# Transitioning out of 911 system, need some guidance. Please



## Trauma Angel (Mar 6, 2017)

Hey all,
   First I just want to say that yes, I know I have a long road of hard work and time invested ahead of me. That being said...

I am currently an EMT working a an ambu in a fire based system where we're always within 10min of a hospital. Um, yawn! Lol
I want to expand my scope/work environment and feel that I am ready to start that journey. I've done a ton of research as far as different parts of the field, courses & certs, companies that cover the things I'm interested in doing and WOW. A little overwhelmed, not sure where to start. 

My ultimate/ideal goal is to get my medic and eventually get on with either a remote SAR team or an international PSD team (if that's even possible without military or LE background).

Will probably be taking the accelerated medic program at Health One in Denver. Meanwhile I'd like to get as prepared for medic school as possible. There are no iv therapy courses offered in my state, only 1 ecg class and it's like 3hrs away and all the pharmacology courses are specifically for nursing school students.

A-EMT or EMT-I course maybe? 
Also, what can I do that will better my chances of getting picked up for a SAR team or PSD team after medic school? 

Not too into the wilderness side of things (like the team they have out in Yosemite park for example) but companies that do stuff like Castle Inl., SOC, Triple Canopy, even Remote Medical Intl would be my absolute dream job.

Any advice? Suggestions? Directions to point me in? Anything at all would be greatly appreciated and if you're still reading, I apologize for the lengthy post. 

Thanks in advance and respectfully yours,
- Angel

Oh also, I'm rather petite and looooove Helos. Though that might be one area of the field where my size would come in handy. Maybe?


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## Handsome Robb (Mar 6, 2017)

PSD is going to be virtually impossible without military or lots of LE experience and even then they generally want tactical experience in a SWAT/SRT environment as a LEO. 

Most wilderness medical programs are going to want to see a lot of experience before they will even look at your application. SAR is mostly volunteer because the volume just really isn't there except for a select few areas like Yosemite. 

My advice would be to go to medic school and work towards getting a job with a reputable agency where you can get good experience and actually be a Paramedic and not just a protocol monkey. 

Most flight programs have height/weight limitations but they're generally north of 200 lbs so while being small make make the job easier for you it won't necessarily be something they look at when hiring you. Same for flight with the above advice, you're going to need a fair amount of experience before any good flight agency will look at you. 

Good luck! 


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## Trauma Angel (Mar 6, 2017)

Thanks for the advice Robb
One last question..... you said work as a medic with a reputable agency vs being a protocol Monkey. I'm guessing by protocol Monkey your referring to working a first due like the one Im in now right? Lol
Definitely agree with you there but how would I do that? Get on a truck that serves a rural area? Move out of the city and try smaller agency's? 
I live in Arizona so Rural metro has a monopoly on most of the EMS CONs out here unfortunately and they're a bit of a joke. Any ideas as far as other options?
Thanks again


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## luke_31 (Mar 6, 2017)

He's talking about where you have flexibility with treating your patients where if box 1 says do this then proceed to box 2 or 3 depending on an answer to a question you follow it to the letter is protocol monkey.  Being an actual paramedic is where you look at your patient see that the protocol won't cover how to treat them appropriately and using knowledge and experience administer the correct treatment for the patient, while understanding that the medical director you work under views the protocols as a guideline and not a hardfast rule to follow. A good system will be one that let's its paramedics treat patients without constantly calling for permission to give appropriate medications and treatments to the patient.


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## Trauma Angel (Mar 6, 2017)

luke_31 said:


> He's talking about where you have flexibility with treating your patients where if box 1 says do this then proceed to box 2 or 3 depending on an answer to a question you follow it to the letter is protocol monkey.  Being an actual paramedic is where you look at your patient see that the protocol won't cover how to treat them appropriately and using knowledge and experience administer the correct treatment for the patient, while understanding that the medical director you work under views the protocols as a guideline and not a hardfast rule to follow. A good system will be one that let's its paramedics treat patients without constantly calling for permission to give appropriate medications and treatments to the patient.



