Private IFT BLS to 911

[Emt257]

Hi guys, I saw some similar threads and don't want to hi-jack theirs with my own issues lol. I was just wondering what you all recommend on this...

I have a goal of becoming a Paramedic, I currently have enough hours for all my local schools to qualify but I have zero ALS experience and Fall 2018 is the soonest I can start at a school. I'm torn between getting some ALS experience or staying with the private BLS company while going to school since I know I can work my schedule around class.
Problem with the BLS company is I feel like I'm not learning anything new, nothing to prepare for a 911 role and I know it's a different world compared to the BLS pick up, take some vitals, drop off, repeat world. Being in California as well our scope of practice here is pretty limited so we really don't do much, can't even check blood sugar....

I was just curious if you guys recommend working with a Paramedic and get some of that experience prior to a Paramedic program.

Also the only 911 company in my area is AMR and I don't know anyone working for them as an EMT right now so if anyone works with them I wanted to ask how you like it.

 

[DesertMedic66]

Everyone is going to give you different responses. There is no one way of doing it. Some people can pass medic school fresh out of basic with no field experience while others want field experience.

The real answer is the one that works best for you. Do you need ALS experience to pass medic school? No. Will it help? Maybe.

The benefits to staying at your company right now is that your schedule is flexible and you are used to the system.

The benefits to working at an ALS company is that: you will get to work with a paramedic partner (good or bad), you will respond to more critical patients and will be able to see them, you will be able to see how 911 calls are generally ran, depending on your area your company may actually pay for your medic school or may actually pay you to go through medic school and pay for the school. The downsides are you will have to adjust to a brand new company in possibly a new area and they may not be as flexible with your schedule.

 

[DrParasite]

I was just curious if you guys recommend working with a Paramedic and get some of that experience prior to a Paramedic program.

Not really. It can be nice, and you can become a really good paramedic helper; but if you have a really sick patient, you are stuck driving.

Before I moved to NC, I had never worked with a paramedic. I had worked at several ALS provider agencies, on a BLS 911 truck, but never had a paramedic looking over my shoulder and telling me what to do. I have dealt with many sick patients, but that's also the benefit of working in a Tiered EMS system.

Will working at a paramedic agency help you in paramedic school? ehhh, maybe, but I doubt it. What working at a paramedic agency will allow you to do is simply transfer from a BLS position to an ALS position, vs coming in from the outside. Many paramedics have trouble getting that first 911 job, because they have no experience working as paramedics. If you are already working for the company, than you can overcome that hurdle more easily.

 

[Emt257]

The benefits to working at an ALS company is that: you will get to work with a paramedic partner (good or bad), you will respond to more critical patients and will be able to see them, you will be able to see how 911 calls are generally ran, depending on your area your company may actually pay for your medic school or may actually pay you to go through medic school and pay for the school. The downsides are you will have to adjust to a brand new company in possibly a new area and they may not be as flexible with your schedule.

Yea that's kinda what I want, even if the paramedic does most of the work obviously, it would just be nice to see the whole 911 process upfront and being part of it. Going through EMT school I really enjoyed my rideouts with the 911 company. I think my biggest issue to be honest is I'm getting bored with the IFT stuff and looking for more to do. Just too repetitive going to the same few destinations and constant long distance transports. The company I'm looking into actually does pay for medic school, one of those "we pay if you work X amount of years for us" deals.

Before I moved to NC, I had never worked with a paramedic. I had worked at several ALS provider agencies, on a BLS 911 truck, but never had a paramedic looking over my shoulder and telling me what to do. I have dealt with many sick patients, but that's also the benefit of working in a Tiered EMS system.

I would actually prefer the 911 BLS like that because I like being on my own but they don't run those rigs in my area :/ it's only BLS IFT, CCT and ALS. I've even considered jumping state nearby to a company expanding their BLS 911 rigs.

Just FYI guys between my own thinking, what I've read and your replies I started the application process for the 911 company. If it goes through or I follow through tho, we'll see lol.

 

[VentMonkey]

There’s currently a huge shift in our deployment model. Our BLS units are running a large majority of our 911 calls due to our currently growing supply vs. demand. ALS will even rendezvous with our BLS units and intercept so that our ALS units can go back in service.

I don’t know exactly what admin has planned long term, but I believe our VP’s last memo said that the last weekend they reviewed, BLS ran nearly half of our 911 call volume.

This is in California, and they also sponsor and “pay if you work X amount of years” as a paramedic here.

 

[Emt257]

VentMonkey, what county is that if you don't mind me asking.

