Ambulance Driver Emt Paramedic Emergency Medicine
To understand the difference between an EMT and a paramedic, it is necessary to understand the levels of training and responsibility in the Emergency Medical System. In the United States, the roles of emergency medical first responders are changing. Currently, there are 5 levels of certification: First Responder, EMT-Basic, Intermediate/85, Intermediate/99, and Paramedic. Under a new comprehensive guideline for the improvement of EMS (Emergency Medical System) delivery in the US, entitled, "EMS Agenda for the Future", the new levels of licensure will be: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), and Paramedic. Each will have clearly defined roles and responsibilities (scope of practice) which outline the type and level of care they may provide.
First Responder/Emergency Medical Responder
This is a person who has received NO MORE THAN 110 hours of training and is someone who, "uses a limited amount of equipment to perform initial assessment and intervention and is trained to assist other EMS providers." (First Responder - National Curriculum Standard) This person is frequently a police officer or fire fighter who, as the title implies, will be first on the scene of an emergency and they've been trained to provide limited initial care. According to the curriculum, they are "not intended to be utilized as the minimum staffing for an ambulance."
EMT-Basic/EMT
This is a person who has received A MINIMUM of 110 hours of training in skills such as CPR, Automated Defibrillation, Oxygen use, Splinting, Bandaging, Lifting and Moving, and emergency childbirth to name a few. These people are the "ambulance drivers" in most areas of the United States. They are the Basic Life Support (BLS) portion of EMS and in most places will respond to all medical and traumatic requests for assistance. The majority of ambulances across the country are staffed by EMTs. They can handle the majority of the calls that they receive and they will take you to the appropriate medical facility. If there is a need for more advanced care, they will call for assistance from one of their higher-trained colleagues.
Intermediate/Advanced EMT
This level of training is not available in all states because while the federal government sets minimum standards for curriculum, the states are not obligated to adopt each level of certification. The Intermediate is someone who has received A MINIMUM of 300-400 hours of instruction which includes approximately 225 classroom/laboratory hours and 75 clinical (on the road) hours. As their title implies, they are trained to provide more advanced care, but not as advanced as that of a paramedic. Their additional skills might include, intravenous medication administration, more aggressive airway intervention, and a deeper knowledge of the anatomy and physiology of the human.
Paramedic
The paramedic is an individual who has received an average of 1000-1200 hours with the new standard moving more towards an associate's degree. The paramedic is the highest level of EMS provider in the United States. They are allowed to administer medications, use electrical means to control heart rhythms, and have a greater knowledge of anatomy, physiology, and pharmacology (medicines). The prerequisite for becoming a Paramedic is to have already been certified as an EMT. If there is a paramedic in the ambulance, it is probable that the patient has an immediately life-threatening illness or injury. The paramedic is in constant contact with the Emergency Department doctor and is begining treatment in the field that would otherwise wait until the patient arrives at the hospital. It is like bringing the Emergency Department to your house.
EMS only began as a concept in the mid-1960's and in practice in the early 1970's. Unlike police and fire, the members of EMS are newcomers to the emergency response business. Prior to just 40 years ago, (recent memory for many readers) you were taken to the hospital by untrained "ambulance drivers" who many times were driving the hearse from the local funeral home which doubled as the town's ambulance. Things have progressed quickly and change is coming even faster now. Treatment advances come quicker as more and more actual research is done on the types of treatments and their effectiveness. New technology is being developed to improve results. The bottom line is that better care in the field is resulting in more people coming home from the hospital later.
Everyone involved in EMS nowadays is well-trained to provide a specific level of care designed to improve patient outcome. There are no more "ambulance drivers"! In fact, the biggest insult to anyone in the EMS field is to be referred to as an "ambulance driver" because they have worked hard to get their training and they all have to go through continuous training to keep their licenses. Regardless of the level of training, you can be assured that when you dial 9-1-1, you will get someone who has spent time and effort at learning how to best help you.
So ultimately, the difference between an EMT and a Paramedic is the level of training and the skills acquired in that training. The Paramedic is considered advanced life support because they have more training and more advanced skills. Not "better" just more advanced. They are specialists that are used for more serious cases.
