EMTs and Paramedics

Summary

What EMTs and Paramedics Do About this section

EMTs and paramedics assess a patient’s condition and administer emergency medical care.

Emergency medical technicians (EMTs) and paramedics care for the sick or injured in emergency medical settings. People’s lives often depend on the quick reaction and competent care provided by these workers. EMTs and paramedics respond to emergency calls, performing medical services and transporting patients to medical facilities.

A 911 operator sends EMTs and paramedics to the scene of an emergency, where they often work with police and firefighters.

Duties

EMTs and paramedics typically do the following:

• Respond to 911 calls for emergency medical assistance, such as cardiopulmonary resuscitation (CPR) or bandaging a wound
• Assess a patient’s condition and determine a course of treatment
• Provide first-aid treatment or life support care to sick or injured patients
• Transport patients safely in an ambulance
• Transfer patients to the emergency department of a hospital or other healthcare facility
• Report their observations and treatment to physicians, nurses, or other healthcare facility staff
• Document medical care given to patients
• Inventory, replace, and clean supplies and equipment after use

When transporting a patient in an ambulance, one EMT or paramedic may drive the ambulance while another monitors the patient’s vital signs and gives additional care. Some paramedics work as part of a helicopter’s or an airplane’s flight crew to transport critically ill or injured patients to a hospital.

EMTs and paramedics also transport patients from one medical facility to another. Some patients may need to be transferred to a hospital that specializes in treating their particular injury or illness or to a facility that provides long-term care, such as a nursing home.

If a patient has a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance and may need to report the case to the proper authorities.

The specific responsibilities of EMTs and paramedics depend on their level of certification and the state they work in. The National Registry of Emergency Medical Technicians (NREMT) provides national certification of EMTs and paramedics at four levels: EMR, EMT, Advanced EMT, and Paramedic. Some states, however, have their own certification programs and use similar titles.

Emergency Medical Responders, or EMRs, are trained to provide basic medical care with minimal equipment. These workers may provide immediate lifesaving interventions while waiting for other emergency medical services (EMS) resources to arrive. Jobs in this category may also go by a variety of titles including Emergency Care Attendants, Certified First Responders, or similar.

An EMT, also known as an EMT-Basic, cares for patients at the scene of an incident and while taking patients by ambulance to a hospital. An EMT has the skills to assess a patient’s condition and to manage respiratory, cardiac, and trauma emergencies.

An Advanced EMT, also known as an EMT-Intermediate, has completed the requirements for the EMT level, as well as instruction in more advanced medical procedures, such as administering intravenous fluids and some medications.

Paramedics provide more extensive prehospital care than do EMTs. In addition to doing the tasks of EMTs, paramedics can give medications orally and intravenously, interpret electrocardiograms (EKGs)—which monitor heart function—and use other monitors and complex equipment.

The specific tasks or procedures EMTs and paramedics are allowed to perform vary by state.

Work Environment About this section

EMTs and paramedics care for sick or injured patients in a prehospital setting.

EMTs and paramedics held about 248,000 jobs in 2016. The largest employers of EMTs and paramedics were as follows:

The above percentages exclude volunteer EMTs and paramedics who do not receive pay.

EMTs and paramedics work both indoors and outdoors, in all types of weather. Their work is physically strenuous and can be stressful, sometimes involving life-or-death situations.

Volunteer EMTs and paramedics share many of the same duties as paid EMTs and paramedics. They volunteer for fire departments, providers of emergency medical services, or hospitals. They may respond to only a few calls per month.

Injuries and Illnesses

EMTs and paramedics have one of the highest rates of injuries and illnesses of all occupations. They are required to do considerable kneeling, bending, and lifting while caring for and moving patients. They may be exposed to contagious diseases and viruses, such as hepatitis B and HIV. Sometimes they can be injured by combative patients. These risks can be reduced by following proper safety procedures, such as waiting for police to clear an area in violent situations or wearing gloves while working with a patient.

Work Schedules

Most paid EMTs and paramedics work full time. About 1 in 3 worked more than 40 hours per week in 2016. Because EMTs and paramedics must be available to work in emergencies, they may work overnight and on weekends. Some EMTs and paramedics work shifts in 12- or 24-hour increments. Volunteer EMTs and paramedics have variable work schedules. For example, they may work only a few days per week.

How to Become an EMT or Paramedic About this section

EMTs and paramedics need to be physically fit as their job requires bending, lifting, and kneeling.

Emergency medical technicians (EMTs) and paramedics typically complete a postsecondary educational program. All states require EMTs and paramedics to be licensed; requirements vary by state.

Education

Both a high school diploma or equivalent and cardiopulmonary resuscitation (CPR) certification typically are required for entry into postsecondary educational programs in emergency medical technology. Most of these programs are nondegree award programs that can be completed in less than 1 year; others last up to 2 years. Paramedics, however, may need an associate’s degree. Programs in emergency medical technology are offered by technical institutes, community colleges, universities, and facilities that specialize in emergency care training. Some states have EMR positions that do not require national certification. These positions typically require state certification.

The Commission on Accreditation of Allied Health Education Programs offers a list of accredited programs for EMTs and paramedics, by state.

Programs at the EMT level include instruction in assessing patients’ conditions, dealing with trauma and cardiac emergencies, clearing obstructed airways, using field equipment, and handling emergencies. Formal courses include about 150 hours of specialized instruction, and some instruction may take place in a hospital or ambulance setting.

