Are you familiar with the people running the stretchers through the door and shouting numbers at the doctors on the television show “ER”? Those are paramedics and Emergency Medical Technicians (EMTs). Paramedics are the highest level of pre-hospital providers; EMTs are the basic level personnel. Paramedics and EMTs are often the first medical people at the scene of an accident or sudden illness; they give immediate care to heart attack victims, car crash victims, gunshot victims, and poisoning victims. They even assist in childbirth. The sick or injured are then transported to healthcare facilities in specially equipped emergency vehicles. On arrival at a medical center, the paramedics transfer the patient to nursing personnel and report their observations and treatment procedure to the attending physician.
The guidelines or procedures followed by EMTs are directly related to their level of training. The EMT-Paramedic is at the upper rung of a three-level hierarchy. Paramedics administer sophisticated prehospital care. They are trained in the use of complex medical equipment, such as EKGs, and are capable of administering drugs both orally and intravenously. EMT-Intermediates have more advanced training than EMT-Basics who bandage wounds, stabilize blood pressure, assist heart attack victims, and treat accident victims for shock. All three levels of EMTs can be talked through care procedures in the event they are confronted with a difficult or complicated situation. Thus EMTs may maintain radio contact with a dispatcher and keep him apprised of the situation. Should the need arise, senior medical personnel (physicians) will then take charge.
For EMTs and paramedics, helping people can be an athletic experience; you have to be where people need you. Like fire fighters or other emergency response personnel, paramedics and EMTs are involved in life and death situations. Their work can be richly rewarding, as when a child is born despite difficulties, or terribly sad, when, even after administering proper care, a patient dies. Conditions are tremendously stressful, hours long and irregular, and salaries low. Paramedics must be physically and emotionally strong enough to do backbreaking and sometimes dangerous work, and ready to hustle on a moment’s notice, whether they feel like it or not, as someone’s life may be on the line. The paramedic never knows what conditions they might meet on any given day, so emotional stability is at a premium. “It’s a lot of stress and anxiety,” says one EMT who has been on the job for three years. “But some days you go home feeling like you really made a difference, and that’s a real good feeling.”
Training to become an EMT is offered by police, fire, and health departments and in some hospitals. Many colleges and universities offer nondegree courses. Basic training to become a first level EMT requires 100 to 120 hours of classroom sessions plus ten hours of internship in a hospital emergency room and twenty to fifty hours on field rescue or ambulance companies. An additional thirty-five to fifty-five hours of instruction in patient assessment, intravenous fluids, antishock garments, and esophageal airways are required in intermediate training. Paramedics usually undergo between 750 and 2,000 hours of training. But the real training comes with experience.
Although registration is not generally required, it does enhance the possibility of advancement and employment opportunities. A certified EMT must renew his registration every two years, which requires that he remain active in the field and meet a continuing education requirement. However, a paramedic seeking advancement must leave fieldwork if she is to move up to operations manager, administrative officer, or executive director of emergency services.
Because of its high-stress environment, many paramedics suffer from burnout. A lack of advancement opportunities and low salaries leads to a high turnover in this profession. On the other hand, police, fire, and rescue squad departments offer attractive salaries and benefits. For paramedics looking to switch careers, the health care profession offers several avenues. With a rapidly aging population and scientific breakthroughs which prolong life, the proliferation of residential retirement communities, nursing homes, adult daycare centers, and health care agencies, the need for health care professionals is virtually assured. With more schooling, paramedics can become R.N.s, occupational and physical therapists, doctors, and other health care workers. Closer to the field, paramedics can make the transition to EMT instructor, dispatcher, law enforcement, or fire fighter.