Emergency Medical Technician-Basic (EMT-B) is the entry level of Emergency Medical Technician (pre-hospital emergency medical provider) in the United States.
EMT-Bs are not trained to provide definitive medical care, but instead focus on rapid in-field treatment and transport to higher medical providers. EMT-Bs work in conjunction with other medical providers such as paramedics, nurses, and physicians, as well as with other EMT-Bs. When operating in the prehospital environment, their actions are governed by protocols and procedures set by their system's physician medical director.
Emergency Medical Technician-Intermediate (EMT-I) is a mid-level provider of prehospital emergency medical services in the United States; a transition of this level of training to Advanced Emergency Medical Technician (AEMT), which has somewhat greater training, is in progress. The EMT-I is not intended to deliver definitive medical care, but rather to augment prehospital critical care and provide rapid on-scene treatment. EMT-Is are most commonly employed in ambulance services, working in conjunction with EMTs and Paramedics. The EMT-Intermediate or AEMT is typically authorized to provide more advanced medical treatment than the EMT and is typically authorized to provide advanced life support.
Typical training for the EMT-I involves a class, which can range from a couple of months to a year, with the length often depending on state requirements. Along with the classroom time, the EMT-I is required to complete many hours of clinical experiences in the operating room, emergency department, other hospital units and advanced life support ambulances. During these clinical hours, the EMT-I must successfully demonstrate full practical knowledge of skills learned.
In the United States, the licensing of prehospital emergency medical providers (emergency medical technicians (EMTs)) and oversight of emergency medical services are governed at the state level. Each state is free to add or subtract levels as each state sees fit. Therefore, due to differing needs and system development paths, the levels, education requirements, and scope of practice of prehospital providers varies from state to state. Even though primary management and regulation of prehospital providers is at the state level, the federal government does have minimum requirements for EMTs, Advanced EMTs and Paramedics set through the National Highway Traffic Safety Administration (NHTSA). In the list, certification levels are provided from most basic to most advanced.
While states are able to set their own additional requirements for state certification, a quasi-national certification body exists in the form of the National Registry of Emergency Medical Technicians (NREMT). The NREMT offers a national certification based on the NHTSA National Standard curriculum for the levels of First Responder, EMT, Advanced EMT and Paramedic. Individual states are allowed to use NREMT certification as part of their certification process, but are not required to. As of 2011, 38 states use the NREMT examination for EMT certification and 45 states use the NREMT examination for Paramedic certification. These levels are denoted below using an asterisk (*). At present time, use of the NREMT examination for EMT-Intermediate 85 and 99 have not been included in this list.
Emergency Medical Services in the United States, (EMS) provide out-of-hospital acute medical care and/or transport to definitive care for those in need. They are regulated at the most basic level by the federal government, which sets the minimum standards that all states' EMS providers must meet, and regulated more strictly by individual state governments, which often require higher standards from the services they oversee.
Wide differences in population density, topography, and other conditions can call for different types of EMS systems; consequently, there is often significant variation between the Emergency Medical Services provided in one state and those provided in another.
Emergency medical responders are people who are specially trained to provide out-of-hospital care in medical emergencies. There are many different types of emergency medical responders, each with different levels of training, ranging from first aid and basic life support. Emergency Medical Responders have a very limited scope of practice and have the least amount of comprehensive education, clinical experience or clinical skills. The Emergency Medical Responder (EMR) is not meant to replace the roles of Emergency Medical Technicians, Emergency Medical Technologists or Paramedics and their wide range of specialities. Emergency Medical Responders typically assist in rural regions providing basic life support where pre-hospital health professionals are not available due to limited resources or infrastructure.
A medic is a trained medical responder which includes people who provide basic first aid and physicians. The term medic does not imply that the individual provides any specific level of care. In some areas, paramedic is also used as a general term for medical responders. However, paramedic may also be a specific level of training.