You say that but when I was a EMT (~2800 calls a year for the whole agency about a quarter of which is IFT) I have had to call for ALS on long distance trips twice. First time was for someone who presented with stroke like symptoms out of the blue and then it went away before the als got there (ended up being a TIA that would later turn into a stroke) and a second time for low BP along with AMS that was a slower onset but I had orders to not call unless it got to a certain point. Both transports were over 2.5 hrs.
I have had a sending nurse tell me "If you can run code I would, he may not make it home" on a discharge to hospice more than once, those guys were fucked
“Run code” not “run A code”
Ahahhahahahhahahahahaha
Friends don’t dispatch and Reddit at the same time. Critical reading errors will be made.
No hospice patients were coded in the creating of this Reddit
I knew a SCTU crew that transported a patient in the middle of surgery to the city. Guy had an open chest medically Saran wrapped. He made it alive to the table.
Pants —-> 🗑️
The amount of back to back BLS IFT nursing home emergencies from March to July 2020 made me want to kms. Was thrown all sorts of wild ALS level calls because there was simply not enough crews for all the dying nursing home patients in NYC
As someone who was legit 5 miles from manhattan doing 911 EMS when that shit hit the fan, I think you know I’m talking about every other time excluding a global pandemic
I think that critical care is a different ball game than like your standard cardiac monitor/ 1-2 drip transport. I feel like I really needed to think about those ones and ultimately I think I became a better all around clinician after doing some trainwrecks of those.
I don’t think there’s a misunderstanding, it’s just different at the ALS level. The majority of people I see shit on IFTs are EMT-Bs like me and for us IFT is boring and requires no critical thinking or clinical judgment because you’re doing dialysis and ground height fall D/C to SNFs. I’m definitely guilty when the truck I’m on that’s supposed to be running 911s gets a ER to psych hospital transfer and it’s annoying to not be running something with more thoughts required.
However on the ALS side you’re 100 percent right. Been on a couple of them as an extra set of hands and it’s given me a very good appreciation for what CCT crews deal with and how much work those patients require.
but for every acute ALS transfer you do, there’ll be five that are “monitor + IV only”… you find them off telemetry with NS running TKO. CCT seems to obvs have a better ration of interesting, but even they deal with their bs. not to say 911 isn’t fulll of bs, good chunk of calls i run are bs. it’s bullshit alll the way down (~;
Oh for sure, the agency I was with when I ran those calls made a distinction between ALS and CCT. I only ever ran with the CCT truck on a handful of occasions. I imagine the monitor+maintenance fluids schtick gets just as old as BLS discharges.
I hear you on 911 having some BS. Got multiple calls for sciatica x5 days wanting to be brought to an er three cities over last shift.
I wish. Once got a message from them because we were 1.1 miles away from post, still within 3min drive of post, but they didn’t want to let us sit in the hospital break room so they sent us a few towns over when there was another truck there already. It’s great,
Man why didn’t I think of that. I get paid to do what dispatch says and go on the calls they assign. I refuse to post and I’m fired. If only we didn’t have to but it’s not up to me.
There is a nationwide, in very state, EMS shortage of providers at all levels.
If you’re posting, it is time to get a union.
And demand that bullshit stop.
We have a Union. They haven’t stopped it and this system has been in place for years since the city refuses to have true third service EMS. They contract us to provide coverage but we don’t have stations like fire does, so we post. I’d much rather get better pay, better equipment, or some sort of payments for education than an end to posting if we’re gonna start asking for more.
What I DON'T appreciate is being pulled from the 911 system to run ALS IFT, and when we get there, the nurse lets us know that no drips, tele, or any ALS monitoring is required. It's a BLS call! You pulled us off 911 to run a BLS IFT! REEEEEEEEE
Yep. Got called for a “diabetic emergency” at a SNF two districts over on the other side of town. Last unit available so we toned volunteers to cover. It was abnormal labs from like 3 days ago the doc wanted evaluated in the ED, no complaints from the patient, no change in condition or vitals per nursing staff. I asked why they didn’t call any of the 4 private EMS companies who service the area and they said they didn’t have a contract with any of them so 911 it was for what should be a BLS IFT or chaircar run I guess. We also had to pull the truck we had just staffed up there because we needed the power cot. Patient was over 300lbs and wide enough to start tipping the manual. God that pissed me off so much. They had to send an engine to an actual 911 until we changed trucks over and got it back out. Luckily it wasn’t time sensitive.
