What Is An EMT Clinical?

An EMT is a health care specialist who is trained to respond to medical emergencies and provide hands-on care at the scene. Consequently it is necessary that they complete a large portion of clinical work during their training. This is mandatory and you will not be able to become an EMT if you do not complete the EMT clinical requirements.

A clinical will usually take place in a real-world healthcare setting under the supervision of a preceptor. Your preceptor may be one of the following:

• A nurse
• A paramedic
• Another EMT of a level higher than the level for which you are training

In cases where your training course is not being offered at a facility where you will have the opportunity to receive real-world training, you will be informed by your instructor of facilities that have policies in place allowing for trainee EMTs to work there in order to complete the clinical portion of their course. If you are at the basic level of training, you will complete approximately 24 hours of clinicals in the emergency department through which you have been told to complete your EMT clinical work and training. A sensible EMT trainee will take any opportunities offered to gain real-world experience.

Surviving EMT Clinicals

One of the biggest challenges for new EMTs is that the nurses or doctors who are in charge of their EMT clinical are far from happy to be there and are, at the very best, unhelpful. This is very difficult to cope with, especially as you are turning to those experts for guidance in your career. Although many trainee EMTs are matched with preceptors that are more than willing to give all help necessary, this is not the norm and you cannot assume that you will receive all of the guidance that you would like. Try to stay close to those nurses and paramedics that seem friendly and willing to help you. If you have a preceptor who repeatedly tells you to take your own initiative and just get involved, you must be careful. As a trainee there is a limit to what you are allowed to do in a health care setting. You have to be supervised, and you should raise any instances where you feel as though are given work that you are unprepared for or that you feel uncomfortable about doing. There are liability issues involved here. If you feel that you are not being challenged during your EMT clinical experience, or that you are not learning through the clinical, you should raise this worry with a supervisor or instructor.

Tips

You Are There To Learn

You are there to learn valuable skills for your career as an EMT, not to do all of the grunt work and function as a kind of slave for your preceptor or supervisor. If you feel that you are not learning anything or that your learning experience is being curtailed in some way, take it up with your course instructor. However this does not mean that you should get ideas above your station. If your supervisor or preceptor tells you to do some of the grunt work, do it with a good attitude, and bring it up later. You will, after all, need to know how to do the basic cleanup operations as well as how to provide primary care to your patient at the scene of a medical emergency. Only make an issue if grunt work forms the main part of your EMT clinical.

Offer Help

There are a number of reasons why you should offer to help your preceptors in your EMT clinical:

• It will make them remember you as a ‘good’ student

• It will provide you with opportunities to practice that the other EMT trainees may not have access to

Consequently two of the most important questions that you should ask during an EMT clinical are:

• “What can I do to help you?”
• “Can I help you with that?”

In addition, if your preceptor asks you to do something, you should automatically say yes (in most cases) and complete the task with a smile on your face. However, there are exceptions to this in cases where you asked opt do something that is outside the boundaries of what you are allowed to do as an EMT trainee.

No Guesses Allowed

If you are in a situation in your EMT clinical where you do not know what to do, or where you are not sure of how to proceed with a test or treatment, ask for help. Do not guess about what you should do next. This could lead to a fatal error. Do not make claims that are not true. If you claim to be able to perform a task as an EMT, but you are not in fact as skilled as you make out to be, you may end up jeopardizing the life of the patient. If you make a mistake do not lie about it and do not cover it up. You must start to think from the point of view of a real EMT, and that point of view always puts the patient first above your own needs and priorities.

Additional Tips

There are a number of additional tips which you can keep in mind:

• Remember that you are not there to watch, you are there to learn and practice your skills. After some initial watching you should try to get involved in the proceedings.

• Your preceptor is in charge, so you must do what he or she says, provided it is within the scope of what you are allowed to do.

• Sometimes your supervisor may try to test you in fairly subtle ways, so be on your feet. For example a preceptor may give you the opportunity to practice a skill on a patient that does not need that service performed. You should, in this case, point out that the patient does not need the skill, and decline the opportunity.

• During your training you must not do anything that is outside of your skill set. Even if you have learned some of the more advanced skills in your previous EMT clinical or theory training, do not perform those skills unless you are specifically instructed to do so by your preceptor.

• An important tip to keep in mind is that it is wise to use “three-way communication”: When the preceptor asks you to do something, repeat it back to the preceptor and wait for a yes/no response before proceeding. This will guarantee that you are all on the same page.

• If you have a weak spot, or aren’t confident in a specific skill, ask your preceptor to help you with it. They may have a different approach that makes it fall into place for you. They’re there to help you succeed, but they can’t help you if you won’t help yourself by telling them what you need. Your preceptor is there to help you and it is your responsibility to ask them for that help when the need arises.

• Even if you feel that you are an expert in a particular skill, don’t brag about it. It is better to show your abilities through actions rather than through words. This will go down much better with your preceptor.

• If there is nothing for you to do in your EMT clinical setting, you should take that opportunity to study some of your theory work – this will look good in the eyes of your instructors who will be evaluating you and will give you a chance to brush up on some of the skills that you may need.

• Last but not least you should look for opportunities to help at all times as this will allow you to gain practice and to stand out in the eyes of your preceptor.

You will, most likely, be rather nervous during your first EMT clinical, but it is important that you do your best to keep your focus and to do the work to the best of your ability. The tips mentioned above are just a starting point for you to refer to in order to make your clinical go a whole lot more smoothly than you expect it to, and many of the tips can be carried forward into your next clinicals as well.

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What Is An EMT?

An EMT, or emergency medical technician, is essentially the person who is first on the scene when a medical emergency occurs. Their responsibility is to provide immediate care to the patient and stabilize them for transport to a medical facility if they deem that the patient needs advanced medical attention and cannot be treated on the scene. In addition the EMT is required to determine whether or not the patient has any preexisting medical conditions. This could help explain the medical emergency in question, but this task is also essential in ensuring that the patient is not given any medications or treatments that could conflict with their condition or with the medications that they are already taking for that condition. To a certain degree the most the EMT can do in this case is to look for medical alert jewelry. There are several other EMT related occupations that you could consider joining that are similar to this one. Some require further training and education while others simply require you to have an EMT qualification or similar degree of medical expertise and knowledge.

911 Dispatcher

911 dispatchers are in charge of ensuring that medical (and other) assistance is given when necessary. Consequently the two major roles of a 911 dispatcher are the following:

• Dispatching police, fire and ambulance personnel to emergency situations.

• Monitoring the location of emergency workers from their desk and can relay messages between emergency officials if needed.

Holding an EMT qualification could make it easier for you to begin a career as a 911 dispatcher as you will have a working understanding of what medical situations will require an EMT or another medical professional onsite and which can simply be referred to a hospital. In addition you will be able to accurately relay information when required regarding the patient’s condition and the instructions and observations provided by the EMT onsite. You will most likely be required to undergo additional training in order to become familiar with the specific vocabulary used in emergency dispatch services and in order to ascertain if you have the right personality to handle the job. For example, you will need to be a level-headed person who does not panic in an emergency.

Lifeguard

Another line of work related to being an EMT in that you provide medical attention in an emergency situation is that of a lifeguard. Lifeguards are trained to keep their eyes open near large bodies of water and to assist anyone in need of help while swimming or diving. In order to become a lifeguard you will need some special certifications, namely:

• Certified in CPR/AED
• Certified in blood pathogens
• Certified in first aid
• Certified in oxygen supplement

As an EMT you will already have knowledge of these skills. Being a lifeguard is generally not considered to be a career, but it is something that you could choose to do on a part time basis when you are not on duty as an EMT in your usual place of employ. There is a great need to ensure that people, especially children, do not hurt themselves or drown while swimming, and consequently medical professionals with the ability to provide basic medical training are needed onsite in order to provide care in the few situations where it is required.

Flight Medic

In many situations a patient will have to be transported from the scene of the medical emergency to a facility where they can be properly cared for. In many cases this can only happen by transporting the patient on a plane or helicopter. This is a situation that wilderness EMTs may encounter regularly. Wilderness EMTs work in parts of the country where there is no immediate access to hospital facilities available. Consequently the patient needs to be stabilized and then, if possible, flown to a medical facility. In some cases a patient may need to be transported to a different state or even out of the country. A flight medic is an EMT who is trained in providing the same basic care that other EMTs provide. In addition to this they are trained in how to deal with any additional medical emergencies that may occur once the patient is on board. In mid flight there is not much you can do for a patient other than to stabilize them until the destination is reached.

EMS Recordkeeping

If you have trained to be an EMT but have come to the conclusion that it is not, in fact, the best line of work for you to be in, there are other EMT related professions that you could try instead. If the actual medical situations are too much for you, there is an administrative position that you could train for, namely EMS record keeping. Paperwork is a very important part of keeping the emergency medical services running smoothly. In this line of work you will deal with the following paperwork:

• Billing procedures
• Medical records
• Federal and state guidelines governing Medicaid
• Medicare
• Worker’s compensation
• Private insurance as it relates to emergency medical services

This is an extremely important part of the medical profession. It is a behind-the-scenes occupation and you will not receive recognition for it form the general public, but this does not make it any less important. Generally you will need to receive some basic administration training, but the fact that you already have a basic knowledge of medical terminology and so on will help you a great deal.

