Paramedics and Emergency Medical Technician

Significant Points

• Employment is projected to grow faster than the average as paid positions replace unpaid volunteers.
• Emergency medical technicians and paramedics need formal training and certification, but requirements vary by State.
• Emergency services function 24 hours a day so emergency medical technicians and paramedics have irregular working hours.
• Opportunities will be best for those who have earned advanced certifications.

Peoples lives 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 fire fighters. (Police and detectives and firefighting occupations are discussed elsewhere in the Handbook.) Once they arrive, EMTs and paramedics assess the nature of the patients 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 patients vital signs and gives additional care as needed. Some paramedics work as part of a helicopters 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 patients 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.

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.

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, and 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 associates 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.

Licensure. All 50 States require certification for each of the EMT levels. In most States and the District of Columbia registration with the NREMT is required at some or all levels of certification. Other States administer their own certification examination or provide the option of taking either the NREMT or State examination. To maintain certification, EMTs and paramedics must recertify, usually every 2 years. Generally, they must be working as an EMT or paramedic and meet a continuing education requirement.

Other qualifications. EMTs and paramedics should be emotionally stable, have good dexterity, agility, and physical coordination, and be able to lift and carry heavy loads. They also need good eyesight (corrective lenses may be used) with accurate color vision.

Advancement. 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.

EMTs and paramedics held about 201,000 jobs in 2006. Most career EMTs and paramedics work in metropolitan areas. Volunteer EMTs and paramedics are more common in small cities, towns, and rural areas. These individuals volunteer for fire departments, emergency medical services, or hospitals and may respond to only a few calls per month. About 30 percent of EMTs or paramedics belong to a union.

Paid EMTs and paramedics were employed in a number of industries. About 4 out of 10 worked as employees of private ambulance services. About 3 out of 10 worked in local government for fire departments, public ambulance services, and emergency medical services. Another 2 out of 10 worked full time in hospitals within the medical facility or responded to calls in ambulances or helicopters to transport critically ill or injured patients. The remainder worked in various industries providing emergency services.

Employment for EMTs and paramedics is expected to grow faster than the average for all occupations through 2016. Job prospects should be good, particularly in cities and private ambulance services.

Employment change. Employment of emergency medical technicians and paramedics is expected to grow by 19 percent between 2006 and 2016, which is faster than the average for all occupations. Full-time paid EMTs and paramedics will be needed to replace unpaid volunteers. It is becoming increasing difficult for emergency medical services to recruit and retain unpaid volunteers because of the amount of training and the large time commitment these positions require. As a result, more paid EMTs and paramedics are needed. Furthermore, as a large segment of the populationaging members of the baby boom generationbecomes more likely to have medical emergencies, demand will increase for EMTs and paramedics. There also will still be demand for part-time, volunteer EMTs and paramedics in rural areas and smaller metropolitan areas.

Job prospects. Job prospects should be favorable. Many job openings will arise from growth and from the need to replace workers who leave the occupation because of the limited potential for advancement, as well as the modest pay and benefits in private-sector jobs.

Job opportunities should be best in private ambulance services. Competition will be greater for jobs in local government, including fire, police, and independent third-service rescue squad departments which tend to have better salaries and benefits. EMTs and paramedics who have advanced education and certifications, such as Paramedic level certification, should enjoy the most favorable job prospects as clients and patients demand higher levels of care before arriving at the hospital.

Earnings of EMTs and paramedics depend on the employment setting and geographic location of their jobs, as well as their training and experience. Median annual earnings of EMTs and paramedics were $27,070 in May 2006. The middle 50 percent earned between $21,290 and $35,210. The lowest 10 percent earned less than $17,300, and the highest 10 percent earned more than $45,280. Median annual earnings in the industries employing the largest numbers of EMTs and paramedics in May 2006 were $23,250 in general medical and surgical hospitals and $20,350 in ambulance services.

Those in emergency medical services who are part of fire or police departments typically receive the same benefits as firefighters or police officers. For example, many are covered by pension plans that provide retirement at half pay after 20 or 25 years of service or if the worker is disabled in the line of duty.

According to the book description of En Route: A Paramedic's Stories of Life, Death, and Everything in Between, Stephen Kelly Grayson has seen the best of us at our worst. When hearts stop working, when blood alcohol levels exceed limits we shouldnt contemplate, when bodies are extricated from car wrecks, hes been there to pick up the pieces, save our lives, and watch us slip away. His touching stories of life and death and the hilarious ones of times in between are here to give us an insight of what happens after we call 911, the ambulance doors close, or even what happens inside the ER when the nurse shows the family to the waiting room.

