Former EMT, current doc here. A bunch of random considerations:
- An RN is longer training but much higher earning potential than a paramedic (especially if you move on to nurse practicioner, etc). More importantly, an RN allows for many, many more practice opportunities. I have nursing friends who do stuff worthy of action movies in the trauma unit, and others who sip coffee at a computer screen. There aren't many coffee sipping paramedic jobs. That may not appeal to you now, but if you have arthritic knees and back at age 50, an RN may be preferable.
- Most critical care transport jobs require experience. In my hospital, it's 5 years of paramedic experience or ICU/Emergency Department nursing experience before you can even apply. If yours is the same, and you go the medic route, can your body handle 5 years of hauling 300 pound folks on stretchers out of 4th floor apartments in buildings where the elevator is (as it always is) out of service?
- It can be difficult to be hired in a metopolitan fire department/EMS squad. A lot of medics end up doing private ambulance transport, which is basically nursing home taxi driving. I enjoyed the old ladies, but most people don't, and the critical care transport folks probably wouldn't consider that valid experience. The other option as a medic would be to work in an emergency department ED, which sounds like a good option for you.
- The safety issue brought up before is a real issue in 2 senses. First, people who work night shift have a significantly decreased life expectancy compared to people who work day shift. Like, by a few years. Messing with sleep is really bad for you. I work nights sometimes. I'm glad others are willing to, as well. Just be aware. Second, helicopter transport is really unsafe. Our hospital helicopters are sweet $7million machines with 2 engines and have never had an accident in >30 years of operating. The private helicopters that come to my hospital are old, crappy, single-engine, and will fly in weather you wouldn't drive in because they have to keep their numbers in the black. They have lost 2 helicopters (6 crew and 1 patient) in the past 4 years. Again, just be aware of what you're getting into. (Re: life insurance- most applications will ask regarding "high risk" activities if you have done them or have any plans for them within the next 2 years. So if you are serious about this and need insurance, you might want to apply for insurance soon).
- If you were 50, age might be an issue. At your age, it isn't.
- Getting a job is about who you know. Critical care transport is a fairly tight community where risks are much greater than typical medical practice. The guy next to you has to know a little turbulence isn't going to result in the dirty syringe in your hand ending up in his thigh. They are most likely to hire a known entity. The great majority of our hiring is internal.
- If you are somewhat rural you can probably join the local fire department without any training and they will pay for most of your training.
- An EMT basic course would be a few grand and takes just 4 months (2 nights per week). There are accelerated courses that take just 3 weeks, full time. It's a fairly cheap and easy way to dip your toes in the water of the field.
If I were you, and I was pretty confident this is what I wanted to do, I would call or figure out how to get a message to the local peds hospital transport dispatch folks and ask if there's someone to talk to. Let them know your thoughts and find out what it would take. You may also be able to ride along for a day (they may not do this if you aren't already an EMT or nursing student).
Best of luck.