Transport Rigs...Where do they stack up?

[JakeEMTP]

Thanks so much.

Are tranfers any fun at all...like do you ever get a chance to do a code run to the hospital; or light up every now and then?

Where I am located, transport ambulances ( Jake cringes :wink: ) must call for ALS intercept if the need arises for you to run emergent. They cannot run emergent traffic in our County. Sorry.

[tskstorm]

BTW, are you a basic or paramedic....in your original post, you say you are a new EMT and in your stats to the side, you call yourself a paramedic.

no it says ASPIRING FF/medic meaning thats what he wants to be.

Now, to the original poster. Lets think for a moment, if a PT needs TXP by AMBULANCE, first question to ask is WHY do they need that ambualnce. Lets say they need it because they have Epilepsy, and they need to go from a hospital where they were for a recent seizure to a long term care facility or assisted living facility. Even if they are on medication which can control there epilepsy to an extent, there is still a risk of a seizure, thats why they need the assisted living and why they need an ambulance. Sure there is little to no probability anything will happen, but in the case it does, you would need to initiate the proper treatment call your dispatcher and get permission to "light it up" to take the PT to nearest ER.

Another example, someone above mentioned that alot of Nursing Home's call private companies, this is very true. When I was in transport, we would get numerous calls for pt's that needed immediate interventions and required us to "Light it up." A spin off of this is, we also would get dispatched to calls going to the ER, Pt needs txp from private home to ER for something that is not very significant, like an infection of a Decubitus Ulcer. So you will get some "emergency" expirience, as well as learning alot of terminology from reading charts, as well as reading nurse's and Dr's histories.

I think there are benefits to both jobs, and it is a tough call. My intent of the post is just to give you some insight on "lighting it up" not really to give you an answer on which to pick.

[snapdragon]

I am lucky that I get to do both with the department I work for. I enjoy the one on one pt contact with transports if you have a pt that talks and isn't being miserable to everyone in their path. Also, most pts don't leave the hospital until they are stable but that isn't always true. I have seen transports go south in a hurry and you are all alone to deal with everything until you can hook up with another agency or get to the hospital.

In either employment situation you won't be dumped on the street until the company feels you are ready to be on your own.

[wakkoemt807]

Like snapdragon I get to work both for my company. Here's my 2 cents from my experience:

Interfacility: You get guaranteed patient contact and assessment practice. Our system is busy and our interfacility trucks typically run 8-10 transports per 12 hour shift. Even though you are transporting grandma home after her CABG or hip replacement you can still do a full assessment. Most patients are generally stable...but you get to see what stable is and after time you'll notice what's not. Recognizing "big sick from little sick." Running interfacility calls familiarizes one with the city (streets, mapping, hospital locations, etc.) without the stress of code 3 driving. It also gives you practice driving with a patient and partner in the back. We regularly put new intermediates and basics on interfacility trucks just for these reasons. Frequently we get pretty decent calls picking up out of nursing homes for "routine" transports. Calls for "change in mental status...stable per facility" are my favorites. Those are fun because you are the highest level of care and actually get to do the detective work because most nursing facilities are pretty much useless when it comes to giving you accurate reports when you arrive on scene. If I had a dollar for every time I have heard "not my patient...I just starting shift" lol.

911: Lights and sirens is fun and games until you hit someone or are hit. A lot of the time you will drive code 3 across town only to get cancelled by fd or pd upon arrival and never see a patient that call. That doesn't get you any patient contact...and for me that isn't being an EMT. I enjoy learning about medicine and eventually plan to be a medic. I like running 911 calls but as an Intermediate on an ALS truck I'm not going to get to do as much until I'm a medic. The "cool" calls I may get to start an iv or put the patient on the monitor (assuming we beat fd on scene and they haven't done it already) but in the grander scheme of things I get to drive to the hospital on ALS calls. On 911 trucks you will see a greater variety of calls than you would on an interfacility truck...this is what I like to gain knowledge from. You'll get to see the unstable patients you don't see on an interfcaility truck...recognizing "big sick from little sick" again. A lot of times seeing things helps make things you read or learn about in class click.

