So just because LA County is doing it means everyone should do it?  Can't you think for yourself?  EMS is not cut and paste.  And explain how my view of EMS is antiquated.  Third service EMS is actually progressive, and something that many municipalities do not consider, because of the "antiquated" cut and paste, or better said that everyone is doing it attitude.  You obviously have not read my previous posts so you are making a redundant argument. One that was already addressed.  

The other issue is the motivations behind LA Counties initial Paramedic Squads was one of excitement, of something new something progressive.  Those Fire/Medics motivations were one of doing more for their patients, and took a risk on a new program that might not have taken.  LA County did not have to mandate individuals to go to Medic school, they did not need to lure them with pay bonuses.  Those individuals were true Paramedics through and through.  They cared about the QUALITY of the pt. care they delivered.  Not these days.  You go around LA County or better yet any Fire Department and ask these newer breed of Fire/Medic why the are a Paramedic and listen to what they tell you.  As in previous posts, if EMS/the occasional fire department took as much pride in EMS as they did in fighting fire then, as I have stated before, I would not be writing this.  But again, you obviously believe in quantity over quality.  Am I upset that fire departments do EMS? No.  Am I upset that the majority of fire departments provide second rate EMS........Yes.   Again the numbers don't lie.  75% to 95% of a fire departments calls are for EMS.  Fact or fiction? Go a head you can say yes...... Now for another bit of reality.  What do fire departments train 75% to 95% for...........again go a head take your time...........if you said fire fighting, you would be correct.  If you answered EMS you would be...........WRONG.   Now what does a third service or private 911 Paramedic or EMT train for 100% of the time..........this is a tough one...............tick, tock, tick, tock,.............bzzzzzzzzzz. Answer is EMS.    And if you had read a previous post of mine, I do not think Harvey Hall, AMR, or any other company is the best answer to provide EMS.  They have political agendas just like the EMS/occasional fire department.  But I guess because all the kids are doing it, I might as well to is a better solution.  

ventura422--your "facts" don't make sense to me. Many people can do something you obviously can't do--multi task.   Being a medic is not like being a brain surgeon and neither is firefighting.  There is should be enough room in your brain to do both jobs and still have the ability to do the jobs well.  If 75% of the calls really are for ems then it makes even more sense to allow them to become paramedics.  And I will bet if you ask the Kern County firefighters if they wanted to become paramedics with no extra pay, the majority of them would.   And I am sure they would increase the number of hours spent on keeping and improving their skills if they became paramedics. And If the name was changed to Kern County Paramedic/Fire Department would that make you feel better?  BZZZZZZ...maybe it's time for your nap!

 Go a head and ask them to not take the pay bonus and see how far that goes.  I see there is no pulling the wool over your eyes.  Brain surgeon not like Paramedic or Fire Fighter, or better said Mongo think fire burn, needle ouch, brain hurt.  That was too much information for you so I will slow it down a bit.  If you think sticking someone with needles, giving them electrical therapy, pushing cardiotoxic drugs, placing tubes in peoples airways, placing a needle in childs bone, so on and so on, don't require 100% of your attention, then you get what you deserve.  AGAIN in a much slower pace this time 75% to 95% of a EMS/fire departments call volume is what.................................the dots are to give you time to think about it.  Three Letters...................come on, you can do it..........ok EMS. Now for the bonus round if 75% to 95% of a EMS/fire departments calls are EMS what is the primary thing that you think they should train for..........................again the dots are for the benefit of thought provocation..........E....M....S.  I did it slow for effect.  Now back to reality......and take a wild guess at which of the two professions they train for the most.......................should I say it about the dots...............F..i..r..e.......F..i..g..h..t ..i..n..g.  So going back to your previous post, sure they run a lot of calls as Paramedics, as I have stated in a few previous posts, 75%-95%, but the public is not the place to make errors that would not happen if you paid the proper respect to training for EMS calls.  Sure it's not brain surgery, but you probably wont make it to the brain surgeon if you are mistreated by a ill prepared Paramedic.  But hey, they can stabilize the pt. before ALS ambulance arrival, wink, wink, nudge, nudge.

