What do you typically do in a Transport EMT job?
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COmedic17
Forum Asst. Chief
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Transport.
For an EMT- either sit in the back with pshyc pts, take vitals in the back during BLS calls and drive during ALS calls.
For an EMT- either sit in the back with pshyc pts, take vitals in the back during BLS calls and drive during ALS calls.
RefriedEMT
Forum Lieutenant
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Even if you get a job at a private 911 company id say 25% if not 1/3 of your calls will be inter-facility, at least that was the rate for my 911 spot in Olympia.
Angel
Paramedic
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Literally you will just be taking vitals and chatting with the patient if they can
COmedic17
Forum Asst. Chief
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That depends where your at.
Almost all 911 EMS here is private and there's private companies here that only do IFT. So if you work for a 911 Private ems, you run very few if any IFT.
jlw
Dirty cot jockey
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You get the big D's. Dialysis and Discharges.
NomadicMedic
I know a guy who knows a guy.
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And the ever popular GGH. Granny's going home.
Jim37F
Forum Deputy Chief
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Taking vitals in the back of a moving bouncing ambulance (taking blood pressures on your young and healthy classmates is fine and dandy, but wait till your on the highway and trying to take granny's not so clear as a drum BP....) But yes, lots of discharges off the floor to SNFs and Convalescent's and to home, and "abnormal labs" runs where you pick up from the SNF and drop off at the ER, Hospital to hospital transfers for insurance reasons....
How to read a medical chart to get a detailed physical, HPI, recent vitals trends (If granny's BP has been 80/40 all week long at the hospital it's probably normal for her, if it's been 120/80 but is now all of a sudden 80/40 then you might want to make sure she gets attention from a doctor or at least a paramedic in the meantime...) get a report from a nurse, how to give a handoff report to the nurse (oftentimes by including the stuff you wish your pickup reports included but never do...)
How to properly and safely operate a gurney and driving in non stressful non emergent situations (that way when you do eventually get that emergent call properly loading/unloading your gurney from the rig is second nature and you're not flustering yourself by messing around with it)
How to talk on the radio to dispatch, how to fill out PCR's using your local areas preferred method (ex. SOAP vs. chronological, single paragraph and check boxes for everything else vs. 5 paragraph novel that includes every possible detail of the call, etc..)
How to properly wear your uniform and show up to work on time....(PLEASE, please don't be that EMT who shows up to the hospital and walks inside with your wrinkled-never-seen-an-iron shirt untucked and boots unzipped and scuffed up like you just came from a week long USAR exercise (they certainly don't have to be spit shined but at least clean and serviceable) after showing up 20 min late to your shift and taking an hour to check out and go in service)
Speaking of which...how to properly check out your truck at the start of shift...If you're in the back, make sure you have your minimum required supplies (if no checklist provided by your employer, there's probably a State and/or LEMSA regulation stating what you should have at a minimum) where everything is, that nothing's expired and works properly and is clean...don't be afraid to use up cavicide spray/wipes on the gurney/bench/shelves/floor/walls/etc; If you're the driver, make sure the rig is fully operational, check all your fluids (oil, transmission, brake, coolant, power steering, DEF if you get lucky and have a fancy new rig lol), headlights, horn, windshield wipers (I personally HATE windshield wipers that do nothing more than streak so much they make visibility worse), heater, AC, radios, all your lights (code 3 lights, flood lights, 4 way hazards and turn signals (I check both because I've literally had it where the bulb is burnt out for one but not the other) headlights, high beams, etc) Clean up the trash and used gloves that inevitable always seem to squirreled away in the front cab crevices..with a little practice it shouldn't take longer that 20 min to do all this once you get it into a routine.
Oh and being able to tell your supervisor that the truck is unserviceable and you can't take it out on the road because it's unsafe for X reason (assuming there's a legit unsafe reason).
As someone above said, even on 911 there's a lot of similarities. Especially since maybe half our calls (give or take up to 10%-I'm being generous and only going off anecdote so
) end up as BLS level transports and when a sizable chunk are out of a SNF anyway...well functionally there's not a whole heck of a lot different than a routine BLS IFT transport out of that SNF to the local hospital (except I'm more likely to be holding the wall in the ER than you are taking them straight to a room on the floor)
How to read a medical chart to get a detailed physical, HPI, recent vitals trends (If granny's BP has been 80/40 all week long at the hospital it's probably normal for her, if it's been 120/80 but is now all of a sudden 80/40 then you might want to make sure she gets attention from a doctor or at least a paramedic in the meantime...) get a report from a nurse, how to give a handoff report to the nurse (oftentimes by including the stuff you wish your pickup reports included but never do...)
How to properly and safely operate a gurney and driving in non stressful non emergent situations (that way when you do eventually get that emergent call properly loading/unloading your gurney from the rig is second nature and you're not flustering yourself by messing around with it)
How to talk on the radio to dispatch, how to fill out PCR's using your local areas preferred method (ex. SOAP vs. chronological, single paragraph and check boxes for everything else vs. 5 paragraph novel that includes every possible detail of the call, etc..)
