Detailed Guide forEmergency Medical Technicians and Paramedics in California
May also be called: EMTs; Fire Fighter First Responders; Firefighters and EMTs; Firefighters and Paramedics; Flight Paramedics
What Would I Do?
People’s lives often depend on the quick reaction and competent care of Emergency Medical Technicians (EMTs) and Paramedics. Incidents as varied as automobile accidents, heart attacks, strokes, falls, childbirth, and gunshot wounds all require immediate medical attention. They are the skilled medical workers who provide this vital service as they care for and transport the sick or injured to a medical facility.
The EMTs are sent to emergencies by specially trained dispatchers who maintain radio contact or patch them through to medical professionals for ongoing instructions. Following procedures, they examine victims to determine the nature and extent of injury or illness and administer first aid and emergency basic life support, such as giving oxygen and doing cardiopulmonary resuscitation. They may use special equipment, such as backboards, to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility.
The EMTs generally work in teams. During the transport of a patient, one EMT drives while the other monitors the patient’s vital signs and gives additional care as needed. They keep the emergency vehicles in excellent condition and well stocked with medical supplies. Some EMTs work as part of a helicopter’s flight crew to transport critically ill or injured patients to hospital trauma centers.
The EMT-Basic (or EMT-I) represents the first component of the emergency medical technician system. An EMT trained at this level cares for patients at the scene of an accident and while transporting patients by ambulance to the hospital under medical direction. The EMT-Basic has the emergency skills to assess a patient’s condition and manage respiratory, cardiac, and trauma emergencies. They help the emergency room staff do pre-admittance treatment and obtain medical histories.
The EMT- Advanced (or EMT-II) has more advanced training. In addition to basic duties, they may insert intravenous catheters, administer intravenous glucose solutions or a limited number of drugs, and obtain blood samples for laboratory analysis. In certain emergencies, EMT-IIs may be approved to perform advanced life support procedures.
The EMT-Paramedics provide the most extensive pre-hospital care. In addition to carrying out the procedures of the other levels, Paramedics may administer drugs orally and intravenously, insert breathing-aid devices, use stomach suction equipment, interpret electrocardiograms, and use monitors and other complex equipment.
Important Tasks and Related Skills
Each task below is matched to a sample skill required to carry out the task.
|View the skill definitions|
|Task||Skill Used in this Task|
|Maintain vehicles and medical and communication equipment, and replenish first-aid equipment and supplies.||Equipment Maintenance|
|Assess nature and extent of illness or injury to establish and prioritize medical procedures.||Active Listening|
|Administer first-aid treatment and life-support care to sick or injured persons in prehospital setting.||Medicine and Dentistry|
|Operate equipment such as electrocardiograms (EKGs), external defibrillators and bag-valve mask resuscitators in advanced life-support environments.||Judgment and Decision Making|
|Perform emergency diagnostic and treatment procedures, such as stomach suction, airway management or heart monitoring, during ambulance ride.||Critical Thinking|
|Communicate with dispatchers and treatment center personnel to provide information about situation, to arrange reception of victims, and to receive instructions for further treatment.||Speaking|
|Immobilize patient for placement on stretcher and ambulance transport, using backboard or other spinal immobilization device.||Service Orientation|
|Comfort and reassure patients.||Customer and Personal Service|
|Decontaminate ambulance interior following treatment of patient with infectious disease and report case to proper authorities.||Public Safety and Security|
|Observe, record, and report to physician the patient's condition or injury, the treatment provided, and reactions to drugs and treatment.||Monitoring|
Below is a definition for each skill.
|View the tasks to skills list|
|Equipment Maintenance||Performing routine maintenance on equipment and determining when and what kind of maintenance is needed.|
|Active Listening||Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.|
|Medicine and Dentistry||Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.|
|Judgment and Decision Making||Considering the relative costs and benefits of potential actions to choose the most appropriate one.|
|Critical Thinking||Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.|
|Speaking||Talking to others to convey information effectively.|
|Service Orientation||Actively looking for ways to help people.|
|Customer and Personal Service||Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.|
|Public Safety and Security||Knowledge of relevant equipment, policies, procedures, and strategies to promote effective local, state, or national security operations for the protection of people, data, property, and institutions.|
|Monitoring||Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.|
The EMT works indoors and out, in all types of weather. When responding to an emergency, EMTs (usually working in two-person teams) must maneuver safely and quickly through traffic while obeying traffic safety laws. Their response times are carefully tracked, and they are expected to reach the emergency scene within a specified number of minutes. They cope with all kinds of emergencies involving many people, such as victims of heart attacks, multiple vehicle accidents, or natural disasters, like earthquakes and floods. Technicians must deal with victims and bystanders while controlling the scene with calmness and a reassuring manner.
