There are a variety of career opportunities available for individuals who obtain their emergency medical technician (EMT) certification. Individuals will be qualified for specific careers depending on their level of EMT certification and/or post-secondary education, as well as the amount of field and clinical experience they have accumulated. EMTs at the Basic level (EMT-Basic) are qualified to assess a patient’s condition and also manage any cardiac, respiratory, or trauma emergency. EMTs at the Intermediate levels (EMT-Intermediate) are trained and qualified to administer certain medications and intravenous fluids, use specialized medical equipment such as a defibrillator, and perform more advanced treatment on a patient with a respiratory emergency.
EMTs who have obtained their Associate’s degree, remained updated on their registration and other necessary certifications, and worked the necessary hours in the field can go on to become paramedics where they can provide the widest range of emergency medical services. Some EMTs and paramedics choose to become EMT instructors or emergency dispatchers. Some change gears altogether and go into marketing or selling emergency medical equipment.
One would be wise to consider that nearly half of the EMT workforce works for ambulance services while another 30% work for local governments and the remaining 20% work in hospitals. Many full-time EMTs and paramedics work in large cities and metropolitan areas for city and municipal emergency medical services (EMS) departments while others work for private or commercial ambulance services.
EMT jobs can expand beyond the hospital or fire house walls, however. Some EMTs work in the oil and gas industries in an offshore EMT position. Or, the EMT can work for a security company providing security officer and EMT services combined, for example in residential communities, on college campuses, or in casinos.
Because paramedics have received the most advanced levels of training and attained extensive clinical and field experience, they can go on to become EMT supervisors or operations managers. They can also advance to administrative- or executive-director levels within an emergency services operation.
The pay and benefits for each EMT career will be determined by where the EMT works and the EMT’s certifications or level of post-secondary education, as well as the EMT’s on-the-job field and clinical experience.
Common EMT Jobs
Private Ambulance Companies
Many emergency medical technicians (EMTs) work for private ambulance companies. Individuals with EMT certification who are considering getting a job with an ambulance or medical emergency service should understand one key difference in responsibilities between city ambulance services and those provided by private ambulance companies. Where city or government owned and operated ambulance services are most commonly part of a first responder emergency team that provides medical care at the scene of an accident or fire, private or commercial ambulance services are more typically involved in providing transportation services for patients who need to be moved from one medical facility to another, for example from a nursing home to a hospital. That is not, however, the only role commercial ambulance companies have.
A private ambulance company can be called to respond or provide medical services in a variety of situations, both emergency and non-emergency. For example, some municipalities contract with private ambulance companies to provide emergency medical services. In these cases, when someone calls 911 to report a medical emergency, the 911 operator will contact and dispatch the ambulance service that is closest to the location of the emergency, which could be either a private ambulance company or a municipal service. The EMTs and paramedics employed by the private company must be prepared to respond to emergencies at all times, similar to their counterparts in city ambulance services.
Commercial ambulance services can also be called when, after municipal emergency services have responded to an emergency and stabilized patients, the commercial ambulances need to transport patients to a hospital. Some municipalities rely on the use of private ambulance services as backup at night or on weekends, when municipal personnel may not be working or the fire department (or municipal emergency service department) may be understaffed.
Oftentimes, private ambulance services are called to remain on standby at sporting events, concerts, or other events where medical emergencies can potentially occur. Some EMTs consider this type of job one of their fringe benefits because it provides them with an opportunity to attend special events without having to pay to get in, even if it means they are not able to sit in the general seating area with the paying ticket holders.
EMTs and paramedics who work for private ambulance companies work under the direction of a medical doctor and will receive orders for treatment as necessary, just as municipal EMTs do.
City Ambulance Services
City or municipal emergency medical technicians (EMTs) work for emergency medical services (EMS) agencies that are run and funded by a city or municipality. These EMTs typically work together with the municipal police and fire departments. Where police officers and fire fighters are the first responders to the scene, EMTs are the ones who will provide the emergency medical care required. But, the role EMTs play in terms of the medical services they can provide will be determined by their level of training and EMT certification.
An EMT will be involved primarily in first assessing the conditions of the people who require medical care, and second, in managing cardiac, respiratory, and traumatic emergencies. An EMT can also continue patient care in the ambulance while en route to a hospital but must do so under the direction of more highly trained emergency medical personnel. Advanced EMTs will be able to address a broader range of medical issues and also provide more specialized medical care such as using a defibrillator or administering drugs.
EMTs and Paramedics typically work in teams. Following their training protocols and emergency service guidelines, they work together to provide patients with the medical treatment needed. In emergency medical services systems, a physician is always available to provide additional medical direction and oversight.
Once the EMTs have transported the patient to the medical facility they will assist in the transfer of the patient to the emergency department. There the EMTs will provide the emergency room staff a full report of their observations and any treatment they provided. When necessary an EMT provides additional emergency treatment at the hospital. Once their ambulance run has completed, the EMTs will check their equipment to ensure it is functioning and properly stored; they will also replace supplies that were used during the course of the emergency. On occasion, it is necessary for EMTs to decontaminate the interior of their ambulance; when this happens the EMTs will also be responsible for reporting any contagious diseases to the appropriate authorities.
EMTs need to be in excellent physical condition. They should be strong, dexterous, have good vision and coordination. EMTs need to respond appropriately and quickly, correctly applying what they learned in class to the real-life emergency, regardless of how stressful the situation may be.