Got it. That makes sense lol  
How would I figure out what agency's operate like that though? Aside from knowing or having dealt with the medical director


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## NomadicMedic (Mar 6, 2017)

Trauma Angel said:


> Got it. That makes sense lol
> How would I figure out what agency's operate like that though? Aside from knowing or having dealt with the medical director



Ask around. Do a ride along. Read the threads here. Many of us are pretty vocal about agencies we work (or worked) for. Both the good and bad.


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## VentMonkey (Mar 6, 2017)

Op, judging by your questions your still green, which is fine. Start here, and no not because I created it, but because it has good insight and feedback from others on the forum that I respect as well. They're all pretty well versed, and/ or seasoned.

https://emtlife.com/threads/whats-it-mean.45412/

If you still don't "get it", don't waste yours or anyone's else's time in this field. All the questions you're asking mean squat in the grander scheme of any paramedic who's worth their weight. They're things you're expected to know, and if flight or some other non-911 system job really is your goal, these folks who've taken time to provide their feedback are the ones to learn from, good luck.


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## RocketMedic (Mar 11, 2017)

Local example: 

Agency A: "That guy looks sick. Protocol is to toss him on oxygen, load and go."
Agency B: "That guy looks sick. He's hypotensive, hypoxic, hypothermic and that smells like a GI bleed. Let's start high-flow oxygen, bilateral large-bore IVs, a fluid bolus and rapid transport."
Agency C: "That guy looks sick. He's hypotensive, hypoxic, hypothermic and that smells like a GI bleed. Let's start high-flow oxygen, bilateral large-bore IVs, and check their hematocrit; I think we may need to transfuse him."

It's all protocol-"driven", but there is somewhat of a difference between how much a particular agency wants people reading into situations.

i.e. STEMI. Some protocols mandate that the computer give its opinion to activate a cath lab, others offer some rudimentary guidance like "elevation-only", and some places get in axis shifting, posterior leads, and all sorts of oddities. 

My advice: if you _really_ want to do weird PMC stuff, see a US Armed Forces recruiter and discover if you like that work first. It's really, really not for everyone, or even most veterans. I'm not in the mood myself to go play medic downrange again, or to go at all. Remote Medical International is a great organization, but it's more of a charitable primary-care service, not exactly a paying gig or even particularly needy of a paramedic.


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## Trauma Angel (Mar 13, 2017)

RocketMedic said:


> Local example:
> 
> Agency A: "That guy looks sick. Protocol is to toss him on oxygen, load and go."
> Agency B: "That guy looks sick. He's hypotensive, hypoxic, hypothermic and that smells like a GI bleed. Let's start high-flow oxygen, bilateral large-bore IVs, a fluid bolus and rapid transport."
> ...




Oh man, thank you roclet!  The detailed and direct response is incredibly appreciated. I've been entertaining the idea of going 68W with the army but 8 years is a long time and imoney alread 32. Could I handle? I have no doubts? Is it for me? Only one way to find out right? The only that has stopped me is that I do want children at some point (when I'm ready-ish) which means after I get my patch forbsure. I'm afraid if I go military I'll miss out on my chance to have kids. I'm still considering it.
Funny you mention RMI, I just started their A-EMT course. Unfortunately my state doesn't even recognize that cert level but I'm doing it for the expertiemcee anyway. 
Why about reserves? Will I get any legit field experience going that route? 
Personally, if I'm gonna sign my soul away for 8 years to the government I might as well get everything I possibly can out if it, things I couldn't get as a civilian. 
I know army doesn't guarantee specific jobs in their contract. From what I understand a 68W could be a clinic tech, a combat medic or anything in between. Just depends on what the needs of your assigned unit are and you're test scores. Is that correct?


