Facts About The Different EMT Levels

Emergency Medical Technicians (EMT) are also sometimes called Emergency Medical Response (EMR) or Emergency Medical Service (EMS) personnel. There are basically three main EMT levels; EMT-Basic, EMT-Intermediate/Advanced and Paramedic. Each level requires intensive training which imbues the individual with advanced medical knowledge and skills. After completion of the training required for each of the EMT levels the individual must obtain certification and register with the National Registry of Emergency Medical Technicians (NREMT). An EMT must be re-certified every 2 to 3 years.

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 Levels

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.

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