private ambulance question

hello. I am new to the ems field and also new to these forums.

I know this question has probably been asked a million times but I haven't really found any useful or satisfying answers. As the title suggests I want to know about private ambulances.

specifically what they do. I know they do a lot of transports or just transports primarily. maybe with a 911 here and there. but I am curious as to what a typical work day is like. is it just like "driving a taxi" as some people complain it is? or is there more to it?

oh and what are the work hours usually like?

thanks everyone!

Honestly it depends where you are. And how long you've been working there. My last private ground ambulance I worked for had dedicated 911 trucks running 12s and 24s in a rural county, doing primary response and transport. We also had primarily IFT trucks in the city north of us that got pulled down to run 911 when needed.
Private services run all sorts of calls, runninh all kinds of shifts. Just depends where you are. Hell I worked for a private company that did 7 days on, 7 days off running frontier 911 amd flight ops in texas.

I see. I think I understand. I'm guessing its safe to assume the newbies get the IFT while the more senior get 911? That makes sense. Thanks for the reply appreciate it. Anyone else have any other info that would be great

Completely depends on what town you work in. Some private ambulances hold the 911 contract for the town/county they are in and do all the 911. The vast majority of private companies are strictly IFT services though. As a basic on a BLS transport truck it becomes VERY mind numbing (for me anyways) and yes it will seem like you are driving a taxi, with sirens, that you will probably never use. Most people don't get the opportunity to jump straight into 911, which does not make much sense because the 911 companies will say go work an IFT truck for 6 months then apply. Well being on an IFT truck taught me nothing that I couldn't have been taught on a 911 rig in a day.

If you can not get a 911 gig, then just use the IFT thing as a stepping stone while you look for greener pastures. Try and learn as much as you can about the disease process and the medications you see on the patients charts, and you will get something out of it.

As others have stated it will depend completely on the system. For my company we are BLS and ALS. We hold the 911 contract for the whole county. We are also the only ALS IFT company on the county. We are primarily 911 with some IFTs mixed in. Our BLS units are IFT units.

Our normal scheduled shifts are either 12s or 24's with the option for employees to pick up a lot more hours.

There are some (many) private companies that will never respond to a 911 call. Sometimes they contract with a facility who will call them instead of 911, but there are certainly places who do scheduled transports exclusively.

There are also municipalities that use private companies as ambulance contractors and that contract might say that some or all of the contracted ambulances can never be used for transfers.

There is no one, or even a few answers.

So exactly what does an emt on a private ambulance do while in the back with the patient? Monitor vitals or just sit and stare? I know this is all pretty self explanatory. You'll have to forgive me I'm new to this industry.

arctic2 said:

So exactly what does an emt on a private ambulance do while in the back with the patient? Monitor vitals or just sit and stare? I know this is all pretty self explanatory. You'll have to forgive me I'm new to this industry.

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Sometimes. Or they never get in the back and their whole job description is to help on scene and drive the ambulance

I've worked for two private companies before getting a FD ambulance operator job, all here in Los Angeles County. First private company was strictly IFT, no 911 response. We did BLS, ALS, and CCT. Every once in a while, a CCT or ALS rig would get a Priority 1 call (code 3-lights and sirens) but that was for things like STEMI transfers and other time sensitive transfers to specialty centers. I worked there 10 months (6 months BLS, 4 months CCT) only ever had one P1 transfer....I was definitely starting to feel like a taxi driver with fancy lights you only ever turned on during start of shift checkouts lol.

Second private company had the 911 response contract for a one city. Almost all BLS ambulances, with a couple ALS units. There was no such thing as 911 only and IFT only units. Closest unit got the call (well theoretically at least). There were some posts near the hospital that you knew you were most likely going to get a discharge, and others most likely to get a 911 call, though most it could be either or. The city fire department had the paramedics and was in charge of all the 911 calls, we were basically just their transport.

In my current system, I'm still a single role EMT but a fire department employee, operating a city owned rig and equipment, city paycheck and benefits, etc. Exclusively 911 only. However, with a significant percentage of our calls coming out of SNFs and ending up going BLS code 2, non-emergent, I find myself realizing a lot of our calls aren't vastly different than an IFT lol

However, there's plenty of other variations of how private companies work. Like I said above about my first company, some don't do any 911 and some are the primary 911 response truck with the paramedics in charge of the calls, while having IFT only divisions that can get pulled into the the 911 system if needed, some are invovled with the local government enough they are the de facto public agency, and some local governments simply contract out to existing private companies to be their third service EMS agency.

