I have been a Paramedic for 16yrs and have worked in many different configurations of EMS delivery.  And fact of the matter is with or without Paramedics in those areas the need for transport is what the residents need.  Paramedics on a fire engine like their counterparts on a ambulance can start IV's give meds, and defibrillate and many other procedures, but fact of the matter is without transport they are useless.  Honestly, the only thing a fire engine needs is a defibrillator, combi-tube, and an epi-pen.  All the other stuff is pointless without transport.  So a patient has chest pain, and the fire medic starts tx, then what.............wait, wait, wait and...... you know the rest.  The medications do not cure the heart attack, the cath lab does that, and the only way to get to a cath lab is with an ambulance.   The other issue and not pine mountain related but EMS related is there are too many Paramedics already in the field.  More is not better.  What it does do is decrease the skill level of the Paramedic as a whole.  If you have four Paramedics standing around on-scene, only two really are doing the job, the other two hopefully assist with getting pt. meds, setting the gurney up, so on and so forth, but only two is what is needed.  Now you make everyone a Paramedic it dilutes the quality of skill, and experience of the Paramedic.  But unfortunately communities, and America in general think that if two is good lets have four, five, twenty..............My experience is that Engine Medics are not at the same level as Ambulance Medics, strictly because they do not do enough.  The Ambulance Medics do it all, and especially if they are single function Paramedics.  It is all they do and they are good at it because of that.  Fire Department train to do primarily one thing, and that is fight fire, they are good at it, and should be.  But when it comes to EMS it is a footnote and a necessary evil that is pushed upon them by the brass, public, and a bonus of 15% or higher.  I have been a preceptor and EMS instructor of 12 of the 16yrs as a Paramedic and most if not all the students primary reason for becoming Paramedics is to get hired on a Fire Department.  Not to become an EMS professional, not because of a desire to do more for their patients, but to get hired?  One current student got hired on a Fire Department that does not have Paramedics while in the middle of his clinical rotations, and he decided to quit? He got what he wanted and dropped his Medic training!  What a waste.  Maybe one day EMS will actually have Men and Women that want to be Paramedics again, instead of treating it as a footnote along their path to a career in the Fire Department.  But the Public doesn't really care about that, specifically residents in Pine Mountain.  To them a Paramedic is a Paramedic. 

I can tell you are not thinking on the best interest of the pt.  Why should a pt. wait an hr. with CP to be treated?  A nitroglycerin, and MS and other ACLS meds can go a long way in vasodilating a pt. and may make the difference of life or death. Waiting for a paramedic for an hr wwith a pt in SVT just doesn't make sense. What about a pt. with CHF--Lasix can be given and diuresis them before the ambulance gets there.  If Kern COunty firefighters were medics, they could treat STABILIZE the pt BEFORE the ambulance gets there--start an IV, administer fluids or meds and have the pt. ready to transport. Hall gets there and all that needs to be done is to load them on the gurney, give report and transport. On scene time can be cut to a few min--no extra time is needed to treat on scene.  Just load and go. If anything, in rural areas the ambulance medics lose there skills as is all they do is reassess and transport as the initial treatment and skills are done when they get there.

So if what you are saying is that all they need is transport, and medics don't make a difference in the first 30 min to an hr of a medical emergency, then maybe we should be advising people in rural areas NOT TO CALL 911.   They could be put in a private vehicle and someone could drive them to the hospital and be there in 20 to 30 min. versus calling 911, waiting 20 min to an hr for an ambulance, then another 10 min on scene time, then another 20 min to the hospital.   MMMmmm be at a hospital in 30 min POV or wait up to 1 for paramedic treatment......no brainer.

If paramedics are not needed, then why do all the other top 15 fire depts. in the state have paramedic/firefighters?  3/4 of the firedept calls are for EMS so why shouldn't they be able to treat patients appropriately? 

Exactly, why shouldn't they treat pt's appropriately?  Thank you.  The reason they never treat pt's appropriately is EMS to a Fire Department is a necessary way for them to stay  a float.  They cant sustain themselves on the basis of being a "FIRE DEPARTMENT".  But the term "Fire Department" is rediculous.  They are EMS departments that fight an occasional fire.  But they don't treat it that way.  When recruits go to a fire academy they are fire fighters first and paramedics second?  Yet as you stated 3/4's of their call volume are for EMS.  Are they just lying to themselves?  Are they in some sort of denial?  Yes they have Paramedics, it creates revenue for them, and keeps them in business, but when you want quality and not quantity you call a single function Paramedic only.  

