Chapter 1
Becoming an Emergency Medical Technician
In This Chapter
Renewing your EMT certification
Welcome to the world of emergency medical services, or EMS! This is a noble profession. The training is challenging, the work unpredictable, and you wonāt become rich performing the job. But you will have the privilege of helping people when they need it the most ā when doing the right thing at the right time may very well save a life. Even in instances when the job isnāt that dramatic, the simple care, comfort, and words of reassurance you provide may be all someone needs to feel better.
This chapter gives you the basics on what EMTs do, how to become one, and how to maintain your certification.
Understanding What Being an EMT Means
An emergency medical technician, or EMT, provides a basic level of emergency and non-urgent patient care. Some EMTs are paid for their work, while others volunteer their time, especially in more rural parts of the United States. In most states, the EMT is the minimum level of training required to provide ambulance transportation or care for the patient in the ambulance. The following sections explain what EMTs do, where they work, and the value of EMT training.
Note: The profession is transitioning from using the older term EMT-Basic (EMT-B) to simply EMT. This book uses the term EMT, but you can assume that the two terms are interchangeable.
What does an EMT do?
The EMT is one component of an EMS system, which may use other trained prehospital professionals to care for patients as well. The four general levels of EMS providers in the United States are
- Emergency medical responder (EMR): 48ā60 hours of training. An EMR provides minimum, basic first aid. Lifeguards, police officers, and some firefighters are often required to have this certification.
- Emergency medical technician (EMT): 120ā180 hours of training. This level serves as the foundation for higher certification levels. An EMT provides basic emergency care, such as oxygen administration, spinal immobilization, and splinting. Many states require this certification as a minimum to work as a staff member on an emergency ambulance. Many firefighters and police officers also earn EMT certification so that they can perform basic emergency care as part of their duties.
- Advanced emergency medical technician (AEMT): 160ā300 hours of training beyond EMT. This training can vary quite widely from one state to the next. In addition to the skill set of the EMT, AEMTs may perform intravenous therapy, administer a limited set of medications, and manage a patientās airway at a higher level than an EMT.
- Paramedic: 1,100 hours or more of training beyond EMT. In addition to the skill set of the AEMT, the paramedic receives more information about human anatomy and physiology, the pathophysiology of disease, and trauma, and can administer a greater array of emergency medications. Paramedics can insert endotracheal tubes to help patients breathe and perform various types of electrical therapy to help heart rhythm disturbances.
In the majority of states, you have to be certified first as an EMT before taking on additional training to become an AEMT or paramedic. All EMS providers function under medical direction; usually a physician oversees the clinical practice of each level of responder.
An EMT does a patient assessment, which includes taking the patientās history and vital signs, and performing a physical examination. The care an EMT provides includes oxygen administration, artificial ventilation, cardiopulmonary resuscitation (CPR), splinting of broken bones, and immobilization for spinal injuries. EMTs are trained to assist patients with specific types of emergency medication that are prescribed for them, such as nitroglycerin for chest pain, an inhaler for breathing difficulties, and an epinephrine autoinjector (EpiPen) for anaphylaxis, a severe, life-threatening allergic reaction. Some states permit EMTs to do more procedures, such as monitor oxygen levels in the blood (oximetry), test blood glucose levels (glucometry), and administer certain emergency drugs.
Because the practice of the EMT isnāt consistent throughout all states, the test questions donāt evaluate your knowledge of things like glucometry. The questions assume only that you were taught to the foundational level as determined by the EMS National Scope of Practice, which is a federal document that describes what each level of EMS provider is permitted to perform. You can see this document at
www.ems.gov/education/EMSScope.pdf.
Where do EMTs work?
EMTs traditionally work in ambulances, caring for and transporting patients from one location to the next: from a hospital bed to the personās home, from an emergency care scene to a hospital, or even from one hospital to another.
In emergency response systems, an EMT may work alongside another EMT, or partner with a more advanced level provider such as an AEMT or paramedic. Firefighters and police officers who are EMT-certified may respond to an emergency call and arrive sooner than the ambulance that may be farther away.
You often find EMTs working as part of an emergency-department team or working at a clinic. Itās not unusual for the EMT to receive additional training in skills such as phlebotomy (blood draws) or recording a patientās electrocardiogram (tracing of the heartās electrical activity).
Wilderness and search-and-rescue teams often deploy EMTs because their skill set is ideal for providing care in remote areas. As in the hospital or clinic setting, EMTs may receive more training to better handle these conditions.
Can you use EMT training for other purposes?
Many students become EMTs to help prepare them for a career in the healthcare field. The information is valuable and serves as a foundation to build upon. EMTs go on to become AEMTs, paramedics, nurses, physician assistants, doctors, or other allied health professionals.
Even if youāre not planning to further your education or pursue a career as an EMT, the training you receive is invaluable. Learning to stay calm, manage a scene, and provide basic care in a medical emergency makes you a more valued member of society.
Walking through the Steps of Becoming an EMT
As you find out in the following sections, you need to complete a few steps before you can apply your skills and knowledge as an EMT. Note: Because emergency medical services are regulated at the state level, these steps can vary from one state to the next. Always check your stateās EMS website for the details.
Finding and completing a class
EMT classes are conducted by a wide variety of institutions. Your local community college may offer the class for college credit. Hospitals may also provide the training. The local EMS agency or fire department may offer the course, especially if itās to help train volunteers. Private organizations provide the training as well.
Searching online usually yields a list of classes closest to you. You can also check your stateās office of EMS to see whether it offers a listing of approved training programs. If you feel adventurous, try visiting your local EMS or fire station and introduce yourself to the EMTs on duty. Ask whether they have any suggestions or recommendations on where to take a course.
After you find a class that meets your needs, you complete your training program. This means passing all the test...
