EMT vs. Paramedic

You have probably seen this a number of times on popular entertainment shows: a team of health professionals rushes to the scene of an emergency and escorts an injured person into an ambulance, administering basic care to keep them alive. These professionals are part of the emergency medical services team, and most likely reached the spot as a result of a 911 call. The emergency medical services teams comprise various professionals trained to provide basic and advanced care to patients during their transportation to a healthcare facility. Emergency medical technicians or EMTs are the most common types of emergency care providers, while paramedics are trained to provide advanced medical care in the case of an emergency.

The basic difference between EMTs and paramedics lies in their level of education and the kind of procedures they are allowed to perform. While EMTs can administer CPR, glucose, and oxygen, paramedics can perform more complex procedures such as inserting IV lines, administering drugs, and applying pacemakers.

The following article takes a look at the responsibilities of an EMT and paramedic, the level of education required to become one, and certification and licensure requirements.

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Side-by-Side Comparison: EMT vs Paramedic

Emergency Medical Technicians (EMTs) Paramedics
What Are They?

In the field of emergency medical services (EMS), emergency medical technicians (EMTs) are the most common type of health professionals. They take care of patients at the entry-level. If there has been a medical or traumatic emergency, then EMTs are generally called to provide medical care. As the first care providers, they examine the nature and severity of injuries and transfer the patient in a well-equipped vehicle. Then, they inform the hospital about the number of patients being brought in and their injuries and illnesses.

EMTs are also responsible for monitoring a patient’s condition till they reach a hospital and provide them with the care they need. Generally, EMTs and paramedics are sent to emergency sites by 911 operators, where they might work alongside firefighters and the police.

Paramedics are skilled, pre-hospital service providers. They are licensed healthcare professionals and can provide advanced life support to patients before they reach a hospital. Providing care on par with that of an emergency medical room, they are better trained than EMTs at treating acute illnesses and injuries. They have extensive knowledge on subjects such as physiology, cardiology, medical procedures, and medication. Like EMTs, paramedics are usually called to a scene via 911.

Where Do They Work?

EMTs are often employed by private ambulance services, governments, hospitals, fire departments, and police departments. They have a limited scope of practice and work under the supervision of a medical director or physician.

Paramedics can work in ambulance services. In this setting, paramedics and EMTs work together; however paramedics are usually outnumbered by EMTs. They can also work for air ambulances (i.e., helicopters and fixed-wing aircrafts that are used to transfer medical patients from one place to another) and fire services. Emergency medical services (EMS) most commonly employs paramedics.

Typical Responsibilities
  • Moving patients between facilities
  • Helping stabilize and treating patients en route to a hospital
  • Informing the hospital about the injury or illness, the number of patients being transported, and the expected time of arrival
  • Assessing patients
  • Maintaining patient records
  • Responding to 911 calls for emergency medical assistance
  • Using backboards and restraints to keep the patient still and safe in the ambulance during transport
  • Providing cardiopulmonary resuscitation (CPR) or bandaging wounds
  • Controlling external bleeding
  • Preventing shock and further injury in patients
  • Stabilizing a patient’s condition, while safely transporting them to a hospital for medical care
  • Bandaging patients and elevating the injured part of the patient’s body to stop the bleeding
  • Delivering babies in an emergency
  • Prioritizing medical care on the spot of the accident to make sure that the most severely injured patients receive care first
  • Creating new airways for patients who cannot breath via a tracheotomy or other means
  • Providing the necessary medication through an intravenous (IV) injection or infusion
  • Sticking needles in the chest to decompress collapsed lungs
  • Keeping records of the treated patient and the type of medication the patient received
  • Applying pacemakers to control heart arrhythmias
  • Providing breathing support with tubes and ventilation devices
Education & Experience Requirements

To become an EMT, one does not need an associate or bachelor’s degree. It is sufficient to have a high school diploma or GED. However, EMTs should have cardiopulmonary resuscitation (CPR) certification. They must complete an EMT training program offered by community colleges and vocational schools. EMT training programs can usually be completed in 150 hours. Students wishing to become successful EMTs must also pass the National Registry Emergency Medical Technicians (NREMT) cognitive exam.

A paramedic is the highest level of EMT (Emergency Medical Technician) certification. Paramedics are required to complete training for basic and advanced EMTs and also complete additional studies. Generally, prospective paramedics might work as EMTs for a a year or two to gain on-the-job experience, and then undertake the 1,200 to 1,800 hours of training to become a paramedic. College degree programs for paramedics usually take two years. After completing necessary training, candidates must take the National Paramedic Certification (NPC) exam and required state licensing counterparts (e.g., Oregon Health Authority) to become a certified paramedic.

Sample Educational Programs
Certification & Licensure

EMTs are required to obtain CPR certification, as most EMT training programs require entrants to already possess CPR training. Organizations such as the American Red Cross and the American Heart Association provide this certification. They are required to obtain the National Registry Emergency Medical Technicians (NREMT) certification as most states recognize this certification as an appropriate guarantee of competency. This certification is a requirement in almost every state for becoming a licensed emergency medical technician. In order to receive a license, the EMT must be at least 18 years of age and should have a valid driver’s license.

To become a certified and licensed paramedic you must be at least 18 years old and a high school graduate; have a valid driver’s license; and hold CPR certification. After graduating from a paramedic program, a student is required to become nationally certified through the National Registry Emergency Medical Technicians (NREMT). However, becoming nationally registered or certified does not guarantee permission to practice. Paramedics must have a license from a state to practice in that state. While some states grant licensure on the basis of NREMT as proof, others have their own tests for providing license.

Credential Renewal Requirements EMTs are required to renew their certification every two years. They can recertify by taking the cognitive examination or by completing continuing education. The EMT National Continued Competency Program (NCCP) has a requirement of 40 hours of continuing education credits in order to recertify. Nationally Registered Paramedics (NRP) must renew certification every two years. They can do this by either taking the cognitive examination or by completing continuing education. The Paramedic National Continued Competency Program (NCCP) requires 60 hours of continuing education to in order to grant recertification.
The Bottom Line EMTs work on the front lines of emergency medical services, providing support to patients, before they reach a hospital. They are trained in administering basic medical care and CPR. While they might work with paramedics, their scope and autonomy are limited. An EMT’s responsibilities and level of education are both lesser than that of paramedics. Paramedics are advanced emergency medical care providers. They provide advanced life support to patients. An ambulance with EMTs alone will be referred to as a “basic life support unit,” while one with paramedics will be considered more advanced. As compared to EMTs, paramedics have 1,200 to 1,800 additional hours of training. Other than basic medical care, paramedics are also trained to administer medicines, perform intubation, insert IV lines, and administer drugs, among other procedures.