A lot of people have asked me over the years; “Hey doc, how do I, an average Joe, become a high speed medic much like yourself?” After I stop blushing, I tell them, “It’s really pretty easy, there are basically two ways. The first is the civilian route and the second is the military route.”
Let’s talk about the civilian route first. This is how I initially got involved with pre-hospital Para-medicine way back in 1986. First off, a little background, there’s an organization called the (NREMT) National Registry of Emergency Medical Technicians (www.nremt.org) that has, in conjunction with the Department of Transportation, set national standards for emergency medical responders.
The four levels of certification are; First Responder (FR), EMT-Basic (EMT-B, “basic”), EMT-Intermediate (EMT-I, “intermediate”) and EMT-Paramedic (AKA EMT-P, EMT-Advanced, paramedic, (“paramagic”, “medic”, etc). These certifications are recognized by a majority of the United States (right now there are five states that do not recognize NREMT certification. As of 31 Dec 2009 they are NY, MA, NC, IL, and WY. When in doubt, check with your state health department to find out which certification is required.
Most states also have a concurrent certification process. Some are easy to obtain by just submitting your NREMT certification and paying the state fee. Or it can be as time consuming as having to sit for another set of tests along with the appropriate fees.
The first step to becoming certified is to find a school or organization that is offering a state-approved First Responder or EMT-B course that meets or exceeds the U.S. Department of Transportation First Responder National Standard Curriculum (www.ems.gov).
My honest opinion is that you should forego the First Responder and get directly into an EMT-B course. For not much more time and money you’re going to learn a lot more, be able to help more people out in the “real world” and have a certification that is pretty much recognized throughout the country.
I recommend calling your local community college to see if they offer a course. A couple of other options are to look for a volunteer fire department or rescue squad that offers the training or attend a private training program.
Last year, I took a Wilderness EMT course through a private outdoor leadership school. The course allowed the students to sit for the NREMT-Basic testing, NREMT-B plus Wilderness EMT, and 30 days in the Rockies. Sign me up!
EMT-Basic is the initial entry position that is required for later becoming an EMT Intermediate or Paramedic and is based on 110 hours of instruction. Additionally, the EMT-B student will have to work several shifts on an ambulance, or in a hospital emergency department, sometimes both.
Generally a candidate must be 18 years old, have no felony convictions, have a current CPR card for the Professional Rescuer, be vaccinated against hepatitis B, DPT and MMR and have had a TB tine test within the past 6-12 months. Most states also require some kind of formal background check that you’ll have to pay for.
After you have passed the didactic portion of the class, you will have to sit for the NREMT and/or state, written and practical tests to become certified. On a side note, EMT’s are not “licensed” we are “certified”. In the pre-hospital setting we work under the license of our Medical Director who is a physician.
The NREMT “written” test is actually a “computer adaptive test”. This means the computer will give you harder and harder questions until you start to miss them. Then it goes back to slightly easier questions to make sure you know what you’re talking about.
The practical test is an actual “hands-on”, psychomotor, scenario based skills test. Some of the skills tested are; patient assessment, cardiac arrest management/Automated External Defibrillator, bag-valve-mask ventilation, spinal immobilization, long bone fractures, traction splinting, bleeding control/shock management, upper airway adjuncts and suction, and supplemental oxygen administration just to name a few.
I know it sounds like a lot, but a good program should devote at least 50% of class room time to skills practice. Practice makes perfect!
In the next article; “Medic 201: How to advance my training” we’ll discuss intermediate and paramedic levels of certification.
Buck M. has been a medic for over twenty years in both the military and in the civilian sector.