Ambulance Drivers & Attendants (non-EMT workers)

An ambulance driver could be said to have an EMT related occupation in that they are required to drive sick or injured individuals from the scene where the medical emergency occurred to a hospital or similar place of safety. In addition they are often required to help the MET lift and move the patient and n many EMS services the ambulance driver will also be an EMT. The following skills and abilities are required in this job:

• To do this job it will be helpful if you are an active listener who can understand and follow directions quickly and easily.

• You will also need the basic skills required to maintain the equipment that is used on the ambulance.

• In addition you will be required to monitor the machinery in the ambulance and ensure that it is working as it should.

• You will need to have coordination in that the ability to adjust your actions according to the reactions of others will be invaluable.

• Reading comprehension will also be required in order to fully comprehend the tasks expected of you.

• The ability to identify that there is a problem is very important, although the actual problem solving skills will generally lie with someone else.

• The ability to communicate your ideas and observations clearly and unambiguously is essential.

• In addition you will need to be able to easily understand the verbal communication that comes from others.

• A very practical skill that you will need is the ability to keep your hands and arms steady while working.

College Instructors – Medicine & Health Specialties

Another EMT related occupation lies in the realm of education. Generally speaking you will need to have a qualification in the medical sphere in order to teach various medical topics. In comparison to most other MET related occupations, however, this one requires a high degree of skill and educational abilities. You will need a minimum of a bachelor’s degree in order to be a college instructor, while a master’s degree is often preferred by employers. In additional you will receive very little to no on the job training for a position such as this with the assumption that you already possess all of the relevant knowledge and skills.

Search And Rescue/Fire And Rescue

Search and rescue is generally considered to be a separate part of the EMS industry, but these organizations frequently hire METs or other medical professionals. Consequently, if you live in an area near mountains or wilderness you will have the opportunity to work in the field of search and rescue with your EMT qualification. You will:

• Use your emergency medical training,
• Work with helicopter crews
• Work with law enforcement
• Work with military personnel
• Receive training in avalanche and crevasse rescue
• Receive training in high- and low-angle rope rescue
• Receive training in whitewater/swift water rescue
• Administer treatment
• Stabilize victims for transport to medical facilities

Another job that is related to rescuing those in danger and that can be considered to be similar to the EMT profession in several ways is that of fire rescue. Fire fighters are first on the scene when a fire occurs and have basic medical training in CPR and other areas, allowing them to give basic medical aid until medical professionals arrive.

Emergency Room Triage

Triage is a process for sorting injured people into groups based on their need for or likely benefit from immediate medical treatment. Often EMTs are employed in these situations to assist other medical professionals and in order to maintain order in the emergency room, something which is not always easy to achieve with limited staff. In this setting you could, with an EMT qualification, do the following:

• Record patients’ vital signs
• Help doctors and nurses with emergency medical treatment
• Keep organized notes and records of procedures

This EMT related occupation is one of the most popular options for EMTs. Quite a large portion of EMTs are employed in hospital emergency rooms for the above mentioned purposes. One of the main benefits to working in this setting is that it allows you to develop an idea of whether or not you want to pursue your medical career further by becoming a nurse or perhaps even a doctor. The exposure that you receive will be invaluable in helping you make this life-altering decision.

Medical Tents At Sporting Events

In many cases EMTs will be able to find additional employment outside of their regular job if they need extra money or simply if they want to help others in as many ways as possible. One of the areas where an EMT could be employed while not on active duty elsewhere is in the medical tent at a sporting event. Such sporting events can be held by schools or professional sporting organizations. Sporting injuries occur frequently in these settings and a medical expert will be needed on site in the event that such an injury occurs.  You will:

• Assess fatigue
• Assess hypothermia
• Assess dehydration
• Assess hyponatremia
• Assess sunstroke
• Assess heat-related illnesses
• Assess traumatic injuries

You will be able to provide the same immediate and basic care as you would in any other medical setting where EMTs are employed. In addition you will be responsible for determining the extent of the illness or injury in question and deciding whether or not advanced medical care a medical facility such as a hospital will be required.

In addition to the above the following, according to www.myplan.com, can be considered to be “Somewhat” related to the being an EMT:

• Biological Technicians
• Bus Drivers – School
• Bus Drivers – Transit & Intercity
• Chiropractors
• College Instructors – Nursing
• Dentists – General
• Fish & Game Wardens
• Lifeguards, Ski Patrol & Recreational Protective Service
• Medical & Clinical Laboratory Technologists
• Nursing Aides, Orderlies & Attendants
• Pharmacists
• Radiation Therapists
• Taxi Drivers & Chauffeurs
• Tour Guides & Escorts
• Travel Guides
• Veterinarians

However the relation between being an EMT and having one of the following occupations is very loose. The most that can be said is that similar medical skills may occasionally be required.

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How To Become A Volunteer EMT

Step # 1: First Aid CPR Certification

Obviously to be an EM, even as a volunteer, you will need to have certain basic skills related to the health care field. To be a volunteer EMT you need to get your basic first aid and CPR certification. If you are unable to perform such basic tasks at the scene of a medical emergency you will be unlikely to be able to help the patient in any meaningful way. You can get this training from the American Red Cross or a local training organization. First aid training will include:

• Knowing how to perform CPR
• Knowing how to clear an airway obstruction
• Knowing how to respond to anaphylactic shock
• Knowing how to splint a broken bone
• Knowing how to control severe bleeding

Although CPR is often included in first aid training you will need to seek separate and additional certification in CPR to become a volunteer EMT.

Step # 2: Training

Once you have completed your basic courses in CPR and in first aid you will need to complete an EMT training course that will properly prepare you for the job and that will allow you to become certified in the career. These courses can vary in length substantially. Longer courses tend to be more comprehensive and offer a better grounding for those who want to begin their voluntary work with a firm understanding of what the job entails. These courses will cost money. This means that at some point along the way you will need to decide whether or not becoming a volunteer EMT is worth the time and money that you will need to put into the career. These courses are offered most frequently by community colleges. There are three main different levels in the EMT field:

• EMT-basic
• EMT-intermediate
• EMT-paramedic

EMT-basic is all you really need to be a volunteer EMT, but if you have a more advanced qualification you will be better equipped to help others as well as better equipped to find a good volunteer position.

Step # 3: Exam

Just because you are employed as a volunteer does not mean that you do not need to meet national standards and have the skills required by the government of all EMTs. Consequently you will be required to pass the EMT examination regardless of whether or not you are planning to work in a volunteer position or in a paid position once you are certified. This exam is offered by the National Registry of Emergency Medical Technicians.  There are usually fees involved in applying to write this examination.

Note: If at this point you are beginning to feel that you are not sure whether being a volunteer EMT is worth all of the training and effort, remember that you can always apply for paid positions in addition to the volunteer work that you plan to do. Many volunteer EMTs have a regular EMT job in addition to which they volunteer with and organization or society which is underserved and which needs additional EMTs on a part-time and voluntary basis in order to function properly. Very few people only volunteer as EMTs as they also have ‘day jobs’.

Step # 4: Certification/Licensure

The next step involves becoming licensed as an EMT. Most states require that volunteer EMTs have a license. The application process varies from state to state, but the supervisor of your volunteer EMT organization should be able to provide you with information on what you need to do to get your license. It will, however, still be mostly up to you to determine what requirements you will need to meet for your specific state before applying for licensure. The U.S. Department of Labor says that all 50 states require some type of certification, but specifics vary based on location. In most states you will need to go through the National Registry of Emergency Medical Technicians in order to become certified. All of the information about this will be provided by your course convener. If it does not form part of the classroom discussion, you will still be able to ask your course convener after the lesson about what requirements you will need to meet in your particular state in order to become certified or licensed and begin working as a volunteer EMT.

Step # 5: Agencies

This step involves finding out what agencies in your area could use a volunteer EMT and what you will need to do in order to apply for a position as a volunteer at that agency. You can search for positions at:

• Your local fire department
• Your local hospitals
• Your local ambulance companies
• You can also search online through websites such as Volunteer Match

The best way to go about selecting a position is by contacting each of the facilities in your area where you may be able to work as a volunteer. Find out, firstly, if they do, in fact, need volunteers. Then go on to ask them about what hours you will need to work in order to be a volunteer there, as well as the shifts. Specific procedures and protocols followed at that particular facility also play a role, so ask about these as well. In this regard it will be helpful to decide before looking for a volunteer position how many hours a week you will be able to commit to voluntary work so that you can narrow down your options more quickly.

