Street EMS vs. Transport

ZombieEMT

ZombieEMT

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I am a newly certified EMT-B in NJ and I am looking to find a career position. I know that many rescue squads and street ems do not hire a lot of new EMTs due to lack of experience, and I was told that volunteer and transport is the best way to get the experience. Now don't get me wrong, because I am willing to start at the bottom if need be, but not really what I was interested in.

My real question is how does street ems compare to transport. I have heard from a few people but I would like some more opinions. If I go the transport route, I want to be useful and do the job I was trained for. I just want to know from people who have done it, if they felt more like an emt or a glorified taxi driver.
 
What exactly is "street EMS?"
 
I think he means 911 vs IFT.
 
Exactly what I meant, sorry. My instructors called it street EMS, I guess its for this area.
 
Don't know about you but I got in to EMS for 911. Granted we deal with a lot of the same BS in 911 as we do in IFT, it's the perception that I'm actually making somewhat of a difference, even if only a slight bit more, doing 911 on the off chance of getting a serious call over the norm of taking granny to her doctors appointment because her family didn't want to do a taxi or take her themselves.



That's just me.
 
911 was the reason I got into EMS and transport is always an option. I appreciate your input, I am trying to see what everyones opinion is on how much the two relate, that is 911 and transport.
 
It's going to be really system dependent. In Southern California where skilled nursing facilities (SNF) rarely call 911, a lot of "emergency calls" coming out of SNFs get handled by BLS units. These calls can be anywhere from something minor to circling the drain. A lot of the time, this was because the IFT companies didn't run (or weren't allowed to run) paramedic ambulances. However, anyplace with a lot of paramedics working IFT will have the EMT IFT units doing very little emergencies. So, in general, yes. 911 is better than IFT (however there are plenty of 911 EMT units who are nothing more than gurney pushers for fire medics), however I'm not entirely sure where I would place critical care transports (CCT) in comparison to 911.
 
CCT is about the only way I can see myself doing IFT after October 26th.
 
Here we have the Patient Transfer Service (IFT) and the Emergency Ambulance Service (111/911). The two are totally different, PTS vehicles are crewed by an advanced first aider and you have to be so stable to go home via PTS its not funny whereas to work on EAS you really need a Bachelors Degree from 2012.

Once you are too old and burnt out for EAS you can slip into PTS until retirement :D
 
HaleEMT said:
I am a newly certified EMT-B in NJ and I am looking to find a career position. I know that many rescue squads and street ems do not hire a lot of new EMTs due to lack of experience, and I was told that volunteer and transport is the best way to get the experience. Now don't get me wrong, because I am willing to start at the bottom if need be, but not really what I was interested in.
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Transport won't exactly get you "experience" that will help you in the street EMS world, but rather get your that 1 or 2 years experience to make it past the HR gate keepers on your resume. Having volunteer experience can sometimes help, but it all depends on which agency you want to work for; some it will be beneficial, others it will be viewed as detrimental. The biggest thing volunteering does do (aside from learning how to operate on a 911 calls) is you ability to network with two hatting people, as well as meet career providers on scenes or at hospitals, and start to network and make connections. this will be the most beneficial to getting a career in EMS, at least in NJ, and at least in the beginning.
HaleEMT said:
My real question is how does street ems compare to transport. I have heard from a few people but I would like some more opinions. If I go the transport route, I want to be useful and do the job I was trained for. I just want to know from people who have done it, if they felt more like an emt or a glorified taxi driver.
Click to expand...
it's BORING!!!!!! you will meet some cool people, and some retards in the IFT world. IFT is much more laid back, less stressed, and taking granny to the doctor. Many in IFT are volunteers as well (or used to be), while some are just getting a paycheck.

I took my core 13 class with an IFT company in North Jersey. No one was a volunteer on the side, they all worked for the company. The people (including the owner/supervisor) could not do basic skills, could not do an assessment, and I wouldn't even trust them to take my BP. They were all cool people, and I would go drinking with them any time, and after the second day, the owner offered me a job there, but it was scarily obvious that they didn't deal with sick patient, and would not know what do with them if they encountered one.

I did IFT for 3 months several years ago, and while I met some cool people, I was bored out of my skull most of the time. about 5 years ago, I was hired by an IFT/911 service, and found it to be most enjoyable, since we got to deal with many municipal 911 calls. now I work for an all 911 service in a busy city (as a button pusher, needed a change after 10 years), and still work my old IFT/911 job, but only in the 911 division.

While you get a lot of BS/taxi calls with municipal 911, there is a greater chance of dealing with a sick or injured patient, instead of just taking granny from one bed to another.
 
I think there is something to be learned from both IFT and 911.

Granted, we all really got into EMS for 911 right? I think IFT can teach you a lot about charting and healthcare facility operations...

911 obviously teaches about street level operations. I have heard from some friends who work IFT that at some of these transfers then patient may as well be sick and in a ditch, because they are in such bad condition, in which case you need to be as on toomof your game in IFT as you are in 911.