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## RocketMedic (Mar 13, 2017)

You only have to enlist for three years. Eight is the "full" commitment, counting inactive reserve time, which you won't get called up for. 

You are correct in that you may not end up a combat medic, but even if you don't, you already have way more field experience in prehospital medicine than any conventional medic and probably more than a few SF ones. Simple answer is that most medics don't do anything combat related, even if they are assigned to a combat unit and deploy in that capacity. If you want injury, naval corpsmen do a lot of primary care as well.

As for kids....plenty of people have kids on the Army.


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## Trauma Angel (Mar 13, 2017)

RocketMedic said:


> You only have to enlist for three years. Eight is the "full" commitment, counting inactive reserve time, which you won't get called up for.
> 
> You are correct in that you may not end up a combat medic, but even if you don't, you already have way more field experience in prehospital medicine than any conventional medic and probably more than a few SF ones. Simple answer is that most medics don't do anything combat related, even if they are assigned to a combat unit and deploy in that capacity. If you want injury, naval corpsmen do a lot of primary care as well.
> 
> As for kids....plenty of people have kids on the Army.




I am very seriously considering this option. More so than I was before. I always regretted not enlisting out of high school, life would have turned out very different had I done it. Anywho, any significant differences come to mind when deciding between corps man vs 68W? Aside from the obvious


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## NysEms2117 (Mar 13, 2017)

Trauma Angel said:


> Anywho, any significant differences come to mind when deciding between corps man vs 68W?


Are you crazy? Then corpsman's for you. Half joking of course, corpsman tend to be a bit more "out there" and of the "loose cannon" type in my personal opinion, still great guys/girls though. Do you want to be in the navy/attach with a marine corps unit, or be in the army? Theres a ton of videos on the internet comparing the two. Although if i'm not mistaken 68w's and corpsman tend to be doing more "er tech" type of work at the moment, instead of that movie type battlefield medicine. Idk because i haven't looked into it, but a buddy of mine who's big into military stuff said theres some kind of 2 year enlistment with the army because their NCS(call to service) just got cranked sky high. I'd definitely look into the fine print with that.


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## RocketMedic (Mar 13, 2017)

Do you want to be stationed at El Paso or Japan?

Do you want to train and focus exclusively on combat injury or are you looking for a rounded approach?

Do you want to see the world or the world's slums?

Navy is a better experience, but Army is an easier transition.


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## Jim37F (Mar 13, 2017)

RocketMedic said:


> Do you want to see the world or the world's slums?








(Sorry, couldn't resist lol)


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## VentMonkey (Mar 13, 2017)

Seriously though, OP, if you're looking to enlist you ought to do it yesterday. Like Rocket said, you can still have a family and all that, but if you're dead set on some sort of combat/ tacti-cool medic gig you'd better act fast. 

None of us are getting any younger. If your goal is to "fly", and are willing to do civilian work, that's not much easier; either way the deck is currently stacked against you. There are tons of other candidates that try year after year to do flight, some ex-military with combat experience, so hopefully you see where I am going. Sometimes I regret not enlisting, but at the end of the day things worked out fine.

You said you wanted honest advice, so the honest truth is you need to act, and decide, none of us can make your mind up, answer your questions, or help you at this point more than yourself and perhaps your local recruitment office.

If you decide to skip the military and go for your medic, your best bet is EMT--->medic with little lag time in between then a whole slew of specialty certs, solid field experience, and many applications. You may luck out and score an "awesome job" sooner than expected, but truthfully most jobs that seem exciting, cool, or don't pertain to "traditional 911" aren't just handed out, they require quite a bit of ambition, and self-motivation.


