recommend anybody without 911 experience work 911. Can you clarify that point for me, because I am having trouble making sense of it.

[FireGuard69]

Sorry if that was unclear...

If you have NOT worked 911 before, dont try to jump into a busy system such as AC EMS, or Camden EMS, FDNY EMS, etc. I feel that if I didnt start out somewhere slow, and was mentored, learned the system, etc, that I would have failed miserably going into such a busy system. I have a friend who I work with now who went to AC right after school,and was bombarded with calls, with little experience, and left after less then a week. An experience like that could be devastating for a new EMT, and cause them to leave the line of work.

If you live in the SJ area, start out somewhere like EHT, or Mutual Aid, or Hamiliton Twp., get some experience, learn how to write your charts, do a proper pt. assesment. THEN try to move up by going to a busy system. I am glad that I got experience before I went to AC, or I would have been burned out.

[Dustdevil]

Ah, fair enough. Good point, actually.

But I'm not so sure that washing out the weaklings who are not sufficiently motivated to succeed is necessarily a bad thing. There is something to be said for the "sink or swim" school of training. But for those people who sink, yeah... it sucks.

[FireGuard69]

Well, for those who sink, that is what AMR, Senior Transportation, Ambivan, etc are for :shock:

[scratrat]

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.

PLEASE tell me you are joking?

First of all you need to ride somewhere else other than New Jersey. That system is in the toilet and is only going to get worse.

Second, when all of those medic units are tied up on calls what then?

And how about when the EMTs can't figure out you are not required (which happens ALL the time) and then the caridac arrest goes out down the street with no medics available? Now the medics on your call are tied up for at least 10-15 minutes doing a SNR.

Yes, hospital based ALS up there does have more quality assurance. But if you think for one minute it's less political that way, you are sadly mistaken. Politics up there, as well as my above point, is why I left. Virtua and Atlanticare are both political and most of the medics are miserable and burned out because of unnecessary "since you're here you can evaluate".

And before you get all pissed of at me, I'm not saying all EMTs suck. Some EMTs I would trust my life with more than some medics. But then there's the ones who splint the non-fractured arm because they can't recognize deformity, inability to operate a BVM (yes, it's happened more than once), or the CHF'r on nasal @ 2 lpm whilst sucking on her last breath, the EMT would have noticed if the clipboard wasn't in hand.

The other problem with NJ is the fact that the FAC even exists. They don't have any requirements. They don't even require that an EMT show up on the call. How can a volunteer organization think that it's kosier to send a non-certified person to an EMS call? Or have 8 volunteers show up in personal vehicles but not one of them is an EMT, or they are too busy fighting over incident command to assist on the scene.

I'm sorry for venting, but NJ is a very screwed up system. Do it for a little while longer and you'll realize it.

And to whoever it was that was hired in AC EMS, good job and good luck. They've got some good people there. Learn from them. Also, if the medics give you a hard time UNJUSTIFIED, stand up for yourself and your decision. That's how you earn respect. Don't let them step all over you for no reason. A lot of them are great with educating, and you'll learn a lot from them. You'll figure out who those right quick. Keep a good head and all I can say is make a decision and stick by it!! Good luck.

[Asysin2leads]

At least Scatrat is on my side when it comes to the "New Jersey's EMS system SUCKS" debate.

[scratrat]

At least Scatrat is on my side when it comes to the "New Jersey's EMS system SUCKS" debate.

Oh absolutely.

It's why I left. Why I still had some degree sanity.

I said some...

[678 Responding]

No no, I won't get all pissed off, I like to hear other peoples opinions from all views. No matter where you go, you're going to get the same bull shit, no matter what. Politics ALWAYS seems to find a way to wiggle itself into everything. As for the First Grade Council, I have to agree. You know their motto "75 years of standing in the way of progress." They should be disbanded and everyone thrown in jail for negligence to the citizens of NJ for supporting sub-standard volly squads.

The tiered system would work (I believe) if everyone would truly understand the way it's supposed to operate. Unfortunately, easier said than done. You must also take into account the gross incompetence from your jolly volly squads that gets FAC support, with (if you're lucky) one EMT because they don't want to swallow their pride and become a paid, professional service. The system is screwed up and flawed because people don't want to allow it to work the way it should.

But don't forget, the ALS services here I feel offers a greater quality of prehospital care compared to some other systems (ex. Philly). If I may, where in NJ were you? Did you work for Virtua or Atlanticare? I'm currently in school, and want to get your opinion on these services if you care to share to help me choose when i'm done. Florida is looking awfully attractive also. Thanks!!

[scratrat]

Both actually. I'm sure you know me...