How to Become an EMT or Paramedic

Overview

Reviewed By Jody Carter, MS, CEM, NREMT-P
EMTs and paramedics in action

EMTs and paramedics provide vital emergency care to ill and injured patients before they reach the hospital or while being transported between facilities. As providers gain experience, there are growing opportunities within hospital emergency departments, as well as in community-based preventative care and education settings with the goal of preventing the need for a hospital visit. The swift and skilled response of EMTs and paramedics can often mean the difference between life and death for their patients.

The duties of EMTs and paramedics include:

  • Responding to emergency calls
  • Assessing patients and quickly formulating care plans
  • Stabilizing broken bones or spinal injuries so patients can be transported safely and comfortably
  • Providing life support such as CPR and airway management
  • Extricating patients who have become entrapped
  • Performing procedures within their scope of practice, such as wound bandaging, administering medications, or conducting and interpreting medical tests
  • Transporting patients to an appropriate facility, either by driving or providing care en route
  • Communicating with the receiving staff about the patient's condition and care plan
  • Working positively and professionally with other emergency personnel, such as fire, law enforcement, or emergency management personnel
  • Giving emotional support to patients or family members during times of stress or even death
  • Documenting the care given in the patient's medical record
  • Decontaminating equipment after every patient interaction
  • Monitoring for possible infectious diseases or at-risk situations and reporting them to the appropriate authorities
  • Maintaining equipment, vehicles and supplies.

While EMTs and paramedics perform similar job functions, paramedics have advanced training that allows them to perform more complex medical procedures. These professionals are commonly referred to collectively as "EMTs."

Due to growth of the elderly population, the need for qualified EMTs is increasing rapidly. While most of these professionals still work primarily in an emergency response capacity, a growing number are embracing new roles in home health care to include chronic disease management and preventative care. These "community" roles will likely expand in response to federal legislation that rewards proactive, coordinated care.

Most EMTs and paramedics find their jobs incredibly meaningful and rewarding. Their skill and decision-making can truly save the lives of some of their patients. By providing timely, appropriate care, they can also shorten patients' hospital stays and lessen the pain and disability that results from a serious injury or illness. EMTs take pride in caring for people during some of the most painful and difficult moments of their lives.

There is also a lot of down time and routine, nonemergency tasks that occupy the day of an EMT. The rapid and frequent swing of necessary mental prowess can lead to fatigue and burnout. The regular and repeated physical demands on EMTs can take a toll, with common injuries to knees and backs.

Work Environment

EMTs and paramedics work in a variety of settings:

  • Private ambulance companies, which account for almost half of all EMT jobs
  • Governments, often health districts or city fire departments
  • Hospitals, usually in an emergency department or urgent care setting.

Working as an EMT can be a full-time job, and about 30 percent work overtime. Some choose to use EMS as supplement income, working only nights or weekends. Traditional shifts run 12 or 24 hours and include evenings, weekends and holidays. In small towns and rural areas, EMTs might work a more irregular schedule or even on a volunteer basis.

The work of an EMT can be physically and mentally demanding. These professionals work outdoors in all types of weather. They must be comfortable working with a wide range of equipment and tools, including vehicles, medical equipment, hazardous materials and protective clothing.

EMTs are very collaborative and team-oriented. In addition to their squad mates, they often work alongside police officers, firefighters and dispatchers. They work under the authority and oversight of an emergency physician who conducts reviews of their work and provides input for improvement. In some cases, EMTs assist the emergency department physicians and nurses in caring for the patient upon arrival at the hospital.

EMTs and paramedics experience relatively high rates of on-the-job injuries due to frequent bending, kneeling, lifting, carrying heavy loads and entering dangerous situations. Their work can also expose them to infectious diseases such as HIV and hepatitis C. Agitated or violent patients are another workplace hazard. EMTs mitigate these risks by wearing protective clothing, following safety protocols and working collaboratively with police officers and firefighters.

Requirements

Education

Entry-level requirements for EMT work depend on the level of certification:

  • EMT certification requires about 150 hours of instruction in a certificate program. Training covers patient assessment, basic supportive care, equipment handling and emergency response.
  • Advanced EMT certification requires about 300 hours of instruction in a certificate program. The curriculum typically covers advanced life support, plus administration of some oral and IV medications.
  • Paramedics must earn EMT certifications and then complete an additional training program. This requires about 1,200 hours of formal instruction and might result in an associate’s or bachelor’s degree. Students learn advanced techniques like IV administration, intubation, suturing, and cardiac interpretation.

