# IFT or 911?



## akemt (Oct 29, 2017)

I've seen many threads with this topic. I am a new EMT and have one more day of training with an IFT company. However, due to submitting various applications to different companies, I have an offer for a 911 company as well. I don't know which to pick. I understand IFTs are what you make of it, is slower paced, you master vitals and talking to patients. 911 is what I went to school for and wanted to do. I don't know if starting with an IFT company is the best for me, granted I have no emt experience, or taking the opportunity to start as 911 and get experience and learn that way. Please help!!


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## PotatoMedic (Oct 29, 2017)

What are the reputations of each?  Both private?  Me personally I learned a lot as an ift emt and medic.  But happy I am now a 911 medic.  Do I regret my ift days no.  But I'm happy to be done with them for now.


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## akemt (Oct 29, 2017)

FireWA1 said:


> What are the reputations of each?  Both private?  Me personally I learned a lot as an ift emt and medic.  But happy I am now a 911 medic.  Do I regret my ift days no.  But I'm happy to be done with them for now.


yes, they are both private companies, the 911 company is for Doctor's ambulance


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## Aprz (Oct 29, 2017)

Are they offering you a job, or are these just interviews? If you are interviewing, interview everywhere.

If 911 pays more, I'd do 911. If IFT pays more, I'd still consider 911, but then it becomes more questionable. I would not give up 911 to do IFT to get experience. Many people do IFT as a way to get experience to get 911 jobs.

I feel like IFT experience is mostly overrated. A lot of the stuff you can learn from it you can learn in 911 as well. Not all calls are out of a home or on the streets; You are going to get 911 calls out of skilled nursing that utilize IFT. Many 911 calls don't require rapid load and go, so you will have plenty of time to learn the patients chart. You'll have plenty of time to talk and assess the patient. In IFT, you probably won't get a chance to do a lot of your BLS skills like splinting, backboarding, putting the patient on oxygen, or wound care.


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## akemt (Oct 29, 2017)

Aprz said:


> Are they offering you a job, or are these just interviews? If you are interviewing, interview everywhere.



I started with the ift, im almost done with field training with them. The 911 i already interviewed and was invited back for their PAT test this upcoming week.
Ift is paying more than 911. You bring up good point that you wouldnt give up 911 to do Ift.....


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## NickSparky (Oct 29, 2017)

I started out as an "IFT", I did dialysis and some IFT for a few months while I was also doing Volunteer 911 at the same time. I personally learned way more from my 911 experience then I did from IFT. But, it all depends on what you end goal is. If you wanna be the "best" you have to be good at everything. If you wanna only do IFT your whole life IFT is the way to go. If you wanna do 911 your whole life 911 is the way too go. Your defiantly going to be learning on the job and while doing things with 911. IFT alot of your skill you will either never touch or do once in a blue moon because the patient deteriorated on their way to a different facility. IFT is not for everyone and 911 is not for everyone. So it is up to you on what you wanna do.


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## Mufasa556 (Oct 29, 2017)

akemt said:


> yes, they are both private companies, the 911 company is for Doctor's ambulance



You'll be doing mostly IFT at Doctors. 

What's the IFT company?


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## hometownmedic5 (Oct 29, 2017)

Are we talking about a dedicated 911 truck or an IFT truck that occasionally will catch a city hit? There is a big difference. My company runs both IFT and dedicated 911 BLS trucks. While our IFT basics get more city experience than most other companies, they aren't strictly speaking 911 EMTs.

Take the better job. That might mean the most money, the better schedule, better equipment, shorter commute. Figure out what you want from a job and take the closest offer you get. I wouldn't work for a hanky chop shop for less money and crap benefits just because I *might* get to do an emergency occasionally.


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## Kevinf (Oct 29, 2017)

Why not both? Full-time for whomever pays better and part-time/per diem to get a sense of the other side of the coin? If one or the other doesn't work out for whatever reason, you have the ability to just swap them around or simply leave as needed.


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## akemt (Oct 29, 2017)

Mufasa556 said:


> You'll be doing mostly IFT at Doctors.
> 
> What's the IFT company?