I enjoy working both. What you get out of what you choose depends on what you put into it. If you treat "routine" calls as bs and don't take advantage of assessment practice when it's available...I have no sympathy for you when your medic or fd is yelling at you on scene because you didn't put oxygen on the SOB patient without being told.

I was on an interfacility truck yesterday and we did a 30 minute transport across town. The patient and I had a great conversation on the way about family, interests, work, etc. The circumstances behind why she was being transported were very unfortunate and she just needed someone to talk to. Once we got her into her room at the hospital she thanked me for "just being there to listen and to talk to her." I got more satisfaction out of that call than any call I've run lights and sirens down the Las Vegas Strip.

[scratrat]

Go with what you are comfortable with. 911 gives you one type of experience, and transport is different. I enjoy both, but I wouldn't want to do transports all the time. I like the long distance runs we do, especially if the pt is interesting to talk to.

Any reputable company shouldn't be throwing you to the wolves anyway. I started as a paid EMT with a local squad. I had to run as a third until they signed off that I knew certain things. It took a couple weeks for them to let me go out alone. I don't know if that was good or bad?? But I've seen companies so desperate they hire someone and throw right into 911 by themselves. I've seen people who have been EMT's for years (later find out it is doing transports), that could not figure out a BVM on a code. No joke. So transport doesn't really give you the experience you will need to finish out that medic goal.

[CBEMT]

In either employment situation you won't be dumped on the street until the company feels you are ready to be on your own.[spoil]

LOL sorry funniest thing I've heard all day.

[bigj1130]

Like most people here I think there are pros and cons to both situations. I spent a year working for a private agency that also did "emergent" 911 type calls out of nursing homes. Definite pro there kinda the best of both worlds. I became very confident doing a secondary assessment v/s documentation pt interview etc. I also became pretty good at "big sick vs. little sick" and what I could do to help either. those are all pros. however most skills kinda go by the wayside running transfers all day. BVM ventilation comes to mind. Real good quality spinal immobilization, use of tools like a scoop and a ked are another. the 911 service has lots of pros. there is always the woop woop show running hot all the way across town. but that will get old real quick especially when you realize people don't move listen or even care that you are behind them making all kinds of noise. or when you can't hear yourself talk cuz of hearing loss. You also will get pt. contacts, like the ones that have been sick with the sniffles for 9 days and call at 0200 hrs. But your chance for a "real" sick person is better at the 911 service. My personal opinion is if you think you are comfortable with the skills of being an EMT and the knowledge base you have try for the 911. if you don't feel comfortable with pt. assessment interviews or your brain skills maybe a transfer service wouldn't be a bad starting point. Good Luck in your decision. Whatever you decide just do it the best you can.

[ericenglund]

My opinion:

I HATED absolutely HATED transport. Did it for about a year as a Basic before I became a Paramedic, the only good thing about it was(as previously mentioned) the schedule and making your own lunch break or bill pay break fit into your day relatively easily. And since you are going on to paramedic, the assessment at a 911 agency for "real" emergencies that you will do or even listen to an ALS provider do will really really help and make things a whole heck of a lot clearer and more practical when the subjects come up in paramedic class. So if it were me, I'd do the 911 agency.

Eric

[snapdragon]

I am sorry that you find that funny. Any good supervisor is not going to let a brand new card carrying EMT of any level hit the streets without some kind of on the job training. You can be book smart and know your regional protocols by heart but if you don't have the street skills to back you up, you are a danger to your pts and yourself.

It may be cool/fun/exciting to be tossed out there at first but when you start running into situations that you are uncomfortable with you start doing things that maybe not be in the best interest of pt. Then other things happen cause we all know that shit runs down hill. After a while you may have what could have been one of the best EMTs burned out or given up because they had their card pulled.

[CBEMT]

Sorry, I should have provided some context. It's just that none of the companies I've ever seen put an EMT on the streets after anything more than 2-3 days of third riding. I know people rag on the fire departments but at least there you're probably going to go through an academy before you get the chance to kill anybody.