Ventura422  I still don't understand?? Why does being a firefighter make you a dumb paramedic?  The state would pull their licences if they made that many mistakes. I can understand being a paramedic needs 100% of your attention but why can't the fire dept. medics do that?  I find it hard to believe they hire people who aren't that smart.  I thought is was hard to get hired by a fire dept.

 Im not saying they are not smart.  Fire Fighting takes intelligence, and the job of a Fire Fighter can be and is extremely difficult.  Any job has it's share of boneheads, including third service Paramedics, private Paramedics, Starbucks, GM, so on and so forth.  And it is not, as I have stated before, that they can not be great Paramedics, I am not against a EMS/fire department having Paramedics, but the reality is that the lack of attention paid to the PROFESSION of EMS creates and harbors poor performance.  It really is not the individual Fire/Medics fault, it is the departments fault for not giving EMS the attention it deserves.  Yes they have the same  license such as a single function or private Paramedic.  The difference is they do not put the emphasis  on training for their primary responsibility, which is EMS.  They train primarily to fight fires.  Yes they do have to go to Continuing Education that is mandated by the state, all of us have to do this or we wouldn't be Paramedics.  That is something the fire department has no say in.  But when it comes to training beyond maintaining their license that is it.  Just the minimum.  Ladders, hoses, extrication, hazardous materials, building construction, fire prevention, sprinkler systems, high rise fire fighting, wild land fire fighting, search and rescue, so on and so forth is what they spend most of their time on.  So EMS becomes as I have said before a watered down, footnote.  Someone that only does one thing, and that one thing is EMS is the answer to quality care.  I have nothing against any department that pays EMS the attention that it demands, but the truth is it doesn't happen.  The trucks, engines, shiny badges, the heroic image of a fire fighter pulling someone from a burning home, are all fine, but that doesn't make them qualified to handle EMS as their primary responsibility.

Ventura, what are you even doing blogging on the Tehachapi News site? And what makes your 16 years of experience better than the 50+ combined years (very conservatively speaking) of private ambulance paramedic experience that KCFD medics have?

I don't think you can see our situation very well, maybe you should have a window installed in your stomach or move your head to a better location.

Ps. everybody knows that you work for a local ambulance, your not fooling anybody.

Great, so we get a fire-fighter/paramedic that hasnt run an ALS call since October that shows up on a full blown CHF patient but since he hasnt put a stethascope to a patients chest in 4-5 months he thinks its COPD and gives the patient epi and albuterol. Now the patient gets to wait for 30 minutes while fire-medic floods his lungs with pulmonary edema until ambulance-paramedic, who actually runs calls, shows up to fix it....only its too late.

Better yet, how about the patient in respiratory failure who requires intubation. Fire-Medic shows up and hasn't pulled out his laryngoscope since his OR clinicals and intubates the esophagus. 30 minutes is a long time to go without a patent airway. Right?

And if L.A. County is so great, why is their intubation success stats at almost half of what kern county is? Why is it that L.A. removed pediatric intubation from their scope of practice....oh yea because their success rate was far from exceptional. I wonder what the difference is between Kern County and L.A. County......oh yea FIRE MEDICS.

And just for the record, I'm not saying ALL fire medics are bad medics. I'm simply implying that lack of call volume leads to deterioration of skills. Just like not working out leads to weak muscles. You can't be a marksman if you only shoot one round a month.

Here is an observation you seem to be missing. In the same breath that you state the major portion of the fire department responses are medical, you also imply that fire medics would be out of practice because they don't run enough calls. So what is it, they run a lot of medical emergency calls or a few? Fact is even the slower stations are running multiple calls daily and yes the majority are medical emergencies. In light of this would it not make sense to have firefighters able to provide advanced life support rather than basic since they generally arrive much sooner than the private provider? Further more, the fire department would not charge $10,000 for a life saving ride to the ER. You might try discussing politics instead of EMS, I'm sure you would be more convincing.

 Drummin4fun says; "until ambulance-paramedic, who actually runs calls, shows up to fix it....only its too late." ---- Ok, so how often do you see an ambulance show up with out a fire truck?