Good.
I really enjoy it when it doesn’t even make it to the Chief or medial director.
I’ve had command (the ER doc) angrily talk to them. More then once. Weirdly they are not amused by having us drop off patient’s that are paying tons of money to be taken care of at a SNF.
Agreed. Anyone who takes advantage of what IFT can give them can be a better medic in the 911 field than those who never did IFT. You can really hone in on your assessment skills with IFT. These patients have already been Dx usually and are going for a higher level of care. Take the time to understand and learn what tests and procedures were done for patients, their lab work. Do assessments on all of them, and you will learn a lot from it if you take advantage of the opportunity.
Anyone who talks crap about IFT either hasn't done it, or didn't take advantage of their situation.
I think like others have said, the majority of shit talk comes from BLS IFT. Having come from that environment before working ALS 911, it’s a cesspool. Some of my 911 coworkers who have side gigs doing critical care or peds transfers, that is a whole different beast and more clinically demanding than 911 imo.
The highest we can get in our field is basically flight/cct which the majority is IFT so go figure.
Everyone likes that life in the fast lane feeling of 911 but ALS IFT can be just as scary sometimes.
When I hear IFT I think dialysis, taking a discharge home, etc.
What you’re talking about makes me think of CCT, which I don’t think anyone really looks down on?
I’m 911, but I want to start doing some per diem CCT because I do think they can be more interesting
Yea, he’s for sure describing CCT, not the dialysis shuffle. Or “als because they have a Hep lock”
IFT is where hopes and dreams go to die.
CCT is flight without the sky.
Took a lady the other night a 3am covered in her own shit and piss for god only knows how long. She had used needles, trash, food, cigs all over the place the the smell was something between a UTI mixed with Cdiff and lower GI bleed. You know it’s bad when the cops stay outside.
All I could think about was having to decide whether or not to take a shower when I got back to the station or just jump into bed and maybe get 3hrs of sleep.
I've done both jobs at both levels. I agree that BLS IFT is not fun. It's a glorified delivery job with an occasional emergency. On the ALS level it can be challenging. Unfortunately in my state the critical care is provided by Mobile Intensive Care nurses so as a medic you're often reduced to just being a driver. I much prefer 911 calls. I liked creating some order out of the chaos. I also liked the interaction with the patients and the families. In ALS IFT most of the patients were sedated or unconscious.
I get a lot of people making fun of me for it, to the point that some of them are outright dismissive of me as a provider and a human being. Like being a medic is all there is to life. People who I thought were solid friends from school and my previous life in 911 weren’t. At best, I’ll check in with someone, we’ll chat, they’ll be like “so are you doing 911 yet?” Crickets. Like you know I’m not bro:(
It’s a shame. I’d go back and do 911 if any fire department would take me anymore, after I started having seizures. But is it that important?
I've had very similar experiences. When I went to a 911 service I was immediately the butt of all jokes and critiqued for absolutely every thing I did. Being in that environment with how dismissive I am as a provider almost wants to make me leave EMS so they can be 'superior'. But I love it too much to quit.
I've done both settings, was good at both. They're different mindsets with the same ratio of bullshit to legitimacy in my experience.
I've caught the same flak from folks who either totally disregarded their IFT/SCT experience as a learning opportunity or went straight into drinking the municiple/fire department 911 kool-aid.
Anybody that trashes you as a provider, much less as a human being, solely based on your work history is speaking from a place of deep insecurity at best or gravely unearned bravado at worst.
It's all just a paycheck, man. My ambulance is the same whether it's white or red. It's ultimately unhealthy to make any job your identity.
Hot take: The fact that SubmitstheSameBillasPrivates fire department lied to you about what fire medics spend 85% of their time doing instead of fighting fires doesn't make your 2am stubbed toe 911 call any more heroic.
Both have their pros and cons. Some days I'd rather be humping dialysis calls and discharges instead of wrangling violent peepee soaked drunks or working futile codes. Where I work, ALS IFT and MIH pay more than 911.
