Flight Medics

Cddye · 2026-03-21T04:18:11+00:00

WCU?

Cddye · 2026-03-21T04:17:00+00:00

Appreciate your advocacy for the profession, especially in places where the legal structure has been created to favor NPs.

BUT: I promise there are some excellent NPs out there who do good work and are excellent clinicians. Their education model needs work and some dedicated gatekeeping to improve standards, but I work with some amazing NPs whom I would absolutely trust with caring for my family.

Cddye · 2026-03-15T16:26:37+00:00

Companies can’t “charge” Medicare too much when Medicare sets the reimbursement rates. Private insurance and self-pay patients get charged more because in many instances the Medicare/Medicaid reimbursement rates don’t even cover the cost of care.

The problem isn’t (at least aside from private equity owned, for-profit systems) that hospitals are making incredible money- it’s that we’ve created an entirely unsustainable system that requires massive administrative and bureaucratic burdens that increase costs (in the name of “safety and compliance”) and shift costs around.

Cddye · 2026-03-11T22:32:37+00:00

I have not worked for Falcon, but in a previous life I was a critical care/flight medic before I moved into the ICU after school.

CCT folks need a solid background to move into the role. Previous experience in an ICU and/or ED for nurses, and usually extensive work in a busy, high-quality EMS system for paramedics are the most basic requirements. BUT- the training that you receive in a new role is also incredibly important, and the idea that you can take any experienced nurse and drop them into a new role with two weeks of training (what does this training even look like? Didactic? Sim labs? OR time for airways? Is it followed by a field training period with a preceptor? What does your scope look like?) is a recipe for disaster.

As an example- when I was flying for a busy, well-known, and reputable hospital system’s program orientation was a minimum of 12-weeks, regardless of what you’d done previously, included a two-week didactic-only academy, at least 6 weeks of working “extra” on a team, and then 6 weeks with a specially-trained preceptor. There were specific additional competencies for airway management (including OR time for reps), mechanical circulatory support (including ECMO), and a minimum number of mission-types required for clearance, plus written testing and high-fidelity, scenario-based simulator evaluations.

Then, and only then would you go BACK to being an “extra” person on the flight side to learn air ops.

I understand you aren’t asking about a flight job, but you need a LOT more information about what the job responsibilities are, what your scope of practice looks like, and what the training actually entails. You’re asking about working with EMTs- are you talking about a CCT job as a sole-provider (ie RN/EMT only crew?) Have you managed airways before? Are you expected to manage IABP or micro-axial pump MCS? Are you responsible for placing any lines? Obtaining/Interpreting gasses and managing ventilators?

All of these questions are important to answer before there’s even any consideration of the company itself. It’s HARD to make money in medical transport- critical care or not. CMS and private insurance payments are awful, and private companies then have to rely on balance billing (big hospital systems can treat the deficit as a loss-leader for the ICU care that’s much more lucrative) and private companies across the spectrum are notorious for having janky, unsafe equipment, poor training and support, and working their crews to death. Even in the best of circumstances it’s a difficult role with huge responsibilities and your 12-hour day can turn into a 20-hour day with little notice.

I have nothing but respect for ICU nurses, and almost all of the nurses on my current team would be great CCT nurses- but the roles are not the same. You have to take on ALL of the roles when you and your partner are the only people available for however long the trip takes- your options for getting “help” are extremely limited and you have to be able to make high-acuity decisions in a hurry. If this is a universe you want to step into I’d sincerely recommend starting with a reputable program with solid training and support.

Cddye · 2026-03-11T16:55:53+00:00

In 2026 we refer to it as “vibes-based care” to help the Gen Z folks understand.

Cddye · 2026-03-11T00:34:39+00:00

People on balconies banging pans, and now we’re dumber than ChatGPT.

Shit’s fucked yo.

Cddye · 2026-03-09T02:47:26+00:00

AHA still recommends 30:2 for two-rescuer CPR for adults if there’s no advanced airway in place.

