Interested in parlaying your medical training as an Emergency Medical Technician (EMT) to the world of wildland fire? There are two different ways that you can do that.
Option #1
The first option is to look for a regular position on a fire crew. Hotshot Crews, Type 2 Hand Crews, Engines, Helitack Crews and Smokejumpers all look for folks with an EMT background. However, it's not the only thing they look for, so if you don't have a few seasons of wildland fire experience under your belt, just being an EMT isn't going to land you a spot on a hotshot crew. But if you do have a season or two of experience on a Type 2 crew and you have your EMT, that will give you an edge over other candidates with similar experience. To be clear, crews will not put out specific job postings seeking EMTs. It's very much a "nice to have" skillset. In fact, the NWCG does not require a hotshot crew to have an EMT. And the Bible of wildland firefighting, the Interagency Standards for Fire and Aviation Operations, otherwise known as the Red Book, specifically has the following to say about the limitations of wildland fire resources:
Responding to Non-Wildland Fire Incidents
Managers will avoid giving the appearance that their wildland fire resources are trained and equipped to perform structure, vehicle, and dump fire suppression, to respond to hazardous materials releases, or to perform emergency medical response for the public.
Wildland fire resources are different from traditional city fire firefighters. Emergency medical calls are just not a big part of the job. And an EMT's benefit to a crew is, primarily, to support an injured crew member, and less to provide care to a member of the public.
Option #2
When a fire goes big, and hundreds of personnel are called in to support the effort, an incident command team might request two types of EMTs:
- Emergency Medical Technician Basic, EMTB
- Emergency Medical Technician-Fireline, EMTF
Both of these are AD positions (Administratively Determined) which allows IC teams to call up resources on an as-needed basis. But what's the difference between the EMTB and EMTF? The EMTB can only stay in fire camp, while the EMTF can patrol the line and be called out to respond to a situation on the fireline. That's because the EMTF must have their Redcard, which means they have completed the following training:
- Introduction to ICS (I-100)
- Firefighter Training (S-130)
- Introduction to Wildland Fire (S-190)
- NIMS: An Introduction (IS-700)
- Annual Fireline Safety Refresher (RT-130)
- Human Factors in the Wildland Fire Service (L-180)
- Passed the Pack Test at the Arduous Level (Walk 3 miles in under 45 minutes with a 45lb Pack).
Now, it is important to note that under this arrangement, you could go all season long without a resource order. Or you could be busy all season. Totally depends. You're classified as an emergency worker. So if there's no emergency? No work? Emergency ends? No more work. And because contracting with the government can be a cumbersome process, many folks will choose to associate themselves with a vendor like WildlernessMedics.com, a company that connects on-call EMTs with assignments.
So how much can you make? Well, it depends. If you contract directly through the government, you are paid according to AD Pay Rates. Every year, the federal government establishes pay rates for emergency workers.
EMTFs are classified as AD-H.
- 2018 AD-H Pay Rate = $30.04 (+1.7% from 2017)
- 2017 AD-H Pay Rate = $29.52
EMTBs are classified as AD-G
- 2018 AD-G Pay Rate = $26.80 (+1.7% from 2017)
- 2017 AD-G Pay Rate = $26.36
Now, if you were to contract through a vendor, like Wildernessmedics.com, you would receive less per hour, as they company receives a percentage for handling the administrative aspects of your AD employment, and that percentage comes out of the pay rate above.
So what types of things do fireline EMTs do? Here's how the National Wildfire Coordinating Group defines the EMTF role's duties, knowledge and requirements:
Emergency Medical Technician-Fireline
Duties
- Performs non-invasive lifesaving procedures focused on the initial management of injured and sick person.
- EMTFs are not independent practitioners and therefore must be supervised by a physician medical director. Although many of the procedures that an EMTF is allowed to perform do not require real-time oversight by the supervising medical director, the EMTF makes destination decisions in collaboration with medical oversight.
- While all EMTFs receive essentially the same training, the specific procedures that each individual EMTF is authorized to perform vary depending on the EMTF’s scope of practice. An EMTF’s scope of practice contains only those procedures for which he or she is educated, certified (by passing an exam), credentialed (medical director grants “permission” to practice), and licensed by a state to perform. Therefore, the scope of practice of an EMTF will vary by individual.
