# Casino EMTs or other on site medical staff



## TacEMT (Jun 17, 2011)

I was wondering if anyone has ever worked as an EMT in a casino or some other physical property (non-ambulance, fire, or hospital) area that hires their own EMTs. I am interested in working as an EMT in a casino. What kind of calls do they respond to? Whats their usual scope of practice, and do you thinks its a good work environment. 

My personal impression on what I have seen, though I have never actually spoken to any of the employees before, is that they provide the routine first aid/CPR/AED to basic slip and falls, intoxication, or generaly individuals not feeling well. 

My main questions focuses on scope of practice. Everything taught in my EMT class was considering you were working in an ambulance or hospital environment where you had full use of the equipment. Being an on site EMT, it appears that they have only limited equipment to work with and usually have to call 911 as a precaution. Do you get a chance to use an airway adjunct, BVM, sunction, or even provide oxygen? Also whats the training and continuing training like. Do you fall under some type of medical direction as well?

Any input would be great. Thank you


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## mycrofft (Jun 17, 2011)

*I talked to a guy once, and been in casinos.*

(Taking Mom to play blackjack, that is  ).
First, not only are you an EMT, but also security, laying out and rearranging que barriers, lost and found, basically an "everything except everything else" sort of deal. This was not in a big Vegas or Atlantic City style casino.
There are a lot of little old people in there with oxygen concentrators and cylinders, in wheelchairs, and a lot of not so old people with obvious serious debilities and weight issues, but apparently in the smaller houses there is very little EMS action versus "everything else".


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## Sako887 (Jun 17, 2011)

was there a big difference in pay compared to a private company?


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## mycrofft (Jun 17, 2011)

*No idea about comparative pay. Check each venue.*

tencharacters


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## Akulahawk (Jun 17, 2011)

A lot of casinos hire EMTs in a dual security/EMT role. Basically, you respond to medical incidents on site. As to treatment, it can be a lot of first aid station kind of stuff... band-aids, people asking for OTC meds... mostly minor stuff. It can be full-blown CVA, MI, stabbings/shootings (pretty rare), or pretty much anything else you can think of. You're not transport, so you have to quickly determine whether or not transport is necessary and get your dispatcher to roll 911 or not... 

Oh, and employment is entirely at will... so you can be fired if someone complains about you... or if the "right" person complains about you. 

For the record, I have never worked at a casino, but I have worked with people that have.


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## TacEMT (Jun 18, 2011)

I know the casino EMTs that I have seen, and actually Akulahawk, they are around the Sacramento County area, and some in Vegas, are with the Casino security department. Because they do have a dual role, I'm sure they get an equal balance of medical calls and security related calls. Even as a mall security guard before, I responded many medical calls. 

Given that is with security, I am guessing the pay is only at or about 12-15 dollars an hour. 

Does anyone know what type of equipment they can carry, at least EMT related. They guys I seen carried large pouches, inside could be a first aid kit, or a BVM for all I know. I'm interested in finding out what they can carry and what they can do. I think their scope is a limited. I doubt there is med control, so the most I seen a EMT doing is conducting a primary assessment, provide oxygen if they have it, and get a sample and opqrst history. If any event that requires CPR, BVM, AED, dropping an OPA, NPA, sever bleeding or other major trauma, I think 911 would of been called immediately upon notification of the incident.


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## yanikemt (Jun 18, 2011)

I have been working at a casino for two months now. Its a good step while your waiting for call backs from ambulance companies. We have 3 EMTs staffed on our busiest nights. I work Graveyard so I don't see as much as some of the other guys do on other shifts. Our pay is 16-17 an hour. But in the two months I have had two serious calls Diabetic and seizure. I have had to bag patients and my last one involved c-spine. I have also dealt with intoxicated guests falling and a lot of first aid such as kitchen staff slicing there hand open.

As for equipment we have medical bags with BVM's, O2 Tank, burn dressings, c-spine, splints, NRB, Oral airways, suction, glucose, and more

So I mean you do see quite a bit some serious some not. For example we had a cardiac arrest last month, but it was the shift before me. Keep in mind the casino I work at is one of the smaller ones, just very busy. The bigger casinos I hear the EMTs can get up to 10 calls a day.
Like stated above you are usually dual role so I also do security which keeps me busy.