I don't believe that LACO’s intubation success is half that of Kern, I’d like to see that report. And in LA CO people aren’t waiting 45 min for a private ambulance paramedic to show up, there is most likely one showing up in a timely manner, on the fire engine, and that fire/paramedic probably runs………...75%............... to………….95% EMS calls just like you have been saying. The dots are there to let your own words sink in ventura.

One more thing, I wonder how much money the fire department will stand to make on an average ALS call where they do stabilize the patient…….. $0.00 and I wonder where ambulance companies get there money? ......... Oh yeah, for transporting patients. So if the Fire Department isn’t getting anything out of this, except better service for the citizens living in rural areas, why would a few people be against it? Those few people work for our local ambulance monopoly and they’re afraid to see the little bit of power they have slip away.

 But fear not rural citizens of KernCounty, most all of Harvey’s good medics took the last test for KCFD (at the risk of loosing there current job).

L.A. County's intubation rates are a matter of public record....look it up. And yes L.A. County people wait just as long. Engine 77 in Gorman is a BLS station. The paramedic squad comes out of Castaic, and the ambulance comes from even further. Or lets look at the area close to Rosamond. Over by 170th, 190th, etc. Paramedic response can take over 40 minutes. And we aren't just talking about 2 houses, this is a community just the size, if not larger than pine mountain club, glennville, woody, stallion, etc.

Now lets back it up to Kern County. How long do you think the people of Sand Canyon wait for a fire engine? The same amount of time as they do an ambulance. Once again, just as many people living around there.

I love to hear people argue that the fire department is better to provide care because "they aren't in it for the money". If that was the case then why do so many private ambulance paramedics do the job for pennies on the dollar? Could it be because they actually like being paramedics? Firemen make loads of money. It doesn't matter who is flipping the bill. True, the department as a whole is not a "profit organization", but every person working for it is bringing home a pretty nice paycheck.

So if private enterprise is "wrong" because they collect a bill, then next time you have an emergency, make sure you tell the ambulance to take you to KMC, becaue every other hospital around here is a "private, profit making" monster....just like that evil private ambulance. Oh wait I almost forgot, they collect a bill too.

And dub, if you ran one medical aid a month out of your station and that was your only call, then that means you ran 100% medical calls. Percents don't mean a thing.

Drum and Ventura, your so biased against  fire dept medics you have many issues.  My first guess is you both work for Halls.  Second, you could not get hired by a fire dept.  Maybe you have been treated poorly by the fire dept on a call, but that goes both ways.   If transport was so important vs. stablization, maybe we should have the fire dept. transport also.  The best of both worlds..   How about the the private medics posting?  That means an ambulance parked in a parking lot at 3 am waiting for a call?  Talk about unsafe working conditions. Tired and drowsy?  If the companies werent in it for the $$, how come so many ambulances are tied up doing interfacility transports???  Hmmmm$$$$$,  thats where the insurance $$$ is..  DUH.  Yes firemen are well paid, but they are also held to a high standard for work performance.  Too many paramedics??  How come Halls has such a hard time staffing ambulances?  Even running BLS ambulances first in.  If being a private medic is so great, why are so many trying to get hired by the fire depts???  Why don't they privates pay better, because it cuts in to thier bottom line.... 

How can you argue that not getting paramedics on scene ASAP can't make a difference??  If you have been medics so long, how long do you wait for a bed for a patient?  I bet hours.  That means you are out of service that much longer. Do  private medics have the training and protective equipment to enter a hazardous enviorment or atmosphere?  How about rappel over the side of a cliff to a patient.  Privates can't even enter a confined space to treat a patient let alone an overturned car or truck.  Maybe firefighters are fairly paid, but there is a reason.  The same as that firefighters should be paramedics.  I am not sure where you get your information, but I have talked to firemedics from the following depts to get mine-LA City and County, Ventura, Orange County, CDF, San Diego City, and Santa Barbara County.

There is plenty of work for fire and private medics.  If you can't accept that, maybe it's time you find a new line of work..