In the end you get what you put in to every job. Get some IFT experience, build your resume, and take some experience and references away from that job. The way the job market is in some areas these days, I wouldn't pass up a job if ome was offered. It is always easier to get a job when you have a job, if that makes any sense.
 
It is probably because CCT is like the 911 of IFT, if that makes any sense...

I did CCT for almost 2 years at Children's in Dallas. It was probably one of my favorite jobs so far, although I have really enjoyed everything I have done up until now.

Anyway, there is nothing wrong with being well rounded, and IFT, 911, CCT, all of these things lead to a really well rounded understanding of how everything works together in this crazy little world of ours.
 
WTEngel said:
It is probably because CCT is like the 911 of IFT, if that makes any sense...

I did CCT for almost 2 years at Children's in Dallas. It was probably one of my favorite jobs so far, although I have really enjoyed everything I have done up until now.

Anyway, there is nothing wrong with being well rounded, and IFT, 911, CCT, all of these things lead to a really well rounded understanding of how everything works together in this crazy little world of ours.
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CCT? IFT? I don't know what those are. Could you unpack those acronyms for me please?
 
CCT=Critical Care Transport
IFT= Interfacility Transport
 
Some say that you'll learn a lot from doing IFT, and that's true up to a point. When you start, you'll be eager to learn about various pt conditions, and notice common presentations with pts having a similar medical hx. Pretty quickly, IFT becomes mundane, lackluster, boring, and other descriptions that cause complacency and apathy for the job. You'll eventually end up doing half an assessment (if you're lucky) on the umpteenth NH discharge or BLS IFT for an MRI, dialysis, or something, having worked for hours on end w/o any kind of break. Your assessment skills and critical thinking will atrophy.

This is why most people have a goal of working for a 911 company. 80-90% of your calls dont really need an ambulance, are just taxi rides, but at least you're doing an assessment and making a provisional diagnosis. You'll actually be dealing with the occasional sick or injured pt, without the crutch of a diagnosis by an MD prior to pt contact. 911 has the potential to be exciting, or at least something different each day. In IFT, you'll always have that same Monday 0730 dialysis x-fer, a round trip or two to the off campus MRI building, and a couple of NH discharges. The faces may change, but your day is more or less the same, boring day in and boring day out.

The misconception of EMS being exciting, constant action, with life saving and other hero stuff, and video game-like emergency driving, is what draws many to EMS. The "boring stuff" in the eyes of EMS hopefuls is more of what appeals to nursing students, I think. Boring as in routine care, pt comfort, empathizing with the pt and actually caring about their emotional needs, and such. EMS, at least in the U.S. attracts a large percentage of type-A personalities, who tend to be thrill seekers. Routine IFT is not a good fit for this type of person.

When I hear of CCT, the common thought is "As a CCM I actually get to use my skills. I'm using my skills on critically ill pts at that". This is why CCT is seen as the 911 of IFT. CC medics at my old hospital ran baloon pump jobs with only another medic, same for the vented sedated pt, a pt receiving 3 or more drips, the post arrest vented x-fer, to name a few things. They also had standing orders to titrate tridil or propofol w/o OLMC, for example. The CCM was typically kept available for only these type of calls. No dialysis, NH discharges, discharge to residence, MRI txp's, etc. They may do the occasional ALS txp if no medics are available, such as a "cardiac rescue", which is a pt with an active MI going to the cath lab. If they're post arrest it's a CCT anyway. Our field supervisors were mostly CCM's, so they could do a CCT if a CCM is unavailable.
 
I will also add that is CCT transport is called, it is almost always emergent. So you may only get three calls or so per shift, but most of those may take 2-3 hours and be very sick patients.

In fact, in my experience, when we go to most referrals, everyone, including the physicians pretty much disappears, as they are happy to have us come fix their really sick patient and dint want to have anything to do with what is going on...so yeah, it is pretty rewarding.
 
I work for an IFT service. On busy days we'll get 6 patients. On not so busy days, we'll get 2.

For me IFT so far seems to be a good step to have taken - to get my name out there in the (small) EMT community, to learn how to do basic things like work the gurney, get used to doing rapid patient assessments. I had zero patient care experience and am still getting used to how things are done (I've only been working 3 weeks now). But yes, in a lot of ways, I do feel like a glorified taxi service, rather than an EMT. But oh well, everybody's gotta start somewhere, right? :)
 
IFT or 911

Wow, I have done both. If I had to chose it would be 911 calls. Those are always fun and every call if different. These 911 pt. can challenge your skills and knowledge. Then you transport. Then you are done with the patient. IFT- these calls are long and medically challenging. I didn't mind the challenge, I don't like the long transport. Also these pt. are already hooked up to equipment, intubated, IV lines in, and so on... I prefer to do all that myself. Make your decision on honesty and comfort level. Then go for it.
 
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