New adventures, Familiar Place

So I have alluded to a new job several times in the past few months on here. And I figured it’s past time to talk about it. As you can tell from the new banner, I have TX and NM represented in that star of life. That’s because I’m now, once again, workin in the state of Texas.

Some of you might remember that three years ago I worked in a small rural TX community as an EMT-I. Well, now I’m back in the same community working as a Paramedic :). I work 7 days on/7 days off. It actually works out well for me. I’ll go into some detail as to what it’s like down here too. But suffice to say, it’s one of my dream jobs. And I’m having a lot of fun overall.

When I worked here before, it was a city run, third service, with pretty typical protocols for this area of Texas. Now, I’m working under flight protocols on a frontier 911 truck. We have some of the broadest sets of guidelines outside of my good friends to the south in Presidio. As a Paramedic I have free reign to use clinical judgement and best practice to deviate from our guidlines, and out critical care medics (more on that in a bit) can perform CVC placements, pericardiocentesis, chest tube insertion, and several other things. The running train of thought is that we can do more in the short term than our little community hospital can, and that they only do scans and give blood (the two things we can’t do at this point).

We regularly transport straight to the airport from scene to meet up with one of our company’s fixed wings for transport of hte patient to a tertiary facility or trauma center (nearest major hospital is a level 2. Closest Level 1 is over 200 miles in any direction). The flight team runs under our same protocols, so in this instance, the flight team doesn’t bring any additional tools (except they carry an ultrasound, ours are coming for ground) or skills to the patient. We use them strictly because we are so far from definitive care.

We also fly out quite a few by rotor. Part of this is that we cover 3000 sq mi of territory, a lot of it is pretty rugged desert. We also have one major interstate running through our county. One of our most common reasons for flying people out by rotor is that we just can’t get safely back down the road the patient is on with any sort of speed, like an oil rig lease road. We have one of the highest numbers of oil rigs in the state of texas here in my county. And with all this, I haven’t seen much abuse of air medical, it’s pretty typical for frontier Texas.

One of hte nice things about our company is that they want all medics to be certified as critical care. And we are 90% paramedic agency (we only have a handful of EMT-I and EMT-B providers. Once myself and four others go through the critical care class, we will be at 100% of paramedics certified as critical care. And I’m in that weird spot because I’m currently an FP-C, which is generally considered critical care level. And the best part is the company will pay for the critical care training. And with the schedules we work, an extra class (like UMBCs 2 weeks course) are easy enough to do trades togo to.

All-in-all I’m excited to be back here. It’s a great place to learn, and I get to play sometimes as a flight medic on our fixed wings. It’s already making me a better provider and it is my favorite type of EMS, rural with great protocols. Plus we have a great crew here. I can’t wait to see what my future holds down here.