What's the Difference Between an EMT and a Paramedic?

Just turn on your television and you'll see them.

Whether it's on the breaking news story of the day or on a TV drama, you'll see them. Hollywood loves them. Remember the show that started it all, Emergency!? They are the uniformed men and women rescuing the victims of an accident or a disaster. Sometimes you'll see them in ambulances, sometimes they are in fire trucks, hospitals or in helicopters. They are everywhere that help is needed. They are EMTs and Paramedics. Both work in a variety of roles and are often the first on the scene of accidents, medical emergencies, and natural disasters. They both wear uniforms and they both help patients - so what's the difference?

In the field of emergency medical services (EMS), there are different levels of certifications for provider of care. Emergency Medical Technicians (EMTs) are the most common type of providers in all of EMS. They are the entry-level patient care provider followed by EMT-Intermediates (in some states) and then paramedics. EMTs are sometimes referred to as EMT-Basics or EMT-1s. However, do not be fooled by the term "entry-level." EMTs learn the essential skills to help in life-threatening situations and their education is the foundation for all other levels of provider. As one EMS instructor recently put it, "You can't learn and be good at advanced skills without having a solid foundation of basic skills." Many paramedics, doctors, nurses, and firefighters have used their EMT education and work experience as a stepping stone to their new career.

Both EMTs and paramedics have the knowledge and skills to transport patients and provide them with emergency care. The biggest difference between them is the amount of education they receive and what they are allowed to do for patients (scope of practice).

EMTs usually complete a course such as UCLA's EMT course that is about 160 hours in length. Paramedic courses can be between 1,200 to 1,800 hours. EMT and paramedic courses consist of lectures, hands-on skills training, and clinical and/or field internships. EMTs are educated in many skills including CPR, giving patients oxygen, administering glucose for diabetics, and helping others with treatments for asthma attacks or allergic reactions. With very few exceptions, such as in the case of auto-injectors for allergic reactions, EMTs are not allowed to provide treatments that requiring breaking the skin: that means no needles.

Paramedics are advanced providers of emergency medical care and are highly educated in topics such as anatomy and physiology, cardiology, medications, and medical procedures. They build on their EMT education and learn more skills such as administering medications, starting intravenous lines, providing advanced airway management for patients, and learning to resuscitate and support patients with significant problems such as heart attacks and traumas. Paramedic education programs (such as UCLA's Paramedic Program) may last six to twelve months.

So How Do You Become an EMT or a paramedic?

In order to become an EMT or a paramedic, there are four (4) major steps that you will need to complete, which may vary from state to state. In California you must:

  1. Meet the eligibility requirements and prerequisites for attending an EMT or paramedic course.
  2. Attend and successfully complete an approved EMT or paramedic education course.
  3. Take and pass the National Registry of Emergency Medical Technicians (NREMT) EMT or Paramedic computer based exam.
  4. Apply and obtain for certification within two years of being issued a course completion certificate.

The eligibility requirements and prerequisites for EMT and paramedic courses may vary from school to school. So be sure to check with the schools you are interested in before you enroll for a course. In general, to be eligible for enrollment into an EMT course you do not need to have any previous medical experience. You must be at least 18 years of age to be eligible to certify as an EMT in California. Becoming an EMT is the first crucial step to becoming a paramedic. To be eligible for a paramedic course, you must be an EMT and generally have at least 6 months of work experience as an EMT.

In addition to these eligibility requirements, some courses have other prerequisites including academic and medical requirements. Again, be sure to check with the course you are interested in to find out what they require from you. Some courses may require you to submit proof of a current basic physical and proof of immunizations. Remember, this is about protecting your health and that of your patients!