Your right, private pay sucks. Thats why medics leave to go to fire departments. TO MAKE MONEY. You are also correct on IFT's. They are the bread and butter of most private ambulance services just as hospitals use special procedures like surgeries, echocardiograms, MRI's, CT's, Nuclear Med Studies, etc to stay afloat. ER's are a money loser. So why aren't you guys out picketing Tehachapi hospital because they are "money hungry" and have a monopoly on the East Kern? With reimbursment rates being in the mid to low 40 percentile, you wonder how anyone in the medical business can stay afloat.

Now lets talk about hazmat and technical rescues. If you can find anyone that has the ability to start an IV or intubate while hanging off a cliff, give them a pat on the back for me. What is the first thing they teach you about treating patients in hazardous areas? YOU DONT. You get them out of the that area as as possible and then treat them. Wasting time starting an IV in a confined space does nothing. Now they are stuck in a tight spot and have a needle in their arm. That's NOT how you save a life.

So the fire department is held to a higher standard of work performance? Then how come the county isn't keeping track of their response times? How come the firemen don't have to complete patient care reports and submit them to the county? Do they even have a Q.A. system in place to assure that they provide appropriate treatment? Why is it that an engine can leave their area to get groceries, play poker with the next in engine or do drills while leaving their area unconcovered? True sometimes you hear ambulances respond from a distance due to multiple calls, but if you listen to a fire scanner you will hear "engine 12 medical aid, engine 11's area" or engine 190 medical aid, 14's area" just as much. Why doesn't engine 14 post at hwy 14 and backus when 15 gets a call? Private ambulances adjust their coverage.

With all fairness. I know private ambulance has its flaws. Staffing is difficult nationwide, not just in Kern County. Getting tied up waiting for beds in ER's causes less units to be on the streets, and under-paid medics can tend to become disgruntled. Its no secret. But the fire department isn't perfect either. Why is it that an engine wont divert from a structure to respond to a medical aid? Why is it that there is no fire station in sand canyon. Could it be becaues of a lack of tax base? So does that mean THEY are putting the dollar sign in front of human lives?

All of this talk about lack of call volume and deterioration of skills applies to private ambulance as well. If a private ambulance medic sits in a remote area and runs 2 calls a month, he (or she) isn't going to be very good at what they do. Not because of training, not because they are stupid, but becaue they simply don't get out and do it enough.

As far as L.A. County goes, look up their protocols. Explain why they can't intubate pediatrics, use an IO needle in pediatric emergencies, utilize gastric lavage to pump the stomach of a person who has overdosed, admister sedatives prior to intubation, use a cardiac pacemaker for people in severe bradycardia, perform a needle cricothyrotomy for a person who is choking, the list goes on. In addition, they have to make base contact before doing pretty much anything. It wasn't always that way over there. Now after you have read that, look up Kern County Protocols.

LA County - dhs.lacounty.gov/ems
Kern County - co.kern.ca.us/ems

As far as performance standards for private ambulances around kern county goes. The county has set very strict guidelines for response times, protocol compliance, complaint resolution, etc. Hall as well as Liberty, Kern, Care and Delano all follow these and have been compliant since they were implimented last year. The County of Kern set the maximum response times for bear valley, pmv, stallion, etc to what they feel is reasonable. This is not the work of Harvey Hall. If you have serious health issues, or ambulance response times is such a great deal of importance to you, then I suggest you move closer to civilization. By the way, how long does it take to drive to the nearest pharmacy in these areas? Why not protest Walgreens for denying the citizens of rural areas timely and convenient perscription service?

If the people of these areas want to increase their property tax to pay for firefighter paramedics, then I have absolutely no problem with that. I just don't feel the rest of county should be held responsible when these people chose to live away from society.