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## NomadicMedic (Mar 13, 2017)

And as an aside, if your state doesn't recognize AEMT, it's a waste of money. And Remote Medical, while great guys, grossly overcharge for their program. (Don't even get me started on MPIC)


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## Trauma Angel (Mar 13, 2017)

NysEms2117 said:


> Are you crazy? Then corpsman's for you. Half joking of course, corpsman tend to be a bit more "out there" and of the "loose cannon" type in my personal opinion, still great guys/girls though. Do you want to be in the navy/attach with a marine corps unit, or be in the army? Theres a ton of videos on the internet comparing the two. Although if i'm not mistaken 68w's and corpsman tend to be doing more "er tech" type of work at the moment, instead of that movie type battlefield medicine. Idk because i haven't looked into it, but a buddy of mine who's big into military stuff said theres some kind of 2 year enlistment with the army because their NCS(call to service) just got cranked sky high. I'd definitely look into the fine print with that.



I definitely was not aware of such a thing. Thank you for the idea and taking the time to reply.


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## Trauma Angel (Mar 13, 2017)

VentMonkey said:


> Seriously though, OP, if you're looking to enlist you ought to do it yesterday. Like Rocket said, you can still have a family and all that, but if you're dead set on some sort of combat/ tacti-cool medic gig you'd better act fast.
> 
> None of us are getting any younger. If your goal is to "fly", and are willing to do civilian work, that's not much easier; either way the deck is currently stacked against you. There are tons of other candidates that try year after year to do flight, some ex-military with combat experience, so hopefully you see where I am going. Sometimes I regret not enlisting, but at the end of the day things worked out fine.
> 
> ...



Dear VentMonkey,
  Did I say something that offended you or something? I feel like you interpreted my desire to broaden my experience in different parts of the field as a insult to those who work the 911 system. First of all, I said that SAR/PSD was an "ultimate goal". Does that mean that's all I want to do? No. Does that mean I will definitely expect to make it to such a position? No. Does that mean ANY part of the EMS field is above or below another? No. Definitely not. 
Yes I very much agree that I "need to act" and am "not getting any younger" which is exactly why I feel it's important I make a wise and informed decision as to my next move to ultimately find what part of the field I truely belong in. Hence me being here seeking information from those who have already been there and done that. The whole point of as forum is information, is it not?
And FYI I spent a few years in the 911 system and loved it. BUT being an EMT in an urban as well as fire based system severely limits my learning potential unfortunately. My company pays next to nothing and has ands specific clause in our contract (in bold lettering actually) that they will not in anyway work with us to accommodate any school schedule. And we can only swap 2 shifts per month! Lol soooooo yeah, excuse me for wanting to set bigger goals and have dreams. Please feel free to ignore any post or question you may see with my name on it from here on out.
Thanks to everyone else though for your time and thoughts,very much appreciate all the 411 guys


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## VentMonkey (Mar 13, 2017)

Trauma Angel said:


> Dear VentMonkey,
> Did I say something that offended you or something? I feel like you interpreted my desire to broaden my experience in different parts of the field as a insult to those who work the 911 system. First of all, I said that SAR/PSD was an "ultimate goal". Does that mean that's all I want to do? No. Does that mean I will definitely expect to make it to such a position? No. Does that mean ANY part of the EMS field is above or below another? No. Definitely not.
> Yes I very much agree that I "need to act" and am "not getting any younger" which is exactly why I feel it's important I make a wise and informed decision as to my next move to ultimately find what part of the field I truely belong in. Hence me being here seeking information from those who have already been there and done that. The whole point of as forum is information, is it not?
> And FYI I spent a few years in the 911 system and loved it. BUT being an EMT in an urban as well as fire based system severely limits my learning potential unfortunately. My company pays next to nothing and has ands specific clause in our contract (in bold lettering actually) that they will not in anyway work with us to accommodate any school schedule. And we can only swap 2 shifts per month! Lol soooooo yeah, excuse me for wanting to set bigger goals and have dreams. Please feel free to ignore any post or question you may see with my name on it from here on out.
> Thanks to everyone else though for your time and thoughts,very much appreciate all the 411 guys


Offend me? Lol, hardly. FWIW, I share similar viewpoints with many of the other posters you've so graciously thanked. Now, I'm not speaking for them, nor would I expect them for me.

