Nature of the Work

People whose lives are in danger often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics. Incidents as varied as automobile accidents, heart attacks, slips and falls, childbirth, and gunshot wounds all require immediate medical attention. EMTs and paramedics provide this vital service as they care for and transport the sick or injured to a medical facility.

In an emergency, EMTs and paramedics are typically dispatched by a 911 operator to the scene, where they often work with police and firefighters. Once they arrive, EMTs and paramedics assess the nature of the patient’s condition while trying to determine whether the patient has any pre-existing medical conditions. Following medical protocols and guidelines, they provide appropriate emergency care and, when necessary, transport the patient. Some paramedics are trained to treat patients with minor injuries on the scene of an accident or they may treat them at their home without transporting them to a medical facility. Emergency treatment is carried out under the medical direction of physicians.

EMTs and paramedics may use special equipment, such as backboards, to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. These workers generally work in teams. During the transport of a patient, one EMT or paramedic drives while the other monitors the patient’s vital signs and gives additional care as needed. Some paramedics work as part of a helicopter’s flight crew to transport critically ill or injured patients to hospital trauma centers.

At the medical facility, EMTs and paramedics help transfer patients to the emergency department, report their observations and actions to emergency department staff, and may provide additional emergency treatment. After each run, EMTs and paramedics replace used supplies and check equipment. If a transported patient had a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance and report cases to the proper authorities.

EMTs and paramedics also provide transportation for patients from one medical facility to another, particularly if they work for private ambulance services. Patients often need to be transferred to a hospital that specializes in their injury or illness or to a nursing home.

Beyond these general duties, the specific responsibilities of EMTs and paramedics depend on their level of qualification and training. The National Registry of Emergency Medical Technicians (NREMT) certifies emergency medical service providers at five levels: First Responder; EMT-Basic; EMT-Intermediate, which has two levels called 1985 and 1999; and Paramedic. Some states, however, have their own certification programs and use distinct names and titles.

• The EMT-Basic represents the first component of the emergency medical technician system. An EMT trained at this level is prepared to care for patients at the scene of an accident and while transporting patients by ambulance to the hospital under medical direction. The EMT-Basic has the emergency skills to assess a patient’s condition and manage respiratory, cardiac, and trauma emergencies.
• The EMT-Intermediate has more-advanced training. However, the specific tasks that those certified at this level are allowed to perform varies greatly from state to state.
• EMT-Paramedics provide the most extensive pre-hospital care. In addition to carrying out the procedures of the other levels, paramedics may administer drugs orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations, and use monitors and other complex equipment. However, like EMT-Intermediate, what paramedics are permitted to do varies by state.

Watch this video for a glimpse into the daily life of several Canadian paramedics.

Work Environment

EMTs and paramedics work both indoors and out, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers risk noise-induced hearing loss from sirens, and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to diseases such as hepatitis-B and AIDS, as well as violence from mentally unstable patients. The work is not only physically strenuous, but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others.

EMTs and paramedics employed by fire departments work about 50 hours a week. Those employed by hospitals frequently work between 45 and 60 hours a week, and those in private ambulance services, between 45 and 50 hours. Some of these workers, especially those in police and fire departments, are on call for extended periods. Because emergency services function 24 hours a day, EMTs and paramedics have irregular working hours.

Training, Other Qualifications

Generally, a high school diploma is required to enter a training program to become an EMT or paramedic. Workers must complete a formal training and certification process.

Education and Training

A high school diploma is usually required to enter a formal emergency medical technician training program. Training is offered at progressive levels: EMT-Basic, EMT-Intermediate, and EMT-Paramedic.

At the EMT-Basic level, coursework emphasizes emergency skills, such as managing respiratory, trauma, and cardiac emergencies, as well as patient assessment. Formal courses are often combined with time in an emergency room or ambulance. The program provides instruction and practice in dealing with bleeding, fractures, airway obstruction, cardiac arrest, and emergency childbirth. Students learn how to use and maintain common emergency equipment, such as backboards, suction devices, splints, oxygen delivery systems, and stretchers. Graduates of approved EMT-Basic training programs must pass a written and practical examination administered by the state certifying agency or the NREMT.

