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EMS

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AN OVERVIEW

A career in Emergency Medical Services (EMS) can take on many different forms, and it can be a great way to start a career in medicine. EMS refers to the system that provides emergency medical care. Much of EMS takes place in the prehospital environment, whether that be urban, rural, or wilderness settings. EMS does not operate in isolation, instead, it is integrated among other systems including health care, public safety, and public health. 

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The certification levels for wilderness EMS do not go as high as those of Urban EMS. WFR will often be paired with EMT or Paramedic to create a higher level of certification known as a WEMT (Wilderness EMT), with the EMT or paramedic certifications providing a wider range of skills, but the WFR providing the individual with the understanding of the differences in working in an urban vs. wilderness environment. An EMT may also be called an EMT-Basic, and while these are the four levels currently being taught, there are people who hold EMT-Intermediate certifications.


Basic EMS certification, such as EMR (Emergency Medical Responder) or EMT can be incredibly beneficial in conjunction with other careers such as structural firefighting, wildland firefighting, and outdoor education. The career ladder in EMS is large and has many directions. This means that it is a great career to try if you are interested in medicine, but unsure of the direction you want to go. There is also the new and evolving role of community paramedics, who function outside the typical emergency response, increase access to primary and preventative care, and decrease the use of emergency rooms, which decreases costs. Other jobs you could pursue after working in EMS include physician assistant, nurse, doctor, medical equipment repairer, surgical technologist, forensic science technician, radiologist, or registered nurse (RN).
 

EMS LEVELS

Urban EMS Certification levels

  • Emergency Medical Responder (EMR)

  • Emergency Medical Technician (EMT)

  • Advanced Emergency Medical Technician (AEMT)

  • Paramedic (highest level of certification)

Wilderness EMS Certification levels

  • Wilderness First Aid (WFA)

  • Wilderness First Responder (WFR)

EMS positions

  • EMT or Paramedic on Ambulance

  • Firefighter

  • Contract medic

  • Emergency room technician

  • Medic for wildland firefighters

  • Offshore Medic

  • Industrial medic

  • Flight medic

  • Leadership and management positions

  • Emergency dispatcher

  • Search and rescue crews

  • Pilot for air ambulance such as LifeFlight

  • Contract medic

  • Emergency room technician

  • Medic for wildland firefighters

  • Offshore medic

  • Industrial medic

  • Flight medic

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Ambulance

Job description

Because there are so many routes that can be taken with EMS, each job description will be different. The description provided here is fairly general, as where you will work will depend on what kind of schedule you have, if you are on an ambulance, and if you operate out of a station or not. Private ambulance companies do not operate out of stations, rather each ambulance will be located in different locations around a city/town while awaiting a call.

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Duties and tasks include:​

  • Ensuring everything is in working order and there are the correct amount of all supplies

  • Restocking supplies when they are used or run low

  • Professionalism as you are continuously working with the public 

  • Documenting calls (charting)

    • There are many different charting systems and methods out there, so it is likely that you will encounter multiple different charting systems throughout your career. 

  • Ambulance driving and operation

  • House chores if based out of a station

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You may respond to:

  • Medical calls

  • Motor-vehichle incidents

  • Trauma 

  • Larger incidents such as fire or other environmental issues

  • Interfacility transfers (taking patients from one hospital to another)

  • Public assist or lift assist calls that are not a medical emergency, for example, someone fell down and is unable to get up on their own. Whether you respond to this type of call or not depends on the system you are in.  

 

Your level of certification will also change your job description, as with higher certifications comes more advanced care options. If you are a paramedic, you are an ALS provider (Advanced Life support), if you are an EMT you are a BLS (Basic Life Support) provider. If you are working in an urban environment, most of your calls will be in this environment and you will transport a patient to the nearest appropriate hospital. Urban environments are closer to a higher level of care, so the time spent with a patient may be quite short. However, in a wilderness environment, such as on a search and rescue (SAR) team or working as an outdoor professional, a higher level of care may be multiple hours away, and so you may spend many hours with this patient.

Job Requirements

  • High school level diploma, GED, or equivalent 

  • The appropriate level of certification of the job you are applying for (EMT, Paramedic, etc.)

  • Valid driver's license and satisfactory driving record

  • Ambulance driving course and certification (oftentimes jobs will provide this training for you if you do not already have it)

  • Background check

  • Drug test is common

  • Physical test

  • Vaccination records

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Paramedic specific:

  • More extensive interview process

  • Psychological testing

EDUCATION

An EMT certification course can be taken through a community college. There are other programs that offer a-typical EMT courses, such as NOLS. EMT programs can differ in length, but typically can be completed in an academic year or less. After you get your EMT, if you wish to continue with EMS this could look like getting your Paramedic certification which totals about two years of schooling. Advanced-EMT (AEMT) is a certification level between EMT and Paramedic that is also an option. 

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All of these certifications can be obtained through a community college. There are also a handful of 4-year universities that offer 4-year EMS bachelor's degrees that include paramedic certification in addition to more specialized training such as mountain medicine, public health, epidemiology, etc. 

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When you obtain your EMS certification you will first become registered nationally through the National Registry of Emergency Technicians (NREMT), and then you can apply to get your state certification. The requirements for state certification vary from state to state.

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