Emergency Medical Technician (EMT)

Overview

• Medical professionals providing emergency services
• Commonly serve on ambulances and fire departments (US & Canada)
• Work under physician-written protocols
• Found in public ambulance services, EMS agencies, hospitals, fire departments
• Employment: Paid or volunteer, especially in rural areas

Hazard Controls

• Exposure to hazards: Lifting, infectious diseases, handling hazardous substances, transportation risks
• Mitigations: Safe patient handling equipment, training, PPE (personal protective equipment)
• COVID-19 specific recommendations: Universal PPE, hygiene, disinfection protocols
• Ambulance ventilation issues: Recirculating aerosols; solutions include unidirectional airflow

Canada

• Paramedic practice varies by province; national standards set by National Occupational Competency Profile
• Levels: Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Advanced Care Paramedic (ACP), Critical Care Paramedic (CCP)
• Regulation: Provincial legislation, professional bodies (e.g., Alberta College of Paramedics)

Paramedic Levels

• Emergency Medical Responder (EMR): Basic pre-hospital care, beyond advanced first-aid
• Primary Care Paramedic (PCP): Entry-level, basic medical care, some advanced skills with training
• Advanced Care Paramedic (ACP): High demand, extensive skills (e.g., airway management, ECG interpretation)
• Critical Care Paramedic (CCP): Focus on patient transfer between hospitals, work alongside RNs/RTs

International Perspectives

Ireland

• EMT, paramedic, advanced paramedic titles protected by Pre-Hospital Emergency Care Council (PHECC)
• EMTs handle non-emergency calls
• Responders trained in basic and advanced life support

Philippines

• Titles defined by Department of Health

Spain

• Tcnico en Emergencias Sanitarias (TES) trained in 2000hrs, covers all EMS
• ALS ambulances have physician and emergency nurse

United Kingdom

• EMT term not strictly defined, varies by employer
• May hold IHCD Ambulance Technician Certificate or equivalent
• Work autonomously, within training scope

United States

• EMTs certified by levels of training as per state standards
• Levels: Emergency Medical Responder (EMR), EMT, Advanced EMT (AEMT), Paramedic
• National guidelines by NHTSA, certification exams by NREMT
• EMR: Basic first aid, CPR, defibrillation, airway management
• EMT: Common entry level, comprehensive skills (e.g., bleeding control, CPR, airway devices)
• Advanced EMT: Intermediate life support, additional medication administration
• Paramedic: Highest level, advanced life support, medical procedures

Staffing and Education

• Ambulances classified by crew levels: BLS (EMTs), ILS (AEMTs), ALS (Paramedics)
• Training: Varies by state, includes clinical rotations in ambulances/hospitals
• Continuing education required for recertification

Employment

• EMTs employed across EMS, fire, police, hospitals, and more
• Volunteer and full-time positions available
• Some EMS agencies operate independently of fire departments

Conclusion

EMTs play a crucial role in emergency medical services, operating within various frameworks and regulations across different countries. Their training and scope of practice are shaped by local, national, and international standards to meet the demands of emergency healthcare.