How did you begin your EMS career?

[wadford]

Ok so I was wondering how everybody started out in EMS. Did you automatically jump into 911 or did you do IFT first, and what you would recommend for a brand new EMT. Our instructor advised us to start out at a private ambulance company if we could so that we could hone our patient assessment skills, and documentation skills before jumping into 911. My current plan (if all goes well) is to get on with a private ambulance service and while there take other classes to build up the resume. Just need some well seasoned advice. Thanks

 

[jjesusfreak01]

Here's my unseasoned advice. If you plan on going into EMS, and you can find a squad that will take you and train you well, do that. IFT is not EMS, you don't do patient assessment, you do monitoring. You already have the patients history, meds, allergies, so you don't need to ask many questions. You document differently from IFT. IFT documentation is focused on transport conditions and writing only what is necessary to get your company paid. Its likely your EMS system is going to use a different program or system for their documentation anyways, so the actual benefit from prior experience is minimal. I've learned a lot doing IFT and EMS simultaneously, but if I had had the opportunity I would have run EMS exclusively. I proactively learn and teach myself from my experiences doing convalescent transport, because actual learning opportunities rarely present themselves in that field. If I had to say one good thing about IFT, its that you will become an expert at moving patients in every way imaginable, although the same can be said of EMS.

PS: i'm writing this from the back of an IFT ambulance

 

[mycrofft]

I was born a poor white boy....naw.

First save: 13 y/o, picked up a kid who fell off his bike and was unconscious in the street, took him to his home.
First job: lifeguard/dock hand/first aid, 19 y/o.
EMT: fired from factory, went USAF fire dept and got my own EMT working on the rescue truck.
See threads about family members in EMS and legacy EMT's.

 

[emtchick171]

As far as immediate family goes...none of them are in ems. So I was the "odd ball" when I chose it as my career. When I was 17 I began doing heavy rescue, well then it got me started on an ambulance. I got my emt at 18, and have been doing 911 ever since. I never did IFT...

 

[HotelCo]

Here's my unseasoned advice

...

IFT is not EMS, you don't do patient assessment, you do monitoring.

If you're not assessing your patient, you're doing it wrong.

Edit: If you're not assessing your patients, you really shouldn't have a license.

Edit edit: You don't assess your patient to make sure they're stable? What about a nursing home to ER call? You don't assess then either?

 

[Melclin]

I don't know about well seasoned

Maybe lightly grilled....

I started my degree, started placements, plodding along, didn't really care one way or the other. Then I went to my first arrest, and I thought, this is bloody awesome. Picked up a copy of NEJM after we got back from the arrest and read an article on vasopressin in asystole. Everything clicked. Came here, looking for more. Its really literature and the discussion here that has helped me a lot. If I would recommend one thing to any new EMT/medic, it would be to hop on the net and find something like EMTlife that floats you boat and keeps you interested so your study (at a real school, doing A&P and so forth) is something you wanna do to answer your own questions rather than compulsory homework.

IFT/vollunteering..all good ways to practice a few psychomotor skills and for me, to whom striking up conversation with average people doesn't come naturally, it helped there. But it was really education that did it all. Get a good education.

I think its a good idea to keep up the classes.

 

[shfd739]

I did 911 on a volunteer ambulance/fire dept while at the same time working full time as a nondriving EMT (I was 18, it was 21 to drive) for a small private service. Most of what we did was IFT but occassionally got a nursing home emergency call or a BLS rollover from the local fire dept. To me the little bit of IFT was nice as I was exposed to alot of patient's and conditions and began to associate prescription meds with their diseases. I also learned alot about diseases in general and how they were treated.

I found it beneficial for me.

 

[HotelCo]

A few other things about IFT: In IFT, you're transporting people in the late stages of various disease processes. You're exposed to things that a 911 provider doesn't get to see all that much. You're forced to learn more about these diseases, and how they can impact your patient.

HEMS can be considered IFT as well. Taking patient from a small, rural hospital, to a large level I trauma center for appropriate treatment. Who transports those patients when HEMS is unable to fly? An IFT ambulance...

Don't go knocking IFT to the ground, just because your service does dialysis all day. Not all IFT companies are like that.

 

[MrBrown]

One of Brown's teachers was a volunteer Ambulance Officer back in the very early 1990s when Lifepak 10, sodium bicarbonate and big white star of life patches were all the rage.

Then Brown was accosted in early 1992 by a spaceship driving nymphomaniac pros chasing alcoholic TV lawyer with said Lifepak 10 as co host on Tuesday evenings

When Brown becomes an Intensive Care Paramedic or HEMS Doctor Brown is going to go back and find Brown's old school teacher and show him.

 

[TransportJockey]

I started by doing IFT, mainly because I was under 21 and couldn't get hired anywhere else. Then I worked in a hospital as a floor and ED tech. Spent 6 months working third service 911, now I work private 911

 

[jjesusfreak01]

You don't assess your patient to make sure they're stable? What about a nursing home to ER call? You don't assess then either?

