Emergency medical personnel are often first on the scene when someone experiences an accident or a medical emergency. EMS workers are generally trained and certified as certified first responders, emergency medical technicians and paramedics. However, the National Registry of Emergency Medical Technicians recognizes five different levels of emergency medical service worker. Though similar, the requirements governing each type of EMS worker vary.

All EMS workers provide life-saving services and help transport individuals to hospitals for additional treatment and care. Here is a deep look into the different EMS personnel and the training one might expect.

Certified first responder

A certified first responder is an integral member of an EMS team. These individuals provide basic medical care at the scene of emergencies, including basic first aid, stabilization of injuries, treating shock, and other tasks. First responders must be certified by the National Registry of Emergency Technicians, according to Learn.org. The American Red Cross offers first responder training courses. Certification requirements vary by state, and each state’s EMS office can provide specific details.

Emergency Medical Technician

According to the UCLA Center for Prehospital Care, EMTs complete a course that is a minimum of 170 hours. One does not need to have previous medical experience to become an EMT, but eligibility requirements may vary from school to school and state to state. For example, to be EMT eligible in California, a person must be 18 years of age. In Pennsylvania, one must be 16 years of age and the training course is 240 hours and includes both classroom and practical lab scenarios. In Massachusetts, to be eligible to be certified as an EMT-Basic, a person must be at least 18 years of age. Like certified first responders, EMTs must pass the NREMT examination in order to obtain certification. EMTs can be EMT-B (basic) or one of two EMT-I (intermediate).

Paramedic

Paramedic students complete many more hours of training that may last between six and 12 months. Coursework builds on EMT education and blends additional medical training, including courses in anatomy, cardiology, medication, and physiology. Paramedics will take part in lectures, skills labs and a hospital internship, followed by an EMS field internship before passing the national certification exam. Upon passing, these individuals will receive the highest certification of pre-hospital care in the United States.

EMS workers provide life-saving medical care and are often first on a scene when a medical emergency takes place. Working as part of an EMS team is a demanding but rewarding career.

Even with extensive caregiving experience, Patti LaFleur was unprepared for the crisis that hit in April 2021, when her mother, Linda LaTurner, fell out of a chair and broke her hip.

LaTurner, 71, had been diagnosed with early-onset dementia seven years before. For two years, she’d been living with LaFleur, who managed insulin injections for her mother’s Type 1 diabetes, helped her shower and dress, dealt with her incontinence and made sure she was eating well.

In the hospital after her mother’s hip replacement, LaFleur was told her mother would never walk again. When LaTurner came home, two emergency medical technicians brought her on a stretcher into the living room, put her on the bed LaFleur had set up, and wished the daughter well.

That was the extent of the help LaFleur received upon her mother’s discharge.

She didn’t know how to change her mother’s diapers or dress her, since at that point, LaTurner could barely move. She didn’t know how to turn her mother, who was spending all day in bed, to avoid bedsores. Even after an occupational therapist visited several days later, LaFleur continued to face caretaking tasks she wasn’t sure how to handle.

“It’s already extremely challenging to be a caregiver for someone living with dementia,” said LaFleur, who lives in Auburn, Washington, a Seattle suburb. Her mother died in March 2022.

“The lack of training in how to care for my mother,” she added, “just made an impossible job even more impossible.”

A new proposal from the Centers for Medicare & Medicaid Services addresses this often-lamented failure to support family, friends and neighbors who care for frail, ill, and disabled older adults. For the first time, it would authorize Medicare payments to health care professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.

The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers — also known as family caregivers — play in protecting the health and well-being of older adults. About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.

“We know from our research that nearly 6 in 10 family caregivers assist with medical and nursing tasks such as injections, tube feedings and changing catheters,” said Jason Resendez, president and CEO of the National Alliance for Caregiving.

But fewer than 30% of caregivers have conversations with health professionals about how to help loved ones, he said.

Even fewer caregivers for older adults — only 7% — report receiving training related to tasks they perform, according to a June 2019 report in JAMA Internal Medicine.