So really, private company EMTs and Paramedics run the entire gamut, it all just depends on where you go as everywhere has their own slightly different version of how they run EMS.

arctic2 said:

So exactly what does an emt on a private ambulance do while in the back with the patient? Monitor vitals or just sit and stare? I know this is all pretty self explanatory. You'll have to forgive me I'm new to this industry.

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Some will do that, both private and public agency EMTs, but otherwise, the same exact things a public agency EMT would do in the back...monitor vitals, do paperwork, secondary assessment, talk with the patient, both follow questions in the secondary exam relating to their chief complaint, as well as just talking to the patient in general like they're spending time with a normal human being, etc etc.

In southern California , Orange county to be exact, what the private ambulance does determines if it has contracts or not. An IFT only company Will do just transfer from hospital to hospital, snf to hospital, and to appointments, etc. But that doesn't mean you won't do anything. I worked at a ift only company and I had a good amount of calls were patient wasn't stable at all.
Now I work at another private company, still doing ifts but the company also has a contract with local fire to do 911 and backup contracts with other cities.

@arctic2, if you tell us where specifically you're looking to work, you'll actually get answers relevant to you.

good ol Rhody (Rhode Island) the major companies are: Alert, Professional ambulance, Med Tech, Coastline, stat south coast (I think its actually the same company as coastline) and Access. im sure I missed some but I heard that New England ambulance is no more. but that's where I live and those are the companies. Right now I am actually going to be volunteering for the time being.

from what I understand in Rhode Island the fire departments pretty much have the 911 side of things covered. either the fire department does or the volley rescue squads for rural areas. so the companies are mainly transports.

The only private 911 I know in RI is alert with an als intercept vehicle in Bristol. But I quite often see meditech responding lights and sirens (probably fpr nh emergency). I don't know where in ri you live but there are some good companies in mass that will get you some good experience. Brewster cataldo and action all have 911 contracts In and around Boston and western ma is medstar. I personally think it's good for an emt to work some ift and not jump right into 911 because it is the best way too learn the customer service side of things and learn how to talk to pt and like some one said before you can get a lot of sick pt.

So does Alert basically do back up 911? I agree that ift would be good for starting out.

In Seattle, we are the transport and assist arm of the fire dept. In downtown, fire doesn't transport ANY patients outside of ALS with their own medics. If they have to tx with an aid car, we get a massive fine from our contract. Out in the Eastside, where I work now (got tired of prepackaged patients) we actually respond WITH fire most of the time, and show up with the engine. That means we get a lot of patient contact and get to do fun stuff like help the heavy rescue teams rip the doors off of cars. Sometimes fire will tx if the trans is short and they sent the aid car and not the engine, sometimes they'll have us do it. And a lot of times, we are the more experienced EMT's with regard to patient care. I don't know how many times I've picked up a patient with a flail chest/pneumothorax, c-spine injury with no backboard, drank a gallon of purell and the firefighters never smelled her breath (and had no idea what was wrong with her) so in our situation, we're essentially the "BLS plus" option.

And never trust a firefighter's MERF or vitals, always take your own!

And the most important part of a private ambulance company is Interfacility Transports. Psych patients, hospital to hospital, hospital to home, basically, if a patient needs to leave the hospital they're at and have some reason they cannot support themselves in a wheelchair (O2, fractures, decubi, psych monitoring/restraints) they go via ambulance. I worked a primarily IFT and Airlift car for about 8 months, and learned a lot. But I think I've gone as far as I'll go with that. The only calls where I learned anything anymore were Airlifts of patients with rare diseases like Toxic Epidermal Necrolysis. Now that I'm back on a fire car, I'm learning a lot more from the psychology of injury side and playing detective.

arctic2 said:

So does Alert basically do back up 911? I agree that ift would be good for starting out.

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They do the als for bristol with an als fly car. (Paramedics in an suv that intercept the bls fire department.

Reviving a dead thread I know. But generally are private companies flexible with scheduling? (appreciate the helpful answers everyones been giving)

arctic2 said:

Reviving a dead thread I know. But generally are private companies flexible with scheduling? (appreciate the helpful answers everyones been giving)

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It's going to be completely different based on company. Some are and some arent.