Ok Halls empyee .........  First off whats with the Kern vs LA protocols?  I think the protocols in Kern are much better whether they are being used by fire medics (Ca City 190) or privates.   It benefits all.  I live in a populated area of the county.    I believe firefighters aren't picketing the hospital because it is not an issue.  Firefighters aren't trying to be doctors or nurses.  Firefighters don't want to take over the emergency rooms.  Just the same as firefighters don't want to take over EMS.  (Although they should).  Firefighters just want to put another vital link in the EMS system.  If you were at all familiar with the fire dept's proposal you would be aware of that.  Fire medics could arrive first and start treatment and than "hand-off" to the private ambulance company for further treatment and transport and go available.   I am assuming your a medic  and you would lose your ability to be the boss and run the call........   If 75% of all fire dept calls were medical in nature, I would suppose the skill level of fire medics would stay focused and dialed.  Wouldn't that be the same for private medics also???  How come the highly skilled private medics requesting a firefighter to ride in the ambulance  to assist whenever the patient may take a turn for the worse?  Seems like you like the firemen when you need CPR, BVM, or a line stripped?  How about when your partner can't pull thier own weight and lift thier own gurney?   Moving around for training by the way,,,  is that similiar to the Rosamond ambulance doing a long distance transfer to.........Long Beach and being gone for several areas and forcing another ambulance to cover a larger area???  Oh yeah, after being on the road for several hours all night and than coming back to running calls........

Firefighters do do reports, on EVERY call they go on. Fire and medical.  I applaud your skills as a KERN County medic.  Why can't the fire medics do the same for the patients also????   The fire depts do have response times that are recomended by NFPA.  That is why a FIRE station was opened in Stallion Springs. others are coming...  I am not sure where you get your info, but fire companies don't leave thier areas for poker games. Yes fire companies do training, I am fairly certain it is for a minimal amount of time.  Conversly, why did Halls pull out of Pine MTN Club?  By there own accounts "There was not enough MONEY in it for us."  If the ambulance companies went bankrupt, went on strike, or became unfunctionable... No more Medics.  The fire dept would still be there..

Your cliff rescue scenario sounds like you have been watching a bit to much Emergency or Rescue 911.  Lets take the simple car rollover.  Do private medics have the proper safety gear to climb in a wrecked auto and simply give oxygen?  Remember ABC's.  Same with that confined space victom or haz-mat incident?  We can play what-if all night.   I agree with you about remote locations.  However, it is 2008.  Bear Valley, Stallion, and PMC have thousands of residents.  Guess what, they all have fire stations.  The ambulance companies have been hoarding thier private little monopolies for far to long.  Now they don't want to share.

Either you couldn't pass the test or have been brainwashed by Harvey's stooges.  The difference between you and the fire dept is that the fire dept doesn't want to take your job.  The fire dept wants to work together with the private ambulances to do the greatest good for the patient/public.  It's not about the bottom line.  But they don't tell you that at the company meetings..

 Why is it that there is no fire station in sand canyon.Could it be because of a lack of tax base? So does that mean THEY are putting the dollar sign in front of human lives------------- If you have serious health issues, or ambulance response times is such a great deal of importance to you, then I suggest you move closer to civilization. I just don't feel the rest of county should be held responsible when these people chose to live away from society.  Can't have your cake and eat it to dude!  So you are going to diss the fire dept for not having stations in all of the rural areas and then in the next breath say that you feel the rest of Kern shouldn't be responsible for the people out in those areas!!?? Oh, wait that's only when an ambulance is involved. So what is it?

Why is it that an engine wont divert from a structure to respond to a medical aid? I don't know about you but last I checked the fire dept. were the only people qualified to put out fires and there are other people able to roll on medical aids if need be.................like you!  Also since the percentage of medical aids vs. structures they are running are so high the chances of this happening are slim right? Come on now. :)

Why is it that an engine can leave their area to get groceries, play poker with the next in engine or do drills while leaving their area uncovered?

Wow you are reaching. I've seen plenty of medics going to the grocery store too. They do have to eat ya know. Also normally only one goes shopping while the other two stay behind.They do not leave their area to play poker ( I know where you pulled that from and you can put it right back), and I believe training takes place for approved amounts of time and is normally split up, but again are you complaining that they don't train enough or that they train at all?? Seriously, you've contradicted yourself several times and keep flipping things so they work to your advantage, but we see through it.

Countygirl--Ventura has tripped himself up so many times he going to fall!  Hope he doesn't hurt himself, esp. out in a rural area.  Then he would know how it feels to wait an hour for pain medicine from an ambulance paramedic!

Funny thing though. I'm sure lots of Hall employees are reading this and NOT ONE has backed ventura up on his point of view.  Any Hall employees want to jump in here and back up what ventura says?