A Paramedic is a professional who is trained to be an aide to licensed medical personnel. More commonly however, paramedics are those who are trained to respond to medical emergencies out in the field for the purpose of stabilizing the victim's condition so s/he can be transported to medical facilities.

In the United States, EMTs are licensed according to their level of training. Although the National Registry of EMT's is one such licensing entity, individual states may set their own standards of licensure. All EMT's must meet the minimum requirements as set forth in the Department of Transportation's standards for EMT curriculum. National Registry recognizes three levels of EMT: EMT-B (Basic), EMT-I (Intermediate) and EMT-P (Paramedic). The paramedic level is the highest level of nationally registered positions. In addition to the basic-level skills of CPR, first aid, airway management, oxygen administration, spinal immobilization, traction splinting, bleeding control and splinting, as well as the intermediate skills of IV therapy, endotracheal intubation and initial cardiac drug therapy, the paramedic is also educated in EKG interpretation, advanced airway skills, pharmacology, trauma resuscitation, pediatric life support and advanced cardiac life support.

Paramedics are employed by various public and private emergency services providors. These include ambulance services, fire suppression agencies, hospitals, law enforcement services, the military, or various multi-service agencies. as firefighters. Paramedics may respond to medical incidents in an ambulance, rescue vehicle, helicopter, fixed-wing aircraft, have their own dedicated response vehicle, and increasingly in fire suppression apparatus.

As nursing shortages become more and more prevalent, paramedics are increasingly used in Emergency Departments and Intensive Care Units of hospitals. Often, paramedics operate with greater lattitude and autonomy than many nurses. In addition, paramedics are often used as chief medical personnel on offshore drilling platforms and on MEDEVACS and airplanes. However, paramedics may be employed in many different medical fields, not necessarily in that of the transport of patients. Such positions may include phlebotomy, blood banks, research labs and educational fields.

In the U.S., salaries paramedics can expect range anywhere from unpaid, volunteer positions to around $60,000, depending on location and experience. It should be noted that volunteer paramedics can provide the same level of care as those at the upper end of the pay scale. Currently, in the United States, the busiest EMS service per ambulance is New Orleans' Health Department EMS, which responds to approximately 4,000 "911" calls per month, utilizing six ambulances for the entire city of about 500,000 people.

Table of contents
1 History
2 Training
3 The Future


Prior to the 1970s, ambulances were staffed with advanced first-aiders and were frequently referred to as "ambulance drivers." There was little regulation or standardized training for those staffing these early emergency response vehicles. However, after the release of the National Highway Traffic Safety Administration's "White Paper" on motor vehicle fatalities, a concentrated effort was undertaken to improve emergency medical care in the prehospital setting.

Portland, Oregon was an early pioneer in prehospital emergency medical training. Dr. Leonard Rose, in cooperation with Buck Ambulance Service, instituted a cardiac training program and began to train the first paramedics. Meanwhile, the City of Los Angelas Fire Department began training some of their firefighters in emergency care. This was vividly portrayed in the television show, Emergency.

The first paramedics began operating around 1973 and there has been a steady deccrease in cardiac related deaths and traffic fatalities ever since.

A few years later, emergency medical helicopters were put into service in the Denver area. It is now routine to have paramedic and nurse staffed EMS helicopters in most major metropolitan areas.


Paramedics receive at least two years of intensive training. Many universities now offer four-year degrees in emergency medical services, but as a relatively young industry, professional standards and training levels are still evolving.

Paramedics are trained to deal with a broad range of emergency medical situations. These include: obstetrics, cardiac, airway and breathing, a vast array of medical emergencies, orthopedics, psychological and mental health emergencies, pediatrics, trauma, vehicle extrication, communications, intravenous therapy, pharmacology, and advanced cardiac life support.

The National Registry requires significant continuing educational requirements and professional standards, as does the American Heart Association and other regulatory and standards boards.

The Future

Gone are the days, at least in the urban setting, of untrained ambulance drivers. Those in need of emergency medical care have come to expect highly trained medical professionals within four to six minutes of the onset of their emergency. Rapid treatment and transport to a qualified medical facility follow the care given by paramedics in the field.

Often fire agencies provide first-response care and support before transporting paramedics arrive.

In the future, we will see fire agencies provide increasing levels of emergency medical services. Granted, even now, due to the success of fire prevention activities, 80% of the the services provided by most fire departments is medical.