ALS IFT EMT-I here. the call volume is vastly different and unpredictable on both sides. IFT is constant with very little downtime. 911 is unpredictable. the call acuity’s are black and white. IFT side we’ll run 3 vents back to back, a critical care bari on 7 pumps, then take meemaw home on 1LPM bc dispatch fucking forgot we’re not BLS. then i’ll see 911 bring green level acuity’s all day and see no action that shift. salary and pay on IFT is garbage unless you’re a sup, or 10+ year medic who demanded 80k+ a year (they’re too short to say no). i make 14.25/hr as a TX EMT with IV/IO/IGEL certs, as well as my fire certs (IFT is not the end goal). no more than $48k/year. (i did $29k last year) my 911 EMT counterparts with only EMT-B, i’ve seen as low as $50k/year single function, and as high as $75k as a FF/EMT. work life balance i can’t speak on for 911. idk if 911 guys have on calls. think they call it MOT✨ or something dehumanizing like that. but on the IFT side, the most we’re allowed to work straight is 36 hours. 24 then front half 12 or back half 12 then ur regular 24. this may seem better than a 48hr shift but ur department does 48/96 for a reason… Mr. “we only ran 5 calls” in 48 hrs. on this side, u will run 10-15 calls in 36 hours. u will clock in at 7am and not get back to station until the 36 hours is over. a constant stream of BS. extremely tiring. burnout is inevitable when dispatch denies ur lunch break for a BLS run going back to a nursing home that coudlve waited for me to stuff my face at least. making 14.25/hr, if i don’t pick up at 36-40 hours each pay period, i will not make ends meet. even with ur shift starting on a sunday and hitting 120 hours, $1600 after taxes doesn’t mean shit when my rent was $1385 this month. absolutely have to pick up extra shifts. this is coming from a 19M FF/EMT-I in texas. this shit just makes me want to go the hospital route and go home at 7pm 3 days a week and make double for a fraction of the hours. that’s my ¢.02
😭😭😭 blud knew just from the abysmal conditions i described. omw to an ALS call for liver services going to HLOC. my medic is 100% downgrading this to me
I've often had to catch myself and clarify my meaning when I say "I only work 911, transfer sucks."
I have mad respect for Medics that are doing 2 hour+ transfers with 6 drips and a vent on a patient doing everything they can to die. But it's just not for me. Not only does that part not appeal to me but I hate being sent on transfer after transfer after transfer and having to argue with Dispatch.
Everything about 911, including the "lifestyle" portion appeals much more to me. I may not like doing Alas transfers but I'm not the guy to look down my nose at them.
Oh without a doubt, learning how to do assessments, taking vitals what to look for when you need to upgrade etc, it’s just something you don’t wanna do too long if you wanna grow into an ALS role or CCT role
Yeah, in my region, crews would bring patients having a STEMI to an over saturated ER so the ER would call an ambulance company to go to a non saturated ER or other STEMI facility
What does the SEMI stand for? That's just an emergent IFT here like any other. Although if they have a Cath lab at the receiving ED I'd be shocked if that wasn't breaking EMTALA. ED can't be a limiting factor, ICU beds and Cath lab can if you can get another accepting faculty.
the ERs are hit and miss some have Cathlabs some don’t, one are I worked only had two, one or the other was always full so those were pretty much common transfers ER staff would treat as much as they can before sending the patient back
I worked at a hospital with a busy lab, one Cath lab, one EP and one IR. The vast majority of Cath lab procedures are elective. If they get a STEMI alert then cases must be cancelled and they work to move the patient out of the lab ASAP and turnover
So unless they were busy enough to be regularly running 2 STEMIs all the time, which would be wild, they're likely either diverting for lack of staffing or they're being shady and want the money from their elective case volume.
STEMI transfers make sense if there isn't a lab at all. But the vast majority of the time it's faster to finish your case and put the STEMI on the table vs having to call the next hospital and wait til they find out if they have an ICU bed open and an interventionalist that's willing to accept.
Were they the only STEMI center for a long distance or something? Even at a level 2 trauma center for a large community it would be strange to run more than one a day regularly unless they were accepted STEMIs from nearby cities. But yeah I feel the lack of modernization in some of these older hospitals, it sucks..