Nancy LeaMond, chief advocacy and engagement officer for AARP, experienced this gap firsthand when she spent six years at home caring for her husband, who had amyotrophic lateral sclerosis, a neurological condition also known as Lou Gehrig’s disease. Although she hired health aides, they weren’t certified to operate the feeding tube her husband needed at the end of his life and couldn’t show LeaMond how to use it. Instead, she and her sons turned to the internet and trained themselves by watching videos.

“Until very recently,” she told me, “there’s been very little attention to the role of family caregivers and the need to support caregivers so they can be an effective part of the health delivery system.”

Several details of CMS’s proposal have yet to be finalized. Notably, CMS has asked for public comments on who should be considered a family caregiver for the purposes of training and how often training should be delivered.

(If you’d like to let CMS know what you think about its caregiving training proposal, you can comment on the CMS site until 2 p.m. Sept. 11. The expectation is that Medicare will start paying for caregiver training next year, and caregivers should start asking for it then.)

Advocates said they favor a broad definition of caregiver.

Since often several people perform these tasks, training should be available to more than one person, Resendez suggested. And since people are sometimes reimbursed by family members for their assistance, being unpaid shouldn’t be a requirement, suggested Anne Tumlinson, founder and chief executive officer of ATI Advisory, a consulting firm in aging and disability policy.

As for the frequency of training, a one-size-fits-all approach isn’t appropriate given the varied needs of older adults and the varied skills of people who assist them, said Sharmila Sandhu, vice president of regulatory affairs at the American Occupational Therapy Association. Some caregivers may need a single session when a loved one is discharged from a hospital or a rehabilitation facility. Others may need ongoing training as conditions such as heart failure or dementia progress and new complications occur, said Kim Karr, who manages payment policy for AOTA.

When possible, training should be delivered in a person’s home rather than at a health care institution, said Donna Benton, director of USC’s Family Caregiver Support Center and the Los Angeles Caregiver Resource Center. All too often, recommendations that caregivers get from health professionals aren’t easy to implement at home and need to be adjusted, she said

Nancy Gross, 72, of Mendham, New Jersey, experienced this when her husband, Jim Kotcho, 77, received a stem cell transplant for leukemia in May 2015. Once Kotcho came home, Gross was responsible for flushing the port that had been implanted in his chest, administering medications through that site, and making sure all the equipment she was using was sterile.

Although a visiting nurse came out and offered education, it wasn’t adequate for the challenges Gross confronted.

“I’m not prone to crying, but when you think your loved one’s life is in your hands and you don’t know what to do,” she said, “that’s unbelievably stressful.”

For her part, Cheryl Brown, 79, of San Bernardino — a caregiver for her husband, Hardy Brown Sr., 80, since he was diagnosed with ALS in 2002 — is skeptical about paying professionals for training. At the time of his diagnosis, doctors gave Hardy five years, at most, to live. But he didn’t accept that prognosis and ended up defying expectations.

Today, Hardy’s mind is fully intact, and he can move his hands and his arms but not the rest of his body. Looking after him is a full-time job for Cheryl, who is also chair of the executive committee of California’s Commission on Aging and a former member of the California State Assembly. She said hiring paid help isn’t an option, given the expense.

And that’s what irritates Cheryl about Medicare’s training proposal.

“What I need is someone who can come into my home and help me,” she told me. “I don’t see how someone like me, who’s been doing this a very long time, would benefit from this. We caregivers do all the work, and the professionals get the money? That makes no sense to me.”

KFF Health News is eager to hear from readers about questions they’d like answered, problems they’ve been having with their care and advice they need in dealing with the health care system. Visit kffhealthnews.org/columnists to submit requests or tips.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling and journalism. 

WICHITA, Kan. (KSNW) – Working in aerospace medicine and as a nationally registered EMT, Sergeant Derrick Judkins traveled the world, assisted surgeons, and treated our nation’s wounded. He was deployed to Operation Desert Storm, Operation Desert Shield, to multiple campaigns in between.