Step # 6: Application

Fill out an application at the agencies that are compatible with your personal schedule and needs. Remember that there may be slightly different application criteria that you will need to meet for each different facility that you are interested in volunteering at. Consequently you need to have a clear idea of what those criteria are as well as of your ability o adhere to them or not.  If you apply to multiple agencies and are accepted by more than one, you can either choose the one that works best for you or do some volunteer work at both. It is recommended that you apply to at least three different agencies. This will help you to keep your options open. Often your first choice will not accept you simply because they do not need any volunteer EMTs at that point in time. You will then have to start the application process all over again at a different facility. To speed things up, apply to several agencies and then choose from among those that accept your application.

Example Of Entry Requirements And Application Process

Although there may be different requirements and procedures for becoming a volunteer EMT in different states and with different organizations, the following are usually true. Minimum requirements include:

• Being 18 years of age at time of appointment
• Being a United States Citizen
• Passing a written and physical ability test
• Passing a background check
• Passing a Medical exam and drug screen

In addition you will have to abide by certain procedures, including many of the following:

• You will have to return a completed Member Application
• You will have to return a completed Authorization for Release of Information
• You will have to submit a current five year driving abstract (available from the Dept. of Licensing)
• You will have to submit a copy of your unexpired drivers’ license
• You will have to successfully complete a written exam
• You will have to successfully complete a physical ability test
• You will have to successfully complete a New Member Interview
• You will have to successfully complete a medical exam
• You will have to successfully complete a drug screen

It must be noted that these procedures may not automatically hold true in all states and for all organizations and that it is your own personal responsibility to find out what requirements you will need to meet to be a volunteer EMT in your area.

Becoming a volunteer EMT is a very noble calling to pursue, but it is suggested that you think very carefully before committing to this line of work. Being an EMT is intensive and, once you have committed to be a volunteer, you will need to fulfill your duties and complete the number of volunteer hours that you promised you would. One advantage is that it can help you decide whether you want to study to be a full-time paramedic or EMT.

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NREMT Mission Statement

According to the NREMT website, the mission statement of the registry is as follows:

“To serve as the National EMS Certification organization by providing a valid, uniform process to assess the knowledge and skills required for competent practice by EMS professionals throughout their careers and by maintaining a registry of certification status”.

In effect this is an organization that aims to monitor and control the EMT profession by maintaining records of EMTs that are allowed to practice. In addition the procedures and standards that the national registry puts into place are aimed at ensuring that the quality of EMT professionals who are allowed to practice in the field is high and that everyone falling under the control of the organization behaves appropriately.

History And Milestones

History up until the NREMT was established:

• 1969: Highway Traffic Safety suggests that uniform standards for EMS be put into place
• 1970: The first meeting of the Task Force in charge of achieving the above was held January 21, 1970
• 1971: Rocco V. Morando is selected as NREMT’s founding Executive Director, first exam administered
• 1973: The first re-certification of a Nationally Registered EMT was processed
• 1974: Development of initial EMT training guidelines
• 1975: Continuing education and re-certification requirements established and the National Association of Emergency Medical Technician formed
• 1976-1977: Exams tested, curriculum was developed nationally and advanced training packages were introduced
• 1978: The first exam is given and the he Registry becomes a member of the National Commission for Health Certifying Agencies

Most recent history and milestones:

• 2000: The Board of Directors adopts a Strategic Plan to help guide the direction of the organization
• 2001: The NREMT examination is used in 43 states as the primary or only means of certification
• 2002: First increase in NREMT membership fees since 1973
• 2003: The NREMT implements a Research Program for the betterment of NREMT programs and to contribute to the EMS community, and receives accreditation of all five levels of exams from the National Commission for Certifying Agencies, a certification accrediting agency sponsored by the National Organization for Competency Assurance.
• 2005: The NREMT exams are now used by 46 states and territories as the sole basis for certification at one or more levels.
• 2007: The NREMT begins the process to transition from pencil-and-paper based exams to computer based testing

General Facts

The NREMT is a non-profit organization that exists to ensure quality on the EMT profession. Before this body was established there were no certification procedures for individuals working in the emergency medical services and no standards were in place. The NREMT stepped forward to address this shortcoming. Over 1 million EMTs have been certified through this body. In order to qualify for certification as an EMT through the NREMT you need to:

• Completing a state-approved EMS education course
• Passing the NREMT written and practical examinations

Board Of Directors

The board of directors for the NREMT consists of 21 individuals. These individuals are experts and prominent and important figures from various segments of the emergency medical services. In addition a certain proportion of the board consists of members of the public who, too, are prominent and important figures. The high level of quality of the board of directors serves to indicate that the NREMT is dedicated to the goals expressed in its mission statement. The point of the board of directors is to ensure that the NREMT is properly governed and well organized and that all of its members are monitored and kept in check. The board of directors is:

• Committed to public protection
• Committed to quality patient care

Exam Development

There are five levels of certification that can be received by writing NREMT examinations. These include:

• First Responder
• Basic EMT
• Intermediate/85 EMT
• Intermediate/99 EMT
• Paramedic

These exam questions are formalized and written by experts in the field. These tests consist of a number of different items. In order to ensure that each item on the test is of the best quality and relevant, they each take 1 year and $1000 to create. The process includes a testing phase.  According to the website of the NREMT “Each of the item banks for the five levels of certification has thousands of questions that are calibrated to entry level competency, and lead to certification that is legally defensible and psychometrically sound”.

How Entry Level Competency Is Determined

The NREMT sets the standards that determine whether or not an individual is allowed to work as an EMT. If you receive certification from the NREMT it means that you meet these requirements. However it is not the same as receiving a license to work as an EMT. Once you have received certification form the NREMT you will still be required to receive a license from your state in order to be allowed to work in that state as an EMT. You will need to go through the NREMT to receive your certification as examinations are based on practice through data obtained from the NREMT Practice Analysis. The psychomotor competency tests involved are also carefully developed and monitored.

How States Use The NREMT

There are a number of benefits for states who use the NREMT in order to certify their EMT workers. The 46 states that currently use the NREMT for this purpose have the following advantages:

• The EMT standards are the same across these states. The states that do not use the NREMT are inconsistent with each other and those states that do, making regulation difficult and statistical analysis a problem.

• States that you the NREMT standards can exchange EMT workers, while those that do not must develop and defend their own certification procedures. These certification procedures may not be recognized by other states, making it difficult for EMTs training there to move from state to another.

Why Re-certification Is Important

In order to continue working as an EMT in states that use the NREMT’s procedures you will need to seek re-certification every two years. The main reason for this is to ensure that the level of quality of the NREMT profession is kept high and that all employees in the profession are adhering to the same standards. To receive re-certification it is necessary to provide proof of continuing education. In addition you will have to demonstrate your competency in various areas of the EMT profession before you will be granted re-certification status by the NREMT. States that do not use NREMT procedures will also require re-certification, but the rules will differ and you will need to investigate the specific procedures required in your state.

Research Development

The NREMT has implemented a research program which exists specifically for the following purposes:

• To improve the medical emergency services in the USA
• To improve the functioning and procedures of the NREMT

Every year the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) is conducted. The point of this survey is to describe the employees currently working as EMTs across the country. It basically serves a statistical purpose.  This survey provides useful information regarding the makeup of the EMT profession, including:

• Salary statistics of EMTs
• Job satisfaction statistics of EMTs
• Gender statistics of EMTs
• Age statistics of EMTs
• Work experience statistics of EMTs
• Ethnicity statistics of EMTs

Professional Accreditation

According to the NREMT website:

“The NREMT is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation body of the National Organization for Competency Assurance (NOCA). The NCCA’s mission is to help ensure the health, welfare, and safety of the public through the accreditation of a variety of certification programs/organizations that assess professional competency. The NREMT is also affiliated with the Commission on the Accreditation of Allied Health Educational Programs (CAAHEP)”.

States that do not adhere to NREMT policies have to defend their own accreditation standards and these may not be recognized across the entire country.

The NREMT is a very well organized organization which is dedicated to the goals that it plans to pursue. Any EMTs who are in doubt about a procedure or policy simply need to refer to the NREMT website for clarity on the issue. In addition there are a number of resources provided to assist EMTs in their jobs and prospective EMTs in their path to becoming certified. The NREMT is the certifying agency for EMT workers and is accredited by the National Commission for Certifying Agencies (NCCA).

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The EMT Oath

This is the oath for the EMT profession:

Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.

I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.

While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot.

So help me God.

If you feel unable to abide by this oath an alternative line of work should be considered.

The EMT Code Of Ethics

The EMT code of conduct or code of ethics is longer and includes the following ideas:

• Preserve life
• Do no harm
• Treat everyone with dignity
• Do not discriminate against patients for any reason
• Use the knowledge gained as an EMT in the best interests of the public and never in a way that will be detrimental
• Maintain confidentiality (there are very specific rules regarding this aspect of the ethical code)
• Maintain your level of competence and observe the competence of others
• Define and uphold professional standards
• Assume responsibility for your own actions

A more comprehensive account of the EMT Oath and Code of Conduct can be found by going to www.naemt.org.

