Dallas EMS questions

[ArkMedic]

Hello, I'm a Paramedic working in Arkansas and may have the opportunity to relocate to the Dallas area (likely Irving), and I'm curious about Medic work there. My questions are as follows:

Is Texas pro EMS?
What types of drugs do your services carry (RSI etc.)?
How long are your transport times?
How aggressively are you allowed to treat your crashing patients (Surgical Cric etc.)?

The service I currently work for does not have RSI, looks down upon Surgical Crics, doesn't carry Calcium Chloride or Gluconate or allow the use of Bicarb for a Hyperkalemic pt. We are allowed 5mg of Versed to "facilitate" intubation, but we must get medical direction to do so. We also need medical direction to administer any other Narcotics (Valium, Morphine, Demerol).

Long story short, I went to a nationally recognized Paramedic School in OK (A state considerably more pro EMS than AR) where I learned the ins and outs of aggressive treatment algorithms like RSI, Surgical Crics, Vasopressor infusions etc, but for all intents and purposes I may as well be an EMT-B that can start IVs where I'm working. Very frustrating.

Is this experience universal for Medics or will Dallas be good to me?

 

[04_edge]

pm sent

 

[RocketMedic]

Lots of questions here:

Texas is a fairly hands-off state in terms of EMS. The state is not involved in protocols or medical direction, that is the responsibility of the individual agency. The primary function of the state is licensing providers.

Texas EMS runs the gambit from BLS to Basic-With-A-Stick to limited ALS to MICU to full-on Rolling Hospital. It is entirely dependent on your employer.

Transport times are wildly variable, but are generally a horrible way to evaluate services. Even in rural nowhere communities, most calls will be close to the hospital- or so far away that you get bored or tired on the way out. That holds true in both rural and urban envoronments. With tnat being said, a better way to measure an employer is how much they expect to be done on-scene: "scoop and run" or "stay and play".

Protocols are wildly variable.

Where I am, we have RSI, paralytics (roc/suxs/vec), ativan, versed, ketamine, etomidate, fentanyl and calcium gluconate, bicarb, etc. Next door, the "paramedic" fire EMS might start an IV, maybe. Next next door, the ALS service doesn't treat abdominal pain and maxes out at 100mcg of fentanyl.

Dallas is Fire-based, Fort Worth is a PUM, there are multiple public and private services in the area.

 

[ArkMedic]

Lots of questions here:

Texas is a fairly hands-off state in terms of EMS. The state is not involved in protocols or medical direction, that is the responsibility of the individual agency. The primary function of the state is licensing providers.

Texas EMS runs the gambit from BLS to Basic-With-A-Stick to limited ALS to MICU to full-on Rolling Hospital. It is entirely dependent on your employer.

Transport times are wildly variable, but are generally a horrible way to evaluate services. Even in rural nowhere communities, most calls will be close to the hospital- or so far away that you get bored or tired on the way out. That holds true in both rural and urban envoronments. With tnat being said, a better way to measure an employer is how much they expect to be done on-scene: "scoop and run" or "stay and play".

Protocols are wildly variable.

Where I am, we have RSI, paralytics (roc/suxs/vec), ativan, versed, ketamine, etomidate, fentanyl and calcium gluconate, bicarb, etc. Next door, the "paramedic" fire EMS might start an IV, maybe. Next next door, the ALS service doesn't treat abdominal pain and maxes out at 100mcg of fentanyl.

Dallas is Fire-based, Fort Worth is a PUM, there are multiple public and private services in the area.

Do you mind telling what service you work for and where you're based? I'd ask in a pm, but I haven't unlocked that capability yet.

 

[RocketMedic]

I work for Lake Jackson EMS, about an hour south of Houston.

 

[ArkMedic]

Is there anyone willing to list the respectable services in the Dallas area? Any services I should avoid?

 

[BigDEMT]

Almost all the metro cities run fire based EMS. All the units I've seen run double paramedic teams and a very large percentage of fireman in the big departments are also paramedics by training (dallas, Plano, frisco, etc.)

As you move out to the fringes of the metro you'll find less strict medical control but also less calls volume.

I know AMR and MedStar run 911 service for some of the smaller cities around as well

 

[TXmed]

AMR arlington is a good system to get experience in and busy. when i left they were going through a huge staffing problem and was miserable. but talking with some friends who are still there they have some new admin that is turning things around. and it is close to irving.