Emergency Medical Technician

An Emergency Medical Technician is the person who is normally first on the scene when there is a medical emergency. EMTs are trained and undergo EMT Certification which equips them to handle various emergency situations, to save lives, and to stabilize patients until they can get them to a hospital. Emergencies happen at any time of the day or night a when that 911 call comes in there are many EMTs who are ready to answer and once again rush out to the accident, drowning, fire, natural disaster or medical emergency.

EMTs are the first line of defence in any emergency situation and it is only thanks to them that many people are still alive today. They attend to the problem, stabilize the patient and transfer them to a hospital by ambulance or even by helicopter sometimes. The EMT will stay with the patient and make sure they are stabilized on the way to the hospital and until they can safely hand them over to other medical professionals.

In order to become an EMT one needs to undertake training in various medical and emergency life-saving disciplines including driving, and have a particular kind of personality. Once the training has been completed EMT certification needs to take place before one can practise as an Emergency Medical Technician.

Skills & Abilities Required By An Emergency Medical Technician

Apart from the legal requirements needed to become an EMT, you also require various personality characteristics such as the ability to deal with stress and some very important skills and abilities which are integral to the work that is done by EMTs.

EMT Skills And Abilities

• Fitness - You will need to be in excellent physical shape as an EMT does a lot of running, bending, kneeling, and heavy lifting.

• Physical - Apart from strength, an EMT needs agility, dexterity, and good physical coordination.

• Sight - You need to have excellent full-color eyesight, although corrective lenses are allowed.

• Deductive Reasoning - You must be able to apply universal rules to specific problems to arrive at logical, sensible solutions.

• Inductive Reasoning - This is the ability to connect isolated facts by a general hypothesis and form universal principles and expectations. This also includes being able to logically explain why seemingly random events occur simultaneously.

• Oral Comprehension & Expression - The ability to understand and convey the spoken and written word so that it is understandable to others.

• Problem Sensitivity - The ability to recognize that there is a problem or that there is the possibility of a problem occurring.

• Active Listening - An Emergency Medical Technician deals with people who are in distress or have just undergone a traumatic experience and may be in shock. It is crucial that the EMT listen carefully to what they are being told and can ask questions where necessary.

• Coordination - EMTs work with a partner and often in conjunction with other emergency personnel, so it is vital that they are quickly able to adjust their actions in relation to another's actions; it could save lives.

• Critical Thinking - Thinking on one's feet is an adage which strongly applies to emergency situations which can change very quickly. EMTs need to be able to apply logical thinking and analysis to any given situation in order to discern which course of action is best in various situations.

• Equipment Selection - Speed is of the essence in an emergency situation, and this means that the EMT needs to quickly assess the situation and determine which equipment is required in that particular situation.

If you have your high school diploma and feel that you have all of the above skills and abilities and the right kind of temperament and personality characteristics, then you have passed the first step on your way to becoming an EMT. The next thing that you have to do is to do some research as to what type of training you wish to do and where you want to do your training.

Emergency Medical Technician – Duties

The Emergency Medical Technician does a sterling job in saving lives, and it the skills and abilities that they learn and the desire to help those who are experiencing trauma that many patients who are involved in car accidents, drive-by shootings, violent assaults, strokes, heart attacks and natural disasters survive.

The duties of an EMT are as follows:

1. Non-Medical

• Legal Aspects - EMTs must have a good knowledge of legal aspects of emergency treatment and knowing when to provide and when to withhold treatment.

• Communication - Written and verbal communication skills are critical for EMTs. Effective communication is not always easy with a patient who has experienced trauma, but an EMT needs to be able to gather information from patients and relay it to others.

• Protocol - Communication and dispatch protocol it of great importance when dealing with emergency situations and EMTs must be able to handle it.

• Driving - EMTs are trained in defensive and emergency driving techniques as they need to transport patients as quickly as possible.Ambulance - Once a patient has been handed over to the hospital or clinic, the EMT ensures that the ambulance is cleaned and disinfected if necessary so that it is ready for the next call, and supplies are replenished.