Too often people come on this forum and ask the same, or similar questions that you're asking. Look two or three threads down in this very sub forum, and you'll find @NysEms2117 started a thread about SAR-type jobs. In it you may find another option called BORSTAR; if it isn't in that thread use the search bar, or google-fu.

Now, if you fail to see the type of non-sugarcoated help some people offer on this site then so be it. Let us know how that works out for you in the military, BTW.

A "few years in a 911 system" that's cool. I can respect wanting to pursue higher education, or expand your stale role (if you only knew...), my guess is there isn't as much "trauma" to be found in the 911 system as you thought? That's ok, too.

People on here have many different ways of offering up their help, and just like in life, oftentimes it's what you make of it. I too got tired of "routine 911 calls", but again aside from searching the forum for yourself (information, remember?) about such matters, one wouldn't know what they don't know.

I don't apologize for giving you the answers the way you didn't want to hear. Much like the many trainees, or interns who thought I was "so mean" because I was blunt, only to thank me later on for helping them avoid the rock I'd previously tripped on. Anyhow, good luck and that is all for now.

-VentMonkey


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## Trauma Angel (Mar 13, 2017)

VentMonkey said:


> Offend me? Lol, hardly. FWIW, I share similar viewpoints with many of the other posters you've so graciously thanked. Now, I'm not speaking for them, nor would I expect them for me.
> 
> Too often people come on this forum and ask the same, or similar questions that you're asking. Look two or three threads down in this very sub forum, and you'll find @NysEms2117 started a thread about SAR-type jobs. In it you may find another option called BORSTAR; if it isn't in that thread use the search bar, or google-fu.
> 
> ...


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## RocketMedic (Mar 13, 2017)

Trauma, your current company wants meat on the seat and billable reports. That's it. If you want to develop, find a new job. ED tech, government service, anything else. 

If you really want PSD, you need to start looking at the military, because PSD is a very small market with a very selective process and they really don't care what you've done if you're an alternative entrant. Without green hats or tridents or whatever weird thing PJs wear, I wouldn't waste the time applying. With that being said, the vast majority of a "tactical medic" job is not medical at all. 

If you want to fly like Vent, you need to go to medic or RN school and get some experience as such, stay light and apply. Of you can't do that at your current employer, move.


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## MackTheKnife (Mar 17, 2017)

RocketMedic said:


> You only have to enlist for three years. Eight is the "full" commitment, counting inactive reserve time, which you won't get called up for.
> 
> You are correct in that you may not end up a combat medic, but even if you don't, you already have way more field experience in prehospital medicine than any conventional medic and probably more than a few SF ones. Simple answer is that most medics don't do anything combat related, even if they are assigned to a combat unit and deploy in that capacity. If you want injury, naval corpsmen do a lot of primary care as well.
> 
> As for kids....plenty of people have kids on the Army.


She could get called up in reserves.

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## Trauma Angel (Mar 17, 2017)

MackTheKnife said:


> She could get called up in reserves.
> 
> Sent from my XT1585 using Tapatalk




Which I am more than fine with. Honestly if I do end up going military I'd go active duty. If that's where I end up than let's go.. all or nothing. That's how I see it anyway


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## MackTheKnife (Mar 18, 2017)

Go active duty. Navy Corpsman, Army medic. Get the GI Bill, separate, stay in reserves. Go to school and get paid doing it. Figure out if you want to go paramedic or nursing, etc.

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## SandpitMedic (Mar 18, 2017)

I'd investigate the age restrictions for enlisted vs. commissioned and active vs. reserve vs. national guard. 

At 31 there may be branches of uniformed service that she is unable to join.


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## MackTheKnife (Mar 20, 2017)

Last I heard, up to age 39.


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