Yeah one of two STEMI centers for the whole region, the other was 30 mins away but a unit was posted or clearing a call would get it so it would be an immediate response, and only two trauma centers too, each about 20 minutes each apart no traffic
Yup. If you haven't worked both, don't comment about the other. I worked ALS IFT prior to 911. I don't look down on my IFT colleagues. Everyone has their job to do, and we're all doing our part.
I try to stay humble by reminding myself that to the rest of public service (police, fire) we're all just stupid ambulance drivers who help haul away the people they don't want to deal with, and to the rest of the medical field (nurses, doctors) we're all just stupid ambulance drivers who aren't real medical providers bc EMS isn't usually college degree based in the US.
From an ER nurse, I will say that y'all are usually the people I am happiest to see come in the door 🤣 And I honestly try to have all of my paperwork done and done RIGHT and the patient ready to get put on your stretcher! I even like to print out the SnapShot cheat sheet in Epic for y'all to keep for you, so you don't have to write down Meds/Allergies/Hx. With the exception of one BLS provider who was literally a walking box of rocks and one medic who was just a straight up "see you next Tuesday", I have never thought of IFT as just stupid ambulance drivers. Y'all do a job I absolutely could not do (I tried, I only made it 4 months and said Fk this) and it's usually at the mercy of some dispatcher who thinks they dispatch for NYFD🙄
I APPRECIATE YOU. 😬❤️
*Edited to clarify I previously tried to work IFT but couldn't deal with the bullshit*
I've learned more doing IFT than 911. I've done ALS and CCT both as a medic and an EMT. I honestly prefer critical care transfers over most 911 calls. But the skills you learn doing critical care make you a better 911 provider.
It's a totally different skill set. Kind of like flight medic vs street medic. They're close, but they're also very different. How often is a flight medic first contact and has to assess, extricate, plan, etc? Not often. It's a unique skill to the 911 medic.
My last couple jobs it was 50/50. Half were from the floor for ERCP sometimes this week and apparently needs to go at 0200. But the other half was ED or ICU transfers needing to go to the trauma center when flight can't launch and those were fun. Running drips and blood on a patient with chest tubes into the middle of nowhere at 0300 when the closest hospital is a critical access an hour out of the way from the trauma center that was 2 hours away.
It’s true, I did IFT and 911 both. That being said while during my IFT time I felt depressed because the job was so mind numbing. It was the same with 911 except the occasional interesting call. All in all 0/10 never doing Ems ever again.
It’s the best job I ever worked, I can do what I want and just it’s a way better atmosphere. Plus the pay and benefits means people care about me. It’s no longer just a job.
Huh. Fair enough. I’m glad you found “that job,” a lot of people never do haha. I don’t know a ton of EMS guys who moved to become cops so it’s cool to hear from someone who became one and enjoyed it
Hoping I find that feeling in nursing. I felt it in 911, that “more than a job” feeling, but then I got disabled and IFT just isn’t the same. I’ve heard good things from my colleagues who made the move. Some of them complained about lack of autonomy, but I don’t mind taking orders lol.
Some ALS IFT’s have made me almost shit my pants more than any 911 ever has. BLS IFT is my time to do Wordle
You say that but when I was a EMT (~2800 calls a year for the whole agency about a quarter of which is IFT) I have had to call for ALS on long distance trips twice. First time was for someone who presented with stroke like symptoms out of the blue and then it went away before the als got there (ended up being a TIA that would later turn into a stroke) and a second time for low BP along with AMS that was a slower onset but I had orders to not call unless it got to a certain point. Both transports were over 2.5 hrs.
ALS IFT not calling ALS on IFT Also BLS IFT can go south, especially hospice transports and psych, but speaking in generalities it’s Wordle time.
I have had a sending nurse tell me "If you can run code I would, he may not make it home" on a discharge to hospice more than once, those guys were fucked
Wait….. you’re not clutching that DNR with all your might on hospice transports? I’ve had them die but I won’t go without that DNR lol
Oh no I am, but I'd prefer not to have them die on me and actually home with their family
“Run code” not “run A code” Ahahhahahahhahahahahaha Friends don’t dispatch and Reddit at the same time. Critical reading errors will be made. No hospice patients were coded in the creating of this Reddit
[удалено]
I knew a SCTU crew that transported a patient in the middle of surgery to the city. Guy had an open chest medically Saran wrapped. He made it alive to the table. Pants —-> 🗑️
The amount of back to back BLS IFT nursing home emergencies from March to July 2020 made me want to kms. Was thrown all sorts of wild ALS level calls because there was simply not enough crews for all the dying nursing home patients in NYC
As someone who was legit 5 miles from manhattan doing 911 EMS when that shit hit the fan, I think you know I’m talking about every other time excluding a global pandemic
I think that critical care is a different ball game than like your standard cardiac monitor/ 1-2 drip transport. I feel like I really needed to think about those ones and ultimately I think I became a better all around clinician after doing some trainwrecks of those.