I treat these as EMS calls and write them up as such, however I run these only very rarely working IFT. I do assess every patient in that I obtain a set of vitals either at the hospital or shortly after leaving (for a baseline), assess mental state by talking to the patient if possible, but what I don't usually do is badger the patients about their recent injuries or do a detailed physical exam. I determine if they are stable before care is transferred to me, and if there are no problems I transport. I'm not going to start taking clothes off or palpating their abdomen, because as an EMT riding BLS my patients have already been stabilized and cared for by higher level providers. My job is to ensure they are initially stable enough for transport, and then to transport them keeping them as comfortable as possible while monitoring them to ensure there is no change in their condition.

Edit: no one should take my earlier post as an attack on IFT. My point is that if you want to do EMS, IFT isnt going to teach you how to treat and think about emergent conditions, nor is it going to give you any practice in motor skills more advanced than taking a blood pressure or listening to lung sounds. It has benefits, but its not essential to do IFT before EMS and if you have the opportunity to jump straight to EMS, I would go for it.

 

[abckidsmom]

I started as a junior on our locals rescue squad when I was 14. First job was IFT when I was 18

 

[dstevens58]

Started out as a "junior" with a first aid card with my local fire department. Enlisted in the Navy as a Hospital Corpsman (13 year career) and got NREMT along the way. Volunteered where ever I could with my multiple duty stations.

Now that I've moved back home (card expired long ago), I went back to EMT-Basic to start running with my department that I began in back in 1974. Looking forward to medic school later this fall.

 

[wadford]

I'm going to apply everywhere, but our county is hiring now so hopefully I can get on 911 here. I was also considering IFT because of the hours (not that I wouldn't welcome 24/48) and the kids. Hubby already works full time (24/48) at the fire department, so finding the right sitter would be crucial.

 

[RocketMedic]

I grew up with paramedics for parents.

 

[Sasha]

Edit: no one should take my earlier post as an attack on IFT. My point is that if you want to do EMS, IFT isnt going to teach you how to treat and think about emergent conditions, nor is it going to give you any practice in motor skills more advanced than taking a blood pressure or listening to lung sounds. It has benefits, but its not essential to do IFT before EMS and if you have the opportunity to jump straight to EMS, I would go for it.

I challenge that, sir!

How sad your company isn't realizing the full market for IFT. We do SNF to ER daily. It's a great place for student to learn how to give an ER report. We utilize many skills including blood pressure, pulse taking, and lung sounds, some you will rarely use on 911!

Of course IFT teaches you how to think and treat, it also shows you how to think more about the chronic comorbidities and asses them than 911 does . You also get the opprotunity to be exposed to a broader range of medicine then the small sliver 911 gives you.

Plus we work harder Always busy.

 

[Sasha]

I'm not going to start taking clothes off or palpating their abdomen,

To be fair, very often you don't do that on 911. You run a lot of BS calls. And I do palpate my patients abdomen, listen to lung sounds, bowel sounds, check pupils and ROM.

I love IFT. We are an integral part of the EMS and healthcare system.

 

[firetender]

Started as Vollie, then IFHT!

Into Funeral Home Transport

1/3rd of my first EMT/AMBULANCE job was backing up the funeral homes in the transport of dead bodies from scenes, morgues, ER's, to the Funeral Homes. When their "Parlor Cars" were not available, we, in our ambulances were.

Yes, I even had to respond to a call, work up the patient, lose him/her and then, to add insult to injury, transport my own failure to the Funeral Home!

If you're talking about an absence of opportunities to learn, find me a better example.

...and it's important to realize that IFT's have ALWAYS been part and parcel of Private Emergency Services; they are what pay the bills. Therefore, if you're going to be in EMS, then master those skills as well. If you can't find things in IFT's that are applicable to "real" calls, then you're not taking your job seriously.

They are ALL real calls!

 

[DesertMedic66]

Been trained in CPR/first aid since I was about 7 or 8. Joined the fire department at 14. Got my first job at a 911 service at 18/19. My main shift is a BLS ambulance doing mostly IFT but we do pick up 911 calls. I'm not a huge fan of IFT but I'm not going to disrespect it at all. It's just not my bread and butter.

 

[jjesusfreak01]

I challenge that, sir!

How sad your company isn't realizing the full market for IFT. We do SNF to ER daily. It's a great place for student to learn how to give an ER report. We utilize many skills including blood pressure, pulse taking, and lung sounds, some you will rarely use on 911!

Of course IFT teaches you how to think and treat, it also shows you how to think more about the chronic comorbidities and asses them than 911 does . You also get the opprotunity to be exposed to a broader range of medicine then the small sliver 911 gives you.

Plus we work harder Always busy.

Dr. Myers does not appreciate convalescence services running ER calls in Wake County for the most part. I personally enjoy these calls, as it is the one time when I don't know what i'm walking into ahead of time in IFT. I agree, I do work harder doing IFT, but a bad EMS day can be almost as bad. I also agree with your second paragraph, mostly.