LifeLine


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## johnrsemt (Oct 29, 2017)

I did both for years;  started as a Volunteer at FD based 911 did it for 4 years, and then got a FT job at a private doing mainly IFT (with some 911) and stayed at FD, they switched from Volunteer to FT/PT paid.
Loved them both.  did it for 8 more years like that, then took a new job in a different state, working 911 for the federal government, did that only for 9 years,  still doing it,  and now working PT for a private 911 service too.


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## mgr22 (Oct 29, 2017)

Akemt, you say you're already training with an IFT company. Why not stay there long enough to see how it goes, rather than leaving abruptly (and possibly burning a bridge) for what might turn out to be the wrong reasons?


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## RocketMedic (Oct 29, 2017)

So, in LA County, your odds of getting sick patients are actually higher on IFT than 911. That holds true for most places. As a basic, you'll likely be exposed to legions of the fragile, sick and injured on IFT, and you'll be it....the expectation is that you 'manage' them as well as possible. 911 in LACo is pretty basic anyway, so it's not like you're going to be doing a whole lot as a private B in any event.

Long-term advice, you need to look outside of LA County. EMT at Hall, move north or out of state entirely, etc. Go somewhere where you can go to medic school and get better at your craft. If you want to do 911, quit limiting yourself to LACo. Come out to Texas. Here at Cypress Creek, you, as a brand-new Basic, can literally be the junior partner on a P/B team that runs all 911 in a metro area the size of Atlanta or Denver. Same certs, same experience, same training you've got, but while you're running dialysis or looking for 'experience' in reps, my partner is doing everything except literally pushing drugs and the like (because I am all about teaching people). Sinking King tubes, ventilating, suction, obtaining and seeing 12-leads, making decisions, etc? They're doing that, because my job as a medic isn't just patient care, it's professional development. Come move out somewhere where you can be more than a stretcher fetching van driver.


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## Mufasa556 (Oct 29, 2017)

akemt said:


> LifeLine



Everyone here has real good advice for you to consider. 

Given the two choices, I'd pass on lifeline and go with Doctor's. You could do better than doctors (Hall, Care, Lynch), but you could do a lot worse than doctors (Lifeline). 

You won't be doing more than driving between two hospital buildings at lifeline. Though Doctors has a contract like that too, the IFTs you'll get will be better and you have the possibility of occasionally getting pulled into the 911 system. Additionally, after some time, you can transfer to other AMR divisions. 

At the same time, since you're already hired at lifeline, why not ride it out there until you can get hired elsewhere. Care has all the contracts and have been gobbling up every employee they can.


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## Tigger (Oct 29, 2017)

RocketMedic said:


> So, in LA County, your odds of getting sick patients are actually higher on IFT than 911. That holds true for most places. As a basic, you'll likely be exposed to legions of the fragile, sick and injured on IFT, and you'll be it....the expectation is that you 'manage' them as well as possible. 911 in LACo is pretty basic anyway, so it's not like you're going to be doing a whole lot as a private B in any event.
> 
> Long-term advice, you need to look outside of LA County. EMT at Hall, move north or out of state entirely, etc. Go somewhere where you can go to medic school and get better at your craft. If you want to do 911, quit limiting yourself to LACo. Come out to Texas. Here at Cypress Creek, you, as a brand-new Basic, can literally be the junior partner on a P/B team that runs all 911 in a metro area the size of Atlanta or Denver. Same certs, same experience, same training you've got, but while you're running dialysis or looking for 'experience' in reps, my partner is doing everything except literally pushing drugs and the like (because I am all about teaching people). Sinking King tubes, ventilating, suction, obtaining and seeing 12-leads, making decisions, etc? They're doing that, because my job as a medic isn't just patient care, it's professional development. Come move out somewhere where you can be more than a stretcher fetching van driver.


Your advice is solid. But I don't recall seeing much in the way of sick when I worked BLS IFT. I can appreciate how sick an ESRD patient is, but it's not something that EMS is really equipped to do much about it. Same with radiation and the like.