- EMTFs will be required to work on the fireline or other remote areas of an incident. The EMTF would be expected to participate in and/or lead the evacuation of a sick or injured person from this environment. The EMTF would also be expected to perform these lifesaving skills with the equipment available to them on the fireline, which is significantly less than those EMT in the medical unit or typical urban EMS system. The EMTF may be the only medical provider on scene for an extended period of time in less than ideal conditions.
Position Knowledge and/or Requirements
The following is a list of the typical skills than EMTF can perform:
- Airway and Breathing
- Insertion of airway adjuncts intended to go into the oropharynx or nasopharynx.
- Use of positive pressure ventilation devices such as manually triggered ventilators and automatic transport ventilators.
- Pharmacological Interventions
- Assist patients in taking their own prescribed medications.
- Provide lifesaving medications with an auto injector.
- Administration of the following over-the-counter medications with appropriate medical oversight including the following:
- Oral glucose for suspected hypoglycemia.
- Aspirin for chest pain of suspected ischemic origin.
- Use of an automated external defibrillator.
- Trauma Care:
- Stabilizing suspected spinal injuries and extremity fractures.
- Controlling bleeding.
- Evacuation of a sick or injured patient using purpose made and improvised litters.
- Appropriate triage of sick or injured patients in order to assist with the formulation of an evacuation plan.
- Application and inflation of the pneumatic anti-shock garment (PASG) for fracture stabilization.
Position Knowledge and/or Requirements
- Current EMT license (must be issued by the EMTs home-state EMS licensing authority)
- Introduction to ICS (I-100)
- Firefighter Training (S-130)
- Introduction to Wildland Fire (S-190)
- NIMS: An Introduction (IS-700)
- Annual Fireline Safety Refresher (RT-130)
- Human Factors in the Wildland Fire Service (L-180)
- An arduous physical fitness level has been established for this position
Other Training Supporting Development of Knowledge and Skills
- Intermediate Wildland Fire Behavior (S-290)
- Basic Air Operations (S-270)
- Helicopter Crewmember (S-271)
- Wilderness Emergency Medical Technician
So what types of things do EMTBs do? Here's how the National Wildfire Coordinating Group defines the EMTB role's duties, knowledge and requirements:
Emergency Medical Technician Basic
Duties
- Performs non-invasive lifesaving procedures focused on the initial management of injured and sick persons.
- EMTs are not independent practitioners and therefore must be supervised by a physician medical director. Although many of the procedures that an EMT is allowed to perform do not require real-time oversight by the supervising medical director, the EMT makes destination decisions in collaboration with medical oversight.
- While all EMTs receive essentially the same training, the specific procedures that each individual EMT is authorized to perform vary depending on the EMT’s scope of practice. An EMT’s scope of practice contains only those procedures for which he or she is educated, certified (by passing an exam), credentialed (medical director grants “permission” to practice), and licensed by a state to perform. Therefore, the scope of practice of an EMT will vary by individual.
Position Knowledge and/or Requirements
The following is a list of the typical skills that an EMT can perform:
- Airway and Breathing:
- Insertion of airway adjuncts intended to go into the oropharynx or nasopharynx.
- Use of positive pressure ventilation devices such as manually triggered ventilators and automatic transport ventilators.
- Pharmacological Interventions:
- Assists patients in taking their own prescribed medications.
- Administration of the following over-the-counter medications with appropriate medical. oversight:
- Oral glucose for suspected hypoglycemia
- Aspirin for chest pain of suspected ischemic origin
- Use of an automated external defibrillator.
- Trauma Care:
- Stabilizing suspected spinal injuries and extremity fractures.
- Controlling bleeding.
- Evacuation of a sick or injured patient using purpose made and improvised litters.
- Appropriate triage of sick or injured patients in order to assist with the formulation of an evacuation plan.
- Application and inflation of the pneumatic anti-shock garment (PASG) for fracture stabilization.
Position Requirements
- Current EMT license (must be issued by the EMTs home-state EMS licensing authority)
- Introduction to ICS (I-100)
- NIMS: An Introduction (IS-700)
- No physical fitness required for this position
Other Training Supporting Development of Knowledge and Skills
- Firefighter Training (S-130)
- Annual Fireline Safety Refresher (RT-130)
- Introduction to Wildland Fire (S-190)
- Human Factors in the Wildland Fire Service (L-180)
- Intermediate Wildland Fire Behavior (S-290)
- Basic Air Operations (S-270)
- Helicopter Crewmember (S-271)
- Intermediate Wildland Fire Behavior (S-290)
- Wilderness Emergency Medical Technician