An emergency medical technician (EMT) is a person who can provide some level of care before a patient can be taken to a hospital for treatment. The term is used in a variety of countries, and many of them share similar responsibilities. EMTs in the United States have very clear responsibilities and training requirements.
Technically, each state in the United States sets its own standards for emergency medical technician certification. However, 46 of the 50 states use the National Registry of Emergency Medical Technicians (NREMT) exams, which are based on the National Highway Traffic Safety Administration’s criteria (NHTSA). As a result, when most people think of an emergency medical technician, they usually think of someone who has completed the NHTSA’s requirements.
The NHTSA recognizes four different levels of emergency medical technician certification. EMT-B stands for Emergency Medical Technician-Basic. The EMT-I/85 and EMT-I/99 are the two levels of Intermediate training. Finally, EMT-P, or paramedic, is the advanced level designation. In some states, you can be certified as a Critical Care Paramedic or an Advanced Practice Paramedic, which is a step up from being a paramedic.
A Basic certification allows a person to deal with a variety of basic critical conditions, almost all of which are non-invasive. A basic emergency medical technician, for example, might splint broken bones temporarily, control external bleeding, or provide positive pressure ventilation with a bag mask. If the person already has a prescription for that drug, they may administer a small amount of medication, such as epinephrine, to treat someone who has gone into anaphylactic shock.
More invasive and pharmaceutical procedures are permitted at the Intermediate level of certification. If a patient is unable to breathe due to an obstruction that cannot be removed, an EMT-I/85 may use endotracheal intubation or administer an IV if necessary. If necessary, an EMT-I/99 may be permitted to administer certain drugs in order to keep a patient stable until they can be transported to a hospital.
Except in cases where a licensed physician may accompany a vehicle, such as some emergency air rescues, a paramedic is the most advanced emergency medical technician available. Cardiac monitoring, resuscitation, less-restricted drug administration, and other advanced procedures are all possible for paramedics. Advanced Life Support vehicles, which are staffed with paramedics, are dispatched to scenes where victims are likely to require advanced medical care upon arrival.
Other types of emergency medical technicians may be required to obtain special certifications in order to work in specific settings. A Wilderness EMT, for example, learns a different set of skills than a traditional urban paramedic, and many people obtain this certification after becoming paramedics. EMTs in the wilderness learn how to splint broken limbs with improvised devices like branches. Because hospitals are farther away and air evacuations or rescues can take longer, there is also a greater emphasis on stabilizing patients for longer periods of time.