Any Paramedics/EMTs/Firefighters?

Off Topic
41

I’m a first responder for the port authority of ny and nj for the past 2 1/2 years, I work at the Lincoln tunnel in the emergency garage, our jobs kinda all inclusive we handle anything and everything from the nj turnpike to the bus terminal in Times Square. We do heavy towing like buses and trucks, to pushing out disabled cars that overheat or run out of gas, vehicle firefighting, vehicle extrication, emergency medical, etc…

So I’m basically a firefighting, EMR, tow truck driver. We do rotating schedules 5 on 2 off 4 on 2 off 4 on 2 off 8 hour shifts, and we never close. At the Lincoln tunnel alone we run about 6000+ stoppages a year, mostly vehicle breakdowns or minor accidents. Plenty of the fakers like mentioned above, but we also get some of the worst accidents in the country.

As far as workouts go, I work steady 2x10s at the moment and either go to the gym with my fiancé after work or go in the morning by myself before work, we do have a small gym here that some of the guys contributed weights to, but it’s not much other then a bench with 300lbs plates a pull up dip bar back extension and cable machine and some light dumbells. If i can’t go after or before work I might hit a light chest or shoulder day here, but only after the rush, and sometimes I’ll get cut short to go on a call.

42

[quote]kpsnap wrote:

[quote]Derek542 wrote:

[quote]kpsnap wrote:

[quote]Uncle Gabby wrote:
I would describe a taxi ride as when someone calls 911 because they want to go to the ER for something that’s not an emergency. Examples:

  1. Grandpa’s 87 years old and has been feeling weak for the last few weeks. We check his vital signs and they’re all fine, but the family wants him to be transported to the ER for further evaluation. They’re going to follow along behind in the van. Could they just give him a ride? Yes. Do they think he’s going to drop dead in the next 45 minutes and need life support? Probably not. One of us is just going to sit in the back with him and take his blood pressure a few times.

What it boils down to is they’re worried, and don’t want to wait to get him in to see his regular doctor. If they drive him up to the ER themselves they will probably have to sit around in the waiting room a while and they don’t want to spend any more time on this than they really have to.

This is 80% of our calls. I’m not even going to go into the fakers. Some agencies are pretty aggressive about refusing transport and even charging people with abuse of the 911 system. Some of them we just take, like grandpa. The family might not take him up there themselves, he might not be able to see his regular doctor till next week, and if he kicked the bucket in the meantime we might be held liable.
[/quote]
Agencies are aggressive about refusing transport for cases like the above because ambulance transporters cannot legally bill Medicare for such transports. Does your agency present patients with an ABN in such situations? Do you bill these? Write them off? Curious here. . . [/quote]
Every state is different Ksnap. [/quote]
Medicare is a national program. The rules defining medical necessity for Medicare patients desiring ambulance transport are the same for all. Google “Medicare ambulance coverage.” There is a government booklet dedicated to the topic. It is illegal to bill Medicare for transports when the patient’s health will not be endangered if he/she is transported by other means.

[/quote]

It’s all in how you write your report.

Ask the right questions and you can usually get down to what the true signs and symptoms are that they are worried about. Do your reporting accurately and correctly, get the correct signatures (patient and facility), correct mileage, correct patient info… you get the picture. They look to kick anything back for even the slightest differences.

Also the monies we receive on these transports is very small even when they are for legit reasons (MI, Stroke).

43

[quote]lanchefan1 wrote:
It’s all in how you write your report.

[/quote]
This is spot on. EMTs have to be trained to write reports in such a way that the verbiage meets Medicare’s definition of medical eligibility for ambulance transport.

44

[quote]kpsnap wrote:

[quote]lanchefan1 wrote:
It’s all in how you write your report.

[/quote]
This is spot on. EMTs have to be trained to write reports in such a way that the verbiage meets Medicare’s definition of medical eligibility for ambulance transport. [/quote]

Not so much trained for Medicare purposes but more so if I have to get up in a court of law and be able to talk about what I did.

45

[quote]lanchefan1 wrote:

[quote]kpsnap wrote:

[quote]lanchefan1 wrote:
It’s all in how you write your report.

[/quote]
This is spot on. EMTs have to be trained to write reports in such a way that the verbiage meets Medicare’s definition of medical eligibility for ambulance transport. [/quote]

Not so much trained for Medicare purposes but more so if I have to get up in a court of law and be able to talk about what I did.[/quote]

Yeah both, but more so for court. It helps our transport time is 45 minutes, I get bored and fill the time writing.

46

[quote]kpsnap wrote:

[quote]lanchefan1 wrote:
It’s all in how you write your report.

