As a paramedic, you are ultimately responsible for all aspects of patient care on the scene of any medical emergency. You are in charge of proper documentation, radio reports, treatment, transport destinations and mode of transport. You will be held legally responsible for all interventions performed on the patient in your presence. In many cases your closest help will be miles away at the nearest hospital. As you may have heard many times before, great power comes with great responsibility.

Scared yet?

With all the responsibilities and stress associated with becoming a paramedic, the job has still proven itself to be rewarding. After a hard days work, the satisfaction of knowing you made a difference in one or many peoples lives, makes it all worth it. People will look to you in their greatest time of need and place all their trust in your training and expertise to save their life. Parents will hand you – a complete stranger – their child and trust that you will make them better and give them a safe journey to the hospital. Some people will life a long and fulfilling life as a direct result of your life-saving interventions, and some may die regardless of the amount of effort you and your crew had put forth.

Anyone who has been working in the EMS for a while knows that the job isn’t all about saving lives. On many occasions the 911 system is flooded with non-emergent calls and in some cases, strait out abuse. Sometimes you sit in a station for 24 hours and never turn a wheel on your ambulance.

So now you might be thinking “so how do I become a paramedic?”

To obtain certification through the NREMT (Nation Registry of Emergency Medical Technicians), you must pass six to eight months of didactic training, approximately a month of hospital-based clinical training and a minimum of 400 hours of field training. You must then pass a series of skills-based tests and a written or computer based exam. For more information on certification requirements, visit the NREMT website as http://www.nremt.org

Didactic (classroom) training typically lasts about 6 to 8 months. You will extensively cover many subjects such as anatomy, physiology, cardiology, pharmacology, pulmonology, trauma emergencies, medical emergencies, scene control, OB/GYN, geriatric emergencies, pediatric emergencies and ECG interpretation. You will also practice several ALS (advanced life support) procedures such as starting intravenous lines, administering IV medications, needle decompression, surgical airways, oral and nasal intubation, NG tube placement, IO placement, manual defibrillation and external pacing. This is a general list of skills taught. Skills may vary from state to state, depending on the allowed scope of practice.

Once you finish your classroom time, you will move on to hospital-based clinical training. Here you will get the opportunity to practice your newly learned skills on live patients in a controlled environment. Most programs include rotations through the ER, Operating Room, OB/GYN, ICU, NICU and sometimes psychiatric hospitals.

Now that you have practiced your newly learned life-saving skills, you will move on to field training. You will be placed with a paramedic-preceptor as you learn how to apply all your acquired knowledge and skills to a pre-hospital setting. This can the hardest part of paramedic training, especially for those who have little to no experience in a pre-hospital setting. This will last a minimum of 400 hours, but typically lasts 500 to 600 hours depending on your progress.

Once you get signed off from field training, you are now eligible to take the NREMT exam and apply for certification as an EMT-Paramedic. Skills testing will usually consist of stations including verbal scenarios, mega codes, pediatric emergencies, trauma and even some BLS stations as well. The written (or sometimes computer-based) tests are difficult and consist of questions covering everything you learned in your didactic portion of your training.

The whole process can be stressful and can quite possibly be the hardest course you ever take. Taking classes in anatomy, physiology and ECG interpretation prior to starting the program will make the class significantly easier. Some other quick classes offered by the American Heart Association like ACLS and PALS can also make paramedic school easier. For a list of AHA classes, visit http://www.americanheart.org

Good luck in your journey towards becoming a paramedic. I hope this article will serve a good reference or starting point. Please feel free to e-mail with any questions or comments.

Before we discuss the steps to becoming an EMT, lets talk about what an EMT is.

EMT’s are a vital link in the health care system, as they are typically the first to arrive at the scene of any medical emergency. EMT’s provide life-saving interventions at the basic, intermediate and advanced (paramedic) level. For the purposes of this article, we will focus on the “basic” or entry-level EMT.

EMT-Basics perform basic airway management, bleeding control, splinting, oxygen administration, spinal immobilization, and suctioning. In some cases EMT’s even administer some medications and are trained in childbirth.

In most settings, EMT-Basics typically work with a paramedic. In some cases ambulances will be staffed with two EMT-Basics in volunteer, rural or inter facility transfer settings.

Now for the big question, “how do I become an EMT?”

To achieve certification through the NREMT (National Registry of Emergency Medical Technicians), you must take a semester long class and pass a written and skills test at a licensed testing facility.

Many community colleges offer EMT-Basic training and testing. Some companies and fire departments also offer in-house EMT-Basic training. For more information on the requirements for certification as an EMT-Basic visit http://www.nremt.org

For someone with no medical or emergency services background, EMT-Basic school can be difficult. The semester-long class is a crash course in anatomy, physiology, pharmacology, airway and breathing emergencies, cardiology, trauma emergencies, pediatric emergencies, patient assessments, OB/GYN and much more.

If you are new to the medical field, I would recommend studying or taking a class in medical terminology. This will relieve a large majority of the challenges associated with EMT-Basic school. Researching basic anatomy and physiology prior to class will also place you ahead of the game.

Unfortunately I can not cover everything that is expected in EMT training as classes may vary from state to state. For information about becoming an EMT-Intermediate or Paramedic, please refer to my article titled “Want to become a paramedic?”.

I hope this will help serve as a starting point in your new exciting career in EMS. Please feel free to e-mail me with any questions or comments.

Now what?

Activating the 911 system for first time often scares people. The thought of loud sirens, bright lights and several strangers entering your home can make you nervous or even hesitant to call in a time of need. For these reasons, I decided to create this article in hopes that you will know what to expect and what you can do to help in the event that someone you know or love takes a turn for the worst.

Unfortunately you can not plan or schedule emergencies. They often occur when you least expect it. Staying calm and taking control of the situation will be your key to a smooth transition from the panic of the incident to definitive medical care.

If you are at home, work or a place of business, always try to use a land-line telephone. In a state of panic you are likely to forget your address. Using a cell-phone makes tracing your location difficult for 911 dispatchers.

The 911 dispatcher is going to ask you several questions. Some of which may seem time consuming or ridiculous. Just remember, be patient and answer all of the questions clearly and accurately. Your answers will assist the dispatchers in assigning a priority to the call and give the paramedics valuable pre-arrival information. Try not to rush though the conversation. There are several dispatchers on duty at all times. While one is talking to you, another is dispatching the closest ambulance.

Once you know that help is on the way, you can perform several tasks to minimize the amount of time that the emergency workers have to be on scene.

- Make sure your lights are on.

The emergency crews will be looking for signs of activity. This will make locating your house easier.

- Leave your front door open.

This will also aid in spotting your house in the event that your address is not clearly visible.

- Clear a path.

Move cars out of the driveway, unlock any gates and move items that might prevent the paramedics from moving a gurney to the scene.

- Gather medications, identification and insurance information.

Have all of this ready in a bag. By doing this, you will cut several minutes away from the time the paramedics must stay on scene. This translates into a quicker transfer to definitive care.

If there are several people standing around, assign these tasks to others. Keeping people busy and out of the way will benefit your loved-one and make the responding paramedic’s job easier.

The paramedics will likely ask several questions. Some of which you may have answered when you spoke to the 911 dispatcher. Although this may seem like wasting time, be patient. The paramedics must have a clear understanding of what is wrong so they can determine the appropriate treatment and transport destination.