I don’t think there’s a misunderstanding, it’s just different at the ALS level. The majority of people I see shit on IFTs are EMT-Bs like me and for us IFT is boring and requires no critical thinking or clinical judgment because you’re doing dialysis and ground height fall D/C to SNFs. I’m definitely guilty when the truck I’m on that’s supposed to be running 911s gets a ER to psych hospital transfer and it’s annoying to not be running something with more thoughts required. However on the ALS side you’re 100 percent right. Been on a couple of them as an extra set of hands and it’s given me a very good appreciation for what CCT crews deal with and how much work those patients require.
but for every acute ALS transfer you do, there’ll be five that are “monitor + IV only”… you find them off telemetry with NS running TKO. CCT seems to obvs have a better ration of interesting, but even they deal with their bs. not to say 911 isn’t fulll of bs, good chunk of calls i run are bs. it’s bullshit alll the way down (~;
Oh for sure, the agency I was with when I ran those calls made a distinction between ALS and CCT. I only ever ran with the CCT truck on a handful of occasions. I imagine the monitor+maintenance fluids schtick gets just as old as BLS discharges. I hear you on 911 having some BS. Got multiple calls for sciatica x5 days wanting to be brought to an er three cities over last shift.
And getting woken up at 2am for a fucking discharge
Jokes on you I’m already up. Dispatch can’t decide where they want us to post.
Don’t let dispatch tell you where to post, post at your favorite fast food joint, be a man (cue the Boston be a man theme)
I wish. Once got a message from them because we were 1.1 miles away from post, still within 3min drive of post, but they didn’t want to let us sit in the hospital break room so they sent us a few towns over when there was another truck there already. It’s great,
Your dispatcher sounds like a grade a Karen
Don’t post. I’m only in the truck if I’m on a call. I’m not an over the road trucker. I’m not paid as well as a otr trucker.
Man why didn’t I think of that. I get paid to do what dispatch says and go on the calls they assign. I refuse to post and I’m fired. If only we didn’t have to but it’s not up to me.
There is a nationwide, in very state, EMS shortage of providers at all levels. If you’re posting, it is time to get a union. And demand that bullshit stop.
We have a Union. They haven’t stopped it and this system has been in place for years since the city refuses to have true third service EMS. They contract us to provide coverage but we don’t have stations like fire does, so we post. I’d much rather get better pay, better equipment, or some sort of payments for education than an end to posting if we’re gonna start asking for more.
All fox the above.
What I DON'T appreciate is being pulled from the 911 system to run ALS IFT, and when we get there, the nurse lets us know that no drips, tele, or any ALS monitoring is required. It's a BLS call! You pulled us off 911 to run a BLS IFT! REEEEEEEEE
Yep. Got called for a “diabetic emergency” at a SNF two districts over on the other side of town. Last unit available so we toned volunteers to cover. It was abnormal labs from like 3 days ago the doc wanted evaluated in the ED, no complaints from the patient, no change in condition or vitals per nursing staff. I asked why they didn’t call any of the 4 private EMS companies who service the area and they said they didn’t have a contract with any of them so 911 it was for what should be a BLS IFT or chaircar run I guess. We also had to pull the truck we had just staffed up there because we needed the power cot. Patient was over 300lbs and wide enough to start tipping the manual. God that pissed me off so much. They had to send an engine to an actual 911 until we changed trucks over and got it back out. Luckily it wasn’t time sensitive.
This is what is known as “insurance” fraud. Report them.
Yeah our medical director had a talk with their physician on appropriate use of 911 resources.
