Tulare County Details
About Tulare County: Tulare county is huge with over 4,000 square miles. The population is over 400,000 and the primary cities are Visalia (pop 150,000), Tulare (pop 60,000) and Porterville (pop 60,000). The rest is dispersed through rural farm towns. Like any county, it has its nicer areas, and gang infested high crime areas. There are major highways, a national forest, national park, lakes, rivers, and some of the richest farming areas in the country. Cost of living is low as far as apartments and houses go. If you are into the outdoors, there is great hiking, fishing, camping, and hunting all over the county.
About the system: the 5 companies (American Visalia, AMR, Lifestar, Exeter, and Imperial) operate a borderless dispatching system. There is one central county dispatch and the closest unit goes regardless of company. All 911 response units are ALS, usually with EMT/Medic. Generally, between the companies, there are 15-20 ALS units to cover that huge area. Despite the thin coverage, response times are surprisingly good. There are a lot of hardworking dedicated paramedics in the system. Most fire departments with the exception of Visalia Fire and Tulare city Fire are BLS departments so you are the only medic on scene. There are a whopping three hospitals in the county, with one being a STEMI and Level III trauma center. The others are small community hospitals. We have an ALS helicopter based in the county for the most serious cases. The system is part of CCEMSA (Freso, Kings, Madera, Tulare counties) so a paramedic license in one of those is good in all of those.
Now on to the companies
AMERICAN VISALIA:
They cover Visalia and the surrounding rural areas. They are an extremely high call volume system with 90% or more 911 calls.
What's the schedules like: 24s and some 12s
Average transport times? 5 minutes in town, 20 minutes in the rural areas or more.
Call acuity: Very many high acuity calls
Morale with every one in those ops: Morale is good from what I have heard.
Of course pay: A little over 12/hour from what I have been told.
AMR Tulare County
They cover Visalia and the surrounding rural areas. They are a high call volume system but more split 50/50 911 and transfer since they have the contract with the largest hospital in the county.
What's the schedules like: 24s with 12s mixed in at times.
Average transport times? 5 minutes in town, 20 minutes in the rural areas or more.
Call acuity: While they run less 911, they still are busy and get decent calls.
Morale with every one in those ops: Morale is high.
Of course pay: A little over 12/hour to start and they are a union shop.
LIFESTAR
They cover the city of Tulare and the surrounding rural areas. They are an extremely high call volume system that calls for mutual aid hundreds of times a year. It is easily 80% of more 911 calls
What's the schedules like: 3 24 hour units and 1 12 hour unit daily.
Average transport times? 5 minutes in town, 30 minutes in the rural areas or more.
Call acuity: Their units in the city get lots of high acuity calls. The one rural unit they have is much slower but does get a lot of trauma calls from the highway and the high crime in some of the smaller towns.
Morale with every one in those ops: Honestly I have heard mixed reviews. They do get run into the ground but no increased staffing has happened as of yet,
Pay: I do not know but I know per diem make more hourly than full time.
EXETER
They cover Exeter and the surrounding rural areas. They are a low call volume rural system that covers a small town that is very nice.
What's the schedules like: 1 24 hour unit and 1 12 hour unit daily.
Average transport times? There is no hospital in town so a minimum of 15 minutes.
Call acuity: They have a low call volume, but due to the nature of the county they do get their share of critical calls.
Morale with every one in those ops: Morale is good from what I know.
Of course pay: I have heard 13 or more, but do not quote me on that. They are not a private company but rather a healthcare district funded ambulance.
IMPERIAL
They cover Porterville and the surrounding rural areas including a large portion of the Sequoia National Forest and a large Indian Reservation. They are a moderate to high call volume system with 75% or more 911 calls.
What's the schedules like: They have 3-5 24 hour units depending on the day. No day cars unless there is a standby for a special event.
Average transport times? 5 minutes in town, 20 minutes in the rural areas or over an hour if in the mountains/forest. They also have occasional calls that require hiking to your patient, sometimes for hours or more.
Call acuity: Very many high acuity calls. They have a good mix of medical and trauma. Also, there is no ALS fire department unlike Visalia and Tulare.
Pay: $12.50 an hour to start.
Morale with every one in those ops: Morale is good and they just got two new ambulances.
If you have any more questions feel free to ask!
