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Emergency Medical Technicians
EMTs provide on-site emergency care. Their goal is to rapidly identify the nature of the emergency, stabilize the patient's condition, and initiate proper medical procedures at the scene and en route to a hospital. Communities often take great pride in their emergency medical services, knowing that they are as well prepared as possible and that they can minimize the tragic consequences of mishandling emergencies.
The types of treatments an individual is able to give depend mostly on the level of training and certification he or she has completed. First responders, the lowest tier of workers in the emergency services, are qualified to provide basic care to the sick and injured since they are often the first to arrive on scene during an emergency. This designation is often held by firefighters, police officers, and other emergency services workers. The most common designation that EMTs hold is EMT-basic. A basic EMT can perform CPR, control bleeding, treat shock victims, apply bandages, splint fractures, and perform automatic defibrillation, which requires no interpretation of EKGs. They are also trained to deal with emotionally disturbed patients and heart attack, poisoning, and burn victims. The EMT-advanced (also known as EMT-intermediate), which is the second level of training, is also prepared to start an IV, if needed, or use a manual defibrillator to apply electrical shocks to the heart in the case of a cardiac arrest. A growing number of EMTs are choosing to train for the highest level of certification—the EMT-paramedic. With this certification, the individual is permitted to perform more intensive treatment procedures. Often working in close radio contact with a doctor, he or she may give drugs intravenously or orally, administer and interpret EKGs, perform endotracheal intubation, insert intravenous lines, and use more complex life-support equipment.
In the case where a victim or victims are trapped, EMTs first give any medical treatment, and then remove the victim, using special equipment such as the Amkus Power Unit. They may need to work closely with the police or the fire department in the rescue attempt.
EMTs are sent in an ambulance to the scene of an emergency by a dispatcher, who acts as a communications channel for all aspects of emergency medical services. The dispatcher may also be trained as an EMT. It typically is the dispatcher who receives the call for help, sends out the appropriate medical resource, serves as the continuing link between the emergency vehicle and medical facility throughout the situation, and relays any requests for special assistance at the scene.
EMTs, who often work in two-person teams, must be able to get to an emergency scene in any part of their geographic area quickly and safely. For the protection of the public and themselves, they must obey the traffic laws that apply to emergency vehicles. They must be familiar with the roads and any special conditions affecting the choice of route, such as traffic, weather-related problems, and road construction.
Once at the scene, they may find victims who appear to have had heart attacks, are burned, trapped under fallen objects, lacerated, in labor, poisoned, or emotionally disturbed. Because people who have been involved in an emergency are sometimes very upset, EMTs often have to exercise skill in calming both victims and bystanders. They must do their work efficiently and in a reassuring manner.
EMTs are often the first qualified personnel to arrive on the scene, so they must make the initial evaluation of the nature and extent of the medical problem. The accuracy of this early assessment can be crucial. EMTs must be on the lookout for any clues, such as medical identification emblems, indicating that the person has significant allergies, diabetes, epilepsy, or other conditions that may affect decisions about emergency treatment. EMTs must know what questions to ask bystanders or family members if they need more information about a patient.
Once they have evaluated the situation and the patient's condition, EMTs establish the priorities of required care. They administer emergency treatment under standing orders or in accordance with specific instructions received over the radio from a physician. For example, they may have to open breathing passages, perform cardiac resuscitation, treat shock, or restrain emotionally disturbed patients. The particular procedures and treatments that EMTs may carry out depend partly on the level of certification they have achieved.
People who must be transported to the hospital are put on stretchers or backboards, lifted into the ambulance, and secured for the ride. The choice of hospital is not always up to the EMTs, but when it is they must base the decision on their knowledge of the equipment and staffing needed by the patients. The receiving hospital's emergency department is informed by radio, either directly or through the dispatcher, of details such as the number of persons being transported and the nature of their medical problems. Meanwhile, EMTs continue to monitor the patients and administer care as directed by the medical professional with whom they are maintaining radio contact.
Once at the hospital, EMTs help the staff bring the patients into the emergency department and may assist with the first steps of in-hospital care. They supply whatever information they can, verbally and in writing, for the hospital's records. In the case of a patient's death, they complete the necessary procedures to ensure that the deceased's property is safeguarded.
After the patient has been delivered to the hospital, EMTs check in with their dispatchers and then prepare the vehicle for another emergency call. This includes replacing used linens and blankets; replenishing supplies of drugs, oxygen; and so forth. In addition, EMTs make sure that the ambulance is clean and in good running condition. At least once during the shift, they check the gas, oil, battery, siren, brakes, radio, and other systems.
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