The EMTs must do considerable kneeling, bending, and heavy lifting. They risk noise-induced hearing loss from sirens and back injuries from lifting patients. Following necessary safety precautions such as proper lifting techniques reduces risk of injury. In addition, EMTs may be exposed to diseases such as hepatitis-B and AIDS, as well as violence from mentally unstable patients. The work is not only physically strenuous but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others.
While most EMTs work for private ambulance companies, a few travel with forest fire fighting teams to provide emergency care for injured workers.
Because emergency services function 24 hours a day, EMTs have irregular working hours. The EMTs employed by private ambulance services work 45 to 60 hours a week. Those employed by small and rural hospitals frequently work 45 to 50 hours, and those in fire departments work about 50 hours a week. They work evenings, weekends, and holidays and their schedule may include a 48-hour shift, followed by several days off.
Many EMTs are represented by various organizations based on where they work, such as the California State Firefighters’ Association.
Will This Job Fit Me?
The job of EMT may appeal to those who enjoy assisting others and promoting learning and personal development. This occupation also may appeal to those who like communicating with people and working in a friendly non-competitive environment.
What Wages and Benefits Can I Expect?
Wages vary between geographic locations, the individual's training and experience, and employment setting, such as private or public ambulance service organizations.
The median wage in 2016 for Emergency Medical Technicians and Paramedics in California was $33,722 annually, or $16.21 hourly. The median is the point at which half of the workers earn more and half earn less.
Benefits generally include medical, dental, and vision insurance as well as vacation, sick leave, and retirement plans. The EMTs who work for fire or police departments typically receive the same benefits as firefighters or police officers.
What is the Job Outlook?
Some departments rely on unpaid volunteers. It is becoming increasingly difficult for emergency medical services to recruit and retain unpaid volunteers because of the amount of training and the large time commitment these positions require. As a result, more paid EMTs are needed. Nevertheless, there will still be demand for part-time, volunteer EMTs in rural areas and smaller metropolitan areas. As the population ages and becomes more likely to have medical emergencies, demand for EMTs will increase.
Job opportunities should be best in private ambulance services. Competition will be greater for jobs in local government, including fire, police, and independent third-service rescue squad departments which tend to have better salaries and benefits. The EMTs who have advanced education and certifications, such as paramedic-level certification, should enjoy the most favorable job prospects, as clients demand higher levels of care before arriving at the hospital.
Projections of Employment
In California, the number of Emergency Medical Technicians and Paramedics is expected to grow much faster than average growth rate for all occupations. Jobs for Emergency Medical Technicians and Paramedics are expected to increase by 24.1 percent, or 4,000 jobs between 2014 and 2024.
|Estimated Employment and Projected Growth|
Emergency Medical Technicians and Paramedics
(Estimated Year-Projected Year)
Due to Net
|View Projected Growth for All Areas|
Annual Job Openings
In California, an average of 400 new job openings per year is expected for Emergency Medical Technicians and Paramedics, plus an additional 270 job openings due to net replacement needs, resulting in a total of 670 job openings.
|Estimated Average Annual Job Openings|
Emergency Medical Technicians and Paramedics
|Jobs From Growth||Jobs Due to|
|View Data for All Areas|
How Do I Qualify?
Education, Training, and Other Requirements
A high school diploma is usually required to enter a formal emergency medical technician training program. Several training providers require proof of various immunizations, negative TB and syphilis test, CPR card, and no felony convictions. Training is offered at progressive levels: EMT-I, EMT-II, and EMT-Paramedic. Universities, community colleges, adult education programs, medical training units of the Armed Forces, some licensed general acute hospitals, and private post-secondary approved schools offer training. Paramedic training programs in California are required to be accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) in order for their graduates to be eligible to take the state licensing examination, which is the examination offered by the National Registry of Emergency Medical Technicians (NREMT). By December 31, 2012, all U.S. paramedic training programs will have to be accredited by CAAHEP in order for their graduates to be eligible to apply for NREMT certification.
At the EMT-I level, coursework emphasizes emergency skills, such as managing respiratory, trauma, and cardiac emergencies, and patient assessment. Formal courses are often combined with time in an emergency room or ambulance. The program provides instruction and practice in dealing with bleeding, fractures, airway obstruction, cardiac arrest, and emergency childbirth. Students learn how to use and maintain common emergency equipment, such as backboards, suction devices, splints, oxygen delivery systems, and stretchers.
At the EMT-II (Advanced EMT) level, students learn advanced skills such as the process to insert an advanced airway device, take a blood sample, and administer some medications.
The most advanced level of training for this occupation is EMT-Paramedic. At this level, the caregiver receives training in anatomy and physiology, as well as more advanced medical skills. Most commonly, the training is conducted in community colleges and technical schools over one to two years and may result in an associate’s degree. Such education prepares the graduate to take the NREMT examination and become certified as a Paramedic. Extensive related coursework and clinical and field experience is required.
Field internship or clinical experience is required for all EMT training programs. In order to advance to EMT-II training, an EMT-I must have at least one year of patient field care experience.