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## EmergencyMedicalSike (Oct 29, 2017)

akemt said:


> I've seen many threads with this topic. I am a new EMT and have one more day of training with an IFT company. However, due to submitting various applications to different companies, I have an offer for a 911 company as well. I don't know which to pick. I understand IFTs are what you make of it, is slower paced, you master vitals and talking to patients. 911 is what I went to school for and wanted to do. I don't know if starting with an IFT company is the best for me, granted I have no emt experience, or taking the opportunity to start as 911 and get experience and learn that way. Please help!!



Where are you from? Your county can make the difference. I worked 911 for a few weeks and currently do IFT’s in LA County and over here, the only differences between 911 and IFT are code 3 driving, shift hours, and responding locations. 911 companies receive calls with FD and 99% of the time fire is already there with their ALS resources with assessments, immobilizations (if needed), and treatments already finished so all you end up doing is transport, ALS assist, and paperwork all the way to the ER. Sometimes you won’t even take vitals en route because there’s a fire medic in the back with his lifepak. In IFT as a BLS unit, you have way more interaction with the patient as well as even taking vitals yourself every call.  Again, this is in LA county so if you ever find yourself here in need of an EMT job, there’s my input.


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## RocketMedic (Oct 29, 2017)

I'd just like to shamelessly plug Texas EMS here, again. My EMT-B partner and a student single-handedly managed a difficult airway with BLS means and pre/re-oxygenated her to the point where the (difficult) intubation was safe and routine. You won't get to do that in SoCal.


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## hometownmedic5 (Oct 29, 2017)

RocketMedic said:


> I'd just like to shamelessly plug Texas EMS here, again. My EMT-B partner and a student single-handedly managed a difficult airway with BLS means and pre/re-oxygenated her to the point where the (difficult) intubation was safe and routine. You won't get to do that in SoCal.



Two people did something single handedly? What was one of them doing, whistling? Moral support?


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## gonefishing (Oct 29, 2017)

Don't do Lifeline.  Look at their past and history including their members of management.  I would do Doctors which are owned by AMR which means you can eventually transfer any where.  Or leave the county entirely.


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## DrParasite (Oct 30, 2017)

RocketMedic said:


> your odds of getting sick patients are actually higher on IFT than 911. That holds true for most places.


that's not true at all.  dialysis runs, transports to doctors offices, hospital discharge, and a psych transfer for IFTs, chest pains, diff breathing, any other medical or trauma for a 911 call (pretty much anything you can imagine).  yeah, you might get a nursing home / contracted facility who gives you guys a 911  call when they should really be calling 911, and yes, many 911 calls don't require an ambulance, but please don't outright lie to the new guy and tell him he will see sicker patients doing IFT than on 911.


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## DrParasite (Oct 30, 2017)

RocketMedic said:


> I'd just like to shamelessly plug Texas EMS here, again. My EMT-B partner and a student single-handedly managed a difficult airway with BLS means and pre/re-oxygenated her to the point where the (difficult) intubation was safe and routine. You won't get to do that in SoCal.


so your EMT partner..... ventilated them with a BVM? maybe dropped an OPA, and suctioned as needed?  I'm guessing your EMT partner did what any competent provider would have done, and the student handed them the equipment that they asked for?

Not to shamelessly plug NC, but I did that my second call in NC as a first responding EMT on a QRV.......


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## gonefishing (Oct 30, 2017)

Your allowed as an emt in So Cal to do that lol


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## akemt (Oct 30, 2017)

akemt said:


> I've seen many threads with this topic. I am a new EMT and have one more day of training with an IFT company. However, due to submitting various applications to different companies, I have an offer for a 911 company as well. I don't know which to pick. I understand IFTs are what you make of it, is slower paced, you master vitals and talking to patients. 911 is what I went to school for and wanted to do. I don't know if starting with an IFT company is the best for me, granted I have no emt experience, or taking the opportunity to start as 911 and get experience and learn that way. Please help!!


Thank you everyone for your input!!!


