Emergencies or Transport
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Most "emergency" calls that I've ever run have been relatively easy. I'll do 911 for a break... I much prefer IFT because I have to think more about patient management. It's just not that often that I'd get a patient that I'd have to really think about things in the 911 arena. SNF to ED transfers were usually very interesting if you're into urosepsis.
WBExpatMedic
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If you want to use your skills 911 is the way to go. I've only done a few IFT (Literally maybe 5 or 6 in 15 years) and there's nothing to them. Everything is already done for you. They have IV's, intubated or drips already going and you just monitor them. 911 you actually have to treat and maintain your patient.
At the end of the day it just depends on how comfortable you are with your skills and if your want to treat your patients or just transport them.
At the end of the day it just depends on how comfortable you are with your skills and if your want to treat your patients or just transport them.
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True, on the skills end of things...
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I'll definitely agree that many of the more sickly patients I've had have been transfers but I really enjoy the puzzle that goes with 911 calls.
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By "transport", I assume you mean an "interfacility transport"? Many interfacility transports are emergencies.
Lemme make sure I understand.....
You concede that you have virtually zero experience with IFT's, yet still feel qualified to proclaim "there's nothing to them"?
How does that work?
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To keep on topic, I prefer 911 over IFT, but it's only because of the variety of 911, and having to form your own provisional Dx and treatment plan. IFT has more challenging medical patients, but they don't occur often enough to make that side of EMS exciting or appealing. IFT is easy work, but very mundane.
If you want mostly easy, constant, boring work, IFT is better. If wou want variety, and some autonomy (depending on where you work), and can tolerate 911 abuse, then 911 is better for you.
If you want mostly easy, constant, boring work, IFT is better. If wou want variety, and some autonomy (depending on where you work), and can tolerate 911 abuse, then 911 is better for you.
JPINFV
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To add to the real discussion, there's also a difference between BLS IFT (scheduled, non-emergent transports), ALS IFT (monitor transports), and CCTs.
NomadicMedic
I know a guy who knows a guy.
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Truth. I learned more on CCT IFTs than on any 911 call. Vented patients on multiple drips was always an experience that left me exhausted at the end.
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Yeah, I was gonna say....there's a lot more to IFT's than the SNF --> ED transports that everyone seems to be referring to when they keep saying how "easy" and "boring" IFT's are.
By far my most challenging transports have been CCT's. Prehospital, even if the patient's are sick, the treatment priorities are usually very straightforward, even if only because you are so limited in your diagnostic and treatment capability.
But the first time you walk into an ICU and have to choose which 4 or 5 drips to D/C because you only have 6 channels between your two pumps, and have to find a way to mimic APRV on your LTV, or the patient is maxed out on pressors and every time the ICU nurse turns their level I off you lose the waveform on the a-line, you won't be saying IFT's are easier than 911. And neither the referring doc or med control are usually much help, because they aren't familiar with your equipment or the logistics of transport, the referring doc doesn't care what you do, he just wants the patient outta there, and ED docs generally aren't intensivists. Fun times. Not every IFT is like that, for sure, but in general, if you are frequently transporting sick patients to a higher level of care, you will often find your self pretty challenged.
FuManChu
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Sorry for my newbie question but what is working CCT like? and anybody have any interesting experiences doing BLS IFT?
I am asking because I am in my first EMT job and all we do is BLS IFT, but another company I'd like to get on with does BLS IFT AND CCT, and I'd like to maybe get on the CCT rig eventually.
I am asking because I am in my first EMT job and all we do is BLS IFT, but another company I'd like to get on with does BLS IFT AND CCT, and I'd like to maybe get on the CCT rig eventually.
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Most CCT's will have a 3 person crew: an EMT driver, and some combination of RN/RRT/EMT-P in the back with the patient.
Where I've worked, the EMT driver had almost zero patient contact. Sometimes they'd put the monitor on the patient for us, that was about it. This is because the generally higher complexity of these patients were well outside of the scope of an EMT, and also the simple practical matter of there already being 2 people dedicated to assessing and managing the patient. This doesn't by any means mean that the driver isn't an important part of the team. There is always plenty to do and a good driver can really make the difference between a smooth transport and a lousy one.
I'd think a place where you did a mix of both BLS IFT and CCT would be a good gig for an EMT.
FuManChu
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The company I have an interview with staff their CCT rigs with two EMTs and an RN. So I guess one of the EMTs would be assisting the RN? Is that not how it usually is on CCT rigs?
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Yeah, that's a little less common.
Jim37F
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That's how my company does it, two basics and a nurse
JPINFV
Gadfly
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To be fair, California is a little bit different.
True. When you take away the CCT's, the routine ALS monitor txp's are useful at first (to gain knowledge), but become routine and mundane after a while. This is why IFT gets boring - you learn some useful info in the first six months or so, then it's just grounhog day over and over, with an occasional assist for a CCT medic if you're lucky. Even the CCT medics are doing mostly routine ALS/BLS in many places.
Jim37F
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90% of the calls we got on our CCT shift in the last two weeks have all been RT calls for a patient that's on a ventilator but otherwise stable
FuManChu
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What kind of things would an EMT assisting an RN do on a CCT rig?
NPO
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I would want a balance. Most IFTs are easy which allow you to get good at other important things like documentation and patient advocacy.
However most IFT calls don't allow you to practice skills, but you do get to exercise your brain. Even on the most mundane IFT calls, there is a lot to consider. Sure you could do point a to point b with little effort but to do your job right you will ask the nurse questions and in doing so you learn a lot more. I can tell you I can talk circles around most 911 EMTs here that have been in the job the same amount of time.
If you do your job right 911 teaches you how to use your skills and IFT expands your knowledge to know WHY those skills work and eventually how to better execute those skills because you will be able to figure stuff out better because you will have more medical knowledge.
They are both good for their own purpose.
Then there are the legit IFTs. 5 or 6 IFTs isn't enough to gauge the job by. Most are easy. Once in a while you get a crazy call. Case in point a call we ran (IFT) a few weeks ago. 12 drips, vent, balloon pump and an ambulance with 2 EMTs, RN, RT, MD and a perfusionist.
However most IFT calls don't allow you to practice skills, but you do get to exercise your brain. Even on the most mundane IFT calls, there is a lot to consider. Sure you could do point a to point b with little effort but to do your job right you will ask the nurse questions and in doing so you learn a lot more. I can tell you I can talk circles around most 911 EMTs here that have been in the job the same amount of time.
If you do your job right 911 teaches you how to use your skills and IFT expands your knowledge to know WHY those skills work and eventually how to better execute those skills because you will be able to figure stuff out better because you will have more medical knowledge.
They are both good for their own purpose.
Then there are the legit IFTs. 5 or 6 IFTs isn't enough to gauge the job by. Most are easy. Once in a while you get a crazy call. Case in point a call we ran (IFT) a few weeks ago. 12 drips, vent, balloon pump and an ambulance with 2 EMTs, RN, RT, MD and a perfusionist.