Critical Care Transport


Use to be "that private" now I'm "that specialist"
Hello everyone. I don't know exactly where to post this, I recently passed my state test (just got the results!!) and will be start working for a 911 system in NC. I have been giving a lot of thought to a critical care job in a few years. I know I will have to do 3-5 years in 911 to gain the skills and experience needed for a critical care job. I have also tossed around the idea of nursing school (but I don't like to be inside and I really enjoy EMS). Has anyone on here ever went from 911 paramedic to a CC nurse? What was the experience like and what help you make the transition? Any advice, tips or first hand experience about moving from a 911 paramedic to a critical care paramedic (or even nurse) would greatly be appreciated. Thanks!


Forum Deputy Chief
I dont know how things are done in NC, but there are places where Paramedics work as true critical care providers, and others where nurses are the primary critical care providers (for prehospital).

California is working on a formal Critical Care Paramedic scope of practice, Texas has quite a bit of critical care work, and where I work in Missouri we do a fair bit of critical care transports.

Once you feel you have the experience and knowledge required, you can test for the FP-C or CCP-C, or even CCEMTP. FP-C is Flight Paramedic Certified, CCP-C is Critical Care Paramedic Certification, and CCEMTP is Critical Care Emergency Medical Transport Provider.

These certification will open doors on your quest for critical care, but they are rarely required to get started in critical care. Usually all that's required is willingness to learn and some smarts.


Flight Nurse
Not necessarily directed at you but I commonly hear "I wouldn't want to work in a hospital", "I can't imagine spending 12 hours with one patient", or "EMS is more fun", etc when discussions like this come up. In my not so humble opinion there is no better critical care experience than being a ICU provider. You spend hours a day every day managing critically ill patients and being involved in almost every aspect of their care. You will see, do, and learn things that you will not in EMS. It can be boring and monotonous at times but do not let that deter you from the amazing knowledge base it will provide you. I love EMS, and sometimes can't imagine going back to the hospital, however the years of bedside ICU experience are what make a great critical care provider.

Nursing is a great option. It is a good education that affords many opportunities and a comfortable life-style. Just like everything else you will have to put in work for school and then time in an ER or ICU for 3-5 years to back into EMS or HEMS but it can be very rewarding.

There are a lot of awesome CC/HEMS Paramedics on this forum that can give you insight on that aspect.


Forum Deputy Chief
I think nursing is probably a better background for CC. Not that EMS is bad, but on a day to day basis and taking care of legit sick patients nursing likely has more learning opportunities. For reference though, I run about 1700~ calls per year. I get good experience just through sheer volume, but the vast majority aren't ALS. A very small set of those patients am I actually providing aggressive ALS care with airway management, cardiac drugs, pressors, etc. A decent, but still small percentage are ALS, but either lower acuity (Mild asthma) or soft in the skills side (Strokes). Working in an ICU, you filter out the drunks, finger cramps, tooth aches, and all the other 911 BS. Then there is what @VFlutter mentioned about seeing long term care, managing and being hands on with a wide variety of things on a regular basis, and everything else that goes into making it a solid foundation.

Don't get me wrong, I absolutely love what I do and am in the process of taking a CCP course myseld. Nursing just seems to have more to offer in terms of regular learning opporities from a best bang for your buck perspective. That being said, EMS also has a lot to offer in terms of experience for HEMS and CC that you probably don't get much of in nursing, so there is that.

At the end of the day, do what you enjoy and do it well. The rest will fall into place.


Family Guy
Hello everyone. I don't know exactly where to post this.
For future reference, probably in the HEMS/ Air Medical Transport sub-section.

The topic of career route RN vs. paramedic has also been asked or talked about on numerous occasions on this forum. I don’t know if that’s what you’re specifically asking though. I also don’t know what level of a provider you are currently. Can you expand on this?

Like everyone is saying though, it all comes down to what will give you the most fulfillment. If you have your heart set on being a paramedic right now, you would more than likely be miserable (or at least bored) sitting through the RN school/ prerequisites process.

On the other hand, if you could go either way go nursing first. Aside from the obvious benefits financially and career-wise, the education is formatted to fit the “professional-minded” critical care provider, or at least most of them.

As a “critical care” paramedic your experience, protocols—and most importantly—education will vary greatly. From what I have seen, learned, and know the more you possess intrinsic self-motivation and the more you have a true desire to learn the extra “advanced topics” that CCP’s traditionally encounter, the easier and more enjoyable it will be.

Long term, nursing will carry your career years beyond that of the average CCP’s aging body. You can always bridge one to the other, and RN—>paramedic/ CCP/ FP-C etc., etc. is much more practical. It just takes a bit more time, and arguably, patience.

TLDR, you’re much more limited in the long run as a CCP than you are as an ICU RN. ICU RN’s are typically some of thee most clinically educated people when it comes to true treatment of the critical ill, and injured. You can still learn to manage these patients from Point A to Point B as a CCP, but being on the same level as a good ICU RN, weeell...


Californian, Lost in Texas
I chose the one that it feels right to play Power Glove's "Night Force" to. I honestly have no interest in nursing.