EMT vs. Paramedic

EMT and paramedics are both emergency medical service (EMS) professionals. The paramedic is the higher of the two. Typically, both travel in ambulances. They may instead travel on firetrucks. Some paramedics are part of flight teams, airlifting patients from emergency scenes or assisting with interfacility transport.

Often EMTs and paramedics travel together. It is standard practice for EMS professionals to travel in teams of two, though the staff mix can vary. There are occasions where an EMT serves as team leader. However, this is a more common expectation at the paramedic level. Different emergency systems have different ways of determining who gets sent where (https://usatoday30.usatoday.com/news/nation/ems-day1-seattle.htm).

In some states, paramedics are classified as EMTs. Their title is Emergency Medical Technician-Paramedic, or EMT-P. However, the trend is away from classifying paramedics as EMTs. This is because they have a scope of practice beyond the technician level.

Both EMTs and paramedics have the training to save lives. However, EMTs are trained to provide training for the more common emergency scenarios. (Notably, both EMTs and paramedics also respond to situations that are not life-and-death – and that are not truly emergencies.)

EMT care may be characterized as BLS (basic life support). They use the more basic medical equipment that is available on ambulances. Paramedics can provide ALS (advanced life support). They can use both basic and advanced equipment available on ambulances. The difference is not necessarily how crucial the care is but how complex and unusual and what the consequence would be of doing them incorrectly.

An EMS professional can generally expect to increase his or her earnings by becoming a paramedic.

The EMT-Paramedic Career Ladder

It’s not an either-or choice to become an EMT or a paramedic. EMTs typically need about six months of experience before they can train to be paramedics. Thus the real difference in preparation may be much greater than the difference in training hours.

EMT is not the lowest EMS role, nor is paramedic necessarily the highest. Emergency Medical Responders (EMRs) have limited lifesaving training. Some paramedics, meanwhile, specialize. A limited number of states officially recognize advanced or specialty roles. Tennessee, for example, has a Critical Care Paramedic license. While there are far fewer specialization options available at the EMT level, EMTs can, in some locales, be involved in Community Health Emergency Medical Services (CHEMS).

Some EMTs have a level of training above the basic and are classified as Advanced Emergency Medical Technician or AEMT.

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EMT vs. Paramedic: Training

The amount of training required varies by state, but paramedics often have nearly 10 times as much training. Paramedic programs include about 1,200 to 1,800 hours of training. Basic EMT training is estimated at 150 to 190 hours by governmental sources, though some states require less.

Becoming a paramedic requires a stronger academic background. Among the typical prerequisites , one finds anatomy and physiology and college math.

There is a push for requiring paramedics to hold associate degrees. However, most states do not require them at this time.

EMTs and paramedics must both pass certification or licensing examinations. Most states require candidates to go through the National Registry for Emergency Medical Technicians (NREMT) certification process. The NREMT administers computer-based examinations for EMTs and paramedics. It administers practical examinations for paramedics. Practical examination for the EMT is administered at the state level but reflects standardized content.

Scope of Practice: EMT vs. Paramedic

While a national scope of practice is found in the NREMT National EMS Scope of Practice Model, actual scope of practice is set at the state level. Some states allow EMTs duties beyond those set forth by the NREMT, at least if they have had additional training.

Both EMTs and paramedics perform lifesaving basics like mouth-to-mouth or mouth-to-barrier resuscitation. Both can suction the upper airway or provide bag valve mask (BVM) positive pressure ventilation. Both can stabilize extremities and place splints.

An EMT can give a limited number of medications in a limited number of ways (for example, an auto-injector of epinephrine or an auto-injector of opioid antagonist). He or she can administer oral glucose or give oxygen. A paramedic can administer a much wider range of medications and can do so through additional pathways. A paramedic may, for example, give medication through endotracheal pathways.

The following are among the skills that are listed for paramedic but not listed for EMT (under the national guide):

• Pleural chest decompression with a needle
• Operating and managing an IV pump
• Blood chemistry analysis – cardiac enzymes

Scope of practice is differentiated by depth and breadth. There are different expectations for clinical behavior and judgment. An EMT is expected to be able to carry out a basic physical examination and history and identify complaints, actual and potential. A paramedic is expected to carry out a comprehensive examination and history, and utilize findings in more complex ways, such as relating assessment findings to underlying conditions and making referrals.

EMT and Paramedic Related Resources

How to Become an EMT

How to become a Paramedic

Paramedic to RN Bridge Programs

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