Summary Of The EMT Oath And Code Of Conduct

Promote Health And Avoid Harm

The two main aspects, as mentioned in regard to the code of ethics above, of an EMTs job are:

• Promote health in a patient as far as is possible given the nature of the situation and the skills of the attending EMT
• Not causing any harm to a patient or to anyone else

All members of the medical profession are required to state that they will do no harm. There is no way in which you will be an effective medical professional if you cannot understand the need for protecting your patients by no harming them and, an extension of that principle, protecting them within the bounds of your job form incurring further harm. Two other principles involved here are:

• The fact that an EMT must treat anyone, regardless of age or race, and regardless of their own personal prejudices.

• The fact that an EMT must work with other professionals when necessary to preserve the life of the patient.

Paramedics And The Law

There are a number of aspects of the law that relate directly to paramedics and EMTs:

• As private citizens EMTs are expected to uphold the law at all times.

• In addition, as medical professionals, EMTs must engage in any legislative procedures that may arise as part of the profession. This could include things such as reporting unethical or illegal behavior on the part of a colleague. This also includes the stipulation that EMTs may not use their professional skills for illegal or immoral purposes.

When health care professionals break the law they struggle to recover from the resulting bad image that is created. It is highly likely that paramedics that do not yield to these stipulations will lose their jobs and may even be banned from seeking further employment in the EMT industry either for a set period of time or for the rest of their working lives. A firm understanding of the law and how it relates to you as an EMT is therefore an essential aspect of the EMT Oath and Code of Conduct.

Professionalism

EMTs and paramedics are professionals. This means that they are required to uphold a certain degree of professionalism in their daily dealing. Essentially EMTs and paramedics are required to:

• Maintain competence
• Uphold the highest standards of emergency care

If, for example, an EMT asks a bystander to help with a procedure, especially in cases where the task in question is one that legally has to be performed by a paramedic or EMT, that EMT is contravening both of the above stipulations. Firstly, by having a bystander help, the EMT is indicating to all present that he or she is not competent enough to perform the required tasks on his or her own. In addition this could compromise the level of care that the patient receives as the bystander will most likely have no medical knowledge or experience and therefore it cannot be guaranteed that they will provide the care accurately.

Scope Of Practice

There are several different levels of EMTs. Each of those levels carries with it a specific scope of practice. The scope of practice is basically a set of rules and regulations regarding what you may and may not do as an EMT at your level of qualification. The scope of practice could vary from state to state and EMTs who may perform certain tasks in one state may be unable to perform them in another. Consequently it is extremely important that you have a thorough knowledge of the particular scope of practice required in your state before beginning your career. EMT training programs always cover the scope of practice and make it very clear what an EMT can and cannot do. If you do not follow your scope of practice strictly it is similar to breaking the law. You may not perform a task that belongs to a professional at a higher level than yourself and you may not overstep your bounds for any reason.

Standard Of Care

An EMT is expected to perform actions that “conform with the reasonable level of skill, prudence, caution, and competence that could be expected under the circumstances.” In order to determine this, the EMT’s behavior will be compared to the behavior of other EMTs to see if there is a match. A large component of this aspect of expected ethical behavior is the question of whether or not the ERMT provided care in good faith and to the best of his or her ability. There are several situations where this will need to be determined:

• In cases where the EMT is the subject of a review for some or other reasons and the care that that EMT provides needs to be established as either being appropriate and in line with standards or inappropriate.

• In addition EMTs may be involved in legal proceedings, often as the result of a death of a  patient, and in those cases their standard of care will also need to be analyzed.

Duty To Act

This is one of the more ambiguous stipulations for EMTs. The basic idea is that the EMT is obligated to act and assist in any medical emergency whether they are on duty in their capacity as an EMT or not. Clearly failure to act while on duty as an EMT is a punishable offense and illegal. However failing to act when you are off duty and the witness to an emergency is often interpreted as being more of a matter of morality than of law. In these situations there is a very fine line between the two and if the situation goes to court you will most likely be treated as a lawbreaker even though you were not at that time on duty as an EMT. A natural affinity to help others is a personality requirement for the job, so you should not have much trouble acting when necessary.

To a large degree the ethical code outlined above is an obvious one for a profession such as emergency medical services. There is a certain code of conduct that we expect our medical professionals to follow instinctively, and people who are drawn to the EMT profession are generally those who already have a natural affinity for the ethical behavior listed above. However a set standard, in this case the EMT Oath and Code of Conduct, is required in order to be certain that everyone is sure of where the line is drawn in terms of what you can and cannot do as an EMT.

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The History Of The EMT Profession

The history of the EMT profession is a fairly long one, but at the same time it can be said that this profession has not been around for a very long time, at least in comparison to some of the other professions that are out there. The main aim of the EMT profession, which can be inferred from the EMT history, as well as the EMS profession in general is to reduce unnecessary injuries and deaths. There is a huge demand for professionals in this line of work. In fact there are more job openings than professional EMTs to fill them. As a result many EMT training programs offered at the moment are not as comprehensive as they once were on the basis that the courses have to be cut short to get more professionals into the field more quickly.

Early Years Of EMT History

In the early years of EMT history (before the 1960s) there were two major leaps forward in the area of emergency medical services:

• Initially hearses were used in order to transport sick people to hospitals or to their homes simply on the basis that the cars were long enough for the stretchers. The funeral workers had no medical training but this did point out the need for special vehicles for the purpose.

• The Second World War resulted in another leap forward as rescue teams began to crop up in various places. However there were no standards in place and pre-hospital care, as it was known at the time, consisted well-intentioned but uncoordinated efforts. Coordinated efforts to provided emergency medical services were not established until the 1960s.

Emergency Care In The 1960s

By the 1960s there were come standards in place. However these standards for emergency medical care only existed in six different states and, like with all things related to the medical field in the US, each of these states had subtly different standards by which it expected its EMTs to function. There were still two major problems at this point:

• Ambulances were not yet suitable for transporting patients effectively and safely and could not accommodate all of the equipment necessary.

• Only a few ambulances at the time had radio access, making it difficult to communicate with hospitals regarding EMS care.

Perhaps the biggest problem at this stage was the fact that a large number of EMTs working in the emergency medical services during this time period had no medical training at all. Even those who had training were not what you could call experts.

1966 Milestones

In 1966 a number of important milestones for the EMT profession were reached which changed the way emergencies were dealt with from thereon out. The first event which occurred in 1966 was a report published by the National Academy of Sciences recommending extensive regulations and methodologies aimed at improving the nation’s ambulance system. This was largely in response to the fact that, the year before the report was published, more people died as the result of car accidents (mainly due to not receiving medical aid quickly enough) than had died in the Vietnam War. The second even that occurred in 1966 was the creation of the U.S. Department of Transportation which aimed to implement training standards for emergency responders as well as advanced education regimes for emergency medical technicians and other emergency respondents.

Continued Developments

After that there were a number of important developments in EMT history that made a substantial difference to how the profession operated and was viewed:

• 1967: The first authoritative textbook for emergency personnel (“Emergency Care and Transportation of the Sick and Injured”) was written by the American Academy of Orthopedic Surgeons.

• 1973 (1997 for official registration): the EMT symbol, the Star of Life, was designed (this symbolizes detection, reporting, response, on-scene care, in-transit care and “transfer to definitive care)

• 1973: The EMS System Act was enacted, funding 300 regional EMS systems

All of these changes show a gradual shift towards viewing the EMT profession as a separate career path and a separate discipline that needed its own rules and its own symbolism. As you can see many of the major changes in EMT history happened fairly recently.

National Standards

Three important events took place in 1975 which have a huge bearing on EMT history. Firstly the American Medical Association acknowledged emergency medicine as a specialty, secondly the University of Pittsburgh established the first EMT training course, and last but not least an association for the profession was founded. This association was known as the National Association of Emergency Medical Technicians. These three precipitating events gradually led to the standardization of practice procedures in emergency medical settings and the profession gradually became formalized with its own set of rules to follow.

• 1977: The National Association of EMS Educators was created
• 1978: The Journal of Emergency Medical Services began publication
• 1978: The American Ambulance Association was formed
• 1982: EMS funding and authority was placed in the hands of states and local government (and still does today)

Modern Paramedics

The paramedic profession today has take the role of the EMT one step further in that they are allowed to provide care other than that which is required in emergency medical situations. The actual role of a modern paramedic differs from state to state, but it is generally accepted that they have greater standing and more authority than the average EMT. If, however, the history of the EMT profession is anything to go by we can expect further developments to take place. In the future EMTs may have the same training and standing as paramedics have today and paramedics themselves may be required to receive advanced medical training that will put them on the same level as nurses or perhaps even doctors. The important thing to note it that EMT history is in the making today and there is plenty of room for growth in the industry.

The History Of The Emergency Medical Service

We rely heavily on the emergency medical services provided for us in this country and we expect to be able to get hold of an emergency response team by simply pushing a few buttons on our phone and making a call. However this service is something that only came into being relatively recently. The end of the 18^th century saw the first major moves towards a cohesive medical emergency response system while the services that we take for granted today have only been around since the 20^th century. The history of the emergency medical services is a brief one, but it is nonetheless extremely interesting despite its brevity. As with EMT history, we can expect to see further advances in EMS history as time passes and better technology is developed globally.

