Career Path Options for an Emergency Medical Technician and Paramedic

The average value of the Associate degree needed to become an emergency medical technician and paramedic is $498,018.00.

A career as an EMT or paramedic can be an exciting and rewarding occupational choice. EMTs and paramedics work in the Emergency Medical Services System (EMSS) and provide pre-hospital care for patients in emergency situations. Situations vary greatly and every single emergency scene may pose unique challenges and dangers to the EMT/paramedic.

Because lives depend on them, EMTs and paramedics undergo extensive education and training in order to develop their skills, knowledge and abilities. They frequently encounter dangerous and difficult situations. EMTs and paramedics learn and follow strict protocols and guidelines to protect themselves and the lives of their patients. An EMT and/or paramedic position can be a very stressful occupation. It can also be an extremely rewarding career when a patient’s life is saved.

Points of Interest

  • Volunteers with minimal training are being replaced by paid certified professionals.
  • Compensation and opportunity increase with additional certifications.
  • Employment is projected to grow at an average rate comparable to other occupations.
  • EMTs and Paramedics must be certified or licensed after attending formal education.
  • Requirements for EMTs and Paramedics vary from state-to-state.
  • EMTs and Paramedics may have irregular working hours and variable shifts, including weekends, nights and holidays.

Nature of the Work

The Department of Transportation Bureau of Traffic Safety requested the assistance of physician groups to provide a standardized curriculum for ambulance personnel. In response, various physician groups assisted in the development of leadership for the EMS. Today, all EMS personnel work under the direct supervision of a physician advisor or medical director. The EMT/paramedic works as part of an overall emergency department team. The team consists of a physician, nurse, and other healthcare staff such as physician assistants and technicians who play a role in the emergency care of the patient.

EMT/paramedics may also find themselves working with public safety personnel such as police officers, fire fighters, other law enforcement officials, social workers, and even public utility workers. The primary responsibility of the EMT/paramedic is to ensure the safety of himself, coworkers, and the patient. The EMT/paramedic is responsible for patient assessment and care based on the assessment. The patient must then be treated and safely transported to the emergency room.

The EMT/paramedic needs to accurately record and report the information to emergency room staff once the patient has been transported. On a day-to-day basis, EMTs and paramedics may find themselves in a wide variety of environments. Most EMTs and Paramedics work from an ambulance shed or fire station. When an emergency situation arises they are dispatched by a 911 dispatch operator or EMS dispatch operator to a medical emergency location. The location could be the scene of a multi-collision automobile accident, a violent domestic dispute at a home, a house fire with possible smoke-inhalation patients, or an unconscious patient who is carrying a contagious disease.

They never know where they’ll be called or what they may encounter once they reach the emergency location. Regardless of the actual emergency, EMTs and paramedics need to be able to handle the situation as competent professionals. The EMT/paramedic must quickly assess the scene upon arrival. They must be able to size up the situation and determine the safety of the scene before approaching the patient. This includes determining the cause of the injury or illness of the patient. If there are law enforcement personnel on the scene they will alert the EMT/paramedic when it is safe to approach the patient.

Once the EMT/paramedic approaches the patient, he must conduct the initial assessment of the patient. The primary assessment includes the condition and responsiveness of the patient, if the condition is life-threatening, the patient’s mental status, airway, ability to breathe, and circulation. Additional standard assessments include gathering the patient’s medical history, complaints, history of the illness, vital signs, and other relevant information. The primary tasks of EMTs and paramedics includes pre-hospital medical treatment and life-support before and during transport to an emergency room, performing initial and continuous assessments of the patient, communicating with hospital staff, recording and reporting the patient’s condition, immobilizing the patient if necessary, coordinating with emergency room staff, and other tasks as required by the EMS physician.

Emergency Medical Tech

EMTs and Paramedics use a variety of specialized equipment during the course of the work day. Some of this equipment includes: Ambulances, analgesic infusion sets or kits, anti shock garments, artificial airway holders, automated external defibrillators (AEDs) or hard paddles, blood collection needles, blood pressure recording units, bullet proof vests, cardiac monitors, EKG transmitters, EKG units, cervical and extrication collars, obstetric kits, tracheal tube kits, resuscitator or aspirator kits, hypodermic injection apparatus such as epi-pens, hypodermic needles, intubation devices, stethoscopes, aspiration and irrigation syringes, oxygen masks and portable oxygen tanks, carbon dioxide detectors, catheters, spine boards, splint sets, and vital sign monitors. EMTs and paramedics may also be required to learn new software such as information retrieval systems or search software.