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## mycrofft (Jun 18, 2011)

*Venues hire them also, or contract.*

Companies I worked for did standby during horse racing season and pre-season at AKSARBEN and Neb State Fair grounds tracks. Calif State Fair has its own first aid operation. Seasonal, but I understand some companies will re-hire you year after year if you work out and stay in touch.

Most venues want the pt pkged and out ASAP, no "single combat with Death" on the casino floor or in the Food Court.


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## TacEMT (Jun 19, 2011)

Thanks for the responses. I guess Casino EMTs, depending where you work, do get their fair share of medical calls. Thats probably why they hired "on site" EMTs in the first place. I know there is a local organization where I am that hires volunteer EMTs to staff speical events, mainly to assist marathon runners. Even some night clubs hire EMTs for the amounts of intoxications and drug overdoes. 

Yanikemt, Do you guys carry any other drugs other then oxygen and glucose? An Epi pen or aspirin? I am guessing you guys can check blood glucose levels as well? Also are you under any kind of medical direction? 
Also how does work since your dual with security, are you security first or EMT first?


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## Chimpie (Jun 19, 2011)

TacEMT said:


> Thanks for the responses. I guess Casino EMTs, depending where you work, do get their fair share of medical calls. Thats probably why they hired "on site" EMTs in the first place. I know there is a local organization where I am that hires volunteer EMTs to staff speical events, mainly to assist marathon runners. Even some night clubs hire EMTs for the amounts of intoxications and drug overdoes.
> 
> Yanikemt, Do you guys carry any other drugs other then oxygen and glucose? An Epi pen or aspirin? I am guessing you guys can check blood glucose levels as well? Also are you under any kind of medical direction?
> Also how does work since your dual with security, are you security first or EMT first?



If you're pushing oxygen you better be under the direction of medical control.  

A scene has to be secure before you can provide care.


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## medicdan (Jun 19, 2011)

I know a few venues around here (one of which is a casino) that instead of fooling around with First Responder SOP, a half-medical director and contracting for an ambulance service to cover their transports... just bought an ambulance for the building. There are 2-3 stretchers scattered around the casino floor, and when the Security Officer/EMTs initiates patient care that requires transport, they just grab a stretcher, ask a partner to move the truck, load and go. 

I even know one that has an ALS license (depending on staffing, they keep 2-3 medics in the building, but can run calls PB). They have extra ALS equipment, but the problem is that the ALS license leaves when the truck does... so they technically cannot continue providing ALS-level skills when the truck is transporting.


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## yanikemt (Jun 19, 2011)

TacEMT said:


> Yanikemt, Do you guys carry any other drugs other then oxygen and glucose? An Epi pen or aspirin? I am guessing you guys can check blood glucose levels as well? Also are you under any kind of medical direction?
> Also how does work since your dual with security, are you security first or EMT first?



We don't have glucometers. we carry other ointments/creams, no epi pen or asprin. And we are EMT first when it is a medical call we have on scene control over everybody (including security supervisors).


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## LucidResq (Jun 19, 2011)

The amusement park I used to work for has full ALS capabilities, every drug and piece of equipment you'd find on a rig, and obviously a medical director. The medical director also granted some special protocols for us (for example - you're not going to send every syncope patient to the hospital). It is completely separate from any ambulance service.


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## TacEMT (Jun 20, 2011)

I am surprised that some of these sites have ALS capabilities and even tranport vehicles. Do you guys know what the reason why, specifically, they had to go that route for pateint treatments? as most places have no special medical capabilities beyond basic CPR and first aid. Were those sites experiencing a high level of medical incidents that required ALS were calling 911 was innapropriate or had a slow response time?


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## LucidResq (Jun 20, 2011)

I don't think the amusement park I worked for is any worse than any other busy one... with as many as 22k + people in a small area playing around in the heat, sometimes getting intoxicated and/or in fights... you do see quite a few patients.

 I think the only thing that may make this particular park more prone to issues is that it's a mile-high attraction - many out-of-town visitors find that riding rollercoasters in the heat and such after rapidly gaining a mile in altitude doesn't bode well for them. 

