Emergency Medical Technicians (EMTs) and paramedics are medical professionals working in the field who provide emergency medical and trauma care that includes assessment and, when appropriate, measures aimed at stabilizing a patient so that he or she may be safely transported to a trauma center or hospital, in accordance with protocols and guidelines established by physician medical directors.
EMTs and Paramedics Job Responsibilities
Specific job responsibilities are determined by the emergency medical service provider’s certification, which reflects his or her level of training.
- First Responder: First Responders support EMTs and paramedics in the field by providing basic first aid for soft tissue and bone injuries, and assisting in childbirth. They also receive special training in moving and transporting patients. A certified “First Responder” must be distinguished from the generic term “first responder”; the latter term refers to the medical service provider who arrives first at the scene of an accident or emergency.
- EMT-Basic (EMT-B): EMT-Bs are allowed to administer medications previously prescribed to patients, and to perform non-invasive procedures such as supplemental oxygen administration, positive pressure ventilation with an Ambu bag, bleeding control and splinting (including immobilizing patients who may have spinal injuries.) Specific protocols vary by state.
- EMT-Intermediate 1985 (EMT-I/85): EMT-I/85s have more advanced training in emergency assessment, and are permitted to perform basic invasive procedures including starting intravenous lines (IVs), administering intravenous drips, and inserting certain types of airways. Specific protocols vary by state.
- EMT-Intermediate 1999 (EMT-I/99): EMT-I/99s are allowed to administer medications to control dangerously irregular heart rhythms, and to perform follow-up cardiac monitoring, as well as to perform invasive procedures such as the decompression of potentially life-threatening pockets of air or fluid in the pleura (pneumothoraces), endotracheal intubation, and nasogastric tube insertion. Specific protocols vary by state.
- Paramedics EMT-P: EMT-Ps are allowed to administer oral and intravenous medications. Additionally, when necessary, they can intubate patients or perform surgical airway insertion (cricothyrotomy), and place sophisticated catheters for venous access (such as central venous lines.) When mechanical ventilation is necessary, EMT-Ps determine the settings for transport ventilators. Again, the specific scope of responsibilities varies by state.
EMTs and Paramedics Training and Education Requirements
First responder training is designed to bridge the gap between the eight hours of field experience required in order to obtain an advanced first aid certificate from the American Red Cross and the 180 hours of field experience necessary to fulfill EMT-B training requirements. First Responders can become certified by taking the American Red Cross’s Emergency Response course.
EMT training is offered at progressive levels through universities, colleges, community colleges, hospitals, Emergency Medical Services (EMS) academies and technical schools. Accredited EMT programs can last between six months and four years depending upon the qualification you are pursuing. Graduates of four year programs will receive bachelor degrees in Emergency Medical Technology, while graduates of community college training programs will receive associates degrees.
EMT-Bs are required to take 120 hours of classroom work and 180 hours of field work. Clinical requirements vary by state, but prospective EMT-Bs are required to spend time in an ambulance and rotate through specific hospital specialties (e.g. emergency services, obstetrics, psychiatry.)
EMT-I certification typically requires 30 to 350 hours of field training based on the scope of practice in the state in which an EMT-I is seeking certification.
EMT-P certification typically requires in excess of 1,000 hours of field training.
EMTs and Paramedics Salary and Wages
EMT and paramedic earnings vary according to the skill level of the practitioner, the setting in which he or she is working, and the geographic location of the job. EMTs and paramedics are employed in a number of different settings that range from acute care settings (hospitals, trauma centers), to local government (fire and police departments), to industrial first aid settings.
In 2009, the highest average wage in the public or nonprofit sector — $17.68 per hour, or $36,780 – was earned by emergency medical providers working for fire or police departments. Private sector wages are higher – an emergency medical provider working in conjunction with a mining operation may make $26.63 per hour, or $55,380 per year. EMT supervisors typically make between $14.64 and $23.12 an hour, or $41,379 to $60,287 per year.*
*According to the BLS, http://www.bls.gov/oco/
EMTs and paramedics who work in acute care settings have frequent opportunities to work overtime for which they are paid at a premium rate.
EMTs and Paramedics Certifications
The National Registry of Emergency Medical Technicians (NREMT) certifies EMTs and paramedics in all states and the District of Columbia at four levels. (First Responders are certified by the American Red Cross.) Forty-six states use the certification exams given by the NREMT as the sole basis for certification at one or more levels. New York, Oklahoma, Rhode Island and Virginia offer emergency service provider certifications that differ in one or more respects from the NREMT’s certifications.
EMTs and paramedics are required to take a certain number of continuing education credits every year in order to maintain certification. Specific scopes of practice can vary widely by state.
EMTs and Paramedics Professional Organizations
National professional organizations for EMTs and paramedics include the National Association of Emergency Medical Technicians and the National Registry of Emergency Medical Technicians. These organizations each have chapters at the state level.