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## iExposeDeformities (Nov 22, 2017)

Aprz said:


> Are they offering you a job, or are these just interviews? If you are interviewing, interview everywhere.
> 
> If 911 pays more, I'd do 911. If IFT pays more, I'd still consider 911, but then it becomes more questionable. I would not give up 911 to do IFT to get experience. Many people do IFT as a way to get experience to get 911 jobs.
> 
> I feel like IFT experience is mostly overrated. A lot of the stuff you can learn from it you can learn in 911 as well. Not all calls are out of a home or on the streets; You are going to get 911 calls out of skilled nursing that utilize IFT. Many 911 calls don't require rapid load and go, so you will have plenty of time to learn the patients chart. You'll have plenty of time to talk and assess the patient. In IFT, you probably won't get a chance to do a lot of your BLS skills like splinting, backboarding, putting the patient on oxygen, or wound care.


The oxygen part is false. There’s a lot of SNFs that don’t do their job so we have to put them on O2 whether it be cannula or NRB


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## Aprz (Nov 22, 2017)

iExposeDeformities said:


> The oxygen part is false. There’s a lot of SNFs that don’t do their job so we have to put them on O2 whether it be cannula or NRB


Oh, my bad. It's been awhile since I've done IFT, so I forgot the three or four years that I did it. I should be more clear about what I am saying since "probably" wasn't a great way to describe what you'll do in IFT. I am glad that your cannula and non rebreather skills are on point as well. Good job and thanks!


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## iExposeDeformities (Nov 26, 2017)

Aprz said:


> Oh, my bad. It's been awhile since I've done IFT, so I forgot the three or four years that I did it. I should be more clear about what I am saying since "probably" wasn't a great way to describe what you'll do in IFT. I am glad that your cannula and non rebreather skills are on point as well. Good job and thanks!


In all fairness, if your “O2 skills” aren’t “on point” there’s no use being in EMS lol. I’m just waiting for the day I actually get to use my CPR skill but then again we don’t have AED’s in our rigs....


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## luke_31 (Nov 26, 2017)

iExposeDeformities said:


> In all fairness, if your “O2 skills” aren’t “on point” there’s no use being in EMS lol. I’m just waiting for the day I actually get to use my CPR skill but then again we don’t have AED’s in our rigs....


CPR isn't all it's cracked up to be, I've yet to get ROSC on a single patient that actually walked out of the hospital or made it to a nursing home.  I've gotten pulses back on a few but they didn't make it.


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## Old Tracker (Nov 26, 2017)

Having no IFT experience I probably ought to keep my mouth shut. That being said, based on what I have read here, and elsewhere, I think I would be bored out of my mind in just a short time. 

Much of what we do down here as a 911 agency, in my mind approximates, what I think IFT does. Just routine trips to the hospital from wherever the patient happens to be. Chat with them, let them sleep (if everything is looking good on them and the monitor), re-evaluate every 15 minutes or so, deliver to the ER or OB, get sigs, write report and leave. 

The bad ones, make for a much shorter ride (even though it's the same distance). On the calls I have been on we have had some saves...2 or possibly 3, but I don't believe those folks ever came back to town, after they were transferred to El Paso or Midland/Odessa. One for sure I know passed after 3 days in El Paso.


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## iExposeDeformities (Nov 26, 2017)

luke_31 said:


> CPR isn't all it's cracked up to be, I've yet to get ROSC on a single patient that actually walked out of the hospital or made it to a nursing home.  I've gotten pulses back on a few but they didn't make it.


Of course there’s nothing greater than breaking ribs


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## RocketMedic (Nov 27, 2017)

Old Tracker said:


> Having no IFT experience I probably ought to keep my mouth shut. That being said, based on what I have read here, and elsewhere, I think I would be bored out of my mind in just a short time.
> 
> Much of what we do down here as a 911 agency, in my mind approximates, what I think IFT does. Just routine trips to the hospital from wherever the patient happens to be. Chat with them, let them sleep (if everything is looking good on them and the monitor), re-evaluate every 15 minutes or so, deliver to the ER or OB, get sigs, write report and leave.
> 
> The bad ones, make for a much shorter ride (even though it's the same distance). On the calls I have been on we have had some saves...2 or possibly 3, but I don't believe those folks ever came back to town, after they were transferred to El Paso or Midland/Odessa. One for sure I know passed after 3 days in El Paso.