Firefighters and police are considered first responders because they are the first to arrive at the scene of an accident, fire, or other life-threatening situation. Fire departments receive emergency calls based upon how closely located to the emergency scene they are. Emergency medical services might arrive shortly after the first responders do, as they could be coming from a different medical facility elsewhere within the municipality or they could be a private medical services company with whom the municipality contracts for such services.
Firefighters will provide basic life support skills to ill or injured patients until the trained emergency medical technicians (EMTs) arrive on the scene. First responder firefighters have no other role in treating or transporting patients to a medical facility, as this is done by a team of EMTs. Or, in the case of a patient requiring advanced care such as intravenous medication, a Paramedic will also provide treatment and accompany the patient to the hospital in the ambulance. Having an EMT certification allows the EMT to play an important role in helping individuals and the community by working alongside firefighters and other emergency personnel.
Many EMTs and Paramedics work for city and municipal fire departments. Some fire departments house their own ambulance and EMT teams, so when the 911 call comes in, both fire department and EMT services are called out at the same time. In some cities, however, firefighters also have their EMT certification and can respond to an emergency in either a fire truck or an ambulance, or in some other emergency type vehicle such as a Medic or Aid van. Fire departments also receive emergency medical support from volunteer EMTs who respond when the fire department makes a call to them for assistance, providing ambulance service and medical care when needed.
EMTs and Paramedics who work for fire departments can be scheduled to work a 24-hour on-call shift followed by two days off. They frequently work overtime hours, with a 50-60 hour workweek not being unheard of. EMTs are prepared to respond to 911 emergency calls at irregular hours.
Approximately 20% of all paid emergency medical technicians (EMTs) and Paramedics work in hospitals. One important hospital job for EMTs is to be part of a team providing routine patient care in the hospital’s emergency department, under the direction of a clinical nurse. EMTs can also be part of the hospital’s ambulance team, responding to medical emergencies or transporting patients between medical care facilities. Having an EMT certification is the first step in obtaining such a job.
To obtain a job working in a hospital’s emergency department, the individual should have more than an EMT certification. To be well-prepared for such a job, the EMT should also possess Basic Life Support certification and be prepared to obtain other advanced life support certifications as required. The EMT should also be knowledgeable in routine patient care procedures, familiar with emergency equipment and supplies, be able to observe and report any changes in a patient’s condition, and understand infection control. EMTs should also have good communication and problem-solving skills.
EMTs can also work as part of a hospital or other medical facility’s ground ambulance team. In this important position, the EMT is responsible for providing emergency pre-hospital support care to critically ill or injured patients and safely transporting them to the hospital facility. EMTs working for a hospital system may also be required to transport patients to a specialized treatment facility, including transporting infants and babies to neonatal and pediatric intensive care units. Like the emergency department EMTs, these EMTs must possess an in-depth knowledge of basic emergency care and basic life support skills. In addition to driving an ambulance, these EMTs should also be able to drive a wheelchair van. Good communication skills are essential as the ambulance team EMT is required to communicate about a patient’s condition with the healthcare personnel of other medical facilities and also with members of the patient’s family. In some cases, the EMT has an additional duty of public relations specialist, supporting educational programs about the critical care transportation system and even speaking publicly about the program.
EMTs and paramedics who work for hospitals can be scheduled to work 12-hour shifts or a 24-hour on-call shift followed by a specified number of days off, usually two. They frequently work overtime hours, so a 50-60 hour workweek can be the norm. EMTs will also be able to receive the hospital’s full benefits.
Maritime industries with offshore operations such as gas and oil, shipping, military, and aviation must meet industry standards for safety and training. These industries operate around the globe in complex and dangerous work environments. They require properly trained emergency medical personnel to work in their offshore and remote locations.
Some companies provide health, safety and survival training, and consulting services to these maritime industries. They also provide safety-related personnel, emergency assistance, and equipment to them to ensure they meet all maritime safety and training requirements. These companies will hire emergency medical technicians (EMTs) and paramedics as part of their professional training staff or as workers contracted to provide the required safety and medical emergency services at these industries’ offshore sites.
EMT certification in the National Registry of Emergency Medical Technicians (NREMT) is a prerequisite for these jobs. EMTs should also have certifications in First Responder, Basic Life Support, Cardiopulmonary Resuscitation (CPR), and Automated External Defibrillator (AED). What is more, EMTs are required to have several years of experience in emergency medical and ambulance services as well as demonstrated competency in performing life-saving treatments.
Paramedics with pre-hospital field experience should have exceptional medical skills and be well-trained and prepared to administer emergency medical care and treatment in just about any offshore or industrial medical emergency. In addition to the work experience and certifications required of EMTs, paramedics must also be certified in Advanced Cardiac Life Support, Pediatric Care and Treatment, and Pre-Hospital Trauma Life Support.
While these types of jobs may appear exciting and glamorous because of the travel involved, they can also be quite rigorous and demanding. Remote or offshore EMTs can be involved in a variety of operations ranging from a technical rescue to a medical evacuation via aircraft. Work environments can be on board a ship or in extreme heat or cold weather conditions. These EMTs must be physically fit, comfortable traveling to foreign countries, and working well in a multi-cultural work environment. Competition for these jobs can be tight. EMTs aspiring to provide their services in a remote or offshore work environment should, in addition to having all the requisite certifications and work experience, provide references or letters of recommendation as part of the application process.