critical care work for new medic

[fireflymedic]

Here's my thoughts for what they're worth. You come out of medic class knowing just enough to effectively kill someone. The critical care class is more in depth, but still doesn't cover enough to adequately educate you for the little ones. Though most CCT programs (UMB's program especially) suggest 2 years of experience in high volume 911 before attempting it. I have seen intelligent medics complete the course struggling that are brand new and most don't pass the exam. The few that get lucky and do pass feel overwhelmed. It is the rare brand new medic that is prepared to take on CCT. I would suggest as others have to hit a hospital ER for experience (if you really desire peds try for a peds hospital if possible) or with a team as a driver. You'll be as Dust said the nurse's beatch, but you'll see and learn alot especially if you have a good team. Glad to see you're motivated, good luck to you !

[VentMedic]

You can also attend some national conferences and monitor some of the critical care websites for opportunities or other classes. It also helps if you have some college especially in the sciences like A&P, Pharmacology and Pathophysiology. Do not just rely on the overview the Paramedic textbooks give you for an educational foundation. If you at least have more than just a Paramedic patch and a few weekend certs, the employer might see you are serious.

You will need a very strong familiarity with the medications and calculations to where they are second nature. There is absolutely no room for guess work or errors made from not being familiar with pediatrics which can be anywhere from 1 day old to 21 y/o. The same when it comes to airway issues. You must have a strong ability to establish and manage an airway for neonates through adults. IVs will also have to be a strong point if they allow you to do invasive procedures.

Critical Care Transport Medicine Conference

http://www.flightparamedic.org/cctmc.htm

International Association of Flight Paramedics

http://www.flightparamedic.org/index.aspx

Current Concepts in Neonatal & Pediatric Transport Conference

http://intermountainhealthcare.org/hospitals/primarychildrens/classes/classesformedical/conferences/Pages/transport.aspx

Conferences at All Children's Hospital St. Pete, FL

Neonatal and Pedi conference, Austin, TX

http://www.int-bio.com/userfiles/file/2010%20conference%20brochure.pdf

Air & Surface Transport Nurses Association

http://www.astna.org/

Great Journal: Pedi Critical Care Medicine

http://journals.lww.com/pccmjournal/pages/default.aspx

Where some of the guidelines originate:

American Academy of Pediatrics (AAP)

http://www.aap.org/

*****AAP Transport Section *****

http://www.aap.org/sections/transmed/default.cfm

[HERBIE1]

Here's my thoughts for what they're worth. You come out of medic class knowing just enough to effectively kill someone. The critical care class is more in depth, but still doesn't cover enough to adequately educate you for the little ones. Though most CCT programs (UMB's program especially) suggest 2 years of experience in high volume 911 before attempting it. I have seen intelligent medics complete the course struggling that are brand new and most don't pass the exam. The few that get lucky and do pass feel overwhelmed. It is the rare brand new medic that is prepared to take on CCT. I would suggest as others have to hit a hospital ER for experience (if you really desire peds try for a peds hospital if possible) or with a team as a driver. You'll be as Dust said the nurse's beatch, but you'll see and learn alot especially if you have a good team. Glad to see you're motivated, good luck to you !

Agreed. Book knowledge only gets you so far. That's why I have a problem with a a fresh EMTB who enters a paramedic program right after they graduate as a Basic. Yes, most paramedic programs are SUPPOSED to require some minimum of street experience before you are allowed to enroll, but we all know that does not always happen. You need to walk before you can run, and you need to learn, understand, and BE ABLE TO APPLY the basics before you move on to more advanced care. I've dealt with paramedics who have gone that fast track route and the vast majority of them are in way over their heads, and an undue burden on their partners. When you have to explain to a licensed paramedic how to change a regulator on a D tank or how to properly lift a cot, there is a problem. (True story)

As everyone has noted, any specialized training is over and above what you already know, and until you have a firm grasp on the basic job of ALS care, I simply think you cannot be effective at something such as a critical care medic or a flight medic.

Look for available options such a critical care tech, and ER tech in a busy ER, or as was noted, see if a critical care company is willing to hire you as a driver so you can be exposed to and begin to learn what the job entails. Take all the requisite classes and THEN start looking for work as a CCT. Maybe you can find a company willing to hire you and pay for your certifications as a reward for future employment.

[VentMedic]

When you have to explain to a licensed paramedic how to change a regulator on a D tank or how to properly lift a cot, there is a problem. (True story)

If it takes someone 2 - 3 years of street experience as an EMT-B to learn how to change a regulator on an O2 tank or lift a stretcher, this is probably not the profession for that person.

What you have described is either and/or a school failure or someone who just doesn't get it. It is not an indication that every well educated Paramedic will be inept at simple skills. If a Paramedic program is properly done, there should be close to or over 1000 hours of clinicals as there is for other professions. The "basics" of the equipment that a particular company uses should also be covered in orientation. The O2 regulator thing can be tricky as there are about 20 different types depending on manufacturer/application and one should be made familiar with the one that company uses.

The "basics" should be learned in the first month of Paramedic school and then one should move on to the nitty gritty medical education. It is of no use for one to just go through the motions of taking a BP and doing basic first aid if you have no clue about what you are assessing or what you should be assessing. In fact, EMT-B does not teach what one needs to know about 95% of the IFT nursing home and dialysis transports. They are mostly medical and require very little first aid.

We require RNs, RRTs and Paramedics applying for transport to have 2 - 5 years of experience functioning at their higher credential level. We don't care how long they were a CNA, CRTT or EMT.

There are a few drawbacks to just working an ALS transfer truck or CCT epecially if it has limited protocols (CA again can be an example). The IVs, medications and airways will already be established. I have known Paramedics working these trucks that have not started an IV or intubated in several years. Some may require an RN (or RRT) to accompany. Some IV medications will be a "look but don't touch" situation as in various areas Paramedics are not allowed to titrate drips on IFTs. Also, if you are in California I would suggest that you move to another state if you want any chance of getting the opportunity to be part of a decent EMS or IFT team.

Edited October 27, 2009 by VentMedic