How to properly wear your uniform and show up to work on time....(PLEASE, please don't be that EMT who shows up to the hospital and walks inside with your wrinkled-never-seen-an-iron shirt untucked and boots unzipped and scuffed up like you just came from a week long USAR exercise (they certainly don't have to be spit shined but at least clean and serviceable) after showing up 20 min late to your shift and taking an hour to check out and go in service)
Speaking of which...how to properly check out your truck at the start of shift...If you're in the back, make sure you have your minimum required supplies (if no checklist provided by your employer, there's probably a State and/or LEMSA regulation stating what you should have at a minimum) where everything is, that nothing's expired and works properly and is clean...don't be afraid to use up cavicide spray/wipes on the gurney/bench/shelves/floor/walls/etc; If you're the driver, make sure the rig is fully operational, check all your fluids (oil, transmission, brake, coolant, power steering, DEF if you get lucky and have a fancy new rig lol), headlights, horn, windshield wipers (I personally HATE windshield wipers that do nothing more than streak so much they make visibility worse), heater, AC, radios, all your lights (code 3 lights, flood lights, 4 way hazards and turn signals (I check both because I've literally had it where the bulb is burnt out for one but not the other) headlights, high beams, etc) Clean up the trash and used gloves that inevitable always seem to squirreled away in the front cab crevices..with a little practice it shouldn't take longer that 20 min to do all this once you get it into a routine.
Oh and being able to tell your supervisor that the truck is unserviceable and you can't take it out on the road because it's unsafe for X reason (assuming there's a legit unsafe reason).
As someone above said, even on 911 there's a lot of similarities. Especially since maybe half our calls (give or take up to 10%-I'm being generous and only going off anecdote so
) end up as BLS level transports and when a sizable chunk are out of a SNF anyway...well functionally there's not a whole heck of a lot different than a routine BLS IFT transport out of that SNF to the local hospital (except I'm more likely to be holding the wall in the ER than you are taking them straight to a room on the floor)
DrParasite
The fire extinguisher is not just for show
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You know, my first thought was you will learn nothing and be bored to tears. But that's not entirely true, especially as a new provider.
things a newbie will learn on a transport unit
1) how to read a transfer sheet, and how to write a run sheet
2) how to perform vitals, in a moving vehicle
3) how to perform a patient assessment
4) how to interact with other healthcare providers
5) how to navigate a large coverage area (geography/map study), especially one you have never been to before.
6) how to perform a through a complete truck check, and how to do it consistently on every shift.
7) and the most important: how to actually TALK TO PATIENTS. You would be surprised how many new EMTs & Paramedics are uncomfortable talking to patients.
The reality is, the vast majority of your patients are super stable, and an untrained monkey can do your job, at least when I worked IFTs almost 13 years ago. When I did them, for the SNF calls anyway, if the patient was unstable, they called 911, if they were stable, or just needed a ride to the hospital, they called a transport unit. The majority of EMTs doing transport are just biding their time until they get a 911 job, a fire or police job, complete school, are doing it on the side while they run their own business, as additional income to get while you are off from your full time job. There is minimal loyalty to the company, and management will see you as replaceable, assuming you fill out the paperwork enough to get billing processed.
I also met some great friends, and good people, who I enjoyed socializing with outside of work. Great people to hang out with, but to work alongside..... well, lets just say they were better friends than coworkers.
You can do very little while working a transport unit, or do a decent job. many people will do the bare minimum (and sometime below that). In the end, only you can decide what type of employee you will be, and how much you will get out of it.
This has been A LOT of help. Thank you to everyone who took the time to comment and give me some insight into what I can expect! I definitely think this is a good starting point for me to ease myself into the field. I'm both excited and nervous! Honestly, my biggest worry is navigating around and driving the ambulance!
CALEMT
The Other Guy/ Paramaybe?
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Do you live in the area that you work in? If no then I would recommend driving around your service area and knowing the streets and cross streets that the hospitals are on. Also the SNF's (Skilled Nursing Facility) streets and cross streets. A GPS always helps, but their not all that reliable (saw on the news that a GPS lead a bus driver 800 miles off course) as a back up a Thomas Brothers is the best. As far as driving goes, drive the speed limit, no texting and driving. For the most part its common sense, accelerate smoothly, and break smoothly/ early. Depending on the ambulance the weight can be in excess of 12,000 pounds so breaking and acceleration is going to be vastly different form you own POV.
Jim37F
Forum Deputy Chief
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Practice makes perfect! Listen to the radio and map yourself to other units calls. If nothing else learn your major arteries (for my city 911 job thats the major north-south, east-west streets; for my previous county wide transport job that was learning where all the freeways were in relation to each other) and how to use that network to get to your hospitals
This. Just remember as a driver your seatbelted up front facing forward (plus since you're the one at the controls you know when the acceleration/braking is coming) whereas in the back your partner and patient are kind of just back there more or less at your mercy. Be kind on them.
At that, 10x the mercy you THINK they are at. Pad your corners - in the box and while driving.
Jim37F
Forum Deputy Chief
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During my third rider training I was actually advised that anything more than 10mph while cornering is too fast....therefore for the OP, don't drive so fast you have to slam on the brakes to take your corners slower than 10mph....IMO sudden stops and accelerations were every bit as bad as hard cornering....err on the side of driving a little slower and you'll be fine until you're more comfortable behind the wheel
Brandon O
Puzzled by facies
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If you're not taking bumps and corners hilariously, comically slow, it's too fast.
CALEMT
The Other Guy/ Paramaybe?
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This, nothing sucks more than getting thrown around in the back.
NomadicMedic
I know a guy who knows a guy.
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Thom D1ck recommends all new EMTs be given a ride in the back, on the stretcher, so they can experience it. Both at speed and when driven with caution.
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The same thing you do in a 911 job, transport... In all honesty, that's the purpose of both, right?
medicaltransient
Forum Lieutenant
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After a few years, you sit there and hate your life.