[/quote]
This is spot on. EMTs have to be trained to write reports in such a way that the verbiage meets Medicare’s definition of medical eligibility for ambulance transport. [/quote]

This is true for me as a therapist as well. How is what I’ve done in a session furthering us toward the goals outlined in the treatment plan. Justifying the cost.

47

[quote]Evolv wrote:

[quote]GrindOverMatter wrote:
Or any other first responders ? I just finished my paramedic program here and I’m just waiting to write my national exam. Just wondering, I’m case anyone bites and wants to post, a few discussion questions

  1. how long have you been a first responders for?
  2. what are your work hours like?
  3. how do you fit in training around your rotations?

[/quote]

I’m a full-time fireman/EMT/HazMat Tech…

I’ve been on it for 3 years now. My schedule is actually the only thing that keeps me there. I work about 10 days a month, 24 hour shifts. Every third weekend I get a 4 day weekend, just started one this morning actually :slight_smile: I get to work just before 7:30AM and leave the next morning at 7:30. I train almost every day I am off from work, I use my days at work as “rest days” from lifting. I’m usually too unmotivated at work to lift heavy things.

I’ve been on both ends of the spectrum as far as call volume. I started at a ridiculously busy station out of rookie school running around 3,000 calls per year on an Engine company and got transferred to a HAZMAT team where we are much slower, probably around 700 calls per year. We sleep almost every night, thank God. Like mentioned above, working a 24 hour shift and being busy is very tough on the body. I’ve lifted on absolutely zero sleep on many, many occasions. I am not someone who can take a nap, because it jacks my sleeping cycles up-- so I just have to tough it out when I come home.

The best thing about being a fireman is the time off. I have 6 weeks off paid vacation coming up… can’t beat it. There is no way in hell I would be a paramedic or EMT on an ambulance truck, that has got to be one of the worst jobs on the planet. Couldn’t be a cop either. Fire is a nice blend of down time, “excitement” whatever that means, and is good because your work days are spread out. At least our schedule is. Although, it is a lot of hours when added up and it can be hard emotionally at times (relating to some calls). [/quote]

Mind (or someone else) elaborating on why you could not be a cop?

48

[quote]legendaryblaze wrote:

[quote]Evolv wrote:

[quote]GrindOverMatter wrote:
Or any other first responders ? I just finished my paramedic program here and I’m just waiting to write my national exam. Just wondering, I’m case anyone bites and wants to post, a few discussion questions

  1. how long have you been a first responders for?
  2. what are your work hours like?
  3. how do you fit in training around your rotations?

[/quote]

I’m a full-time fireman/EMT/HazMat Tech…

I’ve been on it for 3 years now. My schedule is actually the only thing that keeps me there. I work about 10 days a month, 24 hour shifts. Every third weekend I get a 4 day weekend, just started one this morning actually :slight_smile: I get to work just before 7:30AM and leave the next morning at 7:30. I train almost every day I am off from work, I use my days at work as “rest days” from lifting. I’m usually too unmotivated at work to lift heavy things.

I’ve been on both ends of the spectrum as far as call volume. I started at a ridiculously busy station out of rookie school running around 3,000 calls per year on an Engine company and got transferred to a HAZMAT team where we are much slower, probably around 700 calls per year. We sleep almost every night, thank God. Like mentioned above, working a 24 hour shift and being busy is very tough on the body. I’ve lifted on absolutely zero sleep on many, many occasions. I am not someone who can take a nap, because it jacks my sleeping cycles up-- so I just have to tough it out when I come home.

The best thing about being a fireman is the time off. I have 6 weeks off paid vacation coming up… can’t beat it. There is no way in hell I would be a paramedic or EMT on an ambulance truck, that has got to be one of the worst jobs on the planet. Couldn’t be a cop either. Fire is a nice blend of down time, “excitement” whatever that means, and is good because your work days are spread out. At least our schedule is. Although, it is a lot of hours when added up and it can be hard emotionally at times (relating to some calls). [/quote]

Mind (or someone else) elaborating on why you could not be a cop?[/quote]

For me it wasn’t my calling. I enjoyed the EMS side along with the fire.

Another reason was that if you’re carrying a gun then somebody else with a gun is probably going to be pointing back at you sometime in your career.

Lastly cops are just ASSHOLES! (Just Kidding before they all get butt hurt).

49

FF/Medic for almost 9 years in a very busy college town. Very close to being off the rescue and on the engine full time (seniority). We work 24 hrs on and 48 hrs off. I train 2 days on, one off. I use my duty day as a rest day. Day 1 upper…Day 2 lower…rest and repeat. Only basics…bench, squat, dead, military, pullups, dips, prowler work, farmers walk, tire flips, sledge strikes, kettlebell and barbell complexes.