A day in the life of an EMT - Tech Connection

Career World, Feb-March, 2003 by Monika G. Vaccaro

Car accidents, gunshot wounds, heart attacks, and other life-threatening emergencies--they're all part of an Emergency Medical Technician's job. No matter the situation, it is always about caring for people.

The call comes in. A 65-yearold female is having trouble breathing. Time for action.

Sirens activated. Maps checked. It is lightly snowing in Minnesota as the ambulance speeds toward the scene at about 80 miles per hour.

A Call to Action

Dave Page, a paramedic-level emergency medical technician (EMT) with 17 years experience, is in the ambulance. His heart rate is a bit higher than normal. He wonders what they will find when they arrive.

What Page found was a little boy's grandmother (the boy was asleep on the couch) with a case of pneumonia. "We had to convince her to go in to the hospital, because she had an appointment for the next day," says Page.

Page and his crew gave the grandmother oxygen that night. They also started an IV that dripped in medication to open her lungs. They monitored her heart rate and checked her blood pressure. They chatted with her while they "worked her up" in the ambulance.

On-the-Spot Care

Emergency medical service (EMS) workers provide pre-hospital assessment and care to sick or injured people at the scene or on the way to the hospital. They must stay levelheaded at all times to quickly evaluate the emergency and the patient's condition.

The first goal is to stabilize the patient. EMS workers administer emergency medical treatment as needed. They also prepare the patient for the ride to the medical facility.

When an ambulance arrives at the hospital, EMTs transfer the patient to the care of the Emergency Room staff. After the patient handoff, EMTs make sure any supplies they used are restocked and that the vehicle is ready to go when the next call comes in.

Different Levels, Different Responsibilities

The type and amount of medical treatment administered depends on the level of training the EMS worker has. Four levels are recognized by the National Registry of Emergency Medical Technicians (NREMT), the organization that administers the EMT certification exams.

The first level, First Responders, are qualified to provide basic emergency medical care but generally do not transport patients. You may know people in your community who are First Responders--your local police, volunteer rescue squad members, or your town's firefighters.

The other EMT levels are Basic, Intermediate, and Paramedic. Additional training and job experience are required at each level. Hours of training vary from 40 hours for a First Responder to 1,000 to 2,000 hours for a Paramedic. With each level comes increased duties and responsibilities.

Paramedics

Paramedic EMTs perform more advanced pre-hospital care. They may administer drugs, read EKGs, or perform invasive procedures such as opening airways and advanced cardiac life support.

Page feels that 10 to 20 percent of calls require actual paramedic attention, but he said what people don't know is that 99.9 percent require someone with paramedic training to evaluate the patient's medical condition. "Almost all of our calls would benefit from having a paramedic-level assessment," he says.

Not All High Points

EMTs respond to emergency calls such as the call Page was on. But an EMT's job is also about the everyday care of patients.

"What you see on the different TV shows, like ER, are the high points, the dramatics," says Doyle Glennon, an EMT in Louisiana. "But you don't see the nursing home patients. If you're in it for the glory, you're in it for the wrong reason.

"It's a wonderful feeling to jump out there in the middle of chaos and try to bring some order to it," he adds. "But it takes a lot more training and thinking when you're dealing with the medical side of it"

"People get disillusioned with our career. They think it's always like ER."

Michael Amstein, director of human resources for American Medical Response, the largest national private medical transportation service, says that most of their people thrive on the excitement.

"You must be able to handle 23 hours of boredom followed by an hour of pure adrenaline," says Amstein. "You never know what you're going to get."

Extreme Conditions

On top of the mental stress EMTs face, the adrenaline rushes, or the up-and-down nature of the job, can cause physical stress. "Being prepared and being ready to jump into action from standing around while having a cup of coffee can cause burnout from the physical wear and tear on your body," says Amstein.

EMTs also spend a lot of time bending, kneeling, and lifting. They work indoors and outdoors, regardless of weather conditions.

"You must be physically fit to carry people... pull them out," says Page. "Staying in shape and being healthy over the years is challenging."

And, because emergency room services and nursing horn? care operate 24 hours a day, seven days a week, EMTs work irregular hours- nights, weekends, and holidays.

EMTs also face the added stress of possibly being exposed to diseases such as AIDS. However, the risk of infection is small, and EMTs are aware of and follow procedures to minimize these risks.