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Emergency medical technicians (EMTs) and paramedics care for the sick or injured in emergency medical settings. People's lives often depend on the quick reaction and competent care provided by these workers. EMTs and paramedics respond to emergency calls, performing medical services and transporting patients to medical facilities. EMTs and paramedics also transport patients from one medical facility to another. Some patients may need to be transferred to a hospital that specializes in treating their particular injury or illness or to a facility that provides long-term care, such as a nursing home.
Paramedics provide more extensive pre-hospital care than do EMTs. In addition to doing the tasks of EMTs, paramedics can give medications orally and intravenously, interpret electrocardiograms (EKGs), and use other monitors and complex equipment. EMTs and paramedics work both indoors and outdoors, in all types of weather. Their work is physically strenuous and can be stressful, sometimes involving life-or-death situations.
Paramedics and EMTs must be able to quickly evaluate patients' symptoms and administer appropriate treatments in a timely manner. Further, paramedics need to establish communication with distressed victims, in order to determine the extent of their injuries. It may be necessary to perform invasive life-saving interventions, so emergency personnel must be prepared to handle difficult situations with prefessional care.
When transporting a patient in an ambulance, one EMT or paramedic may drive the ambulance while another monitors the patient's vital signs and gives additional care. Some paramedics work as part of a helicopter's or an airplane's flight crew to transport critically ill or injured patients to a hospital. If a patient has a contagious disease, EMTs and paramedics must decontaminate the interior of the ambulance and may need to report the case to the proper authorities.
Typically, a paramedic works with rapid ambulance response units. In ambulance crews, the paramedic is usually the senior professional health officer among a two-person crew, while the second person serves as a technical assistant. People's lives may depend on the quick reaction, and competent care, of trained emergency medical technicians (EMTs) and paramedics. Incidents as varied as automobile accidents, heart attacks, slips and falls, childbirth, and gunshot wounds require critical intervention, and transport to a medical facility. In an emergency, paramedics respond to a 911 dispatch, often arriving at the scene prior to the police and fire fighters. Once they arrive, paramedics may utilize special equipment to immobilize patients before placing them on stretchers, and securing them in the ambulance.
During the transport of a patient, one team member drives, while the other monitors the patient's vital signs, and gives additional care as needed to stabilize the patient.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 document the trip, replace used supplies and check equipment. If a transported patient has a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance and report cases to the proper authorities.
Working as a paramedic is a varied, and often unpredictable job. Paramedics respond to a wide variety of emergency situations, and responsibilities may include the following.
EMT courses include about 150 hours of specialized instruction, and clinical training can be in a hospital or ambulance setting. At the 'Advanced EMT' level, there are 400 hours of instruction, where candidates learn skills such as using complex airway devices, administering intravenous fluids, and giving some medications. To enter specific paramedical training programs, they must already be EMT certified. Community colleges and universities may offer these programs, which require about 1,200 hours of instruction and may lead to an associate's or bachelor's degree. Paramedics' broader scope of practice may include stitching wounds or administering intravenous medications.
Training is offered at three progressive levels, the EMT-Basic, EMT-Intermediate, and 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 licensing agency or the NREMT. At the EMT-Intermediate level, training requirements vary by State. The EMT-Intermediate typically requires 50 to 350 hours of training, based on scope of practice.
The Commission on Accreditation of Allied Health Education Programs offers a list of accredited programs for EMTs and paramedics. Paramedics have the most advanced level of education. Programs at the EMT level include instruction in assessing patients' conditions, dealing with trauma and cardiac emergencies, clearing obstructed airways, using field equipment, and handling emergencies. Formal courses include about 150 hours of specialized instruction, and some instruction may take place in a hospital or ambulance setting.
Emergency medical technicians (EMTs) and paramedics typically complete a postsecondary educational program. All states require EMTs and paramedics to be licensed. Requirements vary by state, but both a high school diploma as well as cardiopulmonary resuscitation (CPR) certification typically are required for entry into postsecondary educational programs in emergency medical technology. Most of these programs are nondegree award programs that can be completed in less than 1 year, while more advanced training may last up to 2 years, resulting in an associate's degree.
Paramedics, in comparison with EMT techs, have more advanced training. They first must complete both the EMT and Advanced EMT levels of instruction, along with expanded practice in advanced medical techniques. Colleges and technical schools may offer programs which require about 1,200 hours to complete, leading to either an associates or bachelors degree. All states require both EMTs and paramedics to be licensed. The National Registry of Emergency Medical Technicians (NREMT) certifis EMTs and paramedics. Finally, most EMTs and paramedics take a course ensuring that they are able to drive a ambulance.
The National Registry of Emergency Medical Technicians (NREMT) certifies EMTs and paramedics at the national level. All levels of NREMT certification require completing a certified education program and passing the national exam. The national exam has both written and practical parts. Some states have first-level state certifications that do not require national certification.
Because EMTs must be available to work in emergencies, they may work overnight and on weekends. Employment of emergency medical technicians (EMTs) is projected to grow 15 percent from 2017 to 2026, much faster than the average for all occupations. Emergencies, such as car crashes, natural disasters, and acts of violence, will continue to require the skills of EMTs and paramedics. Growth in the middle-aged and older population will lead to an increase in age-related health emergencies, such as heart attacks and strokes. This increase, in turn, will create greater demand for paramedic services. An increase in the number of specialized medical facilities will require more EMTs and paramedics to transfer patients with specific conditions to these facilities for treatment.
EMTs and paramedics work both indoors and out, in all types of weather. EMTs and paramedics have one of the highest rates of injuries and illnesses of all occupations. They are required to do considerable kneeling, bending, and heavy lifting. In general, there's a high risk for contracting illnesses or experiencing work-related injuries, such as noise-induced hearing loss from sirens, and lower back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to communicable diseases, such as hepatitis-B and AIDS, as well as to violence from mentally unstable or combative patients.
The work is not only physically strenuous but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, work can be exciting and certainly challenging, with the opportunity to make a difference in the lives of others daily. Many EMTs and paramedics are required to work more than 40 hours a week, and because emergency services function 24 hours a day, EMTs and paramedics may have highly irregular working hours.
The job prospects for paramedics and emergency medical technicians are good, particularly in cities and within private ambulance services. EMTs and paramedics who have advanced education and certification enjoy the best job prospects. In addition, the time that EMTs and paramedics spend with each patient is increasing, as hospital emergency departments are experiencing overcrowding. As a result, when an ambulance arrives, it takes longer to transfer the patient from the care of paramedics to the staff of the emergency department. Some emergency departments divert ambulances to other hospitals when they are too busy to take on new patients. Paramedics and EMTs may become supervisors, operations managers, administrative directors, or executive directors of emergency services.