Origins

There are a number of events in history that show that for most of our existence human beings have been concerned with caring for patients who suffer medical emergencies. Let’s look at two main examples:

• In biblical times a story is told of the Good Samaritan who helps an injured man and takes him to an inn, leaving instructions for his care.

• In 1090 (the Middle Ages) the Order of St. John was created by a group of knights who later became known as the Knights Hospitaller. These knights dedicated themselves to treating injuries on the battlefield.

However these are examples of isolated events that did not represent coordinated action to establish a standardized system for assisting people in medical emergencies. This was not to develop for many years after the Knights Hospitaller made their mark on the world.

First Ambulance

Let’s turn now to the first official ambulance that was created and used for the purpose of emergency medical response services. Technically speaking this is not what we think of when we hear the word ambulance today. The first vehicle used for the transport of injured or ill people to a place where they could be treated (which matches out modern day understanding of the term ‘ambulance’) was used during the Napoleonic wars. Dominique-Jean Larrey, Napoleon Bonaparte’s most trusted physician, created the “flying ambulance” that was a horse-drawn carriage that carried soldiers who had been wounded or who had fallen ill to a place where they could be treated for their injuries or illnesses. Although this is still far removed from we see as an ambulance today the idea did lay the groundwork for the invention of modern day ambulances.

Ambulances At Turn Of 20th Century

Slowly but surely ambulances as we know them today began to emerge. Generally speaking ambulances are owned and supplied by each individual hospital. The following is a list of hospitals in the US that began the trend of owning vehicles specifically for the transport of injured and ill individuals:

• The Commercial Hospital (now the Cincinnati General Hospital), Cincinnati, Ohio: In 1865 this hospital employed its first exclusive vehicle for patient transportation.

• Bellevue Hospital, New York City: The first hospital believed to carry its own medical equipment in the vehicle used for patient transportation.

• Michael Reese Hospital in Chicago, Illinois, and New York City hospitals: These hospitals introduced the first motorized ambulances that ran on electricity at the beginning of the 20th century.

As a result of this ambulances became the norm and eventually developed into the state of the art vehicles we have today.

“The White Paper”

The National Academy of Sciences released a report entitled: “Accidental Death and Disability: The Neglected Disease of Modern Society” which basically did a very good job of highlighting everything that was wrong with the medical emergency services at the time. And there was plenty wrong. The main problem that was highlighted as a theme throughout the document was that people were dying unnecessarily simply because they were not receiving help fast enough. The report, written in 1966 and known as the “White Paper” among EMT professionals prompted a revolution in terms of how the emergency medical services were run. Stronger standards were put into place and more training for EMTs and paramedics became required. Through the changes instigated by this report emergency medical services slowly started to transform into the system that we have today.

Emergency Medical Services Today

Emergency medical services as we know them today are based on a widely accepted and global standard of emergency care. Care is offered through EMS on three levels:

• Standard care
• Basic life support
• Advanced life support

EMTs and paramedics are the main workers in EMS and nurses and doctors usually have contact with the EMS system. Their contact is, however, minimal and involves taking over patients that have been delivered from the scene of the accident or other medical emergency. The EMS system cannot be taken for granted. Only a very short while ago people in this country did not have access to the care that we accept as a norm. EMTs are important members of the medical profession.

EMT history is interesting to those who have a genuine passion for this line of work. In addition it is often a requirement that you know a certain amount about the history of the EMT profession in order to pass your EMT examination. The history of the emergency medical system is also an important one to know in order to have a full appreciation for what EMTs do and what their purpose and overall position in society is. Studying EMT history may not be the most important part of being an EMT, but many believe it to be necessary in order to gain a deeper understanding and appreciation for the profession.

The post Looking Closely Into The EMT History appeared first on Healthcare Careers Guide.

Training for the various EMT levels is offered by community colleges, vocational schools and various other institutions of learning such as universities and technical institutes. The minimal qualification needed in order to study to become an emergency medical technician is a high school pass with at least one science subject. Applicants for EMT courses must also be in possession of a driver’s licence, be physically fit,  and not have a criminal record.

EMT Responsibilities

Emergency Medical Technicians are responsible for the lives of those to whom they attend at the scenes of accidents or tragedies, and they must be able to perform the duties required as per their EMT levels.

In order to do this they must be able to:

• Drive an ambulance swiftly yet carefully
• Assess a patient’s condition and administer the necessary medical assistance
• Work quickly and efficiently
• Maintain calm and composure
• Protect the scene where someone has died as a result of an accident or crime
• Determine to which hospital a patient should be transported
• Notify the medical facility for immediate action and advise them of the patient’s condition upon arrival
• Provide a record of the patient’s first assessment, condition whilst being transported and condition upon arrival at the medical facility
• They must clean and disinfect the ambulance after delivering the patient and do a quick inventory, replacing supplies used, and change the blankets
• Administer medication as required and as per their level

Emergency Medical Technicians must have good eyesight, be able to read a map, have good communication skills, be physically fit and be aware of and abide by medical ethics and procedures.

Emergency Medical Technician (EMT) – Basic

An EMT-Basic is a member of the emergency response team who has completed the first of the EMT levels, the approved basic EMT course, which is typically around 150 hours in length and has passed certification and registered with the NREMT.

EMT-Basics are often the first on the scene and they provide the most basic form of emergency care to patients. They are often exposed to stressful, sometimes dangerous situations, disease, life-or-death situations, and even combative patients sometimes.

EMT-Basic Education Requirements

Applicants should have a high school diploma or equivalent and many programs also require the applicant to complete a preliminary emergency medical course and to have a valid cardiopulmonary resuscitation (CPR) certification.

EMT-Basic Certification

In order to gain National Registry of Emergency Medical Technicians certification at this level, the program must comply with the EMT-Basic National Standard Curriculum as detailed by the U.S. Department of Transportation. Courses generally offer both academic (classroom) training and hands-on training in a medical facility.

The programs for Basic EMT levels are generally one semester long and consist of training in the following:

• Anatomy
• Ambulance operations
• Cardiac emergency care
• Hazardous material management
• Human biology
• Medical terminology
• Patient assessment
• Patient transport techniques
• Pediatric emergency care
• Trauma injury treatment procedures

Once they have completed the course, EMT-Basics must pass the NREMT examination in order to get licensure.

EMT – Basic Duties

EMT-Basics respond to emergencies and assess the conditions of patients on the scene. They are trained to assist with basic life-support and also possess the skills to treat trauma, poisonings, respiratory problems, diabetic problems, and behavioral problems, environmental, allergic and cardiac emergencies. They are also trained in childbirth techniques and can transport patients from an emergency scene to a medical facility and transport patients between medical facilities.

EMT-Basics usually work in pairs; one drives whilst the other sits in the back with the patient and monitors their vital signs and provides any ongoing treatment whist on the way to the medical facility. They keep accurate records and provide vital information to the staff at the medical facility when delivering the patient.

EMT-Basic Employment Outlook And Salary

According to the U.S. Bureau of Labor Statistics (BLS), employment for all EMT levels should grow by around 9% in the 2008-2018 decade. Employment in local governments and independent rescue agencies is highly sought after for the great incentives they offer.

According to May 2010 BLS statistics, the annual median salary of EMT-Basics is $24,070. The lowest 10% earned an annual salary of $19,710 and the highest 10% earned $36,370 per annum.

EMT – Basic Continuing Education

EMT-Basic is the lowest of the EMT levels and is generally the prerequisite for the higher levels which are EMT-Intermediate and Paramedic. Some schools offer associate degree programs at the paramedic level.

EMT-basic re-certification requires 72 hours of continuing education; there is also an exam option. EMTs must complete 24 hours of the 24 hour DOT National Standard EMT-Basic Refresher and 48 hours of additional continuing education.

Emergency Medical Technician (EMT) – Intermediate

The second of the EMT levels is the Intermediate EMT, sometimes referred to as EMT- Advanced. The Intermediate EMT is an individual who has usually completed both the EMT-Basic course as well as an advanced course, which is approximately 250 hours long and has gained certification and registered with the NREMT.

As the designation suggests, the EMT-Intermediates provide a higher level of care and as such are trained in more techniques.

EMT – Intermediate Education Requirements

One must have finished the EMT-Basic level, have a CPR certification and be licensed by NREMT in order to be admitted into the intermediate training.

EMT- Intermediate Certification

The intermediate level is the only one of the EMT levels which is divided into two levels; the EMT-Intermediate 85 and the EMT-Intermediate 99. Intermediate courses include classroom instruction, labs and clinical experience.

The intermediate course builds on the knowledge gained in the basic training and includes additional training in specialized techniques:

• Advanced life support
• Advanced airway care
• Handling and maintenance of ECG machines
• Medication administration
• More advanced skills in the use of intravenous fluids
• Patient assessment
• Patient transport and fluid therapy
• Specialized training in intravenous therapy

Once you have completed the course you will need to pass the NREMT examination in order to get licensure.