These may include Epocrates software, HyperTox, Skyscape, Informed EMS Field Guide, and TechOnSoftware HazMatCE Pro. Medical software EMTs may use is MedDataSolutions Regist*r. EMTs must possess or develop numerous skill sets that include critical thinking under pressure, observation and assessment of a situation, and active listening skills to ascertain details of scenarios and patient information.

EMTs and paramedics must also be able to understand what is being explained to them, think quickly, follow direction and protocol, as well as lift and transport patients. They must be willing to provide compassionate and professional medical attention to patients, interact effectively with co-workers, and deal with family members while attending to a patient. When not directly attending to patients and patient transport they must maintain their emergency vehicles, clean and maintain equipment, and restock supplies as needed. They are also expected to continue the medical training and education on an ongoing basis.

Training, Other Qualifications, and Advancement

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There are three levels of EMTs: EMT-Basic (EMT-B), EMT-Intermediate (EMT-I), and EMT Paramedic (Paramedic). All EMT and Paramedic training includes formal classroom hours as well as additional hours for skills training. Students are also required to perform clinical hours normally performed in an emergency room setting at a hospital as well as ride-along time with an ambulance service. Entry for candidates applying for the EMT-Basic must be 18 years of age or older, complete a state-approved EMT-Basic course, and complete a state-approved EMT-Basic psychomotor exam. Many states require candidates to possess a high school diploma or GED before entering the program. EMT-Basics formal education includes the overall study for pre-hospital care of basic life support (BLS).

Coursework typically includes an overview of the Emergency Medical Services System, maintaining their own health and well-being, legal and ethical issues associated with being an EMT/Paramedic, basic applicable anatomy and physiology, lifting and transporting patients, patient assessments, types of emergencies, communications with dispatch and the hospital, record keeping and reporting, handling various types of emergency situations, treating infants and children, handling disasters and hazardous material scenarios, and public disasters related to weapons of mass destruction including biological, nuclear, and chemical. EMTs are also required to pass a psychomotor exam.

Candidates must demonstrate competency in their skills. Skills training includes using equipment, lifting patients, extricating patients, using backboards, stretchers, opening airways, measuring vitals, performing CPR, operating AEDs, applying splints and slings, applying bandages, managing impaled objects, and much more. EMT-Intermediate training consists of more specialized programs to prepare EMTs for advanced life support (ALS).

These programs typically include more detailed patient assessment, intravenous fluids, EKG interpretation, and basic pharmacology. There are two EMT-Intermediate levels – Intermediate/85 and Intermediate/99. Intermediate/85 must pass the psychomotor examination and demonstrate competency in the following areas: patient assessment/management, ventilatory management, intravenous therapy, and random basic skills such as spinal immobilization for seated and/or supine patients, and bleeding control/shock management.

Intermediate/99 must pass the psychomotor examination and demonstrate competency in the following areas: patient assessment-trauma, patient assessment – medical, ventilatory management, cardiac management skills, IV and medication skills, pediatric skills, and random basic skills such as spinal immobilization for seated and/or supine patients, and bleeding control/shock management. Paramedic training typically takes up to two years to complete typically earning an associate’s degree. The coursework is extremely detailed and includes hours of field training and clinical time. Paramedic students learn to read 12-lead EKG, needle decompression for collapsed lungs, intubation, and administration of medications for cardiac arrests, diabetic reactions, allergic reactions, and respiratory complications.

Paramedics must pass the psychomotor examination and demonstrate competency in the following areas: patient assessment-trauma, ventilatory management, cardiac management skills, IV and medication skills, oral station by verbally managing all aspects of two cases, pediatric skills, and random basic skills such as spinal immobilization for seated and/or supine patients, and bleeding control/shock management. Upon completion of formal education EMTs and paramedics are required to pass the National Registry of Emergency Medical Technicians (NREMT). The NREMT sets the standards for EMS professionals. By standardizing educational requirements for emergency medical service professionals the NREMT ensures the highest quality of emergency medical care possible.


The majority of EMTs and paramedics are employed by privately owned ambulance services. These positions account for approximately 45 percent of EMT/paramedic positions. Local government makes up approximate 29 percent of the EMT/paramedic positions. The remaining EMT/paramedic positions may include firefighters, search and rescue (SAR) medics, ski patrol medics, critical care of flight paramedic, EMS instructor, physical agility testing, event medics, and emergency room technicians. Competition for jobs in fire, law enforcement, and rescue tend to be higher due to the salaries and benefits associated with these positions.

