Transport Service Versus 911 Service

[Oofda]

I posted this on firehouse.com but I wasn't sure who visitied both sites. I apologize if this is repetitive for some of you. I would love any thoughts on this.



I just started posting here so most of you don't know me. I am a fairly new EMT-B who has not had a chance to work on the streets yet. I currently work as a Critical Care Tech in a hospital but I have applied to a few hospitals and ambulance services. Today I did have an interview with one of the transport services provided here in Indy. This service does not handle 911 calls, accidents (unless they are already there) or trauma type calls. They are mostly a transport service. My question is: Is this type of service ok for me to start with? My end goal is to gain some experience to prepare myself for Paramedic training in a year or so. Will I get the right kind of training for this? I have nothing against working for a transport service I am just trying to get ideas and opinions.


Thanks
Sarah

[emmit233]

The only insight that I can give you is that transfers can give a person time to develop great pt. care skills (especially communication) I work for a service that does all transfers of pt.s that are non-ambulatory etc., and all emergency runs. I have met some really interesting folks on transfers and a lot of them have really interesting stories.

Do I like transfers? No not really but it is a part of working in Indiana EMS. :wink: Any time spent in the back of the truck directly involved in pt. care is better than none and yes it will help you for your medic class. :)

Good luck with you decision!
Trish

[IAMedic]

Transfers are part of the game. Everyone has to do transfers. If you don't like to do transfers, then go get a job that does only 911. But as an EMT, your opportunities are severely limited.

So here's my advice. Use this as a learning experience, suck it up until you finish your Paramedic training and then drive on. Everyone's had to do it at one time or another.

Good Luck!!

[Oofda]

Thanks for the input. Like I said, I have nothing against working for a transport service. I fully intend to accept the job. I am just curious how it will prepare me for the future. ;)

Sarah

[emmit233]

Sarah,
Which service are you looking at in Indy? I saw you posted something similar on the Ind. EMS yahoo group a while back...did anyone answer you from that group? Just wondering.
Keep plugging away and one day you might be working for Wishard! :D

[emt-iv-tech]

The service I'm currently working for does both transfers and 911 calls. Sometimes there are 911 calls that get called in as transfers. We'll get on scene and find a pt. unconscious or in severe respiratory distress. Take for example we got a call Friday for pt to be taken to a Dr. office for a checkup. Get on scene and pt. is in severe respiratory distress sats in the lower 80s lung sounds were terrible. Needless to say pt. got a trip to the ED instead of the Dr. office. I haven't experienced it yet but some people have told me that they have worked codes and things. Basically what Im trying to say is you might experience some 911 stuff during your transfers. You will be able to definately get your pt. assesment skills down pat working a convalescent truck.

[Anonymous]

I think transfers are a great way for new basics to get their skills up to speed and become comfortable working in an ambulance. Then ease your way onto an ALS truck that does transfers, and then an MICU truck, and then take the plunge into 911. Transfers are a great confidence builder.

[paramedicliff]

Transfers are a great confidence builder.

I have to agree, I myself have done both, and military flight medic time. I currently work both in a "911" Fire/Rescue EMS, and a private service. Of course with the private service we do transfers (about 60% call volume) AND we do 911 calls. Believe me, even a transfer call can get interesting. You might find yourself doing things you didn't think you would. We were on one discharge call with a patient who although had a trach, wasn't on a vent. Just on O2 at 40% with a venturi, and my EMT was in the back. Well, soon the mucus build up was too much, and we were unable to suction all the crud out. Soon, I found myself in the back, working a respiratory arrest, at least the patient had a trach, bagging the patient and pushing meds. We went right back to the hospital we had just left!

[Anonymous]

Yeah, I've picked up some part time work with private services running critical patients from Weimer, Texas to Houston which is a 1.5 hour drive.

[paramedicliff]

MedicNathan wrote:Yeah, I've picked up some part time work with private services running critical patients from Weimer, Texas to Houston which is a 1.5 hour drive.



now, we know alot can happen with a patient in 5 minutes, but man, an hour and a half? break out the Vivarin!

[emt-iv-tech]

The longest transport I have ever been on so far is 45 minutes and that was with a stable pt. who was just being taken home from a doctors appointment so I haven't had to deal with a long stressful transport.

[paramedicliff]

ranting schizophrenic from hospital in Nassau county to psych center in St. John's county, late afternoon, 50 minutes on I-95. Thank God I'm married, never thought mutterin "Uh-huh" and nodding my head would EVER come in handy! :wink:

[emmit233]

Try 30 minutes or more on E transports. (depending on where we are in the county) and if we catch a transfer to Indy it is 3 hours. :roll: Oh what fun it is..... :lol:

[Anonymous]

I've done Houston Columbus, Texas to New Orleans, that one was bad. They had a guy that transported from Columbus, Texas to Brownsville which is the border of Mexico and Texas. They handed off the patient down there. They were headed to Mexico City. Last time I checked, don't you want to go to better care, guess this guy had a death wish.

[IAMedic]

We are never usually more than 10 minutes away from our ER. However, we do about 15 transfers a year to IA City University hospital which is about 6 1/2 hours one-way. We also do about 12-15 trips a year to Rochester, MN which is about 4 1/2 hours one-way. Otherwise, most inter-facility transfers are about 2 - 3 hours long and they are pediatric, cardiac or respiratory in nature and need a specialist.

[paramedicliff]

one of our crews did Jax, FL to Birmingham, AL....not me!

[smurfe]

At times, I am glad I don't do transfers anymore, but I did them for 20+ years. They are just part of the job. I never minded nursing home calls, returns etc.