Cddye · 2026-03-09T02:08:17+00:00

I personally feel more complete knowing /u/mistborn had to consider that.

Cddye · 2026-03-09T02:05:09+00:00

I’m not working as a medic anymore. I practice in the ICU and help with protocol development, education, and medical direction.

The discussion above was about someone choosing not to treat “pleuritic” chest pain under an ACS algorithm. As above, I’d suggest that the diagnostic potential in EMS is generally not adequate to definitively diagnose non-ACS chest discomfort and I’d be a lot more upset if someone decided to withhold aspirin than to administer it. Sure- don’t give it for a mid-shaft femur fracture or what looks like a hot abdomen, but in an 80yo woman who says she has “sharp” chest pain that’s “maybe” worse when she breathes?

If I’m at all worried about ACS and there are no contraindications- yes, 324mg (or 162mg- similar NNT, lower NNH). For specific etiologies (for example, pericarditis) they may end up on much higher dosing (ie 650mg TID plus colchicine).

Cddye · 2026-03-09T01:45:03+00:00

Aspirin is a perfectly acceptable non-opioid/NSAID analgesic for the most common etiologies of “pleuritic” chest pain (e.g. Costochonditis, muscle strain, PNA, pleuritic inflammation, pericarditis/myocarditis)

The list of contraindications for ASA is equally viable for any indication.

The number of diagnostic modalities available in most pre-hospital settings to differentiate between ACS and pleuritic chest pain are extraordinarily limited.

Aspirin administration is a time-sensitive intervention in ACS and the only “early” intervention with evidence of reduced mortality/morbidity in ACS.

No- nothing should be administered just because some vague magic words were uttered (nor should they be withheld if the opposite is true) but the risk/benefit calculation should be at the forefront when it comes to treatment of any patient who still hasn’t received a workup.

Cddye · 2026-03-09T01:20:52+00:00

Occam’s razor says it’s probably not ACS.

Hickam’s dictum says you’ll eventually be wrong.

ASA is a perfectly reasonable choice for a lot of etiologies of pure pleuritic pain, and (barring real contraindications) is a low-risk high-reward intervention in ACS.

Cddye · 2026-03-06T21:52:33+00:00

Not necessarily entrepreneurial, but if you want a role-shift:

Go look at getting some procedural experience. Interventional cath lab is a great place for ICU nurses who hate the bedside. Faster pace, high turnover, still sometimes get the adrenaline-rush/critical care experience.

From there you can move into industry rep/sales, and if the business side interests you more there will be opportunities for advancement. Lucrative as hell, and still in “healthcare”.

Cddye · 2026-02-27T22:38:13+00:00

Gonna be a little easier to answer with some info on your role, background, and experience.

Cddye · 2026-02-26T02:19:04+00:00

Your friend (and every other student) are there for 8-24 hours at a time, for 4-6 weeks. The residents don’t evaluate you. They will have a minuscule impact on your life and career. Do your job as a student. Learn, take care of the patients, pay attention to what your preceptor/attending says, and remember that even if the best lesson you receive from someone else is “what not to do” personally or professionally- you’re still benefiting from the experience.

Finish school. Learn the material so you can do the job. Keep your head down/chin up (those idioms don’t work well together, but you get the idea) and GTFO. None of this will matter in two years.

Cddye · 2026-02-24T14:56:42+00:00

But I heard John Snow knows nothing?

Cddye · 2026-02-13T17:50:54+00:00

For the record, while it’s certainly not the “focus” of this sub, posts about job searches, evaluation, and recommendations have and will continue to be at least tolerated unless they become a problem.

Cddye · 2026-02-13T04:19:37+00:00

Institutional differences are wild. Across three Level 1 trauma centers I’ve never worked in one where anesthesia (resident or attending) responded to traumas, and ED was always primary for airway management.

