Paramedicine: What Are the Practitioner Levels in the Field?
Paramedicine practitioners play a crucial role in public safety. As first responders they are often the first people on the scene of an accident or crime, providing first aid, life support, and transportation to the hospital. These dedicated professionals literally save lives. No day on the job is like any other, and while the work can be stressful and exhausting, it is also valuable and rewarding.
If you are considering a career in this field, you likely have a passion for helping people. There are few jobs that allow you to get more hands-on in helping people than paramedicine. To make the decision to enter this career, you need to know more about it, how to get an education, how to get certified, and how to choose which level of paramedicine you want to practice. Not all first responders have the same qualifications and certifications. There are different levels, and to make a choice about your future career, you need to understand what they are.
Paramedicine Practitioners and EMT Certification Levels Vary by State
The different levels of paramedicine vary depending on the state you live and work in. Certification requirements and levels are regulated by state law, not federal law, so there can be a lot of variation depending on where you want to work. Most states have one or more levels of professionals called EMTs, or emergency medical technicians, as well as paramedics. Some states, like Minnesota and Alaska, have six or more levels of EMTs and paramedics, while others have just two.
Florida is one of the states that has a simple tier of paramedicine practitioners. In Florida you can become certified and work as an emergency medical technician or a paramedic. In other states there are additional levels for EMTs including basic, intermediate, and advanced. In most states, paramedic is the highest level, although some states include an advanced paramedic certification as well as paramedic certification for nurses or physician assistants.
EMTs vs. Paramedics
Regardless of the specific titles of levels of emergency, first responder care, in general a paramedic has had more training and can perform more advanced medical procedures than an EMT. Both EMTs and paramedics may be responsible for the following duties on the job:
- Responding to 911 calls
- Providing first aid, CPR and resuscitation
- Assessing a patient’s health and current condition
- Deciding on immediate care based on the assessment
- Providing life support
- Transporting patients in an ambulance to an emergency room or hospital
- Transporting patients from the ambulance into the hospital
- Communicating with nurses, doctors, and other health care professionals
- Documenting care given to patients
- Cleaning, replacing, and inventorying equipment
Where EMTs and paramedic practitioners differ is in the types of care that may be administered to a patient. In general, an EMT is not allowed to perform any procedure that punctures the patient’s skin. An exception to this is the use of life-saving injections, such as an epinephrine auto-injector used to treat anaphylaxis from an allergic reaction or the medication used to reverse an overdose caused by opioid drugs.
Other procedures that paramedics may perform, and that EMTs do not, include administering medications, inserting intravenous lines and administering fluids, using and interpreting electrocardiograms, using other advanced health and life support monitors, providing advanced airway management, and caring for and administering life support for patients with significant health problems, like trauma or cardiac arrest.
EMT Paramedicine Levels
While Florida has just one level of certification for EMTs, many states have two or more. For instance, some states certify emergency medical responders as the lowest level of first responder, while other states call this first level EMT I or EMT Basic. There are also EMT Intermediate and EMT Advanced levels in several states as well as specialized EMT levels, such as EMT Ambulance or Cardiac Technician.
EMT Basic or Emergency Medical Responder
This basic level of emergency responder can provide immediate and basic lifesaving care and first aid, but typically must wait for higher-level EMTs or paramedics to perform any more advanced care. They are likely to be partnered with EMTs or paramedics to provide assistance rather than working alone. An EMT Basic may also drive the ambulance and assist with transporting of patients.
An intermediate EMT is trained to administer more advanced medical care than an EMT at the basic level. This may include training to assess the state of patient, more advanced airway procedures and devices, the use of a defibrillator to resuscitate patients, and the administration of some medications, including supplemental oxygen.
In most states the advanced EMT certification is the last level before achieving paramedic status. An advanced EMT can administer more advanced airway management tools, suction patients that have been intubated by a paramedic, prepare a patient for an IV, and administer most medications. These EMTs can work more independently but report to and take direction from any paramedic on staff.
Training and Certification of Paramedic Practitioners in Florida
In Florida there are just two types of emergency and first responder certification: EMT and paramedic. An EMT in Florida performs all of the duties that are described for emergency medical responders and all levels of EMT in other states. Paramedics have more hours of training and are able to perform more medical procedures and use more advanced equipment and monitors. Paramedics in Florida may also be in leadership roles, working with and directing EMTs to assist them. When working with EMTs, paramedicine practitioners are responsible for making decisions about patient care and transport.
EMTs and paramedics in Florida are certified by the Department of Health, Division of Medical Quality Assurance. If you complete an EMT or paramedic program in Florida, the department requires that you pass the appropriate National Registry of Emergency Medical Technicians (NREMT) examinations or that you take a Prometric exam. To become certified for the latter option, you have to first apply to the Department of Health to be authorized to take the exam. This step is not required for taking the NREMT exam for certification.
If you were educated out of state but passed the appropriate NREMT exam, you only need to apply to the department for certification. If you have worked in the military as an EMT or paramedic and you passed the NREMT, you can become certified through Florida’s VALOR program. You must apply to the Department of Health and prove that you were honorably discharged from the military within the last six months. All paramedic and EMT applicants in Florida must also show that they have CPR or Advanced Cardiovascular Life Support certification as well as HIV/AIDS training, both of which can be achieved by graduating from an appropriate EMT or paramedic training program.
The Market for Paramedicine Practitioners is Growing
Whether you choose to practice as an EMT or a paramedic, you will be in a good position to get a job and earn a good income. The allied health industry is one of the fastest growing industries in the country. Allied health describes all positions that support physicians, including paramedics and EMTs. More specifically, jobs for trained and certified EMTs and paramedics are increasing much faster than average job growth, at a rate of 24 percent. There is huge demand in nearly every state for trained professionals in first response care.
Florida is no exception, where the industry is growing, especially in metropolitan areas. You can also expect to earn a good income on this job as well as enjoying good job security. In Florida, the average annual salary for paramedics and EMTs is $31,750. There is a potential to earn more as a paramedic and by working more hours.
Training for Paramedicine Practitioners
The only way to become an EMT or a paramedic is to start with a post-secondary education. You must earn a certificate or associate degree in emergency medical services in order to pass the national exam and gain certification through any state, including Florida. Most paramedics earn an associate degree, which is a two-year degree. You may be able to get through the program more quickly if you are able to take several courses at once. If you have to keep working while you earn your degree, most schools offer flexible course schedules. Coursework in these programs typically include first aid and CPR, HIV/Aids training, first responder training, EMT training, and paramedic training. Most also include hands-on work or externships.
A career in emergency medicine is exciting, fast-paced, rewarding, and most of all important. These valued professionals help save lives every single day. If you’re ready to explore the possibility of a career as an EMT or paramedic in Florida, find a paramedic school in Miami or in other areas of the state. City College offers a comprehensive program that will train you to work as a paramedic and that will prepare you to pass the certification exam so you can begin your career right after graduating.