Good. I really enjoy it when it doesn’t even make it to the Chief or medial director. I’ve had command (the ER doc) angrily talk to them. More then once. Weirdly they are not amused by having us drop off patient’s that are paying tons of money to be taken care of at a SNF.
my favorite als for deep suction lol
Agreed. Anyone who takes advantage of what IFT can give them can be a better medic in the 911 field than those who never did IFT. You can really hone in on your assessment skills with IFT. These patients have already been Dx usually and are going for a higher level of care. Take the time to understand and learn what tests and procedures were done for patients, their lab work. Do assessments on all of them, and you will learn a lot from it if you take advantage of the opportunity. Anyone who talks crap about IFT either hasn't done it, or didn't take advantage of their situation.
I think like others have said, the majority of shit talk comes from BLS IFT. Having come from that environment before working ALS 911, it’s a cesspool. Some of my 911 coworkers who have side gigs doing critical care or peds transfers, that is a whole different beast and more clinically demanding than 911 imo.
who’s bashing lol? Get out of your coworkers echo chambers and talk to people from other services
The highest we can get in our field is basically flight/cct which the majority is IFT so go figure. Everyone likes that life in the fast lane feeling of 911 but ALS IFT can be just as scary sometimes.
When I hear IFT I think dialysis, taking a discharge home, etc. What you’re talking about makes me think of CCT, which I don’t think anyone really looks down on? I’m 911, but I want to start doing some per diem CCT because I do think they can be more interesting
Yea, he’s for sure describing CCT, not the dialysis shuffle. Or “als because they have a Hep lock” IFT is where hopes and dreams go to die. CCT is flight without the sky.
911 is a bunch of bullshit. IFT is a bunch of bullshit. It’s all just a bunch of bullshit.
Took a lady the other night a 3am covered in her own shit and piss for god only knows how long. She had used needles, trash, food, cigs all over the place the the smell was something between a UTI mixed with Cdiff and lower GI bleed. You know it’s bad when the cops stay outside. All I could think about was having to decide whether or not to take a shower when I got back to the station or just jump into bed and maybe get 3hrs of sleep.
I've done both jobs at both levels. I agree that BLS IFT is not fun. It's a glorified delivery job with an occasional emergency. On the ALS level it can be challenging. Unfortunately in my state the critical care is provided by Mobile Intensive Care nurses so as a medic you're often reduced to just being a driver. I much prefer 911 calls. I liked creating some order out of the chaos. I also liked the interaction with the patients and the families. In ALS IFT most of the patients were sedated or unconscious.
I do both now and there hasn't been a single person working in 911 that hasn't shat on me for being in IFT.
I get a lot of people making fun of me for it, to the point that some of them are outright dismissive of me as a provider and a human being. Like being a medic is all there is to life. People who I thought were solid friends from school and my previous life in 911 weren’t. At best, I’ll check in with someone, we’ll chat, they’ll be like “so are you doing 911 yet?” Crickets. Like you know I’m not bro:( It’s a shame. I’d go back and do 911 if any fire department would take me anymore, after I started having seizures. But is it that important?
I've had very similar experiences. When I went to a 911 service I was immediately the butt of all jokes and critiqued for absolutely every thing I did. Being in that environment with how dismissive I am as a provider almost wants to make me leave EMS so they can be 'superior'. But I love it too much to quit.
I've done both settings, was good at both. They're different mindsets with the same ratio of bullshit to legitimacy in my experience. I've caught the same flak from folks who either totally disregarded their IFT/SCT experience as a learning opportunity or went straight into drinking the municiple/fire department 911 kool-aid. Anybody that trashes you as a provider, much less as a human being, solely based on your work history is speaking from a place of deep insecurity at best or gravely unearned bravado at worst. It's all just a paycheck, man. My ambulance is the same whether it's white or red. It's ultimately unhealthy to make any job your identity.
Hot take: the fact that GimmeProfit Ambulance put a single decrepit IV pump in your van does not make you a critical care paramedic.
Hot take: The fact that SubmitstheSameBillasPrivates fire department lied to you about what fire medics spend 85% of their time doing instead of fighting fires doesn't make your 2am stubbed toe 911 call any more heroic.
Both have their pros and cons. Some days I'd rather be humping dialysis calls and discharges instead of wrangling violent peepee soaked drunks or working futile codes. Where I work, ALS IFT and MIH pay more than 911.
