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Becoming a EMT: The Journey

Emergency Medical Technician (EMT) or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services. Common obsolete terms include ambulance driver, ambulance orderly, ambulance attendant and ambulanceman. The precise meaning of the term varies by jurisdiction, but in many countries EMTs respond to emergency calls, perform certain medical procedures and transport patients to hospital in accordance with protocols and guidelines established by physician medical directors. They may work in an ambulance service (paid or voluntary), as a member of technical rescue teams/squads, or as part of an allied service such as a fire or police department. EMTs are trained to assess a patient’s condition, and to perform such emergency medical procedures as are needed to maintain a patent airway with adequate breathing and cardiovascular circulation until the patient can be transferred to an appropriate destination for advanced medical care. Interventions include cardiopulmonary resuscitation, defibrillation, controlling severe external bleeding, preventing shock, body immobilization to prevent spinal damage, and splinting of bone fractures.

The modern EMT program in the United States began as part of the “Alexandria Plan” in the early 70′s. Emergency medicine (EM) as a medical specialty is relatively young. Prior to the 1960s and 70s, hospital emergency departments were generally staffed by physicians on staff at the hospital on a rotating basis, among them general surgeons, internists, psychiatrists, and dermatologists. Physicians in training (interns and residents), foreign medical graduates and sometimes nurses also staffed the Emergency Department (ED). EM was born as a specialty in order to fill the time commitment required by physicians on staff to work in the increasingly chaotic emergency departments (EDs) of the time. During this period, groups of physicians began to emerge who had left their respective practices in order to devote their work completely to the ED. The first of such groups was headed by Dr. James DeWitt Mills who, along with four associate physicians; Dr. Chalmers A. Loughridge, Dr. William Weaver, Dr. John McDade, and Dr. Steven Bednar at Alexandria Hospital, VA established 24/7 year round emergency care which became known as the “Alexandria Plan”. It was not until the establishment of American College of Emergency Physicians (ACEP), the recognition of emergency medicine training programs by the AMA and the AOA, and in 1979 a historical vote by the American Board of Medical Specialties that EM became a recognized medical specialty. The nations first EMT’s were from the Alexandria plan working as Emergency Care Technicians serving in the Alexandria Hospital Emergency Room. The training for these technicians was modeled after the established “Physician Assistant” training program and later restructured to meet the basic needs for emergency pre-hospital care. On June 24, 2011, The Alexandria Hospital Celebrated the 50th Anniversary of the Alexandria Plan. In attendance were three of the nations first ECTs/EMTs: David Stover, Larry Jackson,and Kenneth Weaver.

In the United States, EMTs are certified according to their level of training. Individual states set their own standards of certification (or licensure, in some cases) and all EMT training must meet the minimum requirements as set by the National Highway Traffic Safety Administration’s (NHTSA) standards for curriculum. The National Registry of Emergency Medical Technicians (NREMT) is a private organization[4] which offers certification exams based on NHTSA education guidelines. Currently, NREMT exams are used by 46 states as the sole basis for certification at one or more EMT certification levels.

Resources:
EMT: Info, History, Training
Becoming a EMT: The Journey

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