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23-May. 2011

EMS Is A Great Career

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At no time in our history has it been more important for folks to have training in emergency prehospital care. For those of you looking for an exciting and demanding health care career that is not desk-bound then emergency services may be for you.  Here is what the Bureau of Labor Statistics says about the EMT and Paramedic career field:

Nature of the work:

People’s lives often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics. Incidents as varied as automobile accidents, heart attacks, slips and falls, childbirth, and gunshot wounds require immediate medical attention. EMTs and paramedics provide this vital service as they care for and transport the sick or injured to a medical facility.

In an emergency, EMTs and paramedics are typically dispatched by a 911 operator to the scene, where they often work with police and fire fighters. (Police and fire fighters are discussed elsewhere in the Handbook.) Once they arrive, EMTs and paramedics assess the nature of the patient’s condition, while trying to determine whether the patient has any pre-existing medical conditions. Following protocols and guidelines, they provide emergency care and transport the patient to a medical facility. EMTs and paramedics operate in emergency medical services systems where a physician provides medical direction and oversight.

EMTs and paramedics use special equipment, such as backboards, to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. These workers generally work in teams. During the transport of a patient, one EMT or paramedic drives, while the other monitors the patient’s vital signs and gives additional care, as needed. Some paramedics work as part of a helicopter’s flight crew to quickly transport critically ill or injured patients to hospital trauma centers.

At the medical facility, EMTs and paramedics help transfer patients to the emergency department, report their observations and actions to emergency department staff, and may provide additional emergency treatment. After each run, EMTs and paramedics document the trip, replace used supplies and check equipment. If a transported patient has a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance and report cases to the proper authorities.

EMTs and paramedics also provide transportation for patients from one medical facility to another, particularly if they work for private ambulance services. Patients often need to be transferred to a hospital that specializes in treating their injury or illness or to facility that provides long-term care, like nursing homes.

Beyond these general duties, the specific responsibilities of EMTs and paramedics depend on their level of qualification and training. The National Registry of Emergency Medical Technicians (NREMT) certifies emergency medical service providers at five levels: First Responder; EMT-Basic; EMT-Intermediate (which has two levels called 1985 and 1999) and Paramedic. Some States, however, have their own certification programs and use distinct names and titles.

The EMT-Basic represents the first response of the emergency medical system. An EMT trained at this level is prepared to care for patients at the scene of an accident and while transporting patients by ambulance to the hospital under the direction of more highly trained medical personnel. The EMT-Basic has the emergency skills to assess a patient’s condition and manage respiratory, cardiac, and trauma emergencies.

The EMT-Intermediate has more advanced training. However, the specific tasks that those certified at this level are allowed to perform varies greatly from State to State.

Paramedics provide more extensive pre-hospital care than do EMTs. In addition to carrying out the procedures of the other levels, paramedics administer medications orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations, and use monitors and other complex equipment. However, like the EMT-Intermediate level, what paramedics are permitted to do varies by State.

Work environment. EMTs and paramedics work both indoors and out, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers are at a higher risk for contracting illnesses or experiencing injuries on the job than workers in other occupations. They risk noise-induced hearing loss from sirens and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to communicable diseases, such as hepatitis-B and AIDS, as well as to violence from mentally unstable or combative patients. The work is not only physically strenuous but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others. These workers experienced a larger than average number of work-related injuries or illnesses

Many EMTs and paramedics are required to work more than 40 hours a week. Because emergency services function 24 hours a day, EMTs and paramedics may have irregular working hours.

Job Outlook

Employment for EMTs and paramedics is expected to grow about as fast as the average for all occupations through 2018. Job prospects should be good, particularly in cities and private ambulance services.

Employment change. Employment of emergency medical technicians and paramedics is expected to grow 9 percent between 2008 and 2018, which is about as fast as the average for all occupations. Growth in this occupation is due in large part to increasing call volume due to aging population. As a large segment of the population—aging members of the baby boom generation—becomes more likely to have medical emergencies, demand will increase for EMTs and paramedics. In addition, the time that EMTs and paramedics must spend with each patient is increasing as emergency departments across the country are experiencing overcrowding. As a result, when an ambulance arrives, it takes longer to transfer the patient from the care of the EMTs and paramedics to the staff of the emergency department. In addition, some emergency departments divert ambulances to other hospitals when they are too busy to take on new patients. As a result, ambulances may not be able to go to the nearest hospital, which increases the amount of time spent in transit. Both these factors result in EMTs and paramedics spending more time with each patient, which means more workers are needed to meet demand.

In addition, hospitals are increasingly specializing in treating a particular illness or injury. This results in more patients needing to be transferred to the hospital best able to treat them. Most patients must be transferred by ambulance, so their condition can be monitored en route. Therefore, more demand for transfers between hospitals increases the demand for the services of EMTs and paramedics.

There also still will be demand for part-time, volunteer EMTs and paramedics in rural areas and smaller metropolitan areas.

Job prospects. Job prospects should be favorable. Many job openings will arise from growth and from the need to replace workers who leave the occupation because of the limited potential for advancement, as well as the modest pay and benefits in private-sector jobs. In addition, full-time paid EMTs and paramedics will be needed to replace unpaid volunteers. Emergency medical service agencies find it increasingly difficult to recruit and retain unpaid volunteers because of the amount of training and the large time commitment these positions require. As a result, more paid EMTs and paramedics are needed.

Competition will be greater for jobs in local government, including fire, police, and independent third-service rescue squad departments that tend to have better salaries and benefits. EMTs and paramedics who have advanced education and certifications should enjoy the most favorable job prospects, as clients and patients demand higher levels of care before arriving at the hospital.

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