At the EMT-Intermediate level, training requirements vary by state. The nationally defined levels (EMT-Intermediate 1985 and EMT-Intermediate 1999) typically require 30 to 350 hours of training based on scope of practice. Students learn advanced skills, such the use of advanced airway devices, intravenous fluids, and some medications.

The most advanced level of training for this occupation is EMT-Paramedic. At this level, the caregiver receives training in anatomy and physiology as well as advanced medical skills. Most commonly, the training is conducted in community colleges and technical schools over 1 to 2 years and may result in an associate’s degree. Such education prepares the graduate to take the NREMT examination and become certified as a Paramedic. Extensive related coursework and clinical and field experience is required. Refresher courses and continuing education are available for EMTs and paramedics at all levels.

Other Qualifications

Paramedics can become supervisors, operations managers, administrative directors, or executive directors of emergency services. Some EMTs and paramedics become instructors, dispatchers, or physician assistants; others move into sales or marketing of emergency medical equipment. A number of people become EMTs and paramedics to test their interest in health care before training as registered nurses, physicians, or other health workers.

On the Job

• Administer first-aid treatment and life-support care to sick or injured persons in prehospital setting.
• Perform emergency diagnostic and treatment procedures, such as stomach suction, airway management or heart monitoring, during ambulance ride.
• Observe, record, and report to physician the patient´s condition or injury, the treatment provided, and reactions to drugs and treatment.
• Immobilize patient for placement on stretcher and ambulance transport, using backboard or other spinal immobilization device.
• Maintain vehicles and medical and communication equipment, and replenish first-aid equipment and supplies.
• Assess nature and extent of illness or injury to establish and prioritize medical procedures.
• Communicate with dispatchers and treatment center personnel to provide information about situation, to arrange reception of victims, and to receive instructions for further treatment.
• Comfort and reassure patients.
• Decontaminate ambulance interior following treatment of patient with infectious disease and report case to proper authorities.
• Operate equipment such as electrocardiograms (EKGs), external defibrillators and bag-valve mask resuscitators in advanced life-support environments.
• Drive mobile intensive care unit to specified location, following instructions from emergency medical dispatcher.
• Coordinate with treatment center personnel to obtain patients´ vital statistics and medical history, to determine the circumstances of the emergency, and to administer emergency treatment.
• Coordinate work with other emergency medical team members and police and fire department personnel.
• Attend training classes to maintain certification licensure, keep abreast of new developments in the field, or maintain existing knowledge.
• Administer drugs, orally or by injection, and perform intravenous procedures under a physician´s direction.

Source: BLS

Companies That Hire Emergency Medical Technicians & Paramedics

• American Medical Response
• Medcor
• U.S. Navy

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Additional Information

Sources

• O*Net Online. (2009). National Center for O*Net Development. Retrieved May 1, 2009, from http://online.onetcenter.org/
• Associated Content, Inc. (2007, December 28). Interview with EMT Michael Wright. Retrieved October 22, 2009, from http://www.associatedcontent.com/article/497371/interview_with_emt_michael_wright.html?cat=31
• Idaho Career Information Center. (2008). Real World Interview: Tim Morrison. Retrieved October 22, 2009, from http://www.cis.idaho.gov/Default.aspx?TabId=1591&AspxAutoDetectCookieSupport=1
• U.S. Department of Health and Human Services. (2008, December 13). Yasmin Ahmady: Interview with a Paramedic. Retrieved December 28, 2009, from http://cache.zoominfo.com/CachedPage/?archive_id=0&page_id=-1580747297&page_url=%2f%2fwww.4woman.org%2fspotlight%2f2008%2f12.cfm&page_last_updated=12%2f13%2f2008+10%3a58%3a59+AM&firstName=Yasmin&lastName=Ahmady
• Wisconsin Technical Colleges. (2007, November 9). Emergency Medical Technician - Paramedic. Retrieved December 29, 2009, from http://www.youtube.com/watch?v=y30Cw6oSIf0
• ParamedicTV. (n.d.). Emergency Medical Technicians. Retrieved January 19, 2010, from http://paramedictv.ems1.com/Media/934-Paramedics-Discuss-Job-Highs-and-Lows/

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