There are approximately 211,000 emergency medical technicians and paramedics in the United States. Job growth statistics suggest that over the next ten years the field will grow by 9%, which is about average for all jobs. However, the job outlook is good. As the aging population grows, medical emergencies become more common. Members of the baby boom generation contribute significantly to the population, and as they grow older, more and more medical emergencies requiring emergency medical technicians and paramedics will increase demand. Because of the stressful and somewhat dangerous nature of this work, the turnover is high.
Emergency medical technicians (EMTs) and paramedics travel in ambulances or aboard medical helicopters or planes. They are dispatched to the scene of a medical emergency. Heart attacks, childbirth, wounds that are the result of physical violence, car accidents and other emergencies requiring immediate medical attention are addressed by EMTs and paramedics, both on the scene and in the transport vehicle as they deliver the sick or injured to a medical facility. Upon arrival EMTs and paramedics evaluate patient condition and try to discern if there are relevant pre-existing medical conditions. They use specialized equipment designed for medical emergencies outside a medical facility. EMTs nearly always work as part of a team. When the medical facility has been reached, EMTs and paramedics assist with patient transfer, report what they know of the situation, and if needed, continue to provide additional emergency treatment. They must also keep careful records of the event, evaluate supplies and check over the equipment. EMTs and paramedics must also decontaminate the transport interior and notify the proper authorities. EMTs and paramedics employed by private ambulance services transport patients from one medical facility to another.
EMTs and paramedics are exposed to all kinds of weather, all kinds of situations and all kinds of areas. They must have both strength and stamina, as the job requires bending, heavy lifting, kneeling and assuming difficult positions for extended time periods. Their risk for contracting infectious disease as well as for on-the-job injury is higher than it is for most other occupations. Other job risks include hearing loss from sirens; violent or combative patients, family members or onlookers; and a tremendous amount of stress. EMTs and paramedics often work irregular hours, overtime and are on call. They must be able to remain calm under pressure, have good hand-eye coordination and manual dexterity, and pay meticulous attention to detail. Additionally, they must remain compassionate in all situations.
Most training programs require a high school diploma or the equivalent. There are three progressive levels of training. The EMT-Basic level teaches emergency skills needed in respiratory, cardiac and trauma emergencies as well as patient assessment. Training includes classroom instruction and emergency room or ambulance experience. Students are taught how to maintain and use basic equipment like splints, backboards, suction devices, stretchers and oxygen delivery systems. Graduation from an approved EMT-Basic training program, and passing written and practical examinations administered by the state licensing agency or the National Registry of Emergency Medical Technicians (NREMT), is required.
Requirements at the EMT-Intermediate level vary from state to state, but nationally defined levels require 30 to 35 hours of training. EMTs and paramedics are taught to use advanced airway devices, dispense the appropriate medications as well as intravenous fluids.
The highest level, Paramedic, requires training in advanced medical techniques as well as anatomy and physiology. Typically, this is a two-year associate degree program offered by technical or community colleges. Upon completion, the graduate must pass the NREMT examination in order to become a certified paramedic.
EMTs and paramedics must be licensed in all states. Most states require licenses be renewed every two to three years. Often, there are continuing education requirements as well.
Paramedics advance their careers by becoming supervisors, managers, directors, or executive directors in emergency service departments or businesses. Some return to school to become teachers, or physician assistants, while others progress to marketing or sales of emergency medical equipment. Some go on to a nursing career or become physicians.
Most EMTs and paramedics in metropolitan areas are paid professionals. Rural areas and villages often are served by volunteer EMTs and paramedics who work out of fire departments, emergency services, or hospitals.
The median hourly pay for EMTs and paramedics is around $15. Midrange earners receive between $12 and $19 per hour. The highest paid 10% receive nearly $25 per hour. Over one-fourth of all EMTs and paramedics are covered by a union contract.