Biodude said:
Yeah, I'll bet. Here in Orange County, the private ambulance companies don't get many opportunities to treat the patient beyond transport and ongoing assessments. The firefighters usually arrive on scene first and perform the necessary interventions and baseline vital signs/assessments. At least, that was my experience with a ride-along.
Yep, basics are screwed in Orange County, no matter where you go. Either you have to do the IFTs (primarily Lynch, with Pacific coming in). You haul granny around to dialysis with, on average, 1-2 "ER calls" a shift. You might get a serious one every once in a while (our SNF's suck out here), but generally the patients are as stable as they can be at 90 y/o with a laundry list of medical problems and medications.
On the other hand, you can do the 911 companies (Shaffer in Costa Mesa, Care through out most of the county, Medix for most of south county, and Doctors in the Irvine area). Fire responds (all of the paramedics are with the fire departments) respond code 3 (L/S) to the calls with the contracted private company responding code 2 (normal driving) most of the time. Out of the 4 calls I had during my ride alongs (I did 2 8 hour ride alongs), we responded code 3 once and only arrived first once (non-code 3). The other times it was more of a "ok, the ambulance is here. Put the patient on the gurney and lets get going to the hosptial."
So, IFT (Lynch and Pacific, and AMR)
Pros: You actually get to do an assessment and treat patients, sometimes.
Cons: Bulk of the work is discharges, dialysis, etc.
911
Pro: Emergencies, some of the time (these companies also do IFTs)
Con: Paramedics arrive first 99.99% of the time, so the only thing you're going to get is sloppy seconds (ALS has already evaluated and started treatment).
Besides this, at the ALS level, OC is still a "mother may I" style of EMS (no base contact is available for BLS, to my understanding. You either call for ALS or transport depending on ETA to the nearest hospital), but moving towards more of a standing protocol, no hospital contact style system. My understanding is that Anaheim is the current test subject for a pure standing protocol system.
Another option in OC is the ER tech route. We have a ton of hospitals here (3 trauma centers, plus about 12 other acute care hospitals). Other options include working first aid at either Wild Rivers water park in Irvine or Knott's Berry Farm in Buena Park (Disneyland uses RNs).