Many EMTs work highly flexible hours. Shifts may run 8, 10, 12 or 24 hours. Some companies offer continuing education and recertification assistance to their employees. Other companies may offer various bonuses and benefits in order to retain qualified employees. Job Outlook The job outlook for EMTs and paramedics is good. Emergency medical technicians and paramedics are expected to grow about as fast as the average occupation through 2018. Growth rate is expected to be about nine percent through 2018. More and more professional EMTs and paramedics are replacing the volunteer service responders.

The knowledge and skills needed by EMTs and paramedics require greater in-depth training by dedicated professionals than previously offered by volunteers. Additional jobs prospects are expected to increase as the general population increases among the aging baby boomers. Baby boomers were the generation of children born between 1946 and 1964. There are approximately 80 million baby boomers who are reaching their advanced years. As a consequence, there is significantly more demand for emergency medical services. The baby boomer generation will continue to reach Medicare age over the next twenty years and continue to increase the need for more trained EMTs and paramedics.

The career path of EMTs and paramedics is one of continuous development from EMT-basic, EMT-intermediate, and Paramedic. Transitions beyond paramedic may lead to supervisory positions, EMT instructors, or management. Additional emergency services or medical career options such as firefighter, registered nurse, physician assistant, and healthcare-related sales representatives are also career options for transitioning from a paramedic career. These transitions along the EMS career path further opens the way for entry level positions. EMTs and paramedics are also spending more time with individual patients as emergency rooms become overcrowded. The need for more EMTS and paramedics continues to increases in order to compensate for the additional time required per patient.


As of 2008, there were approximately 210,700 EMTs and paramedics employed in 2008. The projected estimate by 2018 is 229,700, an increase of 19,000 trained and certified EMTs and paramedics.


Overall earnings for EMTS and paramedics are highly dependent on a number of variables that include the EMT or paramedic’s certifications, experience, geographical location, and employer. Recent studies suggest the following general ranges: • EMT-B: $26,000 and $27,000 per year • EMT-I: $24,000 and $32,000 per year • EMT-Paramedics: $40,000 and $46,000 per year Wages Wages for EMTs and paramedics range according to the employer, geographical location, training, experience, and certification. According to the Bureau of Labor Statistics, the median hourly wages of EMTs and paramedics were $14.10 in May 2008.

The middle 50 percent earned between $11.13 and $18.28. Wages were highest for local governments at $15.45. Earning additional degrees and certifications also impacts potential wages. EMTs with a basic certification earned a range from $9.73 – $12.43; paramedics with a certification earned a range from $9.96 to $15.14; paramedics with an Associate of Applied Science Degree earned a range from $13.93 to $16.65.

Employers also provide varying amounts of compensation. Private ambulance services paid a range from $10.00 to $21.97. Compensation also depends on geographical location and population the company serves. The range of benefits also varied across the country. The most common health benefits include: Medical – 77%, dental – 60%, vision – 46%, and no health benefits – 22%. Some companies did provide additional benefits such as tuition reimbursement, employee life insurance, flexible spending accounts, paid time off, holiday pay and employee discount programs.

Related Occupations

According to the Bureau of Labor Statistics, occupations related to EMT/Paramedics require professionals who act quickly and are able to remain level-headed during life-or-death situations. Occupations that fit the criteria include:

  • Air traffic controllers
  • Fire fighters
  • Physician assistants
  • Police and detectives
  • Registered nurses

Sources of Additional Information

  • National Association of Emergency Medical Technicians, PO Box 1400, Clinton, MS 39060-1400. Internet: National Highway Traffic Safety Administricaiton, Office of Emergency Medical Services, 1200 New Jersey Ave., SE, NTI-140, Washington, DC 20590.
  • Internet: National Registry of Emergency Medical Technicians, Rocco V. Morando Bldg., 6610 Busch Blvd., PO Box 29233, Columbus, OH 43229.
  • Internet: Secondary Sources of Information NREMT – State Offices Page.
  • Internet: American Ambulance Association, 8400 Westpark Drive, Second Floor, McLean, VA 22102.
  • Internet: National Association of EMS Educators, 250 Mount Lebanon Blvd, Ste 209, Pittsburgh, PA 15234.
  • Internet: National Association of EMS Physicians, PO Box 19570, Lenexa, KS 66285.
  • Internet: National Association of State EMS Directors, 201 Park Washington Court, Falls Church, VA 22046.
  • Internet:

The EMT Oath “Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law. I shall also share my medical knowledge with those who may benefit from what I have learned.

I will serve unselfishly and continuously in order to help make a better world for all mankind. While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot. So help me God.” by Charles B. Gillespie, M.D. Adopted by the National Association of Emergency Medical Technicians, 1978

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