And as for not having the pt's best interests at heart, were not talking about a patient.  We are talking about a region/area with a call volume and population that does not justify having full time around the clock Paramedics.  Those men and women if staffed there would be lucky to see an SVT, CHF, V-tach, or any other critical rhythm.  Your making it sound like SVT's, CHF's, MI's are being handed out like like bread in a soup line.  Not reality.  Urban Paramedics are lucky if they see these things once a month, let alone or a regular basis.  Again read the part about skill level, and quality of care in my previous post.  You sound like you don't care about the quality of care.  As long as you have the title in the area you feel safe and secure.  Truth is it looks good on paper, but in reality is a nightmare, and an accident waiting to happen.   You chose to live in a Led box, and now you complain your x-ray vision doesn't work.  

Ventura- It's obvious your beef is with fire departments in general. There are medics that love being medics that work for the fire dept because they pay more. Do you know how much Harvey Hall pays his medics?? It's shameful! I'm not sure you really know what is going on with Kern's outlying areas. You just saw fire medics and went off.  

And as for not having the pt's best interests at heart, were not talking about a patient.

That is easy for you to say you don't live in these areas I'm assuming.

Truth is it looks good on paper, but in reality is a nightmare, and an accident waiting to happen.

Tell that to the firefighters and family members of the person dying on the ground because it took the "quality " medics 30, 45, an hour to arrive! What do you call waiting extended periods of time for an ambulance to arrive?? Hum, I'd call it.......................an accident waiting to happen. Only if they don't pass this program it's no longer an accident.......our supervisors decided that you or your family members were not worth it!!

I honestly don't understand your thinking about transport. Yes, the fire dept. can't transport, but the ambulance ONCE it gets there can, and the fire dept would be able to stabilize them until they arrive.  So you think it's better for a patient to suffer until an ambulance gets there instead of getting care as soon as possible??? Please tell me this is fear talking and veteran medics or any medic for that matter dosen't really think this way.

I know a paramedic that works for halls and he gets paid under 12 dollars a hour. Harvey hall is a cheap Bastard that calls all the shots when it comes to EMS.

Thank you Anonnymous I couldn't agree more!

 Stabilize what?  SVT, CHF, and so on and so...........again like most of the public, you think that by placing a Paramedic under your pillow the safety fairy will appear and make things all better, but the reality again is that those calls do not happen enough even in a busy urban EMS system.  And calls are what Medics need.  Not to sit around and collect 15% for doing nothing but pasting a title on the side of a fire engine just so you have the allusion of safety.  You think you see it from a service point of view, but in reality you don't want quality you want quantity.  Doesn't do you much good when that engine medic that has never been on a SVT, or V-tach except for a mannequin, cardioverts EKG artifact.  Im sure you will be the first one claiming law suit.  But in reality your the one that wanted it in the first place.  

Oh, and as for having a beef with the fire department in general.......I speak from being in the field for 16yrs, and seeing first hand how they have treated what they call "EMS".   Again they are an EMS department in denial.  That type of attitude, treating EMS as a footnote, is why they should not have Paramedics.  Some other citizen on here acted like they had some amazing stats to wow me with, of course 3/4 of their call volume are medicals.  They have no choice but to go on them, just like an ambulance has no choice.  Your tones go off and you leave.  The difference is medical calls is all an ambulance EMT or Paramedic trains for.  Fire Fighters train 95% to fight fires, and 5% for medical calls. When the reality is 75-95% of your call volume is medical. Go figure.  And like it or not that is fact.  Spin all the yarn you want, wave the Fire Fighter flag high in the air, it doesn't change the reality of the situation.  Now if the EMS/ occasional fire department trained for what they did most I wouldn't have a problem with it.  But again they don't.  And you will get some inexperienced boob up there that has no clue.  But you probably will not care, as long as there is a paramedic sticker on the side of the fire engine.  Quantity over quality.  Sounds like a concerned citizen to me.

Ventura, you are oozing with hatred of the fire dept. in your post.  Your true colors are flying.   Did you fail  the fire dept exam years ago and have had to settle on a low paying paramedic position?

