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What is the Difference Between an EMT and a Paramedic?

Emergency medical technicians in the United States have different skill levels, although states do differ in their licensing requirements.

Certification Level

Paramedics are the highest level of emergency medical technicians. A paramedic really is an EMT-Paramedic, but is only referred to as a paramedic. The term "EMT" usually refers to an EMT-Basic or EMT-Intermediate level.

A paramedic needs to be an EMT-Basic to get experience in the field before becoming a paramedic. Then a paramedic can complete a two-year degree to become certified. An EMT-Basic does not always go on to become a paramedic, but it is a common transition.


Because of having more extensive training in pharmaceutical drugs, paramedics can administer drugs orally and intravenously. They are also completely responsible for drug administration. The paramedics are really emergency drug experts, as they must know:

  • Immediately what the appropriate drug is for a patient of any age
  • How much to reduce doses for senior citizens and young children
  • How to get information about the medical and drug history of the patient quickly to make sure the patient does not experience negative reactions from drug interactions or have allergies to medications

These are the unique responsibilities of paramedics and not EMTs. While an EMT-Intermediate is able to administer some drugs, the paramedic oversees all drug administration and is legally liable if an EMT-Intermediate inappropriately administers a drug.

A paramedic also has more extensive knowledge in cardiac and vascular emergency treatment than EMTs, so they can operate equipment such as an electrocardiogram (EKG) and interpret the read out. The paramedic takes the responsibility of leading the emergency medical team and assigning tasks to EMTs. In the absence of a paramedic, an EMT would also be a responsible emergency medical team leader.


While EMTs and paramedics are all trained to provide excellent quality emergency care, the paramedic has the most extensive knowledge and experience of the team. The term 'basic' does not accurately describe their qualifications as they are well-qualified. EMTs-Basic are trained to make an accurate patient assessments and:

  • Attend emergency child births
  • Control bleeding
  • Clear airway obstruction
  • Manage respiratory irregularities
  • Effectively treat trauma, cardiac emergencies, and fractures for transport to the hospital

The skills of an EMT-Intermediate build on those already mastered as an EMT-Basic. Overall an EMT-Intermediate functions at a more advanced level. In addition, an EMT-Intermediate can administer intravenous fluids and some medications.

The paramedic has mastered all the skills of an EMT-Basic and an EMT-Intermediate, and takes on the responsibility of administering all needed drugs as already discussed. They have also had more advanced training in anatomy and physiology.

They all must be precise communicators, clear thinkers, and in good physical condition. They all must be able to lift heavy equipment and move patients. They all must be able to make life threatening decisions quickly and be flexible if something is not working. Together emergency medical technicians and paramedics function as an excellent team to save peoples lives.

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