Where to work starting out? 911 or IFT's

[JPINFV]

Well, that's not entirly accurate because all of the private services around here provide IFT, including the ones that hold 911 contracts.

[Richard B the EMT]

Must be geopolitical.

NYC 9-1-1 is municipal, primarily FDNY EMS, with some hospitals providing their own ambulances, with the hospital name on the ambulance's side, and other hospitals in the system subcontracting with private proprietary ambulance services, like AMR and Metrocare. These have something like "Ambulances for XYZ Hospital provided by ZYX Ambulance Service".

Inter Facility Transfer services are exclusively handled by private proprietary ambulance services, like AMR and Metrocare, as well as other providers, like a former employer of mine, Midwood Ambulance Service.

I do know that there is, or was, at least one private ambulance service provider had a contract with the city of Yonkers to provide 9-1-1 emergency services.

Then, there is the mode described in "Mother Jugs and Speed", where the locality has contracts with several private ambulance service providers, each assigned a district, with overlap if one area gets overwhelmed by call volume, the next provider will enter the first one's district.

Some services, I am aware, will handle a 9-1-1, or a IFT call, based on location of whichever ambulance is closest, so nobody knows if they're getting a 9-1-1 or IFT, until dispatch calls them.

[Riblett]

In my area so few 911 agencies staffed Basics, and the ones who do pay less and want two or more years of experience most of the time. When I was a new EMT I decided to work doing IFT because I needed a job and felt that $10.50 an hour was better than what I would make doing the common college student jobs like working at a restaurant, mall, or fast food joint. Plus I would be using my EMT cert and getting some type of experience while I worked on my medic at the local community college AAS program.

Many would disagree with me, but I found the experience of working IFT quite valuable. It gave me the opportunity to become familiar and comfortable with ambulance equipment and do lots of hands on patient assessment, in a non-emergency environment. But you can make it as valuable or invaluable as you choose. I assessed every patient, took full vitals signs (which you should do anyway, but lots of IFT EMTs don't) , did mental status assessments, and even listened to lung sounds and heart tones. I looked at the patient's medical history and medication list, which was provided to our service mandatory for every transport. I learned about trends, common medications, medical conditions and corresponding clinical findings.

While in paramedic school I got to see and assess people with the medical conditions I was learning about...a-fib, dementia, parkinsons, a flutter, sepsis, spinal cord injuries, and various neuro disorders, to name a few. This was a benefit that no one else in my classes had. Aside from the clinicals (during which the medics we rode with let you little more than observe anything more than a basic or stable patient) they all took vital signs and assessed their classmates, all healthy young adults. I rode as a volunteer a few shifts per month with the local 911 service also. This gave me the benefit of experience in the emergency environment with ALS personnel.

If you can work 911 or at least volunteer a bit while in medic school you definitely should. But don't rule out IFT just because it is not lights, sirens, and glamor. I think everyone who goes to paramedic school should do at least some IFT while in school. It is a needed service, the pay is better, and it can be valuable it you make it. Just my own opinion.