IFT or 911?

[DrParasite]

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.......

 

[gonefishing]

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

 

[akemt]

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!!!

 

[iExposeDeformities]

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

 

[Aprz]

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!

 

[iExposeDeformities]

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....

 

[luke_31]

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.

 

[Old Tracker]

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.

 

[iExposeDeformities]

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

 

[RocketMedic]

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.

 

[Aprz]

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!

 

[Gurby]

Of course there’s nothing greater than breaking ribs

¯\_(ツ)_/¯

 

[StCEMT]

Of course there’s nothing greater than breaking ribs

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

 

[VFlutter]

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

 

[Qulevrius]

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 ?

 

[EmergencyMedicalSike]

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

 

[Carlos Danger]

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.

 

[Akulahawk]

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....

Of course there’s nothing greater than breaking ribs

I suggest you look at the quote below...

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.

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.

 

[Qulevrius]

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.

 

[EmergencyMedicalSike]

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”