Newbie EMT-B with tons of questions!

[EMTboi]

Well Hi! This is my first post, so howdy to y'all!

Mine is a complicated story..

I grew up in the Chicago area, then moved to Colorado last year and took an EMT course (and I passed, I'm just now a registered EMT-B *yay*), now I'm moving back to the Chicago area (Evanston). As soon as I get back I'll be looking for a job. I'd like to be in an ambulance, but I wouldn't mind an ER tech-type position as well. I know the Fire Lt. in my home-town who will sponsor me to go to Paramedic school next year and after I'm certified I'll have a position available with that Dept. In the mean time though I need to make some money to save up for EMT-P school.

I have a million (or so..) questions that I hope all the more experienced people will be able to help me with.

-What are the best agencies to work for in that area (especially in terms of salary, flexibility, types of calls, ect..)?

-Are there any Hospital-based agencies in the area? Or what are the non-private services (especially that hire EMT-Bs)? (I had my clinicals with Poudre Valley Hospital which had it's own ambulance service that co-oped with the local Fire Dept and I really liked the way that system worked.)

I'm considering even skipping the job search and just volunteering with Americorps for a year.. Would that be a good idea in your opinion? The pay is a stipend of about 800-1100 a month and I would probably work in an emergency preparedness program (for terrorism and disaster events) Would it be beneficial (directly) at all for my EMS career?

-I'm not yet EKG or IV certified, can I and where are places I can certify at?

-How does it work becoming ACLS and/or ATLS certified? Is it a class or course like IV? Where can I find one?

-One thing I really want to do is become a flight medic. What is the best path to accomplish this?

-Long-ways down the road I'm considering the possibility of becoming a nurse or even going on to medical school, again what's the best route to get there?

-Any advice for a fresh green eager-beaver EMT-B?

-Oh yeah, For those that are EMT-B or P with a fire service, how does it work, what is the structure? DO you ride in the truck or on a bus? Are you a Fire Fighter or 'just' an EMT or Medic?

Thanks for your help!

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[psychbender]

I am not from the Chicago area, so I can only answer a few of these.

-I'm not yet EKG or IV certified, can I and where are places I can certify at?

Most places in the country, EMT-Bs cannot start IVs or read EKGs. For these skills, you would need an ALS class, such as your paramedic program. If, however, you are practicing in a region where BLS providers can start IVs, then there are usually IV classes that are offered, and advertised through the state Office of EMS (check your state's website).

-How does it work becoming ACLS and/or ATLS certified? Is it a class or course like IV? Where can I find one?

ACLS is a course put out by the American Heart Association that ostensibly covers identification and treatment of cardiac dysrhythmias and strokes. However, my classes have always been at the hospital, where I was the only pre-hospital provider, and the only person there who had actually run a code, or could read the EKG (joys). Right now, any medic who is even half-way awake can breeze through a 16 hr ACLS course, and pass with flying colors. I am not convinced of the utility of taking this class if you do not understand cardiac rhythms, or basic cardiac physiology (like the endoscopy nurses I always seem to be in the class with). ACLS courses must be taught through an approved AHA training center (commonly hospitals, sometimes large EMS/Fire training centers) with approved AHA instructors. The cert is good for two years. Check your local hospital, and contact their AHA training coordinator for more information.

ATLS is a four-year cert, that is designed for physicians, PAs, NPs, and military medics/corpsmen. The only civilian pre-hospital providers I have ever known who have taken this course were some flight medics, but they were given near last priority, and could only audit the class (not actually get the cert). The trauma cert for most EMS-folk is either PHTLS or ITLS (formerly BTLS). These cover basic traumatic injury patterns and care from the pre-hospital perspective. If you had a decent EMT-B class, this will probably all just be review, but a useful review.

-One thing I really want to do is become a flight medic. What is the best path to accomplish this?

This is usually a rather long road. My experience with flight agencies is mostly limited to the only one in my area, which is part of the major transport company here. They generally require their flight medics to have several years experience on the road, take the Critical Care Paramedic course, then work on the Critical Care truck for a while before being allowed to apply for the helicopter. Some people seem to bypass one or more of those steps, though (I think bad idea).

-Long-ways down the road I'm considering the possibility of becoming a nurse or even going on to medical school, again what's the best route to get there?

Decide right now if this is something you are just considering, or something you are serious about. EMS can be very fun, but can also distract you from your larger goals. There are several people here that can tell you about how they wanted to become doctors, got involved in EMS, and delayed starting medical school by several years. Remember, a history in EMS will not necessarily help getting in to medical school, and it will not shorten the length of time to train as either a nurse or doctor. Also, if you go to nursing school after time spent in EMS, you will probably become very frustrated with terrible instructors teaching incorrect information, and people trying very poorly to teach you skills with which you are already quite comfortable. Many of the ALS at my rescue squad are also nurses, and they constantly bitched about their incompetent instructors while in school.

-Any advice for a fresh green eager-beaver EMT-B?

Thanks for your help!

Advice: Don't become "that guy" and deck out your POV with a lightbar.

 

[EMTboi]

Thanks so much for your answers! They definitely help a lot! Part of the problem is that I'm just so new to this all that I have so many options and directions to go in. I have a general idea, but really I have no set plan at the moment, I'm fairly certain I want to be a flight medic at some point, but I am just considering nursing or medical school. As for EMT-B what is the best service (and what are all of the different types?) to work for in terms of experience and 'action'?

 

[Druggernaut]

I'm considering even skipping the job search and just volunteering with Americorps for a year.. Would that be a good idea in your opinion? The pay is a stipend of about 800-1100 a month and I would probably work in an emergency preparedness program (for terrorism and disaster events) Would it be beneficial (directly) at all for my EMS career?

