Paramedics and E.M.T.s
Emergency medical technicians (E.M.T.s) and paramedics are dispatched to emergency calls to assist with accidents, injuries, and sudden illnesses. These are typically calls placed to the 911 system. The paramedic is an E.M.T. with advanced training in life support measures and procedures.
Duties, Activities, and Scope of Practice
Upon arrival at the scene, the first thing paramedics or E.M.T.s do is to assess the scene to ensure it does not pose any threat of additional danger to the victim, to others, and to themselves. They evaluate the situation, assess the patient's vital signs, and determine the nature and extent of the patient's condition, illness, or injury. They obtain a history or eyewitness account of the events, and they take a medical history from the patients or others if possible.
They provide basic first aid and then contact their base for instructions from a physician or specially trained nurse. Further care is provided in the field by the E.M.T. or paramedic, and the patient is transported to the hospital for further care and treatment.
Upon arrival at the hospital, the E.M.T. or paramedic reports the patient's status (vital signs, treatment provided, and response) to the emergency room physician or nurse. They may stay at the hospital to help staff attend to the patient.
Education and Training
To become an E.M.T. you must be eighteen years of age, have a high school diploma or GED, and have a valid driver's license. There are four levels of emergency responders:
E.M.T.-2 or -3 (intermediate)
The first responder is the most basic level. These are usually police and firefighters or other emergency workers who have been trained in CPR and basic first aid.
The E.M.T.-1 is trained to assist patients at the site of an accident and provide first aid. They can assess patients and manage respiratory, cardiac, and trauma emergencies. The E.M.T. training is 110 hours of training in emergency medical care. It includes CPR, handling emergencies involving ingestion of toxic chemicals and substances, cardiac arrest, bleeding, fracture, soft-tissue injuries and trauma, shock, internal injuries, and childbirth.
The E.M.T.-2 and 3 (or intermediate E.M.T.) has more advanced training of about thirty-five to fifty-five hours and can start and administer IVs and oral and IV drugs, interpret EKGs, insert endotracheal tubes (intubate patients), use the defibrillator, and manage shock. Some states offer this training as a specialization in either cardiac care or shock/trauma.
The E.M.T.-4, or paramedic, has had E.M.T. basic or intermediate training and has 700 to 1,000 hours of continuous employment, hospital experience, and a supervised field internship. This program typically lasts approximately two years, and the graduate earns an associate's degree in applied science.
After completing E.M.T. basic training, the applicant can take a written and practical exam from NREMT or state agencies and become registered. Registration is required to advance to any other E.M.T. level.
All fifty states require E.M.T.s to be certified. Most states require registration or that candidates pass a state certification exam. All states require re-registration every two years. Candidates must be employed as an E.M.T. and complete continuing-education requirements.
Paramedics with accredited training can take the NREMT exam to become certified. Re-certification is required and requires continuing education.
Work Settings and Salaries
E.M.T.s and paramedics work for fire or police departments, hospitals, private ambulance companies, and public ambulance companies. They work between forty-five and sixty hours a week in most instances. Emergency response workers are available twenty-four hours a day, so E.M.T.s work shifts to cover all hours. They can also be on call for extended hours.
According to the U.S. Department of Labor, the median salary in 2004 was $25,310. Salaries ranged from $16,090 to $43,240.
Career Potential and Additional Information
Opportunities for E.M.T.s and paramedics are expected to grow faster than the average for all occupations thorough 2014. An aging population presents an increased possibility of injuries and other medical emergencies. The highest growth is expected to be with private ambulance services. Competition for jobs with fire and police departments will be stiff due to the potential for better job benefits, such as a pension after retirement.
For more information about a career as an E.M.T. or paramedic, contact the National Association of Emergency Medical Technicians. Their Web site is