Can't say I enjoyed Hosp to Hosp transfers but when ever a long distance one would come along, I would jump on it cause I was able to get out of the "loop" for a shift plus I got to see a different area so it wasn't as boring as going to the same place all the time. Most people think it is "cool" to run 911 calls only but in reality, is isn't any different from transfer services. Most people that get in my truck don't need to see a doctor let alone go to the hospital.

I have ran many a transfer that went "hairy" and had to use my skills to the max. Many hospitals are notorious for transferring patients that are not adequately stabilized prior to transport.

I always say, take what you can get, something better will always pop up in the future and it is good to have you face in the network.

Smurfe :D

[sfd178]

I tend to agree with most of the other posts. Doing transfers can build your "maintenance" patient care and communication skills. The 911 calls will give you experience in emergency care. I have done both. I worked for a fire department that was the only transport service in that part of the county. We did 90% emergency calls, but a lot of them were actually BS BLS calls. I now work for a fire department that is ALS-Nontransport and all we run are 911 calls. I work part-time for a rural EMS agency that about 80% of our calls are ALS transfers to larger hospitals about 60-75 miles away.

[hageremtp]

I am with ya, I work rural EMS. We do about 350 calls per year (911 calls) and about 450 transfers. Of that only about 200 are ALS transfers. If the transfer is BLS, no paramedics are on the transfer, we send two basic members. All of personal, other than the medic on duty, are paid on call unless called to duty.

[Anonymous]

I am with ya, I work rural EMS. We do about 350 calls per year (911 calls) and about 450 transfers. Of that only about 200 are ALS transfers. If the transfer is BLS, no paramedics are on the transfer, we send two basic members. All of personal, other than the medic on duty, are paid on call unless called to duty.

350 calls a year! :shock: Wow, we do between 20 to 30 calls a day. (Divided up amongest our stations.) Thats a little over 10,000 calls a year. But if you break it down, 30 calls divided by 5 stations, so six calls per 24 hours shift. Wow, thats not a lot.

[smurfe]

350 calls a year! Wow, we do between 20 to 30 calls a day. (Divided up amongest our stations.) Thats a little over 10,000 calls a year. But if you break it down, 30 calls divided by 5 stations, so six calls per 24 hours shift. Wow, thats not a lot.

Bragging are we? :lol: We have 1 truck that runs close to 10,000 calls a year :shock:

Smurfe :D

[paramedicliff]

I work Fire/Rescue in a small, rural FL county, we run about 600 calls a year, about 75-85% of those are 1 hr transports because of a lack of adequate medical facilities. I also work for a private service in Jax, FL that runs about 60% emergency, the rest transfer. With that private service (there are 3 others in town, plus Fire/Rescue) we run about 80-100 calls in a 24 period divided between 8 trucks. (Of course my mouth and attitude "guarantee" I do the most!)

[Anonymous]

350 calls a year! Wow, we do between 20 to 30 calls a day. (Divided up amongest our stations.) Thats a little over 10,000 calls a year. But if you break it down, 30 calls divided by 5 stations, so six calls per 24 hours shift. Wow, thats not a lot.

Bragging are we? :lol: We have 1 truck that runs close to 10,000 calls a year :shock:

Smurfe :D

Well I'd hope you guys run more, you guys do have more people her city block then we do. I don't know about running 10,000 calls a year on a single truck, thats just under 30 calls a day, thats a lot of running!

[paramedicliff]

I got away with only four calls/four transports yesterday! :wink:

[Anonymous]

In two days, 0 calls per day. :cry:

[paramedicliff]

sounds great, you complaining? :lol:

[Anonymous]

sounds great, you complaining? :lol:

Because a lot of us are going to other services, and it won't be the same with out the old gang together. I miss my station. It was once Station 1, Then 7, and finally rested as Station 2. (Beats me why we had musical stations.)

[paramedicliff]

I know how you feel. I too have lost partners to moving and changing services, it sucks, but things move on, especially in this job. Good luck with it anyway.

[DaSharkie]

Much as I despised transfers, and to point still do today, they made me a better EMT and now a Medic. You can perfect those little skills that need work in a less stressful setting like BPs (systolic AND diastolic) in the back of a moving ambulance, breath sounds, assessments, medical conditions, labs, X-Rays, and the general medical lingo that is a language unto itself. It also lets you observe other providers in varying settings.

Now I still don't like doing transfers, but as a Medic I do about 15% of my calls as transfers to Worcester and Boston. Since I am applying to PA school I have learned more with infusions, CT scans and understanding them, EKG changes and morphology as well as all the pharmocology adn interactions. They still make me better as a provider and prepare me more for my future.

There is always something to be learned on a transfer, if you are willing to do so. Patient care and personal interaction can be a difficult skill to master and this provides you with a great foundation for when you become a true "Trauma Junkie."

[Anonymous]

I know how you feel. I too have lost partners to moving and changing services, it sucks, but things move on, especially in this job. Good luck with it anyway.

No calls today either.

[paramedicliff]

last trick was Saturday, ran four calls...hope you get back in the streets as soon as you can.

[emt-iv-tech]

I actually enjoy most of the pts. we transfer just because its nice to get to meet some of the community. I really don't like the mental transfer as some of those people really freak me out. Our transfer side of the service averages about 10,000 calls a year and the 911 side around 15,000

[paramedicliff]

See, I don't mind pysch calls, I actually like them. Usually, by the time we get where we're going, the patients are happy to get out! :wink:
Don't know if that's good or bad. But I believe that they're usually more sane than I am! :lol: :lol: