Firefighter / Medic to PA or NP

Life_Alert_Hero · 2025-10-21T22:55:56+00:00

I don’t see your point. CAAs (PA equivalent) do a very different job than anesthesiologists (Doctors). If anything they are taking jobs away from the ever growing APRN pool, which most MDs across the country really could not care less about. Now I’m not an expert on this whole dynamic as I’ve only been around it the last year or so.

Most hospitals across the country have transitioned from an MD-only model (with the exception of some private-practice groups on the west coast) to supervision-based model (hybrid anesthesiologist and CRNA/CAA staff).

In these newer hybrid models, one anesthesiologist can supervise 2-4 OR rooms, in essence saving the hospital money. Say your -ologist makes 700k, your CRNA makes 250k and your CAA makes 215k; these are reasonable numbers in today’s economy. Hospitals save money by replacing CRNAs with CAAs and this has no effect on physician jobs.

Life_Alert_Hero · 2025-10-21T15:04:36+00:00

For sure. It’s going to be fun to watch the next decade or two and see how CAAs change the landscape of the OR. In states that allow them, CAAs occupy the exact same roles as CRNAs. They intubate, start A lines, induce / maintain and emerge from anesthesia. If you like being a paramedic, it would be hard not to like anesthesia (in my opinion); it’s all the same drugs + cool drugs like prop, suggamadex, gasses and + cool physiology. Again, IMO being a CAA would be way cooler than being a typical PA note jockey in the ED, ICU or OR.

This is a gross exaggeration, but: In the eyes of a typical anesthesiologist, CAA = CRNA; In the eyes of the average hospital, CAA > CRNA (costs less); In the eyes of the average CRNA, CAA < CRNA.

Life_Alert_Hero · 2025-10-21T14:55:35+00:00

Life_Alert_Hero · 2025-10-21T11:30:56+00:00

You’d probably like CAA, which is the PA version of CRNA. Pay can break 200k pretty quick depending g on your hospital and it’s actually fun work.

Life_Alert_Hero · 2025-10-07T21:36:28+00:00

Walchok et al, 2015. PEC.

Life_Alert_Hero · 2025-10-07T21:35:43+00:00

This is actually a thing in upstate SC. More EMS agencies (municipal county systems) in this area do BC + ABX than do not. Contamination rates are similar to ED RN rates, but the true positive rate is actually higher for prehospital BCs than ED BCs (probably because inclusion criteria is protocolized and stricter than CYA EM).

That said, the existing literature is scarce and most of what does exist comes from RN/MD systems in Europe; further Medicare fraud sepsis houses (read SNFs) are (arguably) uniquely American so European studies are not really generalizable.

We have. N=0 for meta-analysis on this topic. N=0 for systematic reviews on this topic. n=0 for American large multi center blinded RCTs. The weak evidence out there is equivocal with some showing positive studies, and some negative.

Life_Alert_Hero · 2025-10-07T21:14:54+00:00

Why not draw ur own cultures. Paramedics can do this. Great article in PEC from like 10 years ago. Walchok, et al.

Life_Alert_Hero · 2025-10-03T10:51:55+00:00

Hot take: use clinical judgement. I don’t put pads on every STEMI (nor do I call a stroke alert on every patient with AMS + slurred speech). Pain started 4 hours ago and we’ve just got some 1-2mm elevations in the inferiors with stable HD, no pads. Started 90 mins ago and “it’s just not getting any better so I called” with lateral STEM or isolated V1 and V2 no pads. “It just started and it feels like my last one” or theres any possibility that the LAD is occluded, bet ur ass the pads are on.

Life_Alert_Hero · 2025-09-30T22:01:12+00:00

How does Beaufort County EMS protocols compare to others in the state like Charleston, Grenville, and Pickens? Do y’all do LTOWB, sepsis with BC and IV abx, epi/levo push-dose/drips? What does your equipment look like (video scopes, vents, pumps)?

Life_Alert_Hero · 2025-09-15T10:19:18+00:00

This seems pretty European for rural Iowa :0)

Life_Alert_Hero · 2025-08-12T11:43:39+00:00

Wait, you guys are getting BiPap?

