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- 238
- Emergency Medical Technicians
-
- (D.O.T. 079.364-026 and .374-010)
-
- Nature of the Work
-
- Automobile accident injuries, heart attacks, near drownings,
- unscheduled childbirths, poisonings, and gunshot wounds all demand
- urgent medical attention. Emergency medical technicians (EMT's)
- give immediate care and then transport the sick or injured to
- medical facilities.
-
- Following instructions from a dispatcher, EMT's who usually work in
- teams of two drive specially equipped emergency vehicles to the
- scene of emergencies. If necessary, they request additional help
- from police, fire, or electric company personnel, or they may enlist
- bystanders to direct traffic or remove debris. They determine the
- nature and extent of the patient's injuries or illness while also
- trying to determine whether the patient has epilepsy, diabetes, or
- other preexisting medical conditions. EMT's then give appropriate
- emergency care following strict guidelines for which procedures they
- may perform. All EMT's, including those with basic skills, the
- EMT-Basic, may open airways, restore breathing, control bleeding,
- treat for shock, administer oxygen, immobilize fractures, bandage
- wounds, assist in childbirth, manage emotionally disturbed patients,
- treat and assist heart attack victims, give initial care to poison
- and burn victims, and treat patients with anti-shock trousers, which
- prevent a person's blood pressure from falling too low.
-
- EMT-Intermediates, or EMT-I's, have more advanced training and can
- perform such addtional procedures as administer intravenous fluids;
- and use defibrillators to give lifesaving shocks to a stopped heart.
-
- EMT-Paramedics provide the most extensive prehospital care. In
- addition to the procedures already described, paramedics may
- administer drugs orally and intravenously, interpret EKG's, perform
- endotracheal intubations, and use monitors and other complex
- equipment.
-
- Some conditions are simple enough to be handled following general
- rules and guidelines. More complicated problems can only be carried
- out under the step-by-step direction of medical personnel with whom
- the EMT's are in radio contact.
-
- When victims are trapped, as in the case of an automobile accident,
- cave-in, or building collapse, EMT's free them or provide emergency
- care while others free them.
-
- When transporting patients to a medical facility, EMT's may use
- special equipment such as backboards to immobilize them before
- placing them on stretchers and securing them in the ambulance.
- While one EMT drives, the other monitors the patient's vital signs
- and gives additional care as needed. Some EMT's work for hospital
- trauma centers or jurisdictions which use helicopters to transport
- critically ill or injured patients.
-
- At a medical facility, EMT's transfer patients to the emergency
- department, report to the staff their observations and the care they
- provided, and may help provide emergency treatment.
-
- After each run, EMT's replace used supplies and check equipment. If
- patients have had a contagious disease, EMT's decontaminate the
- interior of the ambulance and report cases to the proper
- authorities.
-
- Most job openings for EMT's will result from people who leave the
- field.
-
- Working Conditions
-
- EMT's work both indoors and outdoors, in all kinds of weather. Much
- of their time is spent standing, kneeling, bending, and lifting.
- They may risk noise-induced hearing loss from ambulance sirens and
- back injuries from lifting patients. EMT's may be exposed to
- diseases such as Hepatitis-B and AIDS, as well as violence from drug
- overdose victims. The work is not only physically strenuous, but
- stressful not surprising in a job that involves life-or-death
- situations. However, many people find the work exciting and
- challenging.
-
- EMT's employed by fire departments often have about a 50-hour
- workweek. Those employed by hospitals frequently work between 45
- and 58 hours a week and those in private between 48 and 51 hours.
- Some EMT's, especially those in police and fire departments, are on
- call for extended periods. Because most emergency services function
- 24 hours a day, EMT's have irregular working hours that add to job
- stress.
-
- Employment
-
- In 1992, EMT's held 114,000 jobs. Two-fifths were in private
- ambulance services, about a third were in municipal fire, police, or
- rescue squad departments, and a quarter were in hospitals. In
- addition, there are many volunteer EMT's.
-
- Most paid EMT's work in metropolitan areas. In many smaller cities,
- towns, and rural areas, there are no paid EMT jobs. All services
- are provided by volunteers.
-
- Training, Other Qualifications, and Advancement
-
- Formal training is needed to become an EMT. EMT-Basic training is
- 100 to 120 hours of classroom work plus 10 hours of internship in a
- hospital emergency room. Training is available in 50 States and the
- District of Columbia, and is offered by police, fire, and health
- departments; in hospitals; and as a nondegree course in colleges and
- universities.
-
- The EMT basic program provides instruction and practice in dealing
- with bleeding, fractures, airway obstruction, cardiac arrest, and
- emergency childbirth. Students learn to use and care for common
- emergency equipment, such as backboards, suction devices, splints,
- oxygen delivery systems, and stretchers.
