An emergency medical technician, or EMT, works as part of the emergency medical services system.

Each state has their own certifications, but all types of technicians respond to calls for help…

from gunshot

wounds to workplace injuries, to childbirth.

The ‘first responder’ is the first to arrive at a scene. They have received approximately 40 hours in an approved training program, and usually work for

industry, police, or fire departments.

The first responder has 4 major responsibilities:

1.They safely gain access to the client, using hand tools if necessary2.They identify what is wrong…the cause of the injury or the nature of the illness3.They determine the number of clients4.They request additional help when necessary

The first responder does not move or lift a client

unless required, and then must do so without causing

further injury.

There are three levels of emergency medical technicians: basic, intermediate, and paramedic.

The “EMT – Basic” has received a

minimum of 120 hours of approved training,

including an internship. They are

sometimes the first on the scene; they

sometimes arrive in response to a call

from first responders.

The EMT-B is the minimum level of certification for ambulance personnel. They are certified to provide basic life support…

the use of oral and nasal airways, applying a cervical spine immobilization collar,

use of an automatic external defibrillator,

assisting a client in taking their own medications

(such as nitroglycerine, Epi-pen, or inhaler) and

immobilization of injuries to arms and legs

The EMT-B has 6 major responsibilities:

1.Ensuring the safety of everyone in the area2.Examining and interviewing the client3.Provides basic client care

4. Lifting, moving, and transporting the client to a medical facility

5. Transferring care of client to medical facility

6. Speaking on behalf of the client by reporting concerns/ findings to receiving medical staff

The “EMT – Intermediate” has received a minimum of 300-400 hours of approved training, including an internship. They perform all the same life support

services as the EMT-B, and more.

The EMT – I can perform tasks above and beyond what the EMT-B is trained to do:

1. They can start an IV2. They can perform

advanced airline techniques

3. They can use a manual defibrillator to provide shocks to the heart

4. They can administer medications beyond those at the EMT-B level

The EMT – I can evaluate and manage clients that have been involved in accidents, cardiac,

respiratory, and other medical emergencies.

They have completed

1,000 or more hours of

classroom, clinical,

practical, and internship

training. They may have an

associate degree.

The paramedic is the highest level of EMS professional.

The paramedic can administer oral, intravenous, subcutaneous, and intramuscular medications.

They can use monitors and more complex medical equipment.

The paramedic uses all local communication tools to coordinate services, and has a thorough

understanding of policies and procedures.

They can assign care priorities, and develop an action

plan. They possess strong leadership

and decision-making skills.

As the EMT arrives at the scene, they must assess safety for the provider, other responders, the

client, and any bystanders in the area.

The EMT must follow body substance

isolation precautions. This includes the use of any personal protective

equipment deemed necessary, such as

gloves, face shields, eye protection, or protective

gowns.

The EMT must note the mechanism of injury. What caused the injuries or illness? A bomb? A

gun? A car? No use of a seatbelt?

The nature of the illness is also

assessed by the EMT. What is the

problem? Shortness of

breath? Abdominal pain?

Chest pain? Wounds?

The EMT must determine the number of clients needing assistance, and then determine whether additional resources and personnel are needed.

Once the scene has been evaluated, the EMT must 1. Form a general impression of the client’s

condition and 2. Determine their level of responsiveness.

Can they talk? Are there abnormalities in skin color? What is

their facial expression? Are they in pain? How old are they? What are their

living conditions like?

3. Determine if the airway open? In an unconscious or nearly unconscious person, the tongue may fall back

and block the airway. There are two types of airway adjuncts (Ǎ junkts)(aids) that help maintain an airway.

The oropharyngeal adjunct is inserted in the unresponsive client (with

no gag reflex).

The nasopharyngeal

adjunct is inserted in the client who might gag on the oropharyngeal

airway.

4. Determine if the client breathing adequately? If breathing is not present, the client will need

breathing assistance.

Oxygen therapy

Bag-Valve-Mask Assistance

5. Assess circulation: pulse and bleeding

A defibrillator detects an abnormal heart rhythm

and shocks it back into a good rhythm.

If there is no pulse, the EMT would start chest compressions.

If there is heavy external bleeding, apply direct pressure

and dressings.

6. The EMT must lastly assess priority. They must determine the urgency of the client’s condition and

arrange for the immediate transport to a medical facility.

The EMT might use the mnemonic ‘SAMPLE’ to take a patient’s history:

S… signs and symptomsA… allergiesM… medicationsP… pertinent past medical historyL… Last oral intakeE…Event preceding

The EMT must continue to assess the client’s

condition until they are transferred to receivers at the medical facility.It may not be until the

patient is loaded into an ambulance that the EMT

can re-evaluate vital signs and take a more

thorough history.

The EMT must communicate with both the client and their families at a time of crisis.

1. Know and use the client’s first and last name.

2. Be respectful.3. Try to be at eye-level. Watch

body language.4. Use eye contact.5. Be honest. Tell the patient

and family what procedures you are doing and if they are going to be painful.

6. Listen.

EMT’s do paperwork as documentation of

information and actions. They must provide written

reports that include the name, age, and address of

the client. They must describe any information they gained by examining

the client, any medications given,

procedures performed, and vital signs.

The EMT may need many special skills to deal with many special

situations, such as:

Emergency childbirth

Spinal injury accidents

Water & Diving

accidents