2. Basic Life Support

• Wounds - Treating wounds, administering emergency medication and inserting intravenous drips are all within the scope of EMTs.

• CPR - All EMTs are trained in CPR and other life support methods.

• Shock - Traumatic incidents tend to cause people to go into shock; all Emergency Medical Technician personnel are trained to deal with patients in shock.

• Cardio Problems - Emergency Personnel are trained in how to support a patient who has suffered from a heart attack.

• Poisoning - Children very often ingest poisons accidentally, and EMTs are trained on how to deal with poisoning.

• Bleeding - The staunching and control of excessive bleeding in order to prevent further damage or death is one of the EMT duties.

3. Non-Life-Threatening Care

• Sports injuries - many sports injuries can be quite traumatic and require immediate emergency attention.

• Broken Bones - often occur in an accident or sports injury and need to be attended to; the EMT will apply a splint.

• Equipment - such as stretchers, backboards, and neck braces are all part of the EMT toolbox and they are trained in their use amongst others.

• Burns - and cuts and Abrasions are just another part of an EMTs duties as part of emergency treatment.

• Child-birth - is something that does not always happen on schedule and can be brought on by emergency situations and trauma. All EMTs are trained in child-delivery and newborn care.

Becoming an EMT

There are 3 different levels of EMT and courses are offered by different types of training institutions and colleges. When deciding at which school to do your EMT course there are four things to take into consideration; EMT certification, the time-frame involved in the training, graduate employment statistics and financial considerations.

1. EMT-Basic Training

• The Basic course consists of approximately 120 hours of classroom training and 180 hours of practical fieldwork which is often completed under the direction of a more senior EMS or other medical staff in a hospital emergency department.

• The EMT-B course covers the most basic emergency treatment skills such as how to assess a patient, how to manage trauma, respiratory problems and how to deal with cardiac emergencies, Obstetrics emergency care, Advance first aid, Patient assessment, and Patient transport techniques.

• Instruction is also given on how to handle bleeding, bandaging, splints, clearing an airway obstruction, cardiac arrest, childbirth and handling a newborn and fractures.

• Emergency equipment is key in emergency situations and handling equipment such as backboards, oxygen delivery systems, splints, stretchers and suction devices forms an integral part of the EMT Basic training.

• EMT-B course also covers Human biology, Anatomy, Medical terminology , Physiology, Trauma injury treatment procedures, Paediatric emergency care, Cardiac emergency care, Respiratory emergency care, Hazardous material management, Ambulance operations, and Mass causality operations.

2. EMT-Intermediate Training

• EMT I training takes between 30 and 350 hours depending on the scope of practice in the state in which you intend to get your certification.

• EMT I training is more advanced than EMT B training and covers some of the same information albeit in finer detail.

• The EMT Intermediate Training Module I: PREPARATORY covers Foundations of EMT-Intermediate 1, Overview of Human Systems, Emergency Pharmacology, Venous Access and Medication Administration.

• The EMT Intermediate Training Module I: AIRWAY covers Airway Management and Ventilation.

• The EMT Intermediate Training Module III: PATIENT ASSESSMENT covers History Taking, Techniques of Physical Examination, Patient Assessment, Clinical Decision Making, Communications, and Documentation.

• The EMT Intermediate Training Module IV: TRAUMA covers Trauma Systems and Mechanism of Injury, Haemorrhage and Shock, Burns, Thoracic Trauma, and Trauma Practical Laboratory.

• The EMT Intermediate Training Module V: MEDICAL covers Respiratory Emergencies, Cardiovascular Emergencies, Environmental Emergencies, Diabetic Emergencies, Behavioral Emergencies, Allergic Reactions, Poisoning/Overdose Emergencies, Gynaecological Emergencies, Neurological Emergencies, and Non-Traumatic Abdominal Emergencies.

• The EMT Intermediate Training Module VI: SPECIAL CONSIDERATIONS covers Assessment Based Management.

• The final item in the intermediate training is clinical rotations.