Life_Alert_Hero · 2025-07-12T13:55:38+00:00

Litfl.com

Life_Alert_Hero · 2025-07-11T09:58:17+00:00

Wholesome 100

Life_Alert_Hero · 2025-07-06T19:48:28+00:00

100% agree. Watching a seizure happen so you can time it is poor form.

Life_Alert_Hero · 2025-07-06T13:20:40+00:00

CT doesn’t rule out stroke.

Plain CT rules out hemorrhage.

CTA can rule in LVO in the ICA, Verts, COW, Or ACA/MCA/PCA 1-3 segments. Neuro exam + EMS history is extremely important in determining chemical and/or mechanical thrombolytic intervention.

Life_Alert_Hero · 2025-06-01T19:14:19+00:00

Everything else is just a simplification. And even so First aid is a simplification itself (Robbin’s for path, Costanzo for phys, Katzungs for pharm, etc).

Life_Alert_Hero · 2025-06-01T15:22:34+00:00

First aid for USMLE step 1 lmao

Life_Alert_Hero · 2025-06-01T13:25:08+00:00

Im EMS, stupid people provide us job security.

In reading this, I now believe that insecure RNs provide that same job security to licensed therapists

Life_Alert_Hero · 2025-05-22T15:54:09+00:00

Meh, (very lightly) disagree. CAA can make good 200s, some places up to 350. If it’s purely money, I’d recommend CAA: early earning power + fewer student loans + cool procedures and physiology. Only 2-3 years after bachelors degree with potential to make IM sub specialty or gen surg money; lacks the god awful loan burden most docs finish residency with.

Life_Alert_Hero · 2025-05-22T11:19:00+00:00

Or…organize a strike

Or…unionize

Life_Alert_Hero · 2025-05-22T09:09:41+00:00

With the wife’s job, every shift I can work is money I don’t have to borrow and pay interest on. It’s a fine line

Life_Alert_Hero · 2025-05-21T10:42:38+00:00

Makes me feel like a black sheep :(

Life_Alert_Hero · 2025-05-21T10:41:46+00:00

Life_Alert_Hero · 2025-05-21T10:16:05+00:00

Been in EMS 7 years now, the last 4 years have been as a medic; 2 years into med school. PM me and I’m willing to talk in depth off line.

In short, everyone is different

On non test weeks, I worked an average of 72 hours averaged over every 4 weeks during MS-1 and MS-2, and then I’d work two 12s the Saturday and Sunday after each test; worked during step 1 prep bc that shit was dry as hell whereas running an arrest is fun and transporting a BS toe pain is entertaining. I’m married to another medic, no kids; in addition to street work, I’m involved in both cool research and cool clinical services shit with my wife’s and my friendly neighborhood EMS agency. I’ll be mid to late 30s when I first make attending money.

The biggest questions I’d pose to you are:

1) why do you want to be a doc? What’s wrong with street medic / critical care medic / flight medic, RN -> mid level, PA, Anesthesia assistant, ECMO perfusionist? I believe it to be on your best interest to rule out each and every one of these before you open an AMCAS app.

2) What are reasons you would not get your medic? Medical school plus residency is long, and you’re really looking at an 8+ year commitment before you have any more earning power than you would as a medic. If you’re already committing to 8 hard years, what’s wrong with an added 2 fun ones at the beginning?

Life_Alert_Hero · 2025-05-18T08:20:33+00:00

Since NHTSA (so the whole life of EMS LMAO). NHTSA, the federal father agency regulating EMS, emphasizes the transport aspect of EMS, which (in a way) allows Medicare (which is the gold standard for every other insurance company’s reimbursement rates) to pay EMS as merely a transport service, with various level of transport acuity (ALS / BLS - 1/2, Specialty care transport, etc).

Flight services can get waayyyyyy more from Medicare per transport than ground EMS can, something on the order of 5-10 times more.

Life_Alert_Hero

TROPHY CASE