What Does an Emergency Medical Technician Do?
An Emergency Medical Technician is a trained individual who responds to an array of medical emergencies. There are several levels of Emergency Medical Technicians (EMT): EMT-Basic, EMT-Advanced, EMT-Intermediate and EMT-Paramedic. Each level of EMT differs in the scope of practice and required training and certifications. The most common level of certification is EMT-Basic and requires the least amount of training. An EMT-Basic commonly works on an ambulance alongside an EMT-Paramedic (often referred to as simply a Paramedic); however, EMT-Basics can also work independently on crew ships, medical teams at private companies, on fire engines, racetracks, search and rescue teams, and ski patrol.
An EMT-Basic’s scope of practice is smaller than that of a Paramedic; however, EMT-Basic skills lay the foundation for every intervention that is done in emergency medicine. The biggest and most useful skill that an EMT-Basic learns and must perform is a proper patient evaluation. Knowing what questions to ask and in which order to do so is, quite possibly, the hardest skill in medicine. EMT-Basics must master this skill and feel comfortable assessing an array of patients, including ones experiencing a medical emergency, a traumatic injury or even cardiac arrest. In addition to assessments, EMT’s can perform the following interventions:
- use of basic adjunctive airway equipment;
- cardiopulmonary resuscitation, according to current AHA guidelines;
- obstructed airway management;
- bleeding control to include appropriate tourniquet usage;
- spine immobilization;
- scene assessment, triage, scene safety;
- use of statewide EMS communications system;
- non-complicated childbirth (imminent delivery);
- administration of oral glucose, aspirin, intramuscular 1:1000 epinephrine, sublingual nitroglycerin
- wound management
What Does an AEMT Do?
An Advanced EMT is a fairly new level of certification, originating only in 2013. As of 2020, there are still several states that do not recognize Advanced EMT certifications and, instead, utilize EMT-Basics and Paramedics. Advanced EMT’s scope of practice varies widely from state to state, but essentially creates a pathway to Advanced Life Support where access to a Paramedic might not otherwise be feasible. In addition to the national EMT-Basic scope of practice, most states allow an AEMT to establish peripheral intravenous access, manually defibrillate a patient in cardiac arrest and administer various intravenous and intramuscular medications.
What Does a Paramedic Do?
A Paramedic is the most advanced level of prehospital emergency medical provider. The scope of practice includes everything an AEMT can do plus a robust pharmacological treatment regimen, cardiac rhythm identification and interventions, endotracheal intubation, transcutaneous pacing, needle decompression of a tension pneumothorax, and surgical cricothyrotomy. Not only does a paramedic have a far greater scope of practice than other levels of EMTs, the paramedic is responsible for what happens on an emergency scene. While an EMT-Basic might help perform life-saving procedures (such as CPR or inserting an emergency airway), the paramedic on scene is directing, instructing and delegating tasks while also performing more invasive and challenging procedures themselves.