 

[VentMonkey]

VentMonkey, what county is that if you don't mind me asking.

Kern County, CA.

 

[DesertMedic66]

Also something to keep in mind is not all companies will pay for medic school for a brand new employee. There may be a time requirement (ie in good standing with the company and 6 months of service).

 

[Tigger]

Will working at a paramedic agency help you in paramedic school? ehhh, maybe, but I doubt it. What working at a paramedic agency will allow you to do is simply transfer from a BLS position to an ALS position, vs coming in from the outside. Many paramedics have trouble getting that first 911 job, because they have no experience working as paramedics. If you are already working for the company, than you can overcome that hurdle more easily.

I've never done something, but sure, I'll throw my two cents in. :/

It will absolutely help. Being able to relax on the many nonsense calls you run during internship is a great benefit. Those that have minimal experience can still be intimidated initially by the most basic of calls, which is totally fair since it's a foreign environment. Being well practiced in the basic skills that paramedics still do (apply the monitor, move patients, call into the hospital, etc) can be of serious benefit because you've greatly lessened your workload in terms of what you have to be proficient with by the end of internship.

All that said, is any of the above of deal breaker? Absolutely not. Any decent program should make you a competent baseline paramedic. You might just have to work harder to get there.

 

[DrParasite]

I've never done something, but sure, I'll throw my two cents in. :/

I hope your not referring to me, because I have worked on paramedic ambulances..... just not in NJ, only in NC, which is exactly what I said. And in my paramedic school, many of my classmates had never worked on an ALS ambulance; we even had some that had never been on an ambulance outside of a few clinical shifts for their EMT class.

Being well practiced in the basic skills that paramedics still do (apply the monitor, move patients, call into the hospital, etc) can be of serious benefit because you've greatly lessened your workload in terms of what you have to be proficient with by the end of internship.

I can honestly say I did all of that before I ever stepped foot on a paramedic ambulance (although my monitor sticker applying skills were greatly improved on the paramedic truck since I did it more often)

All that said, is any of the above of deal breaker? Absolutely not. Any decent program should make you a competent baseline paramedic. You might just have to work harder to get there.

And if you have 911 ambulance experience, you will be more comfortable with many of the basics of EMS

 

[Tigger]

I hope your not referring to me, because I have worked on paramedic ambulances..... just not in NJ, only in NC, which is exactly what I said. And in my paramedic school, many of my classmates had never worked on an ALS ambulance; we even had some that had never been on an ambulance outside of a few clinical shifts for their EMT class.I can honestly say I did all of that before I ever stepped foot on a paramedic ambulance (although my monitor sticker applying skills were greatly improved on the paramedic truck since I did it more often)And if you have 911 ambulance experience, you will be more comfortable with many of the basics of EMS

Did you go to Paramedic school?

 

[RocketMedic]

@VentMonkey , what sort of calls are they BLSing?

 

[VentMonkey]

If the ALS crew deems it BLS they need to still perform an “ALS assessment”, then they can meet with the closest BLS unit provided there’s one available. Once that’s done they hand off, and go back into the system.

Our EMT’s have always been part of the “911” system, and handle (presumably) low-level 911 scraps; oftentimes they’re not so low-level. BLS cars are also (seemingly more frequently) responding to priority 1’s and 2’s and canceling ALS if they’re not needed. They will run on arrests alone with fire not too uncommonly.

Basically, we have way more EMT’s than paramedics, and my personal opinion is that admin is finally realizing that.

 

[DrParasite]

Did you go to Paramedic school?

yes.... however my FD only functions at the BLS level, and my day job doesn't have anything to do with EMS

 

[DrParasite]

BLS cars are also (seemingly more frequently) responding to priority 1’s and 2’s and canceling ALS if they’re not needed. They will run on arrests alone with fire not too uncommonly.

Basically, we have way more EMT’s than paramedics, and my personal opinion is that admin is finally realizing that

as long as fire is the ALS provider, that's not a bad idea. and considering how often dispatch has to upgrade non-life threatening calls based on callers responses to specific questions, I think your admin is finally realizing that a BLS unit can handle many calls, since they don't require ALS.

I'm curious (and not picking on California on this one): If a BLS truck is sent to an allergic reaction, and ALS FD treats with various meds, does the ALS FF have to transport with the BLS crew, leaving the engine OOS? or does the engine follow the ambulance to the ER? this is assuming there is no ALS ambulance available from your agency.

 

[VentMonkey]

as long as fire is the ALS provider, that's not a bad idea.