3. Paramedic Training

• This is the most advanced of the Emergency Medical Services courses and it can take between 12 and 24 months of study at a college or technical school.

• The Paramedic training consists of 8 modules and each module contains 52 sections. Each section contains the following components.

• Preparatory - EMS Systems, The Roles and Responsibilities of the Paramedic, The Well-Being of the Paramedic, Illness and Injury Prevention, Medical/Legal Issues, Ethics, General Principles of Pathophysiology, Pharmacology, Life Span Development, Venous Access and Medication Administration, Therapeutic Communications.

• Medical - Pulmonary, Cardiology, Neurology, Endocrinology, Allergies and Anaphylaxis, Gastroenterology, Renal/Urology, Toxicology, Haematology, Environmental Conditions, Infectious and Communicable Diseases, Behavioral and Psychiatric Disorders, Gynaecology, Obstetrics.

• Patient Assessment - History Taking, Techniques of Physical Examination, Patient Assessment, Clinical Decision Making, Communications, Documentation.

• Trauma -Trauma Systems/Mechanism of Injury, Haemorrhage and Shock, Soft Tissue Trauma, Bums, Head and Facial Trauma, Spinal Trauma, Thoracic Trauma, Abdominal Trauma, Musculoskeletal Trauma.

• Special Considerations - Neonatology, Paediatrics, Geriatrics, Abuse and Assault, Patients with Special Challenges, Acute Interventions for the Chronic Care Patient.

• Assessment Based Management Operations - Ambulance Operations, Medical Incident Command, Rescue Awareness and Operations, Hazardous Materials Incidents, Crime Scene Awareness.

• Lifelong Learning - Continuing Education

EMT Requirements

If you are interested in becoming an EMT, you should take note of the EMT requirements for this type of job. The main non-legal requirement is that you have an interest in the medical field but either do not want to, or cannot for some reason, study to become a doctor or a nurse. An Emergency Medical Technician performs a vital task in society and it is a very honorable profession. There are set legal EMT requirements which need to be met in order for you to become a Certified EMT.

Requirements for becoming an EMT:

• Age - You need to be at least 18 years of age to apply for basic EMT training.

• High School - You need a high school diploma or your GED.

• EMT-Basic course - This is the first step to becoming a qualified Emergency Medical Technician. You need to have completed a state-approved EMT Basic course which is in compliance with the US Department of Transportation EMT-Basic National Standard Curriculum. You must have completed the course within the previous two years and this must be verified on the NREMT website by the Program Director. If it is longer than 2 years since you have completed your course but you have maintained state licensure at EMT level, documentation verifying completion of an EMT-Basic / EMT refresher training program within the previous two years must be submitted.

• Psychomotor Exam - You must have successfully completed the state-approved EMT-Basic / EMT psychomotor exam.

• CPR credential - The Program Director must verify that you hold a current Cardio Pulmonary Resuscitation credential for healthcare providers and have demonstrated that you are competent in EMT-Basic / EMT skills.

EMT Certification Process

In order to apply for the National EMT-Basic/EMT certification you need to have completed both the cognitive and psychomotor exams. Any portions of the exams which you have passed remain valid for 12 months.

Cognitive Examination

The National Registry of Emergency Medical Technicians EMT-Basic /EMT cognitive exam is a computer adaptive test (CAT). You can expect to get between 70 and 120 items on the EMT-Basic/EMT exam. You will have two hours in which to complete the exam.

The exam covers the entire scope of Emergency Medical Technician care including Cardiology, Oxygenation, Medical, Ventilation, Trauma, Airway, and EMS Operations. 85% of the items that you will be tested on related to patient care will be focused on adult patients, and the remaining 15% on paediatric patients. The passing standard of this exam is defined by the ability of the applicant to provide effective and safe entry-level emergency medical care.

Cognitive Examination Retesting

In the event that you do not pass the exam on the first try, the NREMT will provide feedback so that you can see where your weaknesses are and you will be able to apply to be retested 15 days after your previous examination.

