Challenging
Exam:
Some Welcome Back Participants
are eligible to simply challenge the EMT exam and quickly become
certified to work as an EMT. Upon certification participants can
chose to step up into the Trauma Tech position. For more information
on how to challenge you may contact the Welcome Back Center to set
up an appointment with an Educational Case Manager.
Emergency
Room Technician: Nature
of the Work
People's
lives often depend on the quick reaction and competent care of emergency
medical technicians (EMTs) and paramedics, EMTs with additional
advanced training to perform more difficult pre-hospital medical
procedures. Incidents as varied as automobile accidents, heart attacks,
drownings, childbirth, and gunshot wounds all require immediate
medical attention. EMTs and paramedics provide this vital attention
as they care for and transport the sick or injured to a medical
facility.
The specific
responsibilities of EMTs and paramedics depend on their level of
qualification and training. To determine this, the National Registry
of Emergency Medical Technicians (NREMT) registers emergency medical
service (EMS) providers at four levels: First Responder, EMT-Basic,
EMT-Intermediate, and EMT-Paramedic. Some States, however, do their
own certification and use numeric ratings from 1 to 4 to distinguish
levels of proficiency.
The lowest level—First
Responders—are trained to provide basic emergency medical
care because they tend to be the first persons to arrive at the
scene of an incident. Many firefighters, police officers, and other
emergency workers have this level of training. The EMT-Basic, also
known as EMT-1, represents the first component of the emergency
medical technician system. An EMT-1 is trained to care for patients
on accident scenes and on transport by ambulance to the hospital
under medical direction. The EMT-1 has the emergency skills to assess
a patient's condition and manage respiratory, cardiac, and trauma
emergencies.
The EMT-Intermediate
(EMT-2 and EMT-3) has more advanced training that allows administration
of intravenous fluids, use of manual defibrillators to give lifesaving
shocks to a stopped heart, and use of advanced airway techniques
and equipment to assist patients experiencing respiratory emergencies.
EMT-Paramedics (EMT-4) provide the most extensive pre-hospital care.
In addition to the procedures already described, paramedics may
administer drugs orally and intravenously, interpret electrocardiograms
(EKGs), perform endotracheal intubations, and use monitors and other
complex equipment.
Working Conditions
EMTs
and paramedics work both indoors and outdoors, in all types of weather.
They are required to do considerable kneeling, bending, and heavy
lifting. These workers risk noise-induced hearing loss from sirens
and back injuries from lifting patients. In addition, EMTs and paramedics
may be exposed to diseases such as Hepatitis-B and AIDS, as well
as violence from drug overdose victims or mentally unstable patients.
The work is not only physically strenuous, but also stressful, involving
life-or-death situations and suffering patients. Nonetheless, many
people find the work exciting and challenging and enjoy the opportunity
to help others.
EMTs and paramedics employed
by fire departments work about 50 hours a week. Those employed by
hospitals frequently work between 45 and 60 hours a week, and those
in private ambulance services, between 45 and 50 hours. Some of
these workers, especially those in police and fire departments,
are on call for extended periods. Because emergency services function
24 hours a day, EMTs and paramedics have irregular working hours
that add to job stress.
Employment
EMTs
and paramedics held about 172,000 jobs in 2000. Most career EMTs
and paramedics work in metropolitan areas. There are many more volunteer
EMTs and paramedics, especially in smaller cities, towns, and rural
areas. They volunteer for fire departments, emergency medical services
(EMS), or hospitals and may respond to only a few calls for service
per month, or may answer the majority of calls, especially in smaller
communities. EMTs and paramedics work closely with firefighters,
who often are certified as EMTs as well and act as first responders.
Full- and part-time paid
EMTs and paramedics were employed in a number of industries. About
4 out of 10 worked in local and suburban transportation, as employees
of private ambulance services. About 3 out of 10 worked in local
government for fire departments, public ambulance services and EMS.
Another 2 out 10 were found in hospitals, where they worked full
time within the medical facility or responded to calls in ambulances
or helicopters to transport critically ill or injured patients.
The remainder worked in various industries providing emergency services.
Training, Other Qualifications, and Advancement
Formal
training and certification is needed to become an EMT or paramedic.
All 50 States possess a certification procedure. In 38 States and
the District of Columbia, registration with the National Registry
of Emergency Medical Technicians (NREMT) is required at some or
all levels of certification. Other States administer their own certification
examination or provide the option of taking the NRMET examination.
To maintain certification, EMTs and paramedics must reregister,
usually every 2 years. In order to re-register, an individual must
be working as an EMT or paramedic and meet a continuing education
requirement.
Training is offered at
progressive levels: EMT-Basic, also known as EMT-1; EMT-Intermediate,
or EMT-2 and EMT-3; and EMT-paramedic, or EMT-4. The EMT-Basic represents
the first level of skills required to work in the emergency medical
system. Coursework typically emphasizes emergency skills such as
managing respiratory, trauma, and cardiac emergencies and patient
assessment. Formal courses are often combined with time in an emergency
room or ambulance. The program also provides instruction and practice
in dealing with bleeding, fractures, airway obstruction, cardiac
arrest, and emergency childbirth. Students learn to use and maintain
common emergency equipment, such as backboards, suction devices,
splints, oxygen delivery systems, and stretchers. Graduates of approved
EMT basic training programs who pass a written and practical examination
administered by the State certifying agency or the NREMT earn the
title of Registered EMT-Basic. The course also is a prerequisite
for EMT-Intermediate and EMT-Paramedic training.
EMT-Intermediate training
requirements vary from State to State. Applicants can opt to receive
training in EMT-Shock Trauma, where the caregiver learns to start
intravenous fluids and give certain medications, or in EMT-Cardiac,
which includes learning heart rhythms and administering advanced
medications. Training commonly includes 35 to 55 hours of additional
instruction beyond EMT-Basic coursework and covers patient assessment,
as well as the use of advanced airway devices and intravenous fluids.
Prerequisites for taking the EMT-Intermediate examination include
registration as an EMT-Basic, required classroom work, and a specified
amount of clinical experience.
The most advanced level
of training for this occupation is EMT-Paramedic. At this level,
the caregiver receives additional training in body function and
more advanced skills. The Paramedic Technology program usually lasts
up to 2 years and results in an associate degree in applied science.
Such education prepares the graduate to take the NREMT examination
and become certified as an EMT-Paramedic. Extensive related coursework
and clinical and field experience is required. Due to the longer
training requirement, almost all EMT-Paramedics are in paid positions.
Refresher courses and continuing education are available for EMTs
and paramedics at all levels.
EMTs and paramedics should
be emotionally stable, have good dexterity, agility, and physical
coordination, and be able to lift and carry heavy loads. They also
need good eyesight (corrective lenses may be used) with accurate
color vision.
Advancement beyond the
EMT-Paramedic level usually means leaving fieldwork. An EMT-Paramedic
can become a supervisor, operations manager, administrative director,
or executive director of emergency services. Some EMTs and paramedics
become instructors, dispatchers, or physician assistants, while
others move into sales or marketing of emergency medical equipment.
A number of people become EMTs and paramedics to assess their interest
in healthcare and then decide to return to school and become registered
nurses, physicians, or other health workers.
Job Outlook
Employment
of emergency medical technicians and paramedics is expected to grow
faster than the average for all occupations through 2010. Population
growth and urbanization will increase the demand for full-time paid
EMTs and paramedics rather than for volunteers. In addition, a large
segment of the population—the aging baby boomers—will
further spur demand for EMT services, as they become more likely
to have medical emergencies. There will still be demand for part-time,
volunteer EMTs and paramedics in rural areas and smaller metropolitan
areas. In addition to job growth, openings will occur because of
replacement needs; some workers leave because of stressful working
conditions, limited advancement potential, and the modest pay and
benefits in the private sector.
Most opportunities for
EMTs and paramedics are expected to arise in hospitals and private
ambulance services. Competition will be greater for jobs in local
government, including fire, police, and independent third service
rescue squad departments, where salaries and benefits tend to be
slightly better. Opportunities will be best for those who have advanced
certifications, such as EMT-Intermediate and EMT-Paramedic, as clients
and patients demand higher levels of care before arriving at the
hospital.
Earnings
Earnings
of EMTs and paramedics depend on the employment setting and geographic
location as well as the individual's training and experience. Median
annual earnings of EMTs and paramedics were $22,460 in 2000. The
middle 50 percent earned between $17,930 and $29,270. The lowest
10 percent earned less than $14,660, and the highest 10 percent
earned more than $37,760. Median annual earnings in the industries
employing the largest numbers of EMTs and paramedics in 2000 were:
Local government $24,800
Hospitals 23,590
Local and suburban transportation 20,950
Those in emergency
medical services who are part of fire or police departments receive
the same benefits as firefighters or police officers. For example,
many are covered by pension plans that provide retirement at half
pay after 20 or 25 years of service or if disabled in the line of
duty.
