People's lives often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics. Incidents as varied as automobile accidents, heart attacks, slips and falls, childbirth, and gunshot wounds require immediate medical attention. EMTs and paramedics provide this vital service as they care for and transport the sick or injured to a medical facility.
In an emergency, EMTs and paramedics are typically dispatched by a 911 operator to the scene, where they often work with police and fire fighters. Once they arrive, EMTs and paramedics assess the nature of the patient's condition, while trying to determine whether the patient has any pre-existing medical conditions. Following protocols and guidelines, they provide emergency care and transport the patient to a medical facility. EMTs and paramedics operate in emergency medical services systems where a physician provides medical direction and oversight.
EMTs and paramedics use special equipment, such as backboards, to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. These workers generally work in teams. During the transport of a patient, one EMT or paramedic drives, while the other monitors the patient's vital signs and gives additional care, as needed. Some paramedics work as part of a helicopter's flight crew to quickly transport critically ill or injured patients to hospital trauma centers.
At the medical facility, EMTs and paramedics help transfer patients to the emergency department, report their observations and actions to emergency department staff, and may provide additional emergency treatment. After each run, EMTs and paramedics document the trip, replace used supplies and check equipment. If a transported patient has a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance and report cases to the proper authorities.
EMTs and paramedics also provide transportation for patients from one medical facility to another, particularly if they work for private ambulance services. Patients often need to be transferred to a hospital that specializes in treating their injury or illness or to facility that provides long-term care, like nursing homes.
Beyond these general duties, the specific responsibilities of EMTs and paramedics depend on their level of qualification and training. The National Registry of Emergency Medical Technicians (NREMT) certifies emergency medical service providers at five levels: First Responder; EMT-Basic; EMT-Intermediate (which has two levels called 1985 and 1999) and Paramedic. Some States, however, have their own certification programs and use distinct names and titles.
The EMT-Basic represents the first response of the emergency medical system. An EMT trained at this level is prepared to care for patients at the scene of an accident and while transporting patients by ambulance to the hospital under the direction of more highly trained medical personnel. The EMT-Basic has the emergency skills to assess a patient's condition and manage respiratory, cardiac, and trauma emergencies.
The EMT-Intermediate has more advanced training. However, the specific tasks that those certified at this level are allowed to perform varies greatly from State to State.
Paramedics provide more extensive pre-hospital care than do EMTs. In addition to carrying out the procedures of the other levels, paramedics administer medications orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations, and use monitors and other complex equipment. However, like the EMT-Intermediate level, what paramedics are permitted to do varies by State.
EMTs and paramedics work both indoors and out, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers are at a higher risk for contracting illnesses or experiencing injuries on the job than workers in other occupations. They risk noise-induced hearing loss from sirens and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to communicable diseases, such as hepatitis-B and AIDS, as well as to violence from mentally unstable or combative patients. The work is not only physically strenuous but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others. These workers experienced a larger than average number of work-related injuries or illnesses
Many EMTs and paramedics are required to work more than 40 hours a week. Because emergency services function 24 hours a day, EMTs and paramedics may have irregular working hours.
| 1. | Administer first-aid treatment and life-support care to sick or injured persons in prehospital setting. |
| 2. | Perform emergency diagnostic and treatment procedures, such as stomach suction, airway management or heart monitoring, during ambulance ride. |
| 3. | Observe, record, and report to physician the patient's condition or injury, the treatment provided, and reactions to drugs and treatment. |
| 4. | Immobilize patient for placement on stretcher and ambulance transport, using backboard or other spinal immobilization device. |
| 5. | Maintain vehicles and medical and communication equipment, and replenish first-aid equipment and supplies. |
| 6. | Assess nature and extent of illness or injury to establish and prioritize medical procedures. |
| 7. | Communicate with dispatchers and treatment center personnel to provide information about situation, to arrange reception of victims, and to receive instructions for further treatment. |
| 8. | Comfort and reassure patients. |
| 9. | Decontaminate ambulance interior following treatment of patient with infectious disease and report case to proper authorities. |
| 10. | Operate equipment such as electrocardiograms (EKGs), external defibrillators and bag-valve mask resuscitators in advanced life-support environments. |
| 11. | Drive mobile intensive care unit to specified location, following instructions from emergency medical dispatcher. |
| 12. | Coordinate with treatment center personnel to obtain patients' vital statistics and medical history, to determine the circumstances of the emergency, and to administer emergency treatment. |
| 13. | Coordinate work with other emergency medical team members and police and fire department personnel. |
| 14. | Attend training classes to maintain certification licensure, keep abreast of new developments in the field, or maintain existing knowledge. |
| 15. | Administer drugs, orally or by injection, and perform intravenous procedures under a physician's direction. |
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