After scoring high on the Air Force Armed Services Vocational Aptitude Battery (ASVAB) test, young Derrick Judkins saw being a medical technician as his ticket out of Detroit.

“I was ready to get out of Detroit at the time, so I says, ‘You know what, I’m going to go the non-traditional.’ College… Military… So, I went military. And it was the best decision I ever made, to be honest with you,” said Judkins.

His 20-year military career began with basic training at Lackland Air Force Base. He was stationed in Omaha when his unit was deployed to the Gulf War.

“I call him ‘Big George,'” Judkins said of President George H. W. Bush. “Yeah, that was the first one. Desert Storm, and that’s when they sent us over in the sandbox. That was when I guess you’d be saying things get real.”

Judkins said a contingency hospital was set up behind the front lines.

“Where we were stationed at, we weren’t directly in the line of fire, but we were in a position where we were taking care of the individuals that may have been injured or what have you,” said Judkins.

During a six-year stint at Wright Patterson Air Force Base in Ohio, Judkins treated wounded soldiers in a hyperbaric chamber.

“They put us in a chamber because the increased amount of oxygen is healing,” explained Judkins. “Like every other week or so, we were getting in with patients that needed wound care or wound therapy.”

Judkins picked up a few unique skills while working as a medical technician.

“I was asked, ‘How many jobs have you had?’ Even just in the military… aerospace medicine, public health, Honor Guard. I’ve caught mosquitoes when the West Nile virus was going. That was part of public health. Man, I can identify a female mosquito and a male mosquito. All of that stuff made a difference in that little piece of the job. It was integral to the mission at hand,” said Judkins.

His last assignment was a stop at McConnell Air Force Base in Wichita in 2007, where he worked in public health. 

So, what was the most rewarding part of Judkins’ military career?

“The Honor Guard. Honor Guard was the most rewarding to me because that was a memory that you were leaving with the family. Maybe the last time seeing their loved one in a military state like that. Whether it be an active-duty funeral or retirement. That satisfaction or the gratification that you get from folding that flag and getting down on one knee and starting off ‘On behalf of the United States of America.’ That was big to me because it was something that you had to look at that person or that next of kin in their eye, and you saw that, and they were so appreciative of that. So, that was huge to me,” said Judkins.

Judkins retired from McConnell AFB at age 38, and he settled in Wichita. Now, he works as a clinical liaison for a long-term care company.

If you want to nominate a veteran for our Veteran Salute, email KSN reporter Jason Lamb at jason.lamb@ksn.com.

LINCOLN, Neb. (KLKN) — The City of Lincoln unveiled a new approach on Thursday for responding to 911 calls involving homeless people.

Under the Alternate Response Program, police and emergency medical technicians won’t be sent to deal with every situation.

Dispatchers have now been trained to ask questions that determine the appropriate level of response to calls involving unsheltered people.

If no one is violating any laws or in need of medical attention, only the CenterPointe Street Outreach Team will respond.

The team will connect those it encounters with resources for the homeless.

SEE ALSO: Lincoln Police will now work with mental health professionals on some calls

Previously, two police officers responded to each call about an unsheltered person.

Acting Police Chief Michon Morrow said the new program is a more efficient use of resources.

“By redirecting these calls for service to the community partners who can best address the human services needs of unsheltered individuals, our LPD officers have more time to focus on calls requiring law enforcement,” she said.

Melissa Ripley, the Lincoln Police Department’s homeless coordinator, said it’s also more compassionate to Lincoln’s homeless population.

“Often, those experiencing homelessness also experience a stigma and shame associated with being unsheltered,” she said. “Having uniformed police officers contact you repeatedly, when you’re not doing anything illegal, can contribute to that shame and stigma.”

The city’s website says homelessness rates in Lincoln have fallen by more than 50% since 2012.

It credits the efforts of local organizations and the Lincoln Police Department.

There were 429 homeless people living in the city at the start of 2023, according to the Lincoln Homeless Coalition.

Twenty-four percent were considered unsheltered, 19% were adult survivors of domestic abuse, and nearly a fourth of them were children.