Many people (hospital staff included) do not entirely understand the difference between a paramedic (often called medics), an EMT, and a first responder. I never thought about it before my class, but now I am fielding a lot of questions about what I can and cannot do, and I find myself explaining that I am not “just” an EMT. (No, we’re not ambulance drivers, we can save lives, too!)
So let me try to explain the different jobs, with the help of the OEMS website. I am using the Commonwealth of Massachusetts guidelines, and while each state has its own requirements, they all ultimately have to meet the guidelines provided by the Department of Transportation (DOT).
First Responders are the people who arrive first on the scene of a medical emergency or trauma–police officers and firefighters. They are trained in basic first aid, CPR, and the use of AEDs (automatic external defibrillator). This training is in conjunction with their primary training. Many firefighters often go on to get certified as EMTs, to either work within their own fire unit or at an outside company.
EMTs have a “scope of practice” that covers basic life support, care for those with a sudden illness, and trauma care. We can also assist Paramedics. EMT training includes a minimum of 100 classroom hours (with 100% attendance), including time in the field (ambulance ride-alongs), plus a minimum of 10 hours observation time in a hospital setting. Most courses are more like 120-150 hours total. Not only do we have to pass the course (that has tough exams), we have to take the state or national exams (written and practical). Our certification lasts for 2 years, during which we must complete 28 hours of continuing education, as well as a 24 hour refresher course at the end of 2 years to recertify. We must also keep our CPR/AED certification current. EMTs make up the majority of EMS personnel.
Paramedics provide advanced emergency care, including starting IVs, intubating patients who aren’t breathing, and giving more medications. They usually spend a few years as EMTs before completing paramedic training. This includes much more time in the classroom, learning clinical skills in-hospital, and interning in the field (usually closer to 2,000 hours). Their scope of practice includes advanced life support and providing “prehospital emergency care to acutely ill or injured patients… under medical command authority.” They must complete 25 hours of continuing education and a 48 hour refresher course every two years.
I hope that helps! My training lasted about 3 months, and I learned how to splint bones, rapidly extricate people from motor vehicle accidents (smashed up cars from the dump!), deliver a baby, triage multiple patients, take a medical history, assist with medications, and physically examine a patient. I am excited to put these skills to work!