Looking to "move" on

[Fry14MN]

I'm from Alaska and currently live in Minnesota. I have friends in Alaska who are EMTs and they love it. Pay is good and well they have mountains and nature and snow. I love snow. I've heard mixed reviews about Minnesota but over all good and fair compensation for EMTs and Medics. I took a trip to Colorado a few month back and chatted with some folks out there and they highly recommended Colorado for the EMS field and there too you have mountains and nature and all that.

And to just touch on the topic of being gay(which I am), I haven't felt a negative kick back from people but I guess it could happen. My partner is in Law Enforcement and she gets the occasional huff and puff but you get people like that everywhere. My sexual orientation has nothing to do with the level of care I can provide.



OP, I've heard nothing but good things about Colorado. Good luck!

 

[CALEMT]

I took a trip to Colorado a few month back and chatted with some folks out there and they highly recommended Colorado for the EMS field and there too you have mountains and nature and all that.

If he's looking to get out of CA, I wouldn't recommend CO because as Tigger pointed out they're becoming the next CA. But I totally agree that CO has picturesque scenery.

 

[Fry14MN]

If he's looking to get out of CA, I wouldn't recommend CO because as Tigger pointed out they're becoming the next CA. But I totally agree that CO has picturesque scenery.

It was beautiful!

Alaska is always an option to0 OP, you can't really compare Alaska to anything down here. Especially if you are in a more remote part of Alaska. Things are more expensive up there but the pay helps with that.

 

[akflightmedic]

In short, your pay in Alaska is in line with the cost of living in Alaska...same as almost anywhere. The majority of people will still be paycheck to paycheck...however, the scenery and outdoor life is something difficult to find anywhere else in America.

 

[FiremedicSC]

I suggest you look into Greenville County EMS

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[FiremedicSC]

Look up Greenville County EMS. We are a leader in evidence based pre-hospital medicine. We run somewhere in the neighborhood of 60,000 calls a year, with approximately 40 trucks per day. We work with our local medical university and are on the forefront of research and development of treatments. In example, we are administering pre-hospital antibiotics for sepsis. We have attained the Gold status with AHA. Base pay is roughly $40000 + a great benefits package. We work 12 hour schedules. Cost of living is reasonable, we are close to any type of area. In the county itself we go from mountains to rolling farm land. In the nearby counties you can have dirt road rural to big city living. Check out the website for more info, www.greenvillecounty.org/Emergency_Medical_Services/.
I just started a month ago, but it's great. You'll go through one of the most in depth orientation processes I've ever seen. A month third person, and then 6 months with an FTO. To help you adjust. South Carolina is a NREMT state. They do offer a temporary card till you can earn your NRP.

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[TransportJockey]

If the pay wasn't so low that would be good. Is the 40k for medics?

 

[FiremedicSC]

Yeah it's roughly $17.93 hour. High pay for this area

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[Summit]

We are a leader in evidence based pre-hospital medicine... We work with our local medical university and are on the forefront of research and development of treatments. In example, we are administering pre-hospital antibiotics for sepsis.

Dopamine for septic shock? We've known for a while that is not a first... or second... or third choice...
Good summary of evidence agaisnt dopamine here: http://www.uptodate.com/contents/us...otropes/abstract/11,28,48,59-62?utdPopup=true

Pressors before a second liter in septic shock?

In the county itself we go from mountains to rolling farm land.

Hills of moderate size would be more accurate

 

[FiremedicSC]

Not dopamine antibiotics rocephin or zosyn

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[Summit]

Not dopamine

http://www.greenvillecounty.org/Eme...s/training/EMS_Publishing/standing_orders.pdf

Septic shock - Hypotension (SBP <90) refractory to fluid bolus, Consider Dopamine 5-20 mcg/kg/min
• Be alert for signs of anaphylaxis during antibiotic administration
• A second liter of Normal Saline can be administered for septic shock

 

[FiremedicSC]

Yeah. It does say consider but its not set in stone. We have autonomy for the most part. If you don't admin dopamine. Then u just document why.

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[FiremedicSC]

Generally we treat these sepsis way before they are into shock. We're catching with hr above 90, RR above 20, and a suspected source of infection. The ABX goes in and most of are feeling better by the time we get them to the hospital

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[Summit]

Generally we treat these sepsis way before they are into shock. We're catching with hr above 90, RR above 20, and a suspected source of infection. The ABX goes in and most of are feeling better by the time we get them to the hospital

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How long are your transport times?

 

[FiremedicSC]

Short as 5 min as long as 45.

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[RocketMedic]

I think it's a positive step. We're trying to do the same. Do y'all have any data collected on the efficacy of field ABX?

 

[Summit]

Generally we treat these sepsis way before they are into shock. We're catching with hr above 90, RR above 20, and a suspected source of infection. The ABX goes in and most of are feeling better by the time we get them to the hospital

The prospective RCTs that show significant decreases in ICU LOS and 28 day mortality dependent on reducing delays in abx administration in patients found to be in SEVERE sepsis/septic SHOCK (under the old definitions) and there are very few addressing EMS.

So it made sense to do prehospital abx in those patients.

However, minimal SIRS+SoI criteria were not the inclusion criteria shown by these studies to be the indicator for this intervention ported to the prehospital environment! If you want to be evidenced based then you should understand the evidence and act based on it!

Further, minimal SIRS are non-specific and are being phased out. We aren't even looking at HR as a primary indicator and RR is a only a weak surrogate in the absence of more proven indicators.