The lives of people can depend on the fast reaction and competent care of emergency medical technicians (EMTs) and paramedics (EMTs with additional advanced training to perform complicated prehospital medical procedures). EMTs often must deal with automobile accidents, drownings, heart attacks, childbirth, stabbings, and gunshot wounds. These are all conditions that require immediate medical attention. EMTs and paramedics provide this needed attention as they care for the sick or injured and transport them to the hospital.
EMTs and paramedics typically are dispatched to the scene by a 911 dispatcher, and often work with police and fire personnel. When they arrive, they determine the nature of the patientís condition and give appropriate emergency care and, when necessary, transport the patient to a local hospital. Some paramedics are trained to treat patients with minor injuries on the scene of an accident or at their home without transporting them to the hospital. Emergency treatment for more complicated problems is carried out under the supervision of physicians by telephone or radio. Often emergency personnel operate with protocols or standing orders allowing them to perform certain procedures without direct contact with the hospital.
Emergency Medical Technicians may use specialized equipment, such as backboards or "scoop" stretchers, to immobilize patients before placing them on folding stretchers and placing them in the ambulance for transport to the hospital. Usually, one EMT or paramedic drives while the other cares for the patient and monitors their vital signs. They often give additional care as needed. Some EMTs work as part of the flight crew on helicopters or fixed-wing aircraft that transport critically ill or injured patients to tertiary care or trauma centers.
Once at the hospital, EMTs help transfer patients to the emergency department, report their observations and treatments to emergency department nurses and physicians, and may provide additional emergency care if needed. EMTs and paramedics replace used medical supplies such as bandages, linen, and intravenous (IV) supplies and check their equipment. If they transport a patient who has a contagious disease, EMTs and paramedics thoroughly decontaminate the interior of the ambulance and, if required by law, report suspected cases to the proper authorities.
In addition to these general duties, the specific responsibilities of EMTs and paramedics depend on their level of licensure. To determine this, the National Registry of Emergency Medical Technicians (NREMT) registers emergency medical service (EMS) providers at four levels: First Responder (FR), EMT-Basic (EMT-B), EMT-Intermediate (EMT-I), and EMT-Paramedic (EMT-P). Some places, however, have implemented their own certification and use other designations, such as numeric ratings, to distinguish levels of certification.
As an entry-level provider, First Responders are trained to provide basic emergency medical care. These providers are important because they tend to be the first persons to arrive at the scene of an emergency. Many police officers, firefighters, and other emergency providers have been trained to this level.
The EMT-Basic (EMT-B or EMT) represents the first component of the emergency medical technician system. An EMT is trained to treat patients at the scene of an accident and while enroute by ambulance to the receiving hospital. An EMT has the necessary emergency medical skills to assess a patientís condition and manage cardiac, respiratory, and trauma-related emergencies.
The EMT-Intermediate (EMT-I) has more advanced training. Some jurisdictions allow EMT-Is to administer intravenous (IV) fluids, the use of defibrillators, and the placement of advanced airways (such as endotracheal (ET) tubes) to assist patients experiencing severe breathing problems.
EMT-Paramedics (EMT-P) provide the most extensive pre-hospital emergency care. They carry out the procedures described above and may administer drugs intravenously, interpret electrocardiograms (EKGs), perform endotracheal (ET) intubations, and perform advanced procedures such as chest decompressions (for collapsed lungs) and cricothyrotomy.
Statistics: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2004-05 Edition, Emergency Medical Technicians and Paramedics.