 Nope.  Never cared.  And have never taken or had the desire to take an exam.  I love being a Paramedic, but if you decide to make those fire fighters Paramedics you will not get people that love, and want to do the job.  And I will take it a step further and say that not all Fire Medics are poor, that is a blanket statement, and not totally true.  But what is true and maybe you can't understand this but the majority of Fire Medics are not good at EMS.  THEY TRAIN PRIMARILY TO BE FIRE FIGHTERS NOT PARAMEDICS.  Having a license does not a Paramedic make. I don't hate the fire department.  On the contrary they are good at doing what there title suggests.........FIGHTING FIRES.  But once again you obviously don't know what you are talking about and have resorted to presumptions.  I speak from experience, and, again, dealing with it on a daily basis.  You don't.  Walk in my shoes and maybe you might understand.  I get chastised for doing what I love and being proud of it.  Having others i.e. the Fire Department treat it as a necessary evil, and a way to increase revenue is sickening, and the citizens such as yourself eat it up.  If you want Fire EMS go for it.  I don't live their.  I just feel you do not understand how complex being a Paramedic is.  It's more than IV's, drugs, and ekg's.  If EMS/ the occasional fire department loved EMS as much as fighting fire and gave it the attention it deserves I wouldn't be writing this.  It's not hatred.  It's a lack of respect for something that deals directly with the outcome of some ones health and well being.  

Exactly Ventura....You don't live here!! Let me guess you work in the LA area. Is it the county or city guys you have such disdain for?? Saying that all Fire Medics are bad at EMS and just a slight few are actually good that their job is an ignorant statement no matter how you look at it. 

 Once again I did not attack you.  And I unlike yourself speak from experience.  Your lack of knowledge about the in's and outs of EMS and the blind following of the Fire Department have clouded your judgement.  In the case of Paramedics on Fire Engines what you don't know will kill you.  Your ignorance is your bliss.  Best of luck 

That's right we all know nothing about the fire dept. or medics on fire engines or anything. Thank goodness you swept in here and saved us all from blindly following the fire dept.  Well I suppose your experience in the paramedic field makes you qualified to tell people what they do and do not know!!??  I can see why you have so many problems in your professional life. Wish you all the best Ventura.

Where exactly did I say you attacked me???

 How come your so upset?  I would say 16yrs in EMS all in the 911 system,  makes me qualified to tell you what you do and do not know.  Why? Because I do the job, and experience it first hand.  I have no desire for Harvey Hall to continue to monopolize EMS in Kern County.  But I do not want to see it bastardized by the Dual function thinking of the local EMS/occasional fire department.  Implementing  a third service Paramedic provider under the direction of Kern Co. EMS would be the best option for delivery of quality EMS.  If you want great service and coverage then that is the best option.  And if that is not possible, and the EMS/occasional fire department has to  have Paramedics, implement single function Paramedics on ambulances.  The profession of EMS should not be watered down, with fire fighting.  EMS is it's own profession and it should be treated as such.  And yes thank goodness I pissed you off enough to get you to respond to this most important issue.  Not trying to save you.  But maybe you will research options, and actually ask the all important questions of who, what, when, where, why, and how instead of being pissed at me for not pulling any punches.  Best of luck.

Ventura I was a Firefighter AND the towns only paramedic for years in a rural area.  We had the same senario--up to an hr for an ambulance and no ACLS til I was certified as a medic.   Some of our calls were the routine BLS calls but there were many that if ACLS was not available for an hr., people would have died.  Same exact senario here in the rural areas.  What about a head on colllision out on the 202? You got 4 people seriously injured and all the firefighters, some of whom are already paramedics, are waiting for the ONE medic to show up.  Then the ambulance medic shows up and has to do an ALS assessment/ start IV's etc. on all 4 pts. when that could have been done BEFORE the ambulance got there.  Then they could load and GO!

I have worked as a firefighter, as a firefighter/paramedic and as a paramedic for a private ambulance company that covered the Mogillon Rim.  So I have seen this senario from all sides--something you have not done.  And I have been in EMS since 1982 and have 26 years experience so I do know what works and what doesn't.

Bastardized EMS? Ventura it is quite obvious you are biased on this issue. You have no credible reasoning for arguing against fire paramedics. If you knew much about the history of paramedic service you would know that LA County Fire has been providing the service for many years and continues to prove that fire medics are a valuable resource.  The trend nation wide is to implement fire medics. Your reasoning is fallible and antiquated. There is no reason the same level of service could not be provided in Kern County as is elsewhere. I would suggest to you that you get off the typical private sector EMS mentality and start thinking of the well being of the patient instead of the financial gain of the private provider.