If you're planning on going on to paramedic school next year, I would highly suggest you work as a basic full-time for that year. From speaking to experienced paramedics, they've told me that they consider a year of full time work for a busy service to be the minimum someone should have before going through paramedic school. It builds upon the knowledge you gain as an EMT-B, and just going through the EMT course isn't enough. EMS and patient care in general is something that needs to be practiced in order to become competent, not just read about.

 

[deleted6669]

If you're planning on going on to paramedic school next year, I would highly suggest you work as a basic full-time for that year. From speaking to experienced paramedics, they've told me that they consider a year of full time work for a busy service to be the minimum someone should have before going through paramedic school. It builds upon the knowledge you gain as an EMT-B, and just going through the EMT course isn't enough. EMS and patient care in general is something that needs to be practiced in order to become competent, not just read about.

strongly agree with above.
I was an emt-b for 5 yrs before medic school but always worked as an er tech. I was way ahead of the game when it came to knowing about medicine(graduated 1st in my medic class based on classroom gpa) but way behind the 8 ball with regards to FIELD medicine(like how does a gurney work, how do you drive an ambulance, just how do you get a 400 lb guy in full arrest on the 4th floor down to the rig, etc). it worked out ok because most of my preceptors and my first few partners were patient with me but if I could have traded 6 mo to a yr of my 5 yrs as an er tech for field time I would have.
also consider looking into the pa field after your time as a medic. it is a natural transition and builds on skills you gain as a medic. I have seen many medics become nurses after medic school and most of them moved on to something else fairly quickly as they liked running the show(as a medic) and that typically isn't something nurses can do but pa's and docs can.
I also know lots of folks who did medic to md/do and they ended up as great docs and were happy with their choices.
good luck whatever you decide.

 

[Dwindlin]

If you're planning on going on to paramedic school next year, I would highly suggest you work as a basic full-time for that year. From speaking to experienced paramedics, they've told me that they consider a year of full time work for a busy service to be the minimum someone should have before going through paramedic school. It builds upon the knowledge you gain as an EMT-B, and just going through the EMT course isn't enough. EMS and patient care in general is something that needs to be practiced in order to become competent, not just read about.

Also agree with this very strongly. I had people fail out of my medic course because they struggled and failed BLS based lab skills in the first couple quarters. You need a solid grasp of the basics before moving on imho.

 

[ArkansasRanger]

I got certified as an EMT on more of a whim than anything else (some medical interests & a desire to be prepared for the unexpected) and upon reflection felt that I didn't learn what I thought I was going to. Emergency being shown on TV Land at the time also had a role in that. A year passed and I enrolled in the paramedic program which I attended at night while working on a B.S. in a non-related field by day. I finished both courses of study at the same time and went to straight to work as the paramedic on private ambulance contracted to run emergency/911 calls and do interfacility transports. Covering 400 miles three times a day sucked. I got burned out on it in a rather short amount of time because I never had free time. Through school I was always in class and once in the work place - teaching high school science and working part-time as a paramedic - I never had free time. I got out of both, became a cop while briefly doing both LE and ALS EMS, downgraded back to EMT-B (after being a medic just four years) and never got back on the ambulance. I loved medical stuff, and I've been re-reading all the pathophysiology stuff in my paramedic books lately as a hobby realizing that I watch too much tv in my spare time. Great fun. I love that stuff, and I liked assessing people, doing a field diagnosis, and treating the patient, but I just didn't like never having any free time. I also found myself eventually unenthusiastic about (insert apathetic) about working in the back of an ambulance and found myself angry when the 911 bells went off. That was due to burn out, but I still wouldn't want to do it now. I discovered that I need only to take a refresher and retake the National Registry test to get my NR and AR medic credentials back. I'm interested in doing this, but I don't know why because like I say I don't want to get back on the truck. I'm ready to move up to a higher level.

To make some random commentary on the OP, no, you can't take ATLS even if you sat in on the class. A lot of it would probably be above your understanding as well as mine and most other prehospital guys. It would be cool though. You could probably find an ACLS class and even get certified in it, but it'd be outside your scope of practice to do any of that as an EMT so there'd be no point. Let the medic class prepare you for EKG, IV, ETI, and the other skills you want. ACLS was easy once we had gotten pimped on it in medic school so much. In fact, you'll find that paramedics are often the kingpins of ACLS and held to higher standards. You might even take the intermediate test along the way to move up a bit. Some people do that. I never saw the need. The largest city in my native county had its own FD with integrated EMS. The rest of the county got the private-contract service I worked for. There were four fire stations, in a city of about 23,000, and three of them had ALS ambulances. All FFs had to be EMT-Bs, and the department would pay them to become EMT-Ps plus a bump in pay upon certification. They road three guys to a truck - sometimes three medics. They only staffed three guys at each substation although NFPA standards called for four men to be on a pumper/tanker. A lot of them were FFs who had no interest in EMS, and a lot of them were EMTs working there because the pay and benefits were so good, yet they cared nothing about fire. If you want to get into flight medicine get your RN credentials and a BSN to go with that EMT-P. Give up the idea about Americorps as I don't see how that fits in to any of this. It won't help with the job search later if you do anything non-medical/non-emergency management, and I've never encountered Americorps stuff that has that role although it probably is out there since you seem to be aware of it.

 

[MedicFL]

As a medic if you can find a program that will allow you to sit in you can Audit ATLS I have. But however your must be a certified medic already and most of the skills don't apply to you at all, even me in the critical care setting in the helo most of the skills didn't apply to me. You can't get certified you can get a letter of audit though...

 

[146233]

Don't waste your time with ATLS or even ACLS for the time being. Some hospitals require their ED techs to get ACLS to function as part of the code team, but that's about it.