gency medical care. They have more training than first aid, but less than an emergency medical technician (EMT). A certification exists for first responders, and many firefighters, police officers, and other emergency workers have first responder training, which is useful since they may arrive on the scene before an EMT. First responders use a limited amount of equipment to perform initial assessment and intervention and are trained to assist EMTs once the EMTs arrive on the scene (NHTSA and MCHB, 1995; Bureau of Labor Statistics and U.S. Department of Labor, 2004).
EMTs are the backbone of prehospital emergency care in the United States as they are usually the first providers of direct medical care to patients needing emergency treatment. There are generally three levels of EMT: EMT-B (Basic), EMT-I (Intermediate), and EMT-P (Paramedic).
EMT-Bs are those trained to provide basic, noninvasive prehospital care, although their scope of practice varies by state and may include certain invasive procedures in some states. EMT-Bs provide care to patients at the scene of a medical emergency (e.g., car crash) and during transport to the hospital. They perform the following tasks:
Examine victims to determine the nature and scope of their injury or illness.
Administer basic life support (BLS), including providing oxygen or performing cardiopulmonary resuscitation (CPR).
Use automated or semiautomated defibrillators to administer lifesaving shocks to a stopped heart.
Upon arrival at the hospital or medical center, help the staff provide preadmittance treatment and obtain patient medical histories (Bureau of Labor Statistics, 2002; State of California Employment Development Department Labor Market Information Division, 1995).
EMT-Ps are the most highly skilled EMTs, and they provide the most extensive care. Paramedics are trained in all phases of emergency prehospital care, including advanced life support (ALS) treatment. In addition to the tasks performed by EMT-Bs, they may also:
Administer drugs (usually intravenously).
Administer intravenous fluids.
Use manual defibrillators to administer lifesaving shocks to a stopped heart.
Use advanced airway techniques and equipment to assist those patients experiencing a respiratory emergency.
Perform endotracheal intubations and perhaps other invasive airway maneuvers.
Interpret the results of heart-monitoring equipment (Bureau of Labor