I remember transferring patients into Del Sol quite well.


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## Aprz (Nov 27, 2017)

iExposeDeformities said:


> In all fairness, if your “O2 skills” aren’t “on point” there’s no use being in EMS lol. I’m just waiting for the day I actually get to use my CPR skill but then again we don’t have AED’s in our rigs....


Darn. I don't know what I am going to do. I can't put on a nasal cannula to save my or anyone else life! As a paramedic, I never get to do CPR. We don't have AEDs in our rigs either!


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## Gurby (Nov 28, 2017)

iExposeDeformities said:


> Of course there’s nothing greater than breaking ribs



¯\_(ツ)_/¯


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## StCEMT (Nov 28, 2017)

iExposeDeformities said:


> Of course there’s nothing greater than breaking ribs


Um......sure.....whatever you say...


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## VFlutter (Nov 28, 2017)

I was going to comment but it sounded too harsh. I’ll be a nice guy today....


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## Qulevrius (Dec 3, 2017)

I’ll chime in. In SoCal, what makes the difference between private IFT and private 911, is the size of the company. Which is directly related to the size and the quality of their respective contracts, the company’s benefits and the volume of calls. Having worked for both, I can say with confidence that ea one has its merits. On the 911 side, there’s more exposure to trauma and ALS whilst the IFT side offers more opportunities for educating oneself, since the attending Basic has the supporting paperwork. The rah-rah behind the 911 scene is nothing but hot air, and anyone with 1/2 a brain who worked in SoCal soon realized that there isn’t much difference between a 911 call and a scheduled discharge. FWIW, the urgents are the best thing because you get to do your thing without fire breathing down your neck.

As to OP’s question - CARE hires anyone with a pulse these days, why not come over to the dark side ?


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## EmergencyMedicalSike (Dec 10, 2017)

Qulevrius said:


> I’ll chime in. In SoCal, what makes the difference between private IFT and private 911, is the size of the company. Which is directly related to the size and the quality of their respective contracts, the company’s benefits and the volume of calls. Having worked for both, I can say with confidence that ea one has its merits. On the 911 side, there’s more exposure to trauma and ALS whilst the IFT side offers more opportunities for educating oneself, since the attending Basic has the supporting paperwork. The rah-rah behind the 911 scene is nothing but hot air, and anyone with 1/2 a brain who worked in SoCal soon realized that there isn’t much difference between a 911 call and a scheduled discharge. FWIW, the urgents are the best thing because you get to do your thing without fire breathing down your neck.
> 
> As to OP’s question - CARE hires anyone with a pulse these days, why not come over to the dark side ?


I agree with the IFT being not so different from 911. Although, there were rare times we had to go code 3 in IFT because of doctor’s orders or patient destabilizes en route. In SoCal specifically working in IFT, you can somewhat practice your primary and secondary assessment (without trauma assessments) whereas in 911 I imagine fire gets that done before you or takes over the scene completely


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## Carlos Danger (Dec 10, 2017)

RocketMedic said:


> I'd just like to shamelessly plug Texas EMS here, again. My EMT-B partner and a student single-handedly managed a difficult airway with BLS means and pre/re-oxygenated her to the point where the (difficult) intubation was safe and routine. You won't get to do that in SoCal.


BVM skills are highly variable and IME do not correlate at all to education level. I’m sure there are plenty of EMT’s and paramedics and RN’s and EM docs in TX (and everywhere else) who can’t BVM to save their own life. 

One of the most memorable calls of my career included a very difficult airway that after multiple attempts I finally secured with a retrograde intubation and all the while it was the BVM skills of the EMT crew (and the epi-pushing of my flight nurse partner) that kept the kid alive. Not even close to the norm though, unfortunately.