I'd guess at the the park 85% of your patients are going to be very cut-and-dry basic first aid (minor lacs, burns, nosebleeds, etc). 

10-12% at least need ALS assessment and possibly treatment, but can be handled without transport. For example - syncope, dehydration/heat illness, anxiety attacks, nausea/vomiting, sick cases, etc. These are the folks I'm more comfortable having a paramedic check out just to be safe, but we can release after PO fluids and air conditioning PRN... occasionally as much as IV fluids or a neb. They will either return to the park or go home. 

Then there's the 3-5% that will go to the hospital. Broken limbs, cardiac-related chest pain, signs of appendicitis, patients with heat-related illness that don't respond appropriately to treatment, etc. On-site paramedics make a difference here simply by reducing ALS response time by a few minutes. 

I think the biggest reason for on-site ALS is that the company enjoys the customer service benefits, especially for those in the 10-12% that can get some relief and help but don't have to have their day ruined. We can often make them feel better so they can enjoy the rest of their day, or at least not have a miserable car ride home. 

It's also an easy way to provide some occupational health for a large number of seasonal employees. We are also the starting point for worker's comp, and the medics give immunizations to the lifeguards.


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## PhillyEMT (Jul 23, 2014)

I've been working as a casino EMT (not in Philly or PA, despite my user name) for over four years now. It sucks because the casino is more worried about risk management than EMS. 

I do get some serious calls, mostly involving the elderly or younger people with drug/alcohol issues. Most of my serious calls are SOB, chest pain, or syncopal episodes. I've worked multiple codes since I've been there. Trauma calls are few and far between (or legit trauma calls, anyway, outside of basic first aid).

However, risk management is what the company is worried about. The amount of paperwork I have to do with a guest/employee injury is ridiculous. Plus there are medical policies in place where we are required to dispatch an ambulance and , which can get pretty tiring. As in, why is my boss making hold c-spine and dispatch EMS for a guy who slightly bumped his head during a trip-and-fall? A lot of the local medics HATE responding to our calls because a lot of it is BS. 

Plus everything on the casino floor is on camera and I mean EVERYTHING. A co-worker of mine was suspended for using a sternal rub on critical patient when said patient started going unresponsive. Why? Because the patient's wife said my co-worker was trying to harm her husband. They were VIP. The bosses (most of whom have no EMS experience at all) reviewed the footage surveillance had of the call and almost fired my buddy. Left him hanging on a two-week suspension without pay, wondering if he was going to get terminated or not. 

Basically, if you really love EMS -- I do it for a job, not as a passion, though I do my job well -- don't do it at a casino. Because at the end of the day, your primary function is to make sure the wheezy old lady who bumped her elbow on a slot machine can't sue the company.


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## DFD338 (Jul 27, 2014)

I work as Security/EMT for a casino in New York. First and foremost you are Security and then EMT. We deal with everything here; drug overdose, full arrests, diabetic emergencies, cuts to everything, tip and falls, attempted suicides. Don't forget the ludicrous amount of drunks being drunk and fights because of it. I work grave shift so I deal with the fights and drunks a lot. As far as age goes, we deal with every age group out there. When not doing medical calls, we are security guards. Doing everything a regular guard would do.  If we're doing some security thing and a medical comes we have to wait to be relieved to respond.


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## Viper131 (Sep 2, 2022)

TacEMT said:


> I was wondering if anyone has ever worked as an EMT in a casino or some other physical property (non-ambulance, fire, or hospital) area that hires their own EMTs. I am interested in working as an EMT in a casino. What kind of calls do they respond to? Whats their usual scope of practice, and do you thinks its a good work environment.
> 
> My personal impression on what I have seen, though I have never actually spoken to any of the employees before, is that they provide the routine first aid/CPR/AED to basic slip and falls, intoxication, or generaly individuals not feeling well.
> 
> ...


Yes I work for one, do EMS and Fire. The place I work for had all medical equipment needed including a few ambulances.


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## akflightmedic (Sep 2, 2022)

8 year thread bump created in 2011 and last replied to in 2014....impressive, but not the record.


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