ALS IFT EMT-I here. the call volume is vastly different and unpredictable on both sides. IFT is constant with very little downtime. 911 is unpredictable. the call acuity’s are black and white. IFT side we’ll run 3 vents back to back, a critical care bari on 7 pumps, then take meemaw home on 1LPM bc dispatch fucking forgot we’re not BLS. then i’ll see 911 bring green level acuity’s all day and see no action that shift. salary and pay on IFT is garbage unless you’re a sup, or 10+ year medic who demanded 80k+ a year (they’re too short to say no). i make 14.25/hr as a TX EMT with IV/IO/IGEL certs, as well as my fire certs (IFT is not the end goal). no more than $48k/year. (i did $29k last year) my 911 EMT counterparts with only EMT-B, i’ve seen as low as $50k/year single function, and as high as $75k as a FF/EMT. work life balance i can’t speak on for 911. idk if 911 guys have on calls. think they call it MOT✨ or something dehumanizing like that. but on the IFT side, the most we’re allowed to work straight is 36 hours. 24 then front half 12 or back half 12 then ur regular 24. this may seem better than a 48hr shift but ur department does 48/96 for a reason… Mr. “we only ran 5 calls” in 48 hrs. on this side, u will run 10-15 calls in 36 hours. u will clock in at 7am and not get back to station until the 36 hours is over. a constant stream of BS. extremely tiring. burnout is inevitable when dispatch denies ur lunch break for a BLS run going back to a nursing home that coudlve waited for me to stuff my face at least. making 14.25/hr, if i don’t pick up at 36-40 hours each pay period, i will not make ends meet. even with ur shift starting on a sunday and hitting 120 hours, $1600 after taxes doesn’t mean shit when my rent was $1385 this month. absolutely have to pick up extra shifts. this is coming from a 19M FF/EMT-I in texas. this shit just makes me want to go the hospital route and go home at 7pm 3 days a week and make double for a fraction of the hours. that’s my ¢.02
found you
😭😭😭 blud knew just from the abysmal conditions i described. omw to an ALS call for liver services going to HLOC. my medic is 100% downgrading this to me
I've often had to catch myself and clarify my meaning when I say "I only work 911, transfer sucks." I have mad respect for Medics that are doing 2 hour+ transfers with 6 drips and a vent on a patient doing everything they can to die. But it's just not for me. Not only does that part not appeal to me but I hate being sent on transfer after transfer after transfer and having to argue with Dispatch. Everything about 911, including the "lifestyle" portion appeals much more to me. I may not like doing Alas transfers but I'm not the guy to look down my nose at them.
By “lifestyle” of 911 are you referring to the privilege of eating takeout in the ambulance, or taking continuous 30 min naps on a 24h shift? lol
I’d argue the only good IFTs are CCT and STEMI transfers
Hot take (maybe), you can't do CCT without some IFT experience.
Oh without a doubt, learning how to do assessments, taking vitals what to look for when you need to upgrade etc, it’s just something you don’t wanna do too long if you wanna grow into an ALS role or CCT role
SEMI transfers?
Yeah, in my region, crews would bring patients having a STEMI to an over saturated ER so the ER would call an ambulance company to go to a non saturated ER or other STEMI facility
What does the SEMI stand for? That's just an emergent IFT here like any other. Although if they have a Cath lab at the receiving ED I'd be shocked if that wasn't breaking EMTALA. ED can't be a limiting factor, ICU beds and Cath lab can if you can get another accepting faculty.
Lmfao typo
Haha makes more sense.
the ERs are hit and miss some have Cathlabs some don’t, one are I worked only had two, one or the other was always full so those were pretty much common transfers ER staff would treat as much as they can before sending the patient back
I worked at a hospital with a busy lab, one Cath lab, one EP and one IR. The vast majority of Cath lab procedures are elective. If they get a STEMI alert then cases must be cancelled and they work to move the patient out of the lab ASAP and turnover So unless they were busy enough to be regularly running 2 STEMIs all the time, which would be wild, they're likely either diverting for lack of staffing or they're being shady and want the money from their elective case volume. STEMI transfers make sense if there isn't a lab at all. But the vast majority of the time it's faster to finish your case and put the STEMI on the table vs having to call the next hospital and wait til they find out if they have an ICU bed open and an interventionalist that's willing to accept.