EMT- Intermediate Duties

The EMT-Intermediate performs some of the same duties as the EMT-Basic, but they also perform more advanced medical and emergency interventions. They are trained in the use of manual and automatic defibrillators, CPR, splinting, non-visualized airways, the administration of nitro-glycerine, bandaging, epinephrine with an Epi-Pen, aspirin, and activated charcoal, oxygen administration, intravenous access (IV), emergency childbirth, and cardiac monitoring.

EMT- Intermediate Employment Outlook and Salary

According to the U.S. Bureau of Labor Statistics, the growth rate for all EMT levels is set to rise in the next decade due to an increasing call volume by the country’s aging population.

The average salary of an EMT-Intermediate ranges from $25,000 to $39,500. The median annual salary for an intermediate EMT is $34,000. Salaries vary according to geographic location, experience and certifications.

EMT- Intermediate Continuing Education

EMT-Intermediate re-certification requires 72 hours of continuing education, which needs to consist of 36 hours of approved refresher courses and 36 hours in of continuing education in airway, trauma, medical emergencies, pediatrics, breathing, cardiology, and operational tasks. Applicants for re-certification may opt to take a cognitive competency exam, but they may only take this once and must complete it six months prior to certification expiration.

Emergency Medical Technician – Paramedic

A Paramedic is the highest of the EMT levels, and is the designation awarded to an individual who has completed an approved EMT Course plus a Paramedic Course which is typically around 1,500 hours. Paramedics are at the forefront of just about each and every medical emergency, big and small, constantly making life-and-death decisions that impact the lives of thousands of people annually.

EMT- Paramedic Education Requirements

The leap to the top tier of the EMT levels is substantial. Paramedics get an education that provides them with a broad-spectrum of knowledge and skills in pre-hospital emergency care principles.

In order to enroll in a paramedic course individuals are required to have completed their studies in EMT-basic or intermediate, or both.

EMT- Paramedic Certification

Paramedic courses consist of lectures, hands-on skills training and clinical and/or field internships; they can be between 1,200 to 1,800 hours and generally take between 18-24 months to complete.

Paramedics are trained in all of the BLS skills and in advanced skills such as:

• Advanced airway management, including surgical airways
• CPAP and Rapid Sequence Induction
• Intravenous access
• Intraosseous access, which involves placing a needle in a bone and using the bone marrow as a fluid and medication route
• Pharmacology (LifeMed’s paramedics have access to close to 40 medications)
• Pleural decompression – a treatment to re-inflate collapsed lungs
• The use of manual defibrillation
• Transcutaneous cardiac pacing
• The use of 12 lead ECGs

Once training is finished you will need to pass either the National Registry of Emergency Medical Technicians-Paramedic exam or a state specific exam in order to get certified and gain licensure. Paramedics typically receive certification in pre-hospital trauma, advanced cardiac life support, and pediatrics.

EMT- Paramedic Duties

Paramedics can and often do perform all of the same tasks as the other two EMT levels do, but are also trained and licensed to perform more invasive tasks as well.

Typically, a paramedic’s duties may include:

• Administering oral and intravenous medications as required
• Administer cardio pulmonary resuscitation
• Administering and interpreting electrocardiograms (EKGs)
• Assessing the nature of a patient’s illness or injuries on site
• Utilizing specialized equipment to immobilize a patient before transporting him or her to a medical facility for further medical treatment
• Checking a patient’s vital signs
• Driving an ambulance
• Monitoring a patient’s vital signs and administering care and medication on the way to the medical facility
• Reporting observations about a patient to hospital emergency room personnel on arrival at the facility
• Performing endotracheal intubations

EMT- Paramedic Employment Outlook and Salary

The U.S. Bureau of Labor Statistics projects an employment growth of all EMT levels of approximately 33.3 % between 2010 and 2020, which will add another 75,400 more professionals to the 226,500 positions currently held in this field.

According to May 2010 BLS statistics, the annual median salary of EMT-Paramedic is $39,764. The lowest 10% earned an annual salary of $34,931 and the highest 10% earned $51,370 per annum. Salary does depend a lot on geographic location though, as is demonstrated by the fact that the annual median wage of a paramedic in Tacoma Washington is $65,880, and a paramedic in Coeur d’Alene, Idaho is $62,070.

Paramedics often study further and eventually become dispatchers, supervisors, operations managers, or administrative director or executive director of emergency services. Some paramedics even become physician’s assistants or decide to share their many years of experience and vast knowledge by becoming instructors.

EMT- Paramedic Re-certification

Re-certification as a paramedic requires the completion of 72 continuing education hours which must include 24 hours of continuing EMS-related education as well as 48 hours of DOT National Standard Paramedic Refresher.

Individuals at this, the highest of the EMT levels, also have the opportunity of taking an exam in lieu of completion of the re-certification report documenting continuing education hours.

In order to work in any of these EMT levels, one needs to be licensed. Licensure requirements do differ somewhat by state, so it is imperative that you enquire as to the licensing requirements in the state in which you intend to work. Most states require all EMT levels to pass the National Registry of Emergency Medical Technicians exam. Licenses generally have to be renewed every two or three years.

The post Facts About The Different EMT Levels appeared first on Healthcare Careers Guide.

Definition Of A Wilderness EMT

Emergencies occur in all parts of the world and they are usually not foreseeable or expected. In wilderness areas there may not be access to medical services. Consequently wilderness EMTs are trained in order to cope with these medical emergencies when they arise in these isolated situations. In cases where immediate evacuation is not possible you will either need:

• A wilderness first aid user
• A wilderness first responder
• A wilderness EMT

A wilderness EMT is a far more advanced qualification than the previous two options on the basis that it requires far more training (in addition to the EMT training already received).  In order to become a wilderness EMT there are a number of educational requirements that you will have to meet. In addition you will be unable to work in this profession without first obtaining the required number of hours of practical experience in the field, preferably in a wilderness setting.

Certification Requirements

There are a number of fairly basic qualification and requirements that you have to meet in order to be eligible to be a wilderness EMT. For one thing you have to pass the training course and successfully show your ability to put into practice all of the skills and methods taught during your training without help. There are also age requirements for this line of work. In order to be a wilderness EMT you generally need to be at least 18 years old. However ins some circumstances and in some states you can be a wilderness EMT if you are only 16 or 17 years old if you have a letter of permission from your parent or your legal guardian. Additional requirements are:

• The ability to communicate effectively over a radio.
• The ability to assist in balancing a 300-pound individual.
• The ability to calculate medications based on body weight.
• The ability to document all relevant information in prescribed format.

Additional Requirements

There are several additional requirements that you will need as a this kind of EMT of you are to be successful at your job and, more importantly, if you are to receive your certification. These include:

• The ability to interview bystanders.
• The ability to perform specific physical and diagnostic skills (such as determining blood pressure and lung sounds).
• The ability to withstand extreme environmental conditions.

In order to receive certification as a wilderness EMT you must meet all of the requirements mentioned in these two sections. You will be tested on all of the topics mentioned here in order to determine whether or not you have what it takes to be a successful wilderness EMT. If you do not meet these fairly basic requirements you will, unfortunately, be unable to become a wilderness EMT until such time as you are able to demonstrate them. However you will receive a letter that confirms that you completed the training course and that you were willing to try.

Course Description

Certification as a wilderness EMT requires about 180 hours of coursework which will usually be compacted into an intensive month-long training session involving both theory and practical hands-on training. The course will focus on emergency care in settings where calling 911 is not one of your available options. Coursework will include:

• Medical equipment improvisation
• Prolonged patient care

In addition your course will include:

• Ambulance and emergency room observation
• Trauma training
• Intravenous therapy training
• Endotracheal intubation training
• Back country medicine training
• Environmental medicine training
• Toxins training
• Other emergency medical techniques necessary to prolong the life of a patient

As with most other jobs related to the provision of emergency care, they needs to be extremely hands-on and practical as this is the only way in which you will be able to learn everything that you will need to know for an actual medical emergency that takes place in an outlying area where assistance is not available.

Certification Completion

There are a number of things that you will have to do in order to finalize your certification. For one thing you will need to attend 100% of the classes that you have signed up for. If you miss even one class you will not be certified. However, because sometimes events arise that are outside of our control, if you have a good a reason for missing a class you may be able to come to an agreement with your instructor and make up the class at a later date or catch up from another student. Generally speaking, however, 100% attendance is non-negotiable requirement. In addition you will have to perform at a level deemed satisfactory by your instructor during your practical rotations and during your exam. The exam will consist of oral as well as written questions and you will need to display competence in both areas in order to complete the certification process.

Course Length

As the medical profession goes the course does not take a particularly long time to complete and results in a WEMT certificate, which is also recognized by the U.S. Department of Transportation. The exact length of the course will depend on who sponsors the course. Although traditionally speaking these courses require a month-long training regime, as of fairly recently courses have emerged that take as little as two weeks to complete. It is important that you ensure that the course you complete is one that is accredited and acknowledged by the relevant parties to avoid wasting your time and your money. On average your course will take 110 to 180 training hours to complete. It is important to note that, because of the high degree of hands-on practical training you will need in order to become a wilderness EMT, there is no way in which you will be able to complete the coursework online as there is very little theory in comparison to the practical training needed.

