Basic EMT’s will be expected to provide Basic Life Support (BLS) as needed and may also need to do Critical Care Transports (CCT) with a Registered Nurse (RN) present.
Even though private ambulance EMT jobs don’t have the glamour or glory of 911 EMT jobs, they do require strong EMT skills and good patient care.
These jobs are often physically demanding because of all the lifting and transferring of chronically ill patients from bed to gurney and back to bed again at drop off.
Many of these patients have long term chronic illness with multiple body systems affected. Often they are not ambulatory and they can present as a very complicated overall patient.
Emergency Medical Technicians working on a private ambulance will get very good at skills like assessment, vital signs, patient rapport, and communicating with caregivers and family.
These EMT jobs allow time to perfect secondary assessment skills and getting a SAMPLE history because there is more time for a thorough assessment.
An advantage to working for interfacility transfer (IFT) companies is that the Emergency Medical Technician can gain in-depth medical knowledge more quickly than in a 911 job. Transferring non emergency medical patients may involve more time at hospitals or other facilities while waiting around for them to prepare the patient for transport.
During this time and during long transports, the EMT has time to read the patient’s transition of care summary and other medical reports. EMTs can learn a lot about medical conditions, treatments and current medications from these reports.
They can get a clear picture of disease progression and see how it has affected the patient in front of them during assessments.
Working with non emergent patients also gives Emergency Medical Technicians the opportunity to see the longterm effects of chronic conditions and see what these symptoms look like on patients outside of an emergency situation.
Another thing to keep in mind is that private ambulance company EMT jobs are still emergency responders. They may not respond to 911 calls, but there are going to be situations where the patients become emergent.
Sometimes it will be because the patient decompensates and the call is elevated to an emergency after arrival or during transport.
Sometimes it’s because the people who call the ambulance didn’t recognize it was a medical emergency when they called for an ambulance. For this reason EVERY patient should be assessed properly by the Emergency Medical Technician on arrival, and all patients need to be taken seriously.
Any routine transfer can turn into an emergency, but there are a couple types of IFT calls that are more likely to be emergency calls. The first type is patient transfers from Skilled Nursing Facilities (SNF), also known as nursing homes for the elderly.
In many areas these facilities have to report and tally the number of 911 calls that are made from the facility each month. These 911 calls are a black mark against the SNF so they are avoided whenever possible.
For this reason, the SNF will often try to schedule a private ambulance with a fast response time in order to avoid calling 911 if they are unsure about the seriousness of a patient’s condition.
Whenever my partner and I got a call for a transfer from an SNF to an Emergency Department (ED) we assumed it was an emergency and rushed to get to the patient for assessment because these calls so frequently become emergencies. (Often the SNF complaint is altered mental status which is caused by sepsis).
Another type of call that may end up with an emergency transport to the ED is a patient being transferred home after dialysis. These patients can have fluid imbalances and many other issues as a result of the hemodialysis treatment.
Overall, most of these patients will be a routine transport without complications, but dialysis patients can present as very ill and can become unstable quickly during transport.
Private ambulance EMT jobs are a great place to sharpen your skills and become a great EMT and sometimes even a better Paramedic. However, it requires the medical professional to be highly self motivated. Basically you have to force yourself to not be lazy, and you can’t get comfortable with just getting by.
Critical Care Transports
Often IFT companies provide Critical Care Transports (CCT), which offer Basic Life Support (BLS) EMTs the opportunity to work with a Registered Nurse (RN). During critical care transports the EMT can help escort a critically ill patient that has a higher probability of deterioration during transport.
Critical care transport calls offer the EMT experience working with patients on ventilators, vasopressors, and they can even be neonatal patients.
During these calls the EMT will need to be ready to follow any requests made by the RN. Common responsibilities will be lifting and moving the patient, bag valve ventilations, chest compressions, and complying with the RN’s requests during transport.
For patients on a ventilator, be ready to provide ventilations (with the Bag Valve Device) anytime the patient needs to be disconnected from the ventilator, such as when transporting the patient from the ambulance into the facility.
We had the portable ventilator fail once during a CCT transport and as the EMT it was my responsibility to provide ventilations for the entire transport.
The point is there are many things an EMT can learn from working CCTs. They can be exposed to hospital equipment and complicated patients, and the nurses are usually happy to share their knowledge during transport.
This is a great way for the EMT-B to learn about current medications and help the nurse respond to changes in patient status during transport.
More about IFT Jobs
While some people classify these EMT jobs as boring, there are patients that will provide challenges frequently. Paramedics doing IFT may have much more challenging patients on multiple drips who remain unstable and require interventions the entire transport. Even BLS transports can have high acuity patients that require constant monitoring and interventions.
Another good thing about inter-facility transport EMT jobs is that the emergency medical responder gets to build relationships with patients. There is more time spent on each call and this allows the EMT to get to know patients on a more personal level.
This can be just as fulfilling because you get a strong sense that you are helping people and providing a needed service.
Also, family is frequently involved and grateful for a medical professional willing to take the time to listen and answer their questions. (With 911 patient safety and survival often requires the EMT to leave the scene quickly in order to transport the patient to an ED.)
Also, it’s not uncommon for interfacility transports to see the same patients repeatedly which adds to these relationships and can increase patient care. This kind of job might not have the glamor of 911 calls, but getting to know patients and helping them get through a difficult time can be very fulfilling.