-
- EMT-Intermediate training varies from State to State, but includes
- 35-55 hours of additional instruction in patient assessment as well
- as the use of esophageal airways, intravenous fluids, and antishock
- garments. Training programs for EMT-Paramedics generally last
- between 750 and 2,000 hours. Refresher courses and continuing
- education are available for EMT's at all levels.
-
- Applicants to an EMT training course generally must be at least 18
- years old and have a high school diploma or the equivalent and a
- driver's license. Recommended high school subjects for prospective
- EMT's are driver education, health, and science. Training in the
- Armed Forces as a medic is also good preparation.
-
- In addition to EMT training, EMT's in fire and police departments
- must be qualified as firefighters or police officers.
-
- Graduates of approved EMT-Basic training programs who pass a written
- and practical examination administered by the State certifying
- agency or the National Registry of Emergency Medical Technicians
- earn the title of Registered EMT-Basic. Prerequisites for taking
- the EMT-Intermediate examination include registration as an
- EMT-Basic, required classroom work, and a specified amount of
- clinical experience and field internship. Registration for
- EMT-Paramedics by the National Registry of Emergency Medical
- Technicians or a State emergency medical services agency requires
- current registration or State certification as an EMT-Basic,
- completion of an EMT-Paramedic training program and required
- clinical and field interships as well as passing of a written and
- practical examination. Although not a general requirement for
- employment, registration acknowledges an EMT's qualifications and
- may make higher paying jobs easier to obtain.
-
- All 50 States have some kind of certification procedure. In 29
- States and the District of Columbia, registration with the National
- Registry is required at some or all levels of certification. Other
- States require their own certification examination or provide the
- option of taking the National Registry examination.
-
- To maintain their certification, all EMT's must reregister, usually
- every 2 years. In order to reregister, an individual must be
- working as an EMT and meet a continuing education requirement.
-
- EMT's should have emotional stability, good dexterity, agility,
- physical coordination and be able to lift and carry heavy loads.
- EMT's need good eyesight (corrective lenses may be used) with
- accurate color vision.
-
- Advancement beyond the EMT-Paramedic level usually means leaving
- fieldwork. An EMT-Paramedic can become a supervisor, operations
- manager, administrative director, or executive director of emergency
- services. Some EMT's become EMT instructors, firefighters,
- dispatchers, or police officers, or others move into sales or
- marketing of emergency medical equipment. Finally, some become
- EMT's to assess their interest in health care and then decide to
- return to school and become R.N.'s, physicians, or other health
- workers.
-
- Job Outlook
-
- Most job openings will occur because of this occupation's
- substantial replacement needs. Turnover is quite high, reflecting
- this occupation's stressful working conditions, limited advancement
- potential, and the modest pay and benefits in the private sector.
-
- Employment of EMT's is expected to grow faster than average for all
- occupations through the year 2005. Driving the growth will be an
- expanding population. Also, the number of older people, who are
- more likely to need emergency services, is increasing rapidly.
-
- Opportunities for EMT's are expected to be excellent in hospitals
- and private ambulance services, where pay and benefits usually are
- low. Competition for jobs will be keen in fire, police, and rescue
- squad departments because of attractive pay and benefits and good
- job security.
-
- Earnings
-
- Earnings of EMT's depend on the employment setting and geographic
- location as well as the individual's training and experience.
- According to a survey conducted by the
-
- Journal of Emergency Medical Services (JEMS), average starting
- salaries in 1993 were $20,092 for EMT-Ambulance or Basic, $19,530
- for EMT-Intermediate, and $24,390 for EMT-Paramedic. EMT's working
- in fire departments command the highest salaries, as the
- accompanying table shows.
-
- Table 1. Average annual salaries of emergency medical technicians,
- by type of employer, 1993
-
-
- Employer Paramedic EMT7I EMT7-Basic
-
- All employers (mean) $28,079 $22,682 $22,848
-
- Private ambulance services 25,606 20,060 19,383
- Hospitals 24,944 21,088 18,845
- Fire departments 34,994 30,914 31,141
-
- SOURCE: Journal of Emergency Medical Services
-
- Those in emergency medical services which are part of fire or police
- departments receive the same benefits as firefighters or police
- officers.
-
- Related Occupations
-
- Other workers in occupations that require quick and
- level-headed reactions to life-or-death situations are police
- officers, firefighters, air traffic controllers, workers in
- other health occupations, and members of the Armed Forces.
-
- Sources of Additional Information
-
- Information concerning training courses, registration, and job
- opportunities for EMT's can be obtained by writing to the State
- Emergency Medical Service Director.
-
- General information about EMT's is available from:
-
- National Association of Emergency Medical Technicians, 9140 Ward
- Pky., Kansas City, MO 64114.
-