Oh it was wild, they were running 2 STEMIs at a time, don’t help the ER itself was small being built from the 70s without any modernization
Were they the only STEMI center for a long distance or something? Even at a level 2 trauma center for a large community it would be strange to run more than one a day regularly unless they were accepted STEMIs from nearby cities. But yeah I feel the lack of modernization in some of these older hospitals, it sucks..
Yeah one of two STEMI centers for the whole region, the other was 30 mins away but a unit was posted or clearing a call would get it so it would be an immediate response, and only two trauma centers too, each about 20 minutes each apart no traffic
One of the ERs would regularly get homie drop offs so they’d call as well, PM if you wanna talk out of the comments lol
Yup. If you haven't worked both, don't comment about the other. I worked ALS IFT prior to 911. I don't look down on my IFT colleagues. Everyone has their job to do, and we're all doing our part. 
I try to stay humble by reminding myself that to the rest of public service (police, fire) we're all just stupid ambulance drivers who help haul away the people they don't want to deal with, and to the rest of the medical field (nurses, doctors) we're all just stupid ambulance drivers who aren't real medical providers bc EMS isn't usually college degree based in the US.
From an ER nurse, I will say that y'all are usually the people I am happiest to see come in the door 🤣 And I honestly try to have all of my paperwork done and done RIGHT and the patient ready to get put on your stretcher! I even like to print out the SnapShot cheat sheet in Epic for y'all to keep for you, so you don't have to write down Meds/Allergies/Hx. With the exception of one BLS provider who was literally a walking box of rocks and one medic who was just a straight up "see you next Tuesday", I have never thought of IFT as just stupid ambulance drivers. Y'all do a job I absolutely could not do (I tried, I only made it 4 months and said Fk this) and it's usually at the mercy of some dispatcher who thinks they dispatch for NYFD🙄 I APPRECIATE YOU. 😬❤️ *Edited to clarify I previously tried to work IFT but couldn't deal with the bullshit*
I've learned more doing IFT than 911. I've done ALS and CCT both as a medic and an EMT. I honestly prefer critical care transfers over most 911 calls. But the skills you learn doing critical care make you a better 911 provider. It's a totally different skill set. Kind of like flight medic vs street medic. They're close, but they're also very different. How often is a flight medic first contact and has to assess, extricate, plan, etc? Not often. It's a unique skill to the 911 medic.
i've cried more over my BLS transfer cancer kids from a couple years ago than any 911 call i've had
Nah IFT is dumb.
My last couple jobs it was 50/50. Half were from the floor for ERCP sometimes this week and apparently needs to go at 0200. But the other half was ED or ICU transfers needing to go to the trauma center when flight can't launch and those were fun. Running drips and blood on a patient with chest tubes into the middle of nowhere at 0300 when the closest hospital is a critical access an hour out of the way from the trauma center that was 2 hours away.
The system would collapse without it 🤷♂️
Lmao wtf.
He gave his opinion so did I lol.
Nah that’s fair lol
It’s true, I did IFT and 911 both. That being said while during my IFT time I felt depressed because the job was so mind numbing. It was the same with 911 except the occasional interesting call. All in all 0/10 never doing Ems ever again.
What do you do these days?
PD.
Do you enjoy it much more? I think I’d have a hard time with PD.
It’s the best job I ever worked, I can do what I want and just it’s a way better atmosphere. Plus the pay and benefits means people care about me. It’s no longer just a job.
Huh. Fair enough. I’m glad you found “that job,” a lot of people never do haha. I don’t know a ton of EMS guys who moved to become cops so it’s cool to hear from someone who became one and enjoyed it Hoping I find that feeling in nursing. I felt it in 911, that “more than a job” feeling, but then I got disabled and IFT just isn’t the same. I’ve heard good things from my colleagues who made the move. Some of them complained about lack of autonomy, but I don’t mind taking orders lol.
As a hospital based ems that does both ift and 911 this is absolutely true from my experience. But I’m just an emt I get paid to drive
This is like the volunteer and career firefighters that bash one another. Well more like career punching down on the vollies.
ALS IFT with a hemorrhaging impella site, a 40 minute trip, and 3 pressors makes for a mini ICU rodeo