So you have been working the field as an EMT-Basic or EMT-Intermediate for some time now and you feel it’s time to take the next step in your career. Making the decision to become a paramedic takes a lot of time and consideration. Working as an EMT is fun, rewarding and exciting, but are you ready to take on the responsibility of being a paramedic?

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.