High school students interested in an EMT career should take as many science classes as possible, especially anatomy and physiology.

Technical schools, community colleges, universities, specialized EMT schools, health districts, hospitals and the military all offer EMT and paramedic training. To qualify for licensure, students must complete a training program accredited by the National Registry of Emergency Medical Technicians (NREMT).

Training

In addition to their classroom learning, EMTs and paramedics complete clinical rotations during their training program. Paramedics rotate through the various hospital departments much like medical students, and might include labor & delivery, surgery, and the intensive care unit.

EMTs can significantly enhance their resumes and job prospects by pursuing advanced skills training. A variety of options are available, including tactical combat casualty care, advanced life support, community-based care and driving courses.  Others use their time as an EMT to prepare them for further careers in the fire service, nursing, or emergency management.

EMTs and paramedics must engage in regular continuing education in order to renew their certifications/licenses.

Licensing and/or Certification

NREMT offers three levels of national certification for EMTs:

  • EMT (EMT)
  • Advanced EMT (NRAEMT)
  • Paramedic (NRP).

For each certification level, the candidate must complete an NREMT-accredited training program and pass a background check as well as cognitive (knowledge) and psychomotor (practical) exams.

In addition to certification, many states require the licensure of EMTs and paramedics, though exact requirements vary. In some states, NREMT certification is sufficient, while others require state-level certification. Some employers require both credentials, regardless of state minimums. Some states also require a state-administered exam and background check.

Necessary Skills and Qualities

To care for seriously ill patients, EMTs and paramedics rely on excellent reasoning and decision-making skills. They must be able to assess patients' needs quickly and accurately and plan for appropriate care. They often must attend to several pressing matters at once, such as the patient's condition, scene safety and communication with the receiving facility.

Physically, EMTs and paramedics need excellent strength and fitness to lift and carry heavy loads. They must be healthy enough to endure long work hours in harsh conditions.

Emotionally stability is an essential quality for EMTs. They must be able to remain calm in upsetting situations and when dealing with distressed patients, families or coworkers. A strong sense of empathy can help them connect with patients and ease their distress. EMTs also need excellent communication skills in order to relay information between the patient, colleagues and receiving care team.

Opportunities for Advancement

With appropriate training, EMTs may advance to become Advanced EMTs or paramedics. EMTs and paramedics who are also certified firefighters are in high demand in some locations and command good salaries. Many EMTs expand their horizons by following specialized career paths in tactical response, critical care transport and hospital-based emergency care. With appropriate education, EMTs and paramedics can serve as clinical instructors and professors within accredited training programs.

If you would like to gain the necessary education to become an EMT/Paramedic, we highly recommend that you check out our free School Finder Tool located HERE.

Salary and Job Outlook

Interactive Map of Income and Job Growth Projections

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According to the US Bureau of Labor Statistics, EMTs and paramedics earn a median salary of $31,700, which translates to a median hourly wage of $15.24. The highest paid 10 percent make more than $54,690, and the lowest paid 10 percent make less than $20,690.

Salary range varies considerably with training level. Paramedics - and in particular, paramedic firefighters - typically command the highest salaries. The type of employer also matters; private ambulance services usually pay less than hospitals and government entities. EMTs and paramedics who work in a unionized environment may be able to negotiate more favorable salaries and benefits through collective bargaining.

EMTs and paramedics should enjoy very good job prospects in the near future. According to the Bureau of Labor Statistics, employment is expected to grow by 23 percent between 2012 and 2022, considerably faster than average.

Demand for EMTs is largely driven by growth of the elderly population. Older people are more prone to serious medical conditions such as heart attacks and strokes that require emergency care. Recent growth in the number of specialized medical facilities is also a boon for EMTs, who are needed to transport patients to trauma centers, rehabilitation hospitals and skilled-nursing facilities.

Candidates can generally improve their job prospects by seeking advanced certification and training and by choosing a career path suited to their geographic location. For example, tactical combat response training might be more helpful in a large city, while community paramedicine training might be in demand in more rural areas.

NREMT's website maintains job listings for EMTs and paramedics. City, county, health district and hospital job boards are also a good source of job leads, as are job-specific publications and magazines.

Further Reading

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