You are afforded 6 chances to pass the cognitive examination if all other requirements for National EMS Certification have been met. You will have to do 24 hours of remedial training after the third attempt, and provide official verification thereof.

You will then be given an additional three tries at passing, as long as all other requirements for National Certification are met. If you cannot pass after 6 attempts you will have to repeat the entire EMT-Basic / EMT course.

Psychomotor Examination

You will be required to demonstrate competence in a diverse range of emergency care skills throughout your EMT-Basic/EMT educational program. Your program instructor will have to attest to the fact that you are competent in patient assessment/management of a trauma patient, patient assessment/management of a medical patient, long bone fracture immobilization, bleeding control/shock management, mouth-to-mouth ventilation with supplemental oxygen, and supplemental oxygen administration to a breathing patient, cardiac arrest management/AED, spinal immobilization (both seated and supine patient), joint dislocation immobilisation, bag-valve-mask ventilation of an apnoeic patient, upper airway adjuncts and suction, and traction splinting.

Expiration Date & Lapsed EMT Certification

EMT Certification needs to be renewed every two years, and the expiration date depends on the date of successful completion of the entire process.

If your EMT-Basic/EMT National EMS Certification lapsed within a 2-year period, or you do not have a National license but are state-licensed as an EMT-Basic/ EMT, you can complete a state-approved Refresher Course, including the psychomotor and cognitive examinations in order to obtain National EMS Certification.

If it is longer than two years since your EMS certification has expired, you will need to re-do the entire state-approved EMT-Basic/EMT course and complete the psychomotor and cognitive examinations again too.

There are two different options for completing an EMT-Basic/EMT refresher course:

1. The Traditional refresher course, which is an approved DOT National Standard EMT-Basic / EMT Refresher Course.
2. Continuing education topical hours - you can completer a refresher course via continuing education which must include the topics and hours listed below:

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Some states do not recognize the continuing education hours method and insist on the traditional refresher course - you will have to check the requirements in your state. A maximum of 10 hours CECBEMS-approved Distributive Education can be applied to refresher education.

EMT-Basic / EMT Re-certification

By applying for re-certification, certified EMS professionals implicitly agree to comply with all rules, standards and re-certification requirements of the National Registry of Emergency Medical Technicians. It is incumbent on the applicant to demonstrate and maintain compliance at all times.

The steps required for re-certification can be found on the National Registry of Emergency Medical Technicians website.

ADA Compliancy

The National Registry of Emergency Medical Technicians is fully compliant with the Americans with Disabilities Act of 1990, and offers certain accommodations for those with disabilities. Pearson VUE test centers also comply with the ADA.

Disciplinary Policy and Rights of Appeal

The National Registry of Emergency Medical Technicians has policies regarding disciplinary procedures, rights of appeal and due process, and full details of the NREMT Disciplinary Policy and Rights of Appeal can be found on their website. An appeal request must be submitted within 45 days of receiving the notice of determination.

Responsibilities of Certified EMT-Basic/EMT

It is the responsibility of each Emergency Medical Technician and paramedic to notify the Registry of Emergency Medical Technicians within 30 days of the occurrence of any of the following:

• A change in their mailing address.

• A conviction for a felony.

• Disciplinary action taken by any state which has resulted in the expiration, revocation, or suspension of their state registration/licensure; any voluntary surrender of state registration/licensure while under investigation, or termination of right to practice.

EMT Certification Inactive Status

EMS providers and Educators, administrators or regulators who are not directly providing patient care may request an inactive status be applied to their EMT Certification due to illness, moving, family responsibilities, pursuit of education and so forth.

One must meet all the re-certification requirements except affiliation with an EMS provider in order to be eligible for inactive status. Inactive status may only be requested within the first re-certification cycle if you did perform EMS provider duties for a minimum of six months. Inactive status must be reapplied for every two years if you wish to continue your national certification.

In order for your EMT Certification to be reactivated to active status you will need your skills competency and affiliation with an EMS agency to be verified in writing.

The National Registry of Emergency Medical Technicians holds each Emergency Medical Technician and Paramedic responsible for ensuring that their EMT Certification is current.