Licensing Requirements

Becoming a licensed wilderness EMT requires taking and passing a written and practical exam. The skills that you will need to develop in order to pass this exam will be covered in your training and if you attend a good course with a good reputation you will have no trouble at all receiving your license. Requirements vary from state-to-state. This means that when you engage in a wilderness EMT training program you first need to look into what requirements your state has for the profession. Once you are sure what the requirements are you will be able to better determine which courses and schools are the better options for you to choose from in the long run. Remember to check the requirements for your state specifically. Licenses (as well as certifications) are valid for a period of three years. After this time has elapsed you will be required to renew your certification and your license in order to continue working as a wilderness EMT.

Coursework And Training

Coursework

EMT training can be completed at a number of different schools, universities, and colleges. During your training you will learn the following:

• The skills necessary to treat bleeding
• The skills necessary to treat shock
• The skills necessary to treat head injuries
• The skills necessary to treat spinal injuries
• The skills necessary to treat fractures
• The skills necessary to treat sprains
• The skills necessary to treat hypothermia
• The skills necessary to treat heat exhaustion
• The skills necessary to treat altitude sickness
• The skills necessary to treat burns
• In addition you will be trained search and rescue procedures and skills

The training that you will receive, then, is very focused on providing immediate and basic care for a number of medical emergency situations that could arise in a context where no hospitals are nearby and where evacuation is not possible, or at least not where evacuation is not an immediate possibility.

EMT Training

Emergency Medical Technician (EMT) training varies by level. As a wilderness EMT you will have to achieve a fairly high level. This is because you will be the patient’s only source of immediate medical care for a very long time so the more skills you have the better able you will be to take care of the patient.  In the United States, the National Highway Traffic Safety Administration has identified four fundamental levels: EMT-B (Basic), EMT-I/85/EMT-I/99’s (Intermediate), and EMT-P (Paramedic). In general, EMTs are the highest form of pre-hospital care that is available. However, your goal as a wilderness EMT is to stabilize and safely transport the patient, not to heal them. Basically you can only provide a very basic level of care. In wilderness situations or in rural areas where the hospital is too far away to transport a patient without first stabilizing them, your skills as a wilderness EMT will be invaluable. However you cannot expect to be able to cure or treat your patients.

Wilderness First Responder Training

If you do not feel that you are ready to make the commitment to being a wilderness EMT, there is a slightly lesser qualification that requires fewer hours of training to achieve. This is one certification level below the wilderness EMT. In this training you will be taught:

• Basic medicine practices
• How to handle issues a medical team might encounter in the wilderness

The services that you will be able to provide are even more basic than those that an EMT is able to provide. Consequently this is a very entry level position to the medical industry.  A wilderness first responder involves 80 hours of coursework. Wilderness first responders learn how to:

• Assess situations
• Treat injuries
• Determine the best way to evacuate victims from a remote setting

Becoming a wilderness first responder will allow you to develop a feel for the work and decide whether or not you are prepared to dedicate the time required to becoming an actual wilderness EMT.

Organizations That Offer Training

If you want to be a wilderness first responder there are a number of organizations that will provide you with training in this regard:

• The National Outdoor Leadership School (NOLS)
• Aerie Medicine
• Wilderness Medical Society
• Wilderness Medical Institute
• Wilderness Medical Associates

To become a wilderness EMT you will need to attend a college or university. Note that because a great deal of practical work is required it is better to attend a college or university that is located in a setting fairly close to an area where you can observe actual wilderness EMTs at work in the field. However to a certain degree simulated exercises as well as general EMT training in urban settings will also go quite a long way to preparing you for this line of work. The school that you attend should be accredited and have a good reputation to improve your resume and assist you in finding a job as wilderness EMT once you are qualified.

Because of the lack of support and the relative isolation of the job, being a wilderness EMT can be highly stressful for people choosing to work in this area of emergency medical response. However it is something that is definitely necessary. If you have a natural affinity for the outdoors and if you have, combined with that, a desire to help others in dangerous situations, becoming a wilderness EMT may be the best career path for you as you will be able to combine your outdoor skills with helping others.

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Steps To Becoming A Certified EMT

There are a number of steps that you can follow in your journey to becoming an EMT:

Visit the Emergency Medical Services website for your state and find out what the EMT certification procedures are. These differ from state to state, so do your research well. Most states require a combination of the following with some slight variations from state to state:

• Coursework
• Practical hands on training
• Background checks
• Physical exams
• Cognitive exams
• Standardized test administered by NREMT

Next, after you have ascertained what your state’s requirements are, you need to look for a place to complete your program. Locations for an EMT qualification include:

• Medical trade schools
• Community colleges
• Private schools (more expensive)

Most community colleges will have an EMT study option, so this is a good place to start. The course will be about a year long.

Note: If you’re not entirely sure that you want to be an EMT you could join a:

• Fire department
• Rescue squad

Usually you can join one of the above as a volunteer without any EMT training. On the job you will be given basic training and you will get e preliminary look into what you will do as an EMT. If you decide to pursue the qualification, there is no reason to stop volunteering as all the experience you can get will be useful.

If you’re looking at online EMT schools, be very, very careful. You need to be sure that these schools, as with any other schools, are accredited by the state in which you want to practice as EMT. Also remember that not all the requirement for an EMT qualification can be fulfilled online. For example you cannot complete the hands-on practice training in an online setting.

Complete the coursework and then get your 100 to 200 hours of hands-on experience. Once you have done all of this register to take the required examination (this will also include mandatory physical exams). When you’ve done this, you will be a certified EMT.

You will be required to re-certify yourself as an EMT once every four years. Again the rules here depend on the state in which you live, so find out more from your states EMS website.

After that you have the option to continue your education and even work your way up to being a paramedic, which comes with many advantages of its own.

Types Of EMTs

What Is An EMT?

An EMT is an Emergency Medical Technician and has special training that qualifies him or her to work in the field providing emergency care to patients in emergency medical situations. EMTs are the first respondents on scenes where people have been badly injured and require medical assistance. Such situations include:

• Car accidents
• Natural disasters
• Fires
• Violent crimes

You will need a driver’s license as an EMT. This is because a big part of your job involves driving. You will need to drive safely and quickly to the place where the patient has been injured. You will then need to prepare the patient for transport and then securely and safely transport them to the nearest medical facility of it is a feasible options. If wounds are minor the patient can be treated on the scene.

EMT-B

There are a number of different levels of EMT certification. EMT-B is the lowest of these levels and this is where you are most likely to start out if you plan to pursue a career in emergency medical response. Consequently you will only be permitted to perform the most basic procedures when you respond to a scene. Your exact scope of practice will depend on the rules and regulations of your particular state. You may be allowed to:

• Administer oxygen and glucose
• Administer activated charcoal and epinephrine for allergic reactions

Whether or not you need to be supervised when performing tasks such as these will depend largely on the rules of your state’s Emergency Medical Services Department. It is helpful to know what you can and cannot do with an EMT-B before deciding to pursue that qualification or a more advanced one.

EMT-I

The next step up from being an EMT-B is being an EMT-I. As with most professions there are clear steps that you can take as you progress through your EMT career. The EMT-! Level is the second step in your progression. Among other things, an individual with an EMT-I qualification is able to:

• Administer additional medical attention that an EMT-B (where the B stands for “basic”) cannot
• Administer D50
• Administer Narcan
• Administer nitro tablets
• Intubate with an ET tube
• Start a lactated ringer

Again, the degree of supervision you need and the exact tasks that you are allowed to perform with an EMT-I qualification depend on the rules and codes of your particular state.

EMT-II

It is impossible to skip the EMT-I Level when you want to become an EMT-II. In order to become an EMT-II you must:

• Hold an EMT-I qualification
• Have had at least 10 contacts with patients while working as an EMT-I

Note: The exact number of patient contacts that you have to have before becoming an EMT-II depends on the state in which you work as, once again, there are differing rules form state to state.

You will have to undergo additional training to be an EMT-II. The length of this training will vary depending on your state and school. With this additional training come additional responsibilities that you can perform at a scene. You may be able to (among other things):

• Start intravenous (IV) lines
• Administer additional prescription medications as directed by a medical professional

EMT-III

The next level that you can pursue is, logically the EMT-III level. On top of all of the training you receive in other areas, you will need to undergo specialized training in cardiac care if you want to be an EMT-III. This is the main prerequisite to be certified at this level. You will need:

• Additional training in the use of morphine
• Additional training in the use of atrophine
• Additional training in the use of epinephrine

Requirements differ from state to state, but in order to become an EMT-III you will probably need to have completed:

• 50 hours of training
• 10 patient contacts
• 10 venous punctures as an EMT-II

The exact numbers may differ very slightly depending on where you are training to be an EMT-III.