According to the book description of Workbook for Mosby's Paramedic Textbook, Updated to reflect the new 2005 emergency cardiac care guidelines! This easy-to-use study guide reinforces the basic principles and skills needed to successfully practice in the field. This exceptional workbook follows Mosby's Paramedic Textbook, Revised 3rd Edition, on a chapter-by-chapter basis in an easy-to-use, self-pacing format. Chapters contain patient care scenarios, multiple-choice questions with rationales, review questions, matching, and fill-in-the-blank questions, and more. Also included is a thorough review of anatomy and physiology, basic math tutorials, and much more!

More than 2,200 questions in a variety of formats - including multiple choice, matching, fill in the blank, labeling exercises, and short answers - help students learn and understand essential concepts. All questions have answers with rationales, and the answers are cross-referenced to the objectives in the book. Perforated flash cards (32 drug cards and 22 ECG cards) make reviewing convenient and fun. NREMT skills sheets are included to aid in skills review and practice. Updated to reflect the new 2005 emergency cardiac care guidelines. A new case study section called "Wrap it Up" features questions at the end of each chapter. Chapter summaries from the textbook reinforce key concepts.

According to the book description of Paramedic: On the Front Lines of Medicine, In this unforgettable, dramatic account of one man's experience as an EMT, Peter Canning relives the nerve-racking seconds that can mean the difference between a patient's death and survival, as Canning struggles to make the right call, dispense the right medication, or keep a patient's heart beating long enough to reach the hospital. As Canning tells his graphic, gripping war stories--of the lives he saved and lost; of the fear, the nightmares, and the constant adrenaline-pumping thrill of action--we come away with an unforgettable portrait of what it means to be a hero.

According to the book description of Barrons Paramedic test prep manual, it prepares applicants to qualify for a paramedic license. Presented here are three full-length model examsone in the book and two more on the CD-ROM. Each consists of multiple-choice questions with answer sheets and answer keys for self-testing. Subject review chapters cover the following paramedical topics: airway and breathing, cardiology, medical, obstetrics/gynecology/pediatrics, and operations. The author also offers helpful test-taking advice.

According to the book description of Paramedic Exam, To get an EMT-Paramedic certification, candidates must not only complete a rigorous course of study, but also take and pass the EMT-Paramedic certification exam. This book offers the most current test prep for the exam sponsored by the National Registry of EMTs. In addition to the four practice exams and the official Practical Skills Exam of the National Registry of EMTs, this edition also includes a list of professional EMT associations and organizations, educational and training resources, and certification requirements for each state.

According to theWorkbook Essentials of Paramedic Care it, presents the knowledge of emergency care in an accurate, standardized, and clear manner. This book is based upon the 1998 USDOT National Standard Curriculum for the EMT Paramedic, helping readers prepare to be excellent care providers in any emergency situation. Clearly written and well-organized, this book covers the fundamentals of paramedic practice including pathophysiology, pharmacology, medication administration, and advanced airway management; assessment skills; trauma emergencies; medical emergencies; and neonatal, pediatric, geriatric, home health care, specially challenged patients, incident command, ambulance service, rescue, hazardous material, and crime scene operations. For paramedics and those working in the field of advanced prehospital care.

According to the description of REAs Interactive Flashcard® book for the EMT-Paramedic exam, it helps students check their test-readiness before taking this crucial exam. Our flashcard book is the perfect refresher and offers a quick and convenient way to practice answering questions. Written by an expert in the fire and EMS arenas, these flashcards give students full scenarios to evaluate in a multiple-choice format, just like the actual test.

This recommended study aid contains more than 350 must-study questions that cover all official test categories found on the EMT-Paramedic exam, including Airway & Breathing, Cardiology, Medical, Obstetrics & Pediatrics, Scene Size-Up, and Trauma. Our handy icons help students locate questions by subject, so they can review and test their knowledge in specific areas. The book also provides fascinating fun facts about the medical/EMT profession and its history.

The Premium Edition with CD-ROM also contains four timed quizzes with detailed explanations of answers to challenge test-readiness. As an added bonus, weve also included four full-color anatomy charts covering: Anatomy & Physiology; The Skeletal System; The Cardiorespiratory System; The Muscular System. Unlike most flashcards that come loose in a box, our flashcards are bound in an organized, portable book that makes studying a breeze. Students can write their answer on the front of the card, and then compare it to the answer on the back of the card. This concise question and answer format makes it easy to find the right answer, and we even give details explaining why the answer is correct. Fully indexed for smarter study, this book is an indispensable asset for anyone preparing for the EMT-Paramedic test!