Strictly speaking, there isn’t such a thing as an individual who is an “EMS.” EMS generally stands for Emergency Medical Services and it includes pre-hospital care provided by individuals trained and certified as EMRs, EMTs, and Paramedics. We will discuss each of those designations below.
While EMS generally includes everything from the 911 dispatcher who answers the phone to the MD (medical doctor) who delivers your final care, when most people talk about EMS they mean pre-hospital care. Pre-hospital care is the 911 system that starts when a person dials 911. Multiple first responders may be dispatched to the scene of an emergency such as a police officer, a firefighter and of course an ambulance service (sometimes operated by the fire department) with a combination of EMTs and Paramedics.
All EMS personnel must be licensed by the state they work in, and in most cases, EMS personnel begin the process by becoming nationally registered with the National Registry of Emergency Medical Technicians (NREMT). The lowest level of first responder that can operate on an ambulance is the EMR (Emergency Medical Responder). Many services will not hire EMRs because they do not have face-to-face clinical training, and in most states, they are not allowed to have direct patient contact. Axon generally discourages students from seeking EMR training unless they have a very specific need to do so.
What Is an EMT vs Paramedic?
Almost every person wanting to be employed in EMS starts out as an EMT or Emergency Medical Technician. The training can generally be completed in weeks, not months, and generally includes face-to-face clinical experiences, and face-to-face field experiences (work on an ambulance). EMTs can drive the ambulance and are frequently the first licensed healthcare worker that a person sees in an emergency. While the EMT’s “scope of practice” varies from state to state the list of services that an EMT can provide is growing nationwide.
Most individuals who work in EMS aspire to become a paramedic. While doctors, nurse practitioners, physician’s assistants, nurses and others might occasionally fly with medivac or take a rotation on an ambulance, the paramedic is customarily most advanced practitioner on an ambulance. In many states, the scope of practice for paramedics is constantly increasing and there is a nationwide trend generally referred to as Community Paramedicine to allow that would increasingly allow paramedics to provide in-home care to patients in addition to providing emergency transport for patients in urgent need of hospital treatment.