Early Career Planning
Biology, English, and mathematics are helpful courses for those interested in becoming an EMT.
Work Study Programs
Some Regional Occupational Training Programs (ROP) offer EMT training. To find an ROP program near you, go to the California Association of Regional Occupational Centers and Programs Web site.
To maintain certifications, EMT-Is must complete 24 hours of continuing education every two years, and EMT-IIs (Advanced EMTs) must meet the continuing education requirements of the local Emergency Medical Services (EMS) Agency totaling no less than 48 hours every two years. Licensed Paramedics must complete a minimum of 48 hours of continuing education every two years.
Licensing and Certification
The California Emergency Medical Services Authority (EMSA) issues the required paramedic license after the appropriate fees are paid and the required documentation is processed. The documentation required includes a copy of the paramedic training course completion, proof of passing the NREMT written and practical exams, documentation of citizenship or immigration status, and a copy of the Request for Live Scan Service form. Paramedic applicants are also checked to see if they are in arrears on court-ordered child support. If so, they must receive clearance from the respective county child support services office in order to be licensed or maintain licensure. The two-year paramedic license is valid throughout California and is a prerequisite for local accreditation. Paramedics must be accredited to practice in the county in which they work. Documentation for accreditation includes proof of employment with an approved paramedic provider agency and the paramedic license. Contact the agency that issues the license for additional information. Click on the license title below for details.
Certification is required to work in California as an EMT-I and EMT-II. County EMS agencies and approved public safety agencies certify EMT-Is, and county EMS agencies certify EMT-IIs (Advanced EMTs). All EMT levels require the individual be at least 18 years old, have a high school diploma or equivalent, and pass a NREMT written and skills certifying examination. All EMT applicants must pay the appropriate fees and submit the required paperwork. Documentation usually required for the application include a copy of the EMT training course completion certificate, the NREMT card, a current CPR card, valid photo identification, and the Department of Justice Live Scan background report. The certifications are valid for two years. For more information, go to the U.S. Department of Labor's Career InfoNet Web site and scroll down to "Career Tools." Click on "Certification Finder" and follow the instructions to locate certification programs.
Where Can I Find Training?
There are two ways to search for training information:
Contact the schools you are interested in to learn about the classes available, tuition and fees, and any prerequisite course work.
Where Would I Work?
The largest industries employing Emergency Medical Technicians and Paramedics are as follows:
|Industry Title||Percent of Total Employment for Occupation in California|
|Other Ambulatory Health Care Services ||74.9%|
|Local Government ||5.2%|
|Outpatient Care Centers ||1.6%|
Finding a Job
Job seekers who want to become EMT-I trainees may contact the Emergency Medical Services (EMS) office in their county or in any county they wish to work. Qualified EMT-Is, EMT-IIs (Advanced EMTs), and Paramedics are encouraged to register with the EMS office in the county or counties where they want to work.
Job seekers should also apply directly to ambulance companies. Some city and county medical-provider agencies have a separate classification for EMTs and Paramedics. Applicants can find employment opportunities through placement offices at colleges or universities and instructors at training facilities. Newspaper classified ads and the Internet provide sources for job listings as well. Online job opening systems include JobCentral at www.jobcentral.com and CalJOBSSM at www.caljobs.ca.gov.
To find your nearest One-Stop Career Center, go to Service Locator. View the helpful job search tips for more resources. (requires Adobe Reader).
Yellow Page Headings
You can focus your local job search by checking employers listed online or in your local telephone directory. Below are some suggested headings where you might find employers of Emergency Medical Technicians and Paramedics.
- Ambulance Services
- Fire Departments
- Government Offices
Find Possible Employers
To locate a list of employers in your area, go to "Find Employers" on the Labor Market Information Web site:
- Select one of the top industries that employ the occupation. This will give you a list of employers in that industry in your area.
- Click on "View Filter Selections" to limit your list to specific cities or employer size.
- Click on an employer for the street address, telephone number, size of business, Web site, etc.
- Contact the employer for possible employment.
Where Could This Job Lead?
Advancement to either an EMT-II or EMT-Paramedic requires additional classroom and clinical training hours. Paramedics can become supervisors, operations managers, administrative directors, or executive directors of emergency services. Some EMTs and Paramedics become instructors or dispatchers, others move into sales or marketing of emergency medical equipment. Some take additional medical training to become nurses.
Advancement in government service requires success on promotional examinations. In both private and public sectors, experience and ability are the keys to advancement.
Below is a list of occupations related to Emergency Medical Technicians and Paramedics with links to more information.
|Ambulance Drivers and Attendants, Except Emergency Medical Technicians||Profile|
|Nursing Aides, Orderlies, and Attendants*||Profile|
These links are provided for your convenience and do not constitute an endorsement by EDD.
For the Career Professional
The following codes are provided to assist counselors, job placement workers, or other career professionals.