Pre-Hospital Emergency Care: Pros and Cons


Advantages and disadvantages

Pre-hospital emergency care is a fundamental component of the United States healthcare system. Pre-hospital emergency care services in the US are undertaken by Emergency Medical Technicians (EMT) and paramedics.Their core role is to attend to various medical emergencies which occur outside medical facilities. Their training enables them to provide life-sustaining services on the scene where an emergency occurs and during transportation of the victim to a medical facility. There are various challenges associated with working as an EMT or a paramedic. For example, there is a high level of stress associated with working as an EMT. This arises from irregular working hours. For example, an individual may be required to attend to life-or-death situations. In addition, paramedics and EMTs may be required to work for long hours. For example, the paramedics and EMTs working in fire departments may be required to work for 50 hours every week while those working in hospitals may work for 45 to 60 hours every week. As a result, they are required to have an effective way of dealing with job pressure (United States Bureau of Labor Statisitcs, 2003, p. 286).

Paramedics and EMTs are required to be the first medical responders in relation to life threatening situations. For example, in some cases, paramedics and EMTs attend to patients suffering from contagious and infectious diseases such as AIDS and Hepatitis B. As a result, they are exposed to numerous safety issues. For example, they may be required to handle mentally unstable patients or individuals suffering from drug overdose. These individuals may be very violent.

Despite the challenges associated with pre-hospital emergency care, EMTs and paramedics consider the work exciting due to the opportunity presented in relation to helping others. EMTs and paramedics working in private ambulance company receive a number of benefits which are made possible by the EMT union. These benefits are accessed directly by paramedics and EMTs who work in hospitals and fire departments. According to Ryan-Flynn (2008, p.142), some of these benefits include vacations, pension plans, health insurance, and paid holidays, Due to the irregular nature of their work, paramedics and EMTs benefit from overtimes which increase their salary.

EMTs and paramedics’ jobs requires them to work in both indoor and outdoor environments. This exposes them to varying weather conditions. Regardless of the weather condition, they are required to execute their duties. In the process of administering their services, a lot of kneeling, lifting heavy weights and bending is required. As a result, they may experience back injuries and pain. In addition, they are also exposed to noise from the ambulance siren which may lead to loss of hearing.


EMTs and paramedics remuneration in the United States is dependent on a number of factors (Boyce, 2010, para. 1). These include their geographic location, individual level of training, experience, certification and employment settings. However, the US government has set an annual median earning level. In addition, EMTs and paramedics remunerations also depend on the employer. According to Ryann-Flynn (2008, p.141), paramedics and EMTs who are employed by the government to work in various departments such as the police, hospitals and fire departments receive a higher salsary compared to those employed in the private sector. According to the latest pay scale released in 2006, the median annual earnings were set at $27, 070. However, the lowest 10% received a salary of $17, 300 while the highest 10% received a salary of $45,280. Individuals employed by the US local government received a mean salary of $30, 750 while those working in hospitals received a salary of $29,210 (Coe, 2009). The table below gives an illustration of paramedics’ salary on the basis of years of experience.

Years of experience Salary scale (Amount in $)
Less than 1 year 29,163-48,331
1-4 years 29,969-43,938
5-9 years 35,466-47,977
10-19 years 35,916-57,155
20 years and above 44, 576-75,317

The private stations offering pre-hospital emergency care services are privately funded while public stations are funded by the government (United States Bureau of Labor Statistics, 2003, p. 286).

Worker compensation and life insurance

EMTs and paramedics are exposed to numerous risks in line of their duties. The insurance industry has developed policies which are aimed at protecting the EMTs and paramedics. These policies are sold to firms and departments which have paramedics and EMTs as a part of their human resource. The rates for the policy are determined on the basis of the risk exposure. Firms operating in the United States healthcare industry are required to comply with the Workers Compensation and Diseases Act(United States Bureau of Labor Statisitcs, 2003, p. 289).

. This ensures that paramedic adnd EMTs receive the benefits that they are entitled with regard to specific injury or diseases which result from their line of duty. Some of the specific illnesses or condition which the employer is required to compensate the employee include heart diseases, respiratory disease, hypertension, hearing loss, cancer and tuberculosis.

Considering the fact that EMTs and paramedics are first responders to life threatening situations. For example, they may be blamed as a result of something going wrong. This may lead into lawsuits which culminate into heavy financial cost. The paramedic’s insurance policy may not be relevant in covering the cost. To seal the gap, insurance companies have developed insurance plans to cover possible first responder liability. The liability plans are flexible and hence they can be formulated to suit the client’s needs with regard to price and nature of liability exposed.

Professional upgrade contingency

For one to become professional EMT or paramedic, a comprehensive training is required. All the states in the United States of America have a well laid down procedure on how paramedics and EMTs can upgrade their profession. In 38 US states, all the paramedics are required to register with the National Registry of Emergency Technicians (NREMT). Other states have got their own certification. This makes it optional for EMTs and paramedics to be certified by NREMT.Certification by NREMT give the individual more responsibility. In addition, this enables the individual to be entitled to higher paying jobs.

The paramedics and EMTs are required to renew their registration every two years. To attain this, the individual is required have been practicing as a paramedic or an EMT in addition to attaining certain educational requirements.

  • EMT training is progressive. It is designed into three levels which include
  • EMT basic
  • EMT intermediate
  • EMT paramedic

In the EMT basic level, emphasis is paid on the various skills such as trauma management, patient assessment, and dealing with cardiac emergencies. Other skills which are integrated include dealing with airway obstructions, fractures, bleeding and emergency child birth. In addition, skills on how to use and maintain EMT and paramedic tools are learnt. EMT intermediate learn how to administer various drugs and intravenous fluid. On the other hand, EMT intermediate are trained on how to administer advanced medications. The EMT paramedic is the most advanced level. After taking examinations by the NREMT, one becomes a certified EMT paramedic. EMTs and paramedics may upgrade their profession by undertaking training in a different field within healthcare. Due to the nature of work, paramedics and EMTs are given the provision to retire before the age of 65 years. The US pension plan allows paramedics and EMTs to retire 10 years before their normal retirement. Despite early retirement, one is entired to his or her pension. However, the pension is only payable upon attainment of the normal retirement age.


From the analysis, it is evident that paramedics and EMTs play a significant role in relation to pre-hospital emergency care. Paramedics and EMTs are faced with numerous challenges ranging from health to financial risks. Some of the health risks relate to contraction of infectious diseases in the course of their duty. With regard to financial risks, they may be charged in a court of law due to occurrence of mistakes in the course of operation. Despite the fact that they are faced with numerous risks due to their nature of work, they are also some benefits which they are entitled to. For example, paramedics and EMTs receive medical benefits in addition to better payments. Paramedics are also eligible to early retirement and also receive their pension. The insurance industry has also provided a policy which covers risks faced by paramedics.

Reference List

Boyce, A. (2010). EMT and paramedic salary. New York: XYZ Media.

Coe, C. (2009). Handbook of urban services: a basic guide for local governments. Boston, MA: M.E Sharpe.

Ryan-Flynn, M. (2008). The top 100: the fastest growing careers for the 21st century. Washington: Infobase Publishing.

United States Bureau of Labor Statistics. (2003). Occupational outlook handbook. New York: The Bureau.