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## Akulahawk (Dec 11, 2017)

iExposeDeformities said:


> In all fairness, if your “O2 skills” aren’t “on point” there’s no use being in EMS lol. I’m just waiting for the day I actually get to use my CPR skill but then again we don’t have AED’s in our rigs....





iExposeDeformities said:


> Of course there’s nothing greater than breaking ribs


I suggest you look at the quote below...


luke_31 said:


> CPR isn't all it's cracked up to be, I've yet to get ROSC on a single patient that actually walked out of the hospital or made it to a nursing home.  I've gotten pulses back on a few but they didn't make it.


I would say it's a good bet that all of the experienced folks on here that have been in the medical field for a while _know_ what it feels like to initiate CPR on an elderly patient. There's nothing great about starting CPR on such a person. I have lost count of the number of people upon whom I have initiated CPR or have participated in their code, including doing CPR on them. 

When I worked in the field, I never had an AED on hand. All the defibrillators were manual. A very few had an AED mode available, but I always used mine in manual mode. 


iExposeDeformities said:


> There’s a lot of SNFs that don’t do their job so we have to put them on O2 whether it be cannula or NRB


There are a LOT of SNF nurses that actually _do_ know what needs to be done but they may actually not have oxygen orders (either by protocol or by specific order for a given patient) that allow them to apply oxygen to a patient. Oxygen _is_ considered a drug and without some kind of order for supplemental oxygen (and protocol _is_ an order), I cannot apply oxygen either. I'm an ED nurse and if our ED didn't have a blanket oxygen titration order, I'd technically have to ask one of our providers to write an order for each and every patient that needed supplemental oxygen.


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## Qulevrius (Dec 11, 2017)

This is the scourge of EMS, right there - the 20 y.o.’s who pulled through their 120 hrs of ‘education’, then spent a few months on a rig and now think that they’ve seen it all and know it all. I am a rather patient dude, but having to tell people, time after time, that ROSC =/= ‘saving a life’, seriously stretches the limits of my patience. Only to end  up hearing how ‘salty’ I am. Goddamn kindergarten.


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## EmergencyMedicalSike (Dec 11, 2017)

Qulevrius said:


> This is the scourge of EMS, right there - the 20 y.o.’s who pulled through their 120 hrs of ‘education’, then spent a few months on a rig and now think that they’ve seen it all and know it all. I am a rather patient dude, but having to tell people, time after time, that ROSC =/= ‘saving a life’, seriously stretches the limits of my patience. Only to end  up hearing how ‘salty’ I am. Goddamn kindergarten.


I always say “If you get to the point of pumping  someone’s chest with your hands, chances are they’re gone”


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## VentMonkey (Dec 11, 2017)

EmergencyMedicalSike said:


> I always say “If you get to the point of pumping  someone’s chest with your hands, chances are they’re gone”


But what if this directly contradicts the “so that others may live” tattoo on my forearm?...


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## EmergencyMedicalSike (Dec 11, 2017)

VentMonkey said:


> But what if this directly contradicts the “so that others may live” tattoo on my forearm?...


At least we’re skilled in the Heimlich maneuver?


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## Goofy (Jan 8, 2018)

I started on an IFT private company and stayed there for a year and half. When I got hired on a 911 private company that also did IFTs, I had the opportunity to work either BLS good schedule or ALS bad schedule. For three years I worked 911 and I loved it.


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## EMTlash (Feb 8, 2018)

akemt said:


> I've seen many threads with this topic. I am a new EMT and have one more day of training with an IFT company. However, due to submitting various applications to different companies, I have an offer for a 911 company as well. I don't know which to pick. I understand IFTs are what you make of it, is slower paced, you master vitals and talking to patients. 911 is what I went to school for and wanted to do. I don't know if starting with an IFT company is the best for me, granted I have no emt experience, or taking the opportunity to start as 911 and get experience and learn that way. Please help!!


Do 911, more fun and if you are not gonna be in EMS for long you are gonna get the best out of it.


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## FirstResponder (Feb 11, 2018)

Obviously your role is equally important; whether you're doing IFT or 911. If you've completed the training with the IFT company and you're confident in yourself that you've got the "basics" down, then take advantage of the 911 side of things. You'll have the opportunity to learn a lot more and challenge yourself. Not to mention- you'll probably enjoy it a lot more than strictly doing IFT's.


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