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EMT vs Paramedic

Updated on March 18, 2013

Emergency Medical Technicians come in 3 different types. The lowest level is the EMT Basic (EMT-B), which most people refer to as only an EMT. There is also the EMT Intermediate (EMT-I) and the Paramedic (EMT-P). In general, all three types of Emergency Medical Technicians can be called EMT's. But, EMT Basics and EMT Intermediates do not get the honor of being called a Paramedic.

Most people who have considered the emergency medical field focus on choosing whether to become an EMT Basic or a Paramedic. The reason for this is because if you are going to invest the extra time and energy beyond the basic certification, you might as well go all the way.

The biggest differences between the Basic level certification and the Paramedic level are:

  • Education & Training
  • Salary
  • Job Duties & Responsibilities

The best option to get certified as an EMS professional is the NREMT.
The best option to get certified as an EMS professional is the NREMT. | Source

EMT vs Paramedic Education

EMTs and Paramedics must both be certified as Emergency Medical Personnel. Each state has different requirements as to whether a state, local or national certification is necessary. The most common requirement is the NREMT (National Registry for Emergency Medical Technicians) Certification. To obtain this certification, you must go through some form of training course that is approved by the NREMT. The training course required is what differentiates the EMT Basic and Paramedic education requirements. These training courses can usually be completed at a community college, technical school, Ambulance service, or a private company. Just make sure that whatever training course you do, you are eligible to take the NREMT exam after you are finished. The biggest difference in the EMT and Paramedic training is the amount of material covered, the length of the training, and the depth of subjects covered.

Emergency Medical Technician (Basic) Training

NREMT Basic Education Requirements:

  • Successful completion of a state-approved EMT-Basic / EMT course in the last two years.
  • CPR / BLS (Basic Life Support)
  • 70 - 120 question cognitive, computer based exam
  • Hands on Skills testing
  • Approximately 6 months long
  • 322 clock hours of didactic learning
  • 48 hours of ambulance runs to include a minimum of 5 emergency ambulance runs
  • 24 hours of clinical rotation in an emergency department

The EMT-Basic course you will complete will cover the following:

  • Airway
  • Ventilation
  • Oxygenation
  • Trauma
  • Cardiology
  • Medical and EMS Operations

The EMT- Basic Hands on Skills testing will cover the following:

  • Patient assessment/management of a trauma patient
  • Patient assessment/management of a medical patient
  • Cardiac arrest management/AED
  • Bag-valve-mask ventilation of an apneic patient
  • Spinal immobilization (both seated and supine patient)
  • Long bone fracture immobilization
  • Joint dislocation immobilization
  • Traction splinting
  • Bleeding control/shock management
  • Upper airway adjuncts and suction
  • Mouth-to-mouth ventilation with supplemental oxygen
  • Supplemental oxygen administration to a breathing patient.

Paramedic Training

NREMT Paramedic Education Requirements:

  • You must be a certified EMT-B or higher before you can begin training to become a Paramedic
  • Successful completion of a state-approved EMT-Paramedic / Paramedic course in the last two years
  • CPR / ACLS (Advanced Cardiac Life Support)
  • 80 - 150 question cognitive exam
  • Hands on Skills testing
  • 624 clock hours of didactic learning
  • 240 hours of ambulance rotation to include 20 emergency MICU runs
  • 120 hours of clinical rotation at various medical department facilities (ER, ICU, CCU)

The EMT-Paramedic course you will complete will cover the following:

  • Airway
  • Ventilation
  • Oxygenation
  • Trauma
  • IV Treatment
  • Pharmacology
  • Cardiology
  • Medical and EMS Operations


The Paramedic Hands on Skills testing will cover the following:

  • Patient Assessment-Trauma including scene size-up, initial assessment/resuscitation, focuses history and physical examination, rapid trauma assessment and a detailed physical examination.
  • Ventilatory Management including adult and dual lumen airway device.
  • Cardiac Management Skills including dynamic cardiology and static cardiology.
  • IV and Medication Skills including intravenous therapy and intravenous bolus medications.
  • Oral Station includes verbal treating patient from scene management, patient assessment, patient management, interpersonal relations and integration.
  • Pediatric Skills including pediatric ventilatory management and pediatric intraosseous infusion.
  • Random Basic Skills including spinal immobilization of a seated and supine patient and bleeding control/shock management.

Bicycle Paramedics in Los Angles, California
Bicycle Paramedics in Los Angles, California | Source

Job Duties

Both EMTs and Paramedics can work in a hospital as an Emergency Room Technician or on an ambulance as part of an Emergency Medical Service (EMS) Crew. Typically, EMTs and Paramedics can hold the same job titles but can not complete the same job duties. However, most of the time the Paramedic is the Supervisor of the EMT. The typical set-up in an ambulance is that the EMT drives and and the Paramedic is in the back with the patient.

If you have thoroughly looked at the training of an EMT and a Paramedic, you can clearly see that a Paramedic is trained to do much more than an EMT. This is also where they differ in what they do at work, via their scope of practiced. EMTs do what their training covers and Paramedics do everything else.

There is an easy way to remember what kinds of things EMTs and Paramedics do on the job. Generally, an EMT can not do anything where the skin is broken. Paramedics can break the skin via IV's, chest tubes, ect. Paramedics also can administer a greater variety of pharmaceuticals to patients.

EMT vs Paramedic Salary

Average EMT Basic Salary: $24,000

Average Paramedic Salary: $40,000

Would You Rather be an EMT or a Paramedic

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    • johnyoger profile image

      johnyoger 4 years ago from Indiana

      I agree, I would much rather have a paramedic if given the choice.

    • Learning in Life profile image
      Author

      Megan Sisko 4 years ago from SW Florida

      Being as I am a certified EMT-Basic, I would much rather have a Paramedic assist me in my time of need. This is also why and EMT will always be accompanied by the Paramedic. The EMT is basically a glorified ambulance driver, there to assist if the Paramedic needs help.

      I plan to get certified as a Paramedic if I continue to practice emergency medicine. However, I was training by the Army to be a Medic and even they don't stop at the EMT level. The Army teaches their Medics and equivalent to the EMT-Intermediate but only issues certification for the EMT-B.

    • Peggy W profile image

      Peggy Woods 4 years ago from Houston, Texas

      It seems to me that if one is involved in an accident, one could hope that they have a paramedic attending them instead of an EMT. They can do so much more to assist one and hopefully save one's life if it is in peril. Perhaps many EMTs go on to become paramedics? The salary is certainly better although not all that high considering the work that they do. Up, useful and interesting votes.