Our BLS intercepts/ rendezvous are currently only being done in our metro response areas. The ETA’s to the hospital’s here are your average 5-20 minutes.

In the City of Bakersfield, and pretty much the rest of the county (excluding 2 outlying fire stations), the fire department functions at the BLS-level.

I think your admin is finally realizing that a BLS unit can handle many calls, since they don't require ALS.

Hey??? Thasss what I meant...

Basically, we have way more EMT’s than paramedics, and my personal opinion is that admin is finally realizing that.

I'm curious (and not picking on California on this one): If a BLS truck is sent to an allergic reaction, and ALS FD treats with various meds, does the ALS FF have to transport with the BLS crew, leaving the engine OOS? or does the engine follow the ambulance to the ER? this is assuming there is no ALS ambulance available from your agency.

Again, fire are 98% EMT-level providers here. If the BLS unit is sent to a truly life-threatening emergency and the ALS unit is farther out than the closest ED, they proceed to the hospital with a firefighter riding in. If it makes sense to, they’ll wait for the ALS unit.

Typically, on truly life-threatening calls ALS units miraculously appear out of nowhere, canceling the BLS unit who may, or may not have been en route or on scene. This is all in my current county.

In my previous county, in a galaxy not so far away, the FD’s who were ALS engines only and perhaps didn’t have the budget for an ambulance or squad would staff two firefighters on an engine. If they required a standard ALS follow up, 1 FFPM was usually sufficient. If it was critical 2 FFPM’s would ride in, and the next-in engine would backfill for that particular engine until they were able to return to their service area.

Surprisingly, it worked almost flawlessly for them. I don’t know about today’s staffing patterns. Los Angeles seems more and more crowded every year.

 

[DrParasite]

They will run on arrests alone with fire not too uncommonly.

If the BLS unit is sent to a truly life-threatening emergency and the ALS unit is farther out than the closest ED, they proceed to the hospital with a firefighter riding in.

My earlier statement was due to my erroneous assumption that fire was ALS, and providing ALS to the patient. If the firefighter is just an EMT, does he or she ride in as just another set of hands, supporting the ambulance crew, or is he or she riding in because he or she is still responsible for the patient? meaning, is the ambulance crew in charge or patient care, or the FF/EMT?

I know my former EMS agency has been known to magically find an ALS crew on confirmed ALS calls (typically staffed by an administrator and an educator using a reserve ambulance or supervisor's vehicle), when BLS is on scene with a cardiac arrest, or other super sick patient... But if that wasn't an option, the BLS crew would simply transport the patient emergently to the ER, and request advance notice be given to the receiving facility to be ready for the patient.

 

[VentMonkey]

If the firefighter is just an EMT, does he or she ride in as just another set of hands, supporting the ambulance crew, or is he or she riding in because he or she is still responsible for the patient? meaning, is the ambulance crew in charge or patient care, or the FF/EMT?

If they’re riding in it’s because the patient is presumed to be critical, otherwise the FD would need to return to service. Our EMT’s on BLS do a lot more hands on than even some of them realize. Part of this is due to culture in and of itself with regards to the service and EMS in general. You know? ALS, and particularly “medic stuff”, is sooo much cooler.

It’s a big reason I’m happy that they now force EMT’s to cut their teeth on BLS cars before bidding on to ALS, where they’ll more or less function as the driver/ paramedic “assistant”. Many (not all) of the ALS EMT’s become extremely complacent over time.

the BLS crew would simply transport the patient emergently to the ER, and request advance notice be given to the receiving facility to be ready for the patient.

This is pretty much what happens on any call. Respond to call, assess patient, load patient, give patient report/ ring down while transport, arrive at ED, rinse and repeat.

Again, while not ideal, or an everyday occurrence, BLS will—on occasion—end up having to load and go workable arrests, AMI’s, CVA’s etc.

Is the FD always happy? No, but if it makes sense then the supes have no qualms to telling them to essentially kick rocks; I certainly didn’t. Even a super-duper critically ill patient 5 minutes from an ED needs an ED so much more than a paramedic that’s further away.

And to get back to OP’s original question: Do you need experience working with a paramedic in a 911 system to get into, pass, and/ or become proficient as a paramedic? No, but your learning curve once you’re on your own may be a bit steeper; really, not that big of a deal.

 

[Tigger]

yes.... however my FD only functions at the BLS level, and my day job doesn't have anything to do with EMS

For me, when I started to intern and then work as a paramedic I realized how useful my previous experience could be. In class it was negligible.