Paramedic

The highest level of EMT is to become a full-blown paramedic and this is something that is well worth working towards. You will have an increased salary, although there is a major increase in the responsibility that you will have to carry that will come with this increase in your salary. Certification and responsibilities vary from state to state, but you will basically have an increased range of treatments and procedures that you are allowed to perform, and you will not be nearly as closely supervised as an EMT. For example you will be able to:

• Shock hearts
• Make new airways
• Administer over 30 different kinds of medications
• Ventilate patients
• Deliver babies

EMT Training Program

If you want to be an EMT and become certified as one legally you have to complete and EMT training program which can be offered at a variety of different place. Community colleges are the best places to begin your hunt for an EMT training program. There are several different levels of EMT qualifications (as mentioned above), and the length of your EMT training program can be anything from 6 months to two years to complete depending on which one of those levels you would like to aim for first. There are some prerequisite to completing an EMT training program:

• You must be at least 18 years old
• You must have completed (successfully) a check into your background as in most states, EMTs cannot have a criminal record

Education Prerequisites

Before you can become a certified EMT you have to complete an EMT training program. In order to qualify for entrance into an EMT training program there are a number of educational prerequisites that you will have to meet. Firstly you will need to have a high school diploma. If you do not have a high school diploma, but you do have an equivalent thereof, such as a GED, you will still be able to enter an EMT training program. After that the prerequisites will differ from course to course. A common prerequisite that often arises is that the course conveners will require you to have a valid cardiopulmonary resuscitation (CPR) certification. In addition they may require you to complete a preliminary training course before you can begin proper training.

Course Topics

The coursework that you will do may include the following:

• Basic cardiopulmonary resuscitation (CPR)
• First aid
• Patient assessment and stabilization
• Respiratory and trauma management
• Anatomy and physiology
• Basic life support
• Cardiac management
• Human biology
• Medical terminology
• Trauma injury treatment procedures
• Patient transport techniques
• Pediatric emergency care
• Hazardous material management
• Ambulance operations

A willingness to learn the above information, as well as an interest in it will stand you in good stead on your path t becoming a certified EMT. All of the above can be taught, so do not feel daunted by any of the topics mentioned above as you will not be expected to demonstrate knowledge of any of the curse work topics mentioned here before your training is complete.

EMT Certification

In order to become certified as an EMT:

• You must complete a state-recognized training program
• You must pass the National Registry of Emergency Medical Technicians (NREMT) certification exam, OR
• You must pass a state licensing exam

Remember that there are different NREMT exams for each of the different EMT levels that have been discussed here. Make sure that you register and write the correct exam. The exams in question are aimed at testing two aspects of your skill, namely:

• Your cognitive understanding of the course theory
• Your ability to demonstrate your understanding in a practical and hands-on situation

You get three tires to pass the exam. If you fail on try three you will need to do 24 hours additional training before you can take it again. You must apply for re-certification once every four years.

The path to becoming an EMT is a little shorter than many other paths to enter the medical profession. As an EMT you will have a steady and stable job as there will always be medical emergencies that will require the knowledge and expertise of trained medical professionals. In addition you will be remunerated fairly well throughout your career, and you may have the option of pursuing more advanced careers and qualifications within the healthcare industry from the starting point of an EMT qualification. As you can see becoming a certified EMT is not nearly as difficult as one may think. The steps require hard work and motivation as well as dedication on your part, but provided you are serious about becoming certified in this line of work, you will have very little trouble achieving your aims.

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Popular EMT Industries

There are a number of highly popular EMT industries that you should choose to work in, each with slightly different job roles for the EMT:

• In the Ambulance Service you will be on the actual ambulance that responds to a medical emergency to provide first line support to the patient. In general an EMT working in this domain can earn around $8.44 – $14.72 an hour.

• EMTs also have the option of working in the Emergency Medical Services. This could also be on an ambulance as this qualifies as an emergency response system, or it could be in the emergency room of a hospital where patients are sent in an emergency. You will earn $8.44 – $14.72 an hour in this job.

• In Healthcare you will earn $8.75 – $15.23 an hour.

• If you work in a Hospital as an EMT you will earn something in the region of $9.03 – $15.81 an hour.

• Last but not least an EMT that works in Transportation earns something in the region of $8.63 – $15.52 an hour.

EMTs find these jobs to be the most rewarding jobs as they are given the opportunity to save lives. However these are also highly stressful EMT industries to be involved in as there is also an extremely high chance that you will lose your patients and that you will not be able to save their lives. However this is true for all EMT jobs, so a certain personality set is required to be a success in a job such as that.

Popular EMT Employers

There are also a number of popular employers within those industries that pay fairly good rates to their EMTs. If you choose to work as an EMT for American Medical Response, for example, the rate that you will be paid should be in the region of $9.69 – $17.62 an hour. This is by far the most popular employer for an EMT to work for. There are also several other fairly popular employers that you may want to consider as well:

• An EMT that works for Rural / Metro Ambulance service can expect to earn around $8.43 – $11.42 an hour.

• An EMT that works for AMR Corp can expect to earn around $10.29 – $13.85 an hour.

• An EMT that works for Acadian Ambulance Service Incorporated can expect to earn around $10.55 – $12.50 an hour.

• An EMT that works for Care Ambulance can expect to earn around $9.66 – $13.25 an hour.

So, although there are a number of popular EMT industries that you could look into, there are also specific employers within those industries that are, for varying reasons, more popular than other employers in the same industry. Do a bit of homework to see which industries and which employers are more popular in your area, but remember to also find out why they are popular. The hourly rate is not everything – you also need to consider additional benefits that are offered as well as the degree to which the EMTs employed there experience job satisfaction.

EMT Job Description And Characteristics

EMT industries are many and varied, but in most cases the EMT provides care in a pre-hospital setting. This means that you will be the first person to see the patient, and you will more often than not see them before they are taken into a hospital for further treatment. As an EMT you will be required to:

• Provide basic life support
• Perform patient assessment
• Engage in airway management
• Use the automatic defibrillator
• Assist patients with taking some of their own medications
• Drive the ambulance in a safe manner
• Have a thorough knowledge of the street, highway and addressing system
• Work under the direction of a Paramedic
• Assume a support role
• Understand all applicable legal, moral and ethical issues
• Be dedicated to continued learning

Working in any EMT industry requires that you have a certain set of personality requirements in order to handle the job properly. These are:

• The ability to accept the challenge and responsibility
• Excellent judgment
• The ability to prioritize decisions
• The ability to act quickly
• The ability to function at an optimum level in a non-structured environment that is constantly changing
• The ability to remain calm
• The ability to stay focused
• Good judgment
• Knowledge and technical skills
• Excellent verbal communication skills
• The ability to adapt to situations characterized by violence and emotional instability in multicultural settings
• Critical reasoning skills
• Self motivation

If you feel that you lack any of the above characteristics you should consider an alternative line of work.

Some Things EMTs Do On The Job

There are 12 man things that you, as an EMT, will be required to do on the job. Firstly you will have to communicate with dispatchers, the people who provide you with the information you need about the medical emergency that you are being called on to deal with. The dispatchers will also give you the location of the emergency. Secondly you will have to make your way to the scene of the accident or emergency where you will be required to assess the extent of the illness or injury from which the patient is suffering. Thirdly you will have to decide where to administer treatment. This depends on the severity of the patient’s condition.

If the injuries or illness is minor you will simply treat the patient in their own home or at the scene of the accident and not admit them to the hospital. If the injuries or the illness are severe you will be required to transport the patient to hospital. If it is necessary to take the patient to hospital you will be required to immobilize the patient. This means strapping or securing the patient to a stretcher so that he or she can be safely transported to the medical facility at which you are based. While you are on your way to the hospital and sometimes before you leave the scene from which you fetched the patent you will need to communicate with the hospital or medical care facility to which you are taking the patient. You will need to inform the medical facility of the patient’s condition and provide them with all of those details. You will receive further instructions regarding care of the patient, and you will provide the hospital with information regarding when you expect to arrive at the hospital. There are a number of pre-hospital treatments that you may have to perform before the patient gets to hospital.

Often you will perform these in the ambulance. These include things like administering intravenous medication, putting the patient on a drip, and using machinery found in the ambulance such as the EKG. A big part of what you do entails comforting the patient who will almost definitely be frightened by the situation that he or she is in. emergencies are often terrifying so it will be your responsibility, partially at least, to support the patient and try to allay his or her fears. As EMTs generally work in pairs or teams you may either be required to drive the ambulance or to be the EMT responsible for monitoring the patent’s vital signs or providing any treatment that has been deemed necessary. Both roles are equally important and both need to be taken very seriously. At times you may work with a helicopter team when a patient needs to be removed for a long distance away or when they have experienced the emergency in a place inaccessible by land based vehicles. Sometimes you will be the EMT that is based in the emergency room itself to ensure that everything is in order and ready to receive emergency victims at the drop of a hat.

Being an EMT will open a number of doors for you in terms of your future career. There are also, as you can see, a number of different industries that you can work in as well as a number of different employers that will hire you at very lucrative rates of pay. It is in your best interests to look into each f the different EMT industries that are available when applying for a job because, generally speaking, certain industries suit certain people better than others. Be wise in your decision making and think about the options carefully right from the start of your EMT training.

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