Where is the best EMS system?

[VentMonkey]

Driving around in the city is something I don't love!

I love Boston too, and still love visiting it. But good lord is it a horrible city to drive in or navigate

I picture cobblestone streets and oystee bars galore. Am I an ignorant west coast sonofagun or what? Oh, and I thought it was pronounced "Baaa-stin"??

 

[medichopeful]

I picture cobblestone streets and oystee bars galore. Am I an ignorant west coast sonofagun or what? Oh, and I thought it was pronounced "Baaa-stin"??

Nah that's actually a pretty accurate description of some areas!

It's funny, I grew up about 30 minutes from the city, and I still don't know the "correct" pronunciation!

 

[WestMetroMedic]

Does Alina and North Memorial do 911 as well? Is the pay structure and benefit package similar?

Yeah, pay scales are very similar. Hennepin and Allina health are union. North and Allina health have a great dichotomy of urban and rural even in their metro service area. All three have great equipment and vehicles. Hennepin has the police and fire pension which is probably the biggest difference.

That being said, my departure from Hennepin at the end of the month is for North Memorial.

And for the badge conversation, Hennepin wears badges. Probie shield for 6 months and then you are issued your permanent shield.


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[Tigger]

No Idea, I do know from the info on their website that they do not directly hire paramedics. Boston EMS only hires EMTs, and then they promote EMTs with Paramedic certification to paramedic once they have enough experience and positions within the department open up. So Boston EMS does have some EMTs who are actually licensed Paramedics that are just practicing at the BLS level until an ALS spot opens up for them.

Why would they? They have a ton of medics working as basics until one of their few ALS spots comes open.

TMK, that is the majority of their EMT's that they hire, who await the oh so coveted ALS promotion. I'm sure @Tigger or another former, or current Bostonian could enlighten us though.

While there certainly some paramedics working as EMTs for BEMS, most of the EMTs are just EMTs (or at least that's how it was when I lived there). They do a paramedic class when they have openings, though I am not sure if you have to go back through if you already are a medic. There are only six (I think) double medic ALS ambulances during the day plus some medic staff, so promotions are pretty rare.

Boston EMS itself has a 6 month academy you have to pass once you are hired before you actually come off probation and get your badge. (Yes they have badges because they are technically a government organization, not a private company.) So the ****ing academy for BEMS is longer than the entire training course to even get the EMT license in the first place!!!!!!!!!!!!!!! That is because of the crazy amount of extra training they give both about EMS skills/knowledge, as well as info related specifically to Boston and managing any disaster that may happen (I.e Boston Marathon Bombing in 2013, which had an excellent response from city officials and helped saved a lot of lives.)

While I am happy that Boston EMS actually puts there new people through a well thought out academy and field training process, they are still primarily serving the city of Boston with EMTs. Now with hospitals in such close proximity, that's maybe ok, but let's be clear, they are are still EMTs. 3 month academy aside, their skill set is still that of an EMT with some added assessment knowledge. Also, they strive to be an all hazards organization, so a lot of the academy time goes towards that as well.

 

[EpiEMS]

their skill set is still that of an EMT with some added assessment knowledge

I'd wager for most urban calls, national EMT scope plus Mass protocols permitted skills (see pg. 176 of the protocols) like an albuterol breathing treatment would be more than sufficient. Yes, I said it, EMT scope is "sufficient" for something .

 

[DrParasite]

Also, they strive to be an all hazards organization, so a lot of the academy time goes towards that as well.

What do yo mean, all hazards organization? What do they prepare for that other urban ems systems don't?

 

[Tigger]

What do yo mean, all hazards organization? What do they prepare for that other urban ems systems don't?

Probably nothing different really. But they do give all their new members hazmat ops, some basic rescue stuff, basic "tactical EMS" things, things like that. Nothing exciting, but all their new people go through it, not just team people.

 

[hometownmedic5]

I'd wager for most urban calls, national EMT scope plus Mass protocols permitted skills (see pg. 176 of the protocols) like an albuterol breathing treatment would be more than sufficient. Yes, I said it, EMT scope is "sufficient" for something .

What makes the primary BLS model work so well in Boston isn't the training the BEMSs guys receive, its the scoop and screw short transport times to the world class hospital conveniently located on every corner. If you couldn't be at a harvard or tufts affiliate in 3 minutes, you'd probably see a much higher medic : emt ratio.

