How Online EMT and Paramedic Training Works - The Basics
To understand how online EMT and paramedic training functions, it is necessary to have a working knowledge of the licensure process. All EMTs and paramedics in the United States must be licensed and obtaining licensure almost always requires certification by the National Registry of Emergency Medical Technicians (NREMT).There are four levels of NREMT certification: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT) and Paramedic. Each level comes with its own set of training and examination requirements. That's where EMS/Paramedic training courses come in. Among other requirements, individuals applying for certification on any EMS/Paramedic level must take and pass a state-approved course specifically designed for that level. All courses must meet or exceed education standards set out by the NREMT. Additionally, all levels of NREMT certification require that students pass both cognitive and psychomotor examinations. Cognitive exams are computer adaptive tests tailored for each certification level. Psychomotor examinations are designed for students to demonstrate their hands-on skills and procedures.
One other important factor to bear in mind.Although most states follow the basic structