Emergency Medical Technicians Health Article

Definition

An emergency medical technician-paramedic is a licensed and/or certified out-of-hospital health-care provider. EMTs represent the uppermost level of prehospital health care providers and serve as managers of pre-hospital treatment teams. They work under the direction of a physician—often by two-way radio—to evaluate and manage acutely ill or injured patients in ambulance services or other life-support units.

Description

The emergency medical system is a complex emergency response structure that has strict guidelines for its certification levels of health professionals. Emergency medical technicians are classified under four levels of prehospital certification: First Responder; Emergency Medical Technician-Basic (EMT-B); Emergency Medical Technician-Intermediate (EMT-I), and Emergency Medical Technician-Paramedic (EMT-P). Education and training varies across the four levels, with the emergency medical technician-paramedic having the highest level of training. An emergency medical technician has developed independent reasoning and training to make rapid assessments and interventions that can save people's lives. The EMT-P is considered an extension of the emergency room physician to the patient in the field and has the greatest amount of responsibility.

Provision of initial treatment

The responsibilities of an emergency medical technician are numerous, demanding, and extremely stressful. The EMT's most common responsibilities are related to provision of initial treatment:

• Organization and preparation for emergency calls: Besides having all of the equipment stocked, ambulance maintained and cleaned, and communication devices checked, the emergency medical technician must be psychologically and emotionally prepared to care for distressed patients and family members.
• Immediate and safe response to the emergency scene by knowing the proper location and road systems while maneuvering a heavy and bulky ambulance through traffic.
• Assessment of the safety hazards at the emergency scene, including the safety of the crew, the victims, and the bystanders—as well as understanding the nature of the injuries or illnesses that may be encountered.
• Rapid and efficient evaluation of victims of trauma or illness, using advanced patient assessment skills while recognizing and assigning priority to the most critical injury or illness.
• Delivery of high-quality patient care while utilizing protocols for procedures and interventions established by the emergency medical technician agency, as well as recognizing the need for back-up by an emergency physician.
• Transportation of patients to appropriate institutions if the patients are unstable or needing specialty care (i.e. neurological trauma, cardiovascular intervention). The emergency medical technician makes the decision regarding the best facility for managing the patient's injury or illness.
• Keeping records of all assessment findings and interventions completed on the patient from the field to the receiving facility.

Other responsibilities

Over the years, the scope of the EMTs responsibilities has widened to include educating the public about health issues and participating in injury and disease prevention programs. EMTs are also playing an increasingly important role in medical and public health research programs.

Work settings

Emergency medical technicians can work in a variety of settings. Many EMTs work for ambulance agencies. On the other hand, emergency centers, sports facilities, long-term care facilities, and large industries are also employing emergency medical technicians to deliver health care.

Prerequisites

Educational requirements for emergency medical technicians differ slightly from state to state. Some EMT programs are designed to accommodate part-time students; others are structured as full-time college-level courses of study. The average length of training for EMTs is 1000 hours, but upgraded standards will probably add a small increase to the number of training hours over the next few years.

Persons considering an EMT-P program must be high school graduates and demonstrate their ability to meet the physical and psychological demands of emergency work. The physical demands are considerable, since EMTs must frequently lift and move patients away

from danger zones or into emergency vehicles, without time to call for assistance. Likewise, the sheer number of potential on-the-job hazards, ranging from toxic chemical spills or fire to collapsing buildings or human violence adds to the emotional stress of EMT work. In addition to demonstrating their physical stamina and emotional stability, persons entering an EMT-P program must be certified at the EMT-ambulance level. Some programs, however, offer a combination of EMT-ambulance and EMT-P training. Students who have acquired basic EMT training in the armed forces within the past 12 months and have had their work approved by a state agency may be permitted to enroll in an EMT-P program.