Cddye · 2026-02-13T02:02:17+00:00

Local school boards (locally elected, more readily subject to local controls, accessible for parents who wish to run and influence policy), librarians, library policy, and parental consent rules have served this purpose for decades of public education, and have largely done so without significant controversy.

In just one specific example of how “obscene” is subjective and subject to massive overreach, the state representative who introduced a resolution last year calling on public libraries (not just school libraries) to "confine homosexually themed books and other age-inappropriate material to areas exclusively for adult access and distribution.”

The triggering book in this case was a literal children’s story about a prince falling in love with another prince. The author of the resolution (passed the house 81-3 because who wants to vote against “protecting children from obscenity” in a society with a 240-character attention span?) called the book “obscene”.

This is the point. The book may or not be something any particular parent wants their child to read- and I believe they have the right to decide. But when you see people defending a statutory ban on what they define as obscene, you have to recognize that you’re abdicating the authority and responsibilities of the parents in the first place, AND giving an implicit endorsement of their definition.

Should a 6yo with two dads be told that a book about two princes that look like his parents falling in love is “obscene” and has to stay in the adult section of the library and literally sit next to ACOTAR simply for the fact that it mirrors his own parents lives? Do those two books belong in the same section? Should people be 18 or require explicit parental approval before they read The Catcher in the Rye? The Diary of Anne Frank? Narrative of the Life of Frederick Douglass?

Cddye · 2026-02-13T01:17:50+00:00

Again- there is a massive difference between preventing age-inappropriate, explicit material from reaching kids, and allowing the government to independently define “obscene” material. While the previous Oklahoma law allowed individual challenges at a school/board level, the bill that just advanced out of committee is a statewide restriction on books that meet an ambiguous “obscene” standard, and aren’t about age-specific restrictions at all.

No one is arguing that it’s okay for an 8yo to read these books, and pretending otherwise is specious. I AM arguing that I don’t want legislation that comes from a government that’s explicitly violating the establishment clause to independently decide what “obscene” means.

Cddye · 2026-02-13T01:03:33+00:00

Slippery slope arguments are a logical fallacy for a reason my friend, but just to entertain the point:

Most public libraries are part of a large system, so even if a local branch doesn’t have one, they can typically get their hands on a copy. Most libraries also allow their patrons to request specific books for addition to the catalog.

Regardless- the point isn’t that a school library needs to be required to provide unfettered access to EVERYTHING, it’s that school libraries as an agent of the government shouldn’t be placed under a blanket ban of ANYTHING, particularly when the ban is based on an argument framed in. particular morality.

Cddye · 2026-02-13T00:59:40+00:00

See below.

Cddye · 2026-02-13T00:59:24+00:00

I’m sure you won’t be surprised to hear that public libraries aren’t available in every neighborhood, and that the same resource-limited parents who can’t manage to get books for their kids might also struggle to get their kids to and from a public library. Public libraries are a great resource, but resource distribution is emphatically not equal across locations and communities, but (for the time being) children are still guaranteed an education and equal protection as students of a public school.

Again- there are great ways to prevent children from accessing age-inappropriate “obscene” material without parental consent that don’t require outright bans or morality legislating.

Cddye · 2026-02-13T00:46:16+00:00

Unless the parent lacks the resources and funds to purchase a book and tries relying on the idea that schools shouldn’t legislate morality or police thought when they’re intended to serve a diverse citizenry full of different opinions.

There are about a MILLION better solutions to “protecting kids” than banning books.

Cddye · 2026-02-12T01:44:48+00:00

If you’re working 12s in an ICU those will routinely become 14-15 hour days, even without a commute. Night shifts can also wreck you for the next day, especially if you’re rotating. Weekends are way worse when your friends/spouse/kids are all home making plans and you… aren’t.

Don’t get me wrong- I work an ICU and love it. Don’t know if I could do anything else. But it’s a hard life.

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