by Kirk W. Johnson

Created on: July 18, 2010   Last Updated: May 15, 2011

To understand the difference between an EMT and a paramedic, it is necessary to understand the levels of training and responsibility in the Emergency Medical System.  In the United States, the roles of emergency medical first responders are changing.  Currently, there are 5 levels of certification: First Responder, EMT-Basic, Intermediate/85, Intermediate/99, and Paramedic.  Under a new comprehensive guideline for the improvement of EMS (Emergency Medical System) delivery in the US, entitled, "EMS Agenda for the Future", the new levels of licensure will be:  Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), and Paramedic.  Each will have clearly defined roles and responsibilities (scope of practice) which outline the type and level of care they may provide.

First Responder/Emergency Medical Responder

This is a person who has received NO MORE THAN 110 hours of training and is someone who, "uses a limited amount of equipment to perform initial assessment and intervention and is trained to assist other EMS providers." (First Responder - National Curriculum Standard)  This person is frequently a police officer or fire fighter who, as the title implies, will be first on the scene of an emergency and they've been trained to provide limited initial care.  According to the curriculum, they are "not intended to be utilized as the minimum staffing for an ambulance."

EMT-Basic/EMT

This is a person who has received A MINIMUM of 110 hours of training in skills such as CPR, Automated Defibrillation, Oxygen use, Splinting, Bandaging, Lifting and Moving, and emergency childbirth to name a few.  These people are the "ambulance drivers" in most areas of the United States.  They are the Basic Life Support (BLS) portion of EMS and in most places will respond to all medical and traumatic requests for assistance.  The majority of ambulances across the country are staffed by EMTs.  They can handle the majority of the calls that they receive and they will take you to the appropriate medical facility.  If there is a need for more advanced care, they will call for assistance from one of their higher-trained colleagues.

Intermediate/Advanced EMT

This level of training is not available in all states because while the federal government sets minimum standards for curriculum, the states are not obligated to adopt each level of certification. 

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