Programs at the Advanced EMT level typically require about 400 hours of instruction. At this level, candidates learn EMT-level skills as well as more advanced ones, such as using complex airway devices, intravenous fluids, and some medications.

Paramedics have the most advanced level of education. To enter specific paramedical training programs, they must already be EMT certified. Community colleges and universities may offer these programs, which require about 1,200 hours of instruction and may lead to an associate’s or bachelor’s degree. Paramedics’ broader scope of practice may include stitching wounds or administering intravenous medications.

High school students interested in becoming EMTs or paramedics should take courses in anatomy and physiology and consider becoming certified in CPR.

Licenses, Certifications, and Registrations

The National Registry of Emergency Medical Technicians (NREMT) certifies EMTs and paramedics at the national level. All levels of NREMT certification require completing a certified education program and passing the national exam. The national exam has both written and practical parts. Some states have first-level state certifications that do not require national certification.

All states require EMTs and paramedics to be licensed; requirements vary by state. In most states, an individual who has NREMT certification qualifies for licensure; in others, passing an equivalent state exam is required. Usually, an applicant must be over the age of 18. Many states require background checks and may not give a license to an applicant who has a criminal history.

Although some emergency medical services hire separate drivers, most EMTs and paramedics take a course requiring about 8 hours of instruction before they can drive an ambulance.

Important Qualities

Compassion. EMTs and paramedics must be able to provide emotional support to patients in an emergency, especially patients who are in life-threatening situations or extreme mental distress.

Interpersonal skills. EMTs and paramedics usually work on teams and must be able to coordinate their activities closely with others in stressful situations.

Listening skills. EMTs and paramedics need to listen to patients to determine the extent of their injuries or illnesses.

Physical strength. EMTs and paramedics need to be physically fit. Their job requires a lot of bending, lifting, and kneeling.

Problem-solving skills. EMTs and paramedics must evaluate patients’ symptoms and administer appropriate treatments.

Speaking skills. EMTs and paramedics need to clearly explain procedures to patients, give orders, and relay information to others.

Advancement

EMTs and paramedics may advance into other related healthcare occupations, such as physician assistants and medical assistants, as well as administrative positions in various healthcare settings, such as ambulatory care companies or hospitals.

Pay About this section

The median annual wage for EMTs and paramedics was $33,380 in May 2017. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $21,880, and the highest 10 percent earned more than $56,990.

In May 2017, the median annual wages for EMTs and paramedics in the top industries in which they worked were as follows:

Most paid EMTs and paramedics work full time. About 1 in 3 worked more than 40 hours per week in 2016. Because EMTs and paramedics must be available to work in emergencies, they may work overnight and on weekends. Some EMTs and paramedics work shifts in 12- or 24-hour increments. Volunteer EMTs and paramedics have variable work schedules. For example, they may work only a few days per week. 

Job Outlook About this section

Employment of emergency medical technicians (EMTs) and paramedics is projected to grow 15 percent from 2016 to 2026, much faster than the average for all occupations. Emergencies, such as car crashes, natural disasters, and acts of violence, will continue to require the skills of EMTs and paramedics. The need for volunteer EMTs and paramedics in rural areas and smaller metropolitan areas will also continue.

Growth in the middle-aged and older population will lead to an increase in age-related health emergencies, such as heart attacks and strokes. This increase, in turn, will create greater demand for EMT and paramedic services. An increase in the number of specialized medical facilities will require more EMTs and paramedics to transfer patients with specific conditions to these facilities for treatment.

Job Prospects

Job opportunities should be good because the growing population will require more emergency services generally. There will also be a need to replace workers who leave the occupation due to the high stress nature of the job or to seek job opportunities in other healthcare occupations.

Employment projections data for EMTs and paramedics, 2016-26

Occupational Title	SOC Code	Employment, 2016	Projected Employment, 2026	Change, 2016-26		Employment by Industry
				Percent	Numeric
SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program
Emergency medical technicians and paramedics	29-2041	248,000	285,400	15	37,400	xlsx

State & Area Data About this section

Occupational Employment Statistics (OES)

The Occupational Employment Statistics (OES) program produces employment and wage estimates annually for over 800 occupations. These estimates are available for the nation as a whole, for individual states, and for metropolitan and nonmetropolitan areas. The link(s) below go to OES data maps for employment and wages by state and area.

• Emergency medical technicians and paramedics

Projections Central

Occupational employment projections are developed for all states by Labor Market Information (LMI) or individual state Employment Projections offices. All state projections data are available at www.projectionscentral.com. Information on this site allows projected employment growth for an occupation to be compared among states or to be compared within one state. In addition, states may produce projections for areas; there are links to each state’s websites where these data may be retrieved.

CareerOneStop

CareerOneStop includes hundreds of occupational profiles with data available by state and metro area. There are links in the left-hand side menu to compare occupational employment by state and occupational wages by local area or metro area. There is also a salary info tool to search for wages by zip code.

Contacts for More Information About this section

For more information about emergency medical technicians and paramedics, visit

National Association of Emergency Medical Technicians

National Association of State EMS Officials

National Highway Traffic Safety Administration, Office of Emergency Medical Services

National Registry of Emergency Medical Technicians

For information about educational programs, visit

Commission on Accreditation of Allied Health Education Programs

O*NET

Emergency Medical Technicians and Paramedics