Again, not dogging BEMS at all, but they aren't super EMTs or anything. They do the same job as every other 911 EMT in the state. Absolutely they receive much more training than your average IFT basic. On the other hand, the training they get is specialty stuff, not BLS medicine.

 

[EpiEMS]

What makes the primary BLS model work so well in Boston isn't the training the BEMSs guys receive, its the scoop and screw short transport times to the world class hospital conveniently located on every corner.

I don't disagree at all, this helps, but even in an urban area without world class hospitals nearby, just your run of the mill Level II or Level III trauma center less than 5 minutes away, say, BLS measures are more than enough for most calls.

 

[hometownmedic5]

Very true, but how far do you want to carry it? For the majority of the calls I respond to, any one of the cars I have to maneuver past in the driveway are sufficient...

 

[VentMonkey]

So I just watched a "seasoned medic" on that BEMS show ask their tech to "grab a curb" so that their paramedic partners could get an IV on a (presumably) hypotensive patient while transporting "hot" to a "world class" hospital.

I get showbiz editing and what not, but the quote that came out of the paramedics mouth being something to the effect of "that's what this job is, getting IV's and not losing them" made me cringe and look over at my wife. Lol, my poor wife she knows all too well whaf will come out of my mouth with these shows, but they're like the tabloids for folks like me.

#Bostonwrong?

 

[PotatoMedic]

Wrong thread

 

[DrParasite]

So I just watched a "seasoned medic" on that BEMS show ask their tech to "grab a curb" so that their paramedic partners could get an IV on a (presumably) hypotensive patient while transporting "hot" to a "world class" hospital.

Sadly, I know of too many EMS agencies that have their ALS patients transported "hot" as a matter of routine practice, who wait until they get the IV to leave the scene (even if in the back of the ambulance), as well as several providers who think if they don't get the IV in the field, they have failed their patient, especially when the ER complains about the lack of IV access.

 

[NomadicMedic]

Sadly, I know of too many EMS agencies that have their ALS patients transported "hot" as a matter of routine practice, who wait until they get the IV to leave the scene (even if in the back of the ambulance), as well as several providers who think if they don't get the IV in the field, they have failed their patient, especially when the ER complains about the lack of IV access.

I work at one. I always get the quizzicality tilted head when I tell the driver to turn the lights and sirens off and drive with the flow of traffic.

And aside from working an arrest on scene, getting a 12 lead in the house or fixing immediate issues, I'll do my interventions in the truck please. While we're driving. At a NORMAL rate of speed.

 

[NomadicMedic]

So I just watched a "seasoned medic" on that BEMS show ask their tech to "grab a curb" so that their paramedic partners could get an IV on a (presumably) hypotensive patient while transporting "hot" to a "world class" hospital.

I get showbiz editing and what not, but the quote that came out of the paramedics mouth being something to the effect of "that's what this job is, getting IV's and not losing them" made me cringe and look over at my wife. Lol, my poor wife she knows all too well whaf will come out of my mouth with these shows, but they're like the tabloids for folks like me.

#Bostonwrong?

Is this as bad as the guy on nightwatch cardioverting a septic patient? Or any of the other cringeworthy things that happen on that show? (If a person on my truck ever put the end of a IV cath or needle cap in their mouth to pull it off with their teeth, I'd come unglued.)

 

[RocketMedic]

Is this as bad as the guy on nightwatch cardioverting a septic patient? Or any of the other cringeworthy things that happen on that show? (If a person on my truck ever put the end of a IV cath or needle cap in their mouth to pull it off with their teeth, I'd come unglued.)

#Nightwatch

 

[VentMonkey]

Is this as bad as the guy on nightwatch cardioverting a septic patient? Or any of the other cringeworthy things that happen on that show?

#Nightwatch

 

[DrParasite]

(If a person on my truck ever put the end of a IV cath or needle cap in their mouth to pull it off with their teeth, I'd come unglued.)

you mean there is a better way to remove the needle cap? Does it look as cool? I have been doing it wrong all these years!!!!

 

[VentMonkey]

Are you're telling me that night shift supervisors at NOLA EMS don't just jump every "rad" call and "drop lines" in patients hands and leave?

Clearly, BEMS and NOLA are the best systems there are, hands down, bar none, coolest medicine ever.

 

[NomadicMedic]

It's just like anything else. It's a TV show. Creative editing can make even the most boring call look good. Lots of jump cuts of trucks flashing lights and profile shots of strong jawed paramedics. Add in some random radio chatter, concerned bystanders, an NRB and Motorola squawks and all of a sudden even an IFT can look like an MCI