Emergency Medical Technician Info

EMT’s
Emergency Medical Technician
In the Spirit of Florence Nightingale
An overview

The term Emergency Medical Technician applies to a group of healthcare professionals who are thoroughly trained to provide emergency medical service prior to hospital admittance. Although this broad stroke generic classification varies with jurisdiction, the service is usually performed within strict guidelines and under the supervision of physicians and acceptable protocols. As first responders, EMT’s can be found in the ambulance service, fire, police departments and rescue teams or squads.

 

This community of care givers are trained to assess a patient’s physical condition and perform emergency medical procedures that include; maintain breathing and cardiovascular circulation, ensuring an open airway, cardiopulmonary resuscitation, defibrillation, severe bleeding control, prevention of spinal damage through immobilization, splinting in cases of bone fractures and shock prevention. The emergency care given by EMT’s is generally performed upon discovery at the scene and during transfer to a facility for advanced medical care.

This professional discipline makes a critical contribution to the chain of survival.

The most recognizable EMT providers are Paramedics, those who conduct pre hospital medical services from the platform of an ambulance. They have been glorified in movies and Television shows on countless occasions thus raising their profile, but there are others working in similar capacities that are just as deserving as well. Skill level certification is the benchmark that allows EMT’s to provide increasingly complex medical services as they treat their patients.

In North America, standardization of skill level training is now offered in 46 States under the banner of The National Registry of Emergency Medical Technicians (NREMT) www.nremt.org and must meet or exceed the minimum requirements as set out by the National Highway Traffic Safety Administration. (NHTSA) www.nhtsa.gov

Certification/Levels of EMT’s

Individual States and Canadian Provinces currently set their own certification standards and generally recognize four levels of proficiency. They include,

  • Basic EMT-B
  • Intermediate EMT-I/85
  • Intermediate EMT-I/99
  • Paramedic EMT-P

Recognition of AP (Advanced Practice) and CCP (Critical Care Paramedic) certification is accepted in some States as a higher level of qualification beyond that of Paramedic. Advanced training is also available leading to accreditation as a Wilderness Paramedic and Flight Paramedic practitioners.

By 2014, a new rating system will be implemented and replace the current fragmented system. The purpose is to have universal qualification and acceptable standards, nation wide, rolled into new names for classification. No longer will the same job have a different name or set of qualifications from State to State.

For example, a first responder will become Emergency Medical Responder, EMT Basic becomes Emergency Medical Technician, EMT Intermediate 85 changes to Advanced Emergency Medical Technician and finally EMT Intermediate 99 and EMT paramedic becomes Paramedic.

EMT Basic is the entry-level qualification for practice allowing the practitioner to perform a number of non-invasive tasks. These include,

  • Control of bleeding
  • Positive pressure ventilation using a bag valve mask
  • Nasopharyngeal airway and opharyngeal supplemental oxygen administration
  • Splinting including total spinal immobilization
  • Administering some prescription medications for example epinephrine/anaphylactic shock – use of an EpiPen

Certification, training and protocols vary State to State.

Intermediate level EMTs have qualified through more rigorous training programs and fall between the EMT Basic program and that of Paramedic.

Currently the two levels that exist are EMT-I-85 and EMT-I-99. Once again, depending upon the State, the name and qualifications can change.

For EMT-I-85, advanced training allows for more invasive emergency medical care and can include IV therapy, multi-lumen airway devices and in some areas, endotracheal intubation. The I-85 classification also provides training in advanced assessment skills.

EMT-I-99 classification allows for an even more expanded scope of practice and represents a higher level of training than I-85 practitioners. With completion of additional training time, I-99 graduates are qualified to administer more pharmaceutical interventions and perform cardiac monitoring within their skill set.

EMT Paramedics represent the highest level of pre-hospital medical provider except in those cases where a physician might be in attendance. The additional training leading to inclusion in this classification qualifies the practitioner to perform even more advanced procedures. Fluid resuscitation, IV access, cardiac monitoring and pharmaceutical administration are all part of the duties performed by Paramedics along with their greater assessment capabilities.

Ambulance unit classification

Just as the personnel that staff an ambulance have various levels to describe their capability, so to does the designation of the ambulance unit.

A BLS unit, (Basic Life Support), would have only EMT-Bs manning that facility. ILS, (Intermediate Life Support) would have a practitioner qualified in that discipline. Advanced Life Support or ALS has a crew with at least one member being a qualified Paramedic. Ambulance teams operate at the highest level of EMT certification on board.

Education and Training

Certification for the various levels of EMT like so much else about this profession, varies from State to State but both National and Local requirements must be met. These certification minimums include,

  • 110-120 hours of training for EMT Basic
  • 200-400 hours of training for EMT Is
  • 1,000 hours or more for certification as a Paramedic

Continuing education/refresher course hours are required to maintain NREMT certification. For example, in the case of EMT-B personnel, 48 more hours of training/education must be completed in order to maintain certification.

A more detailed look at the Emergency Medical Technician profession can be found on the following pages. This overview is advanced to hi-light basic information about EMTs.

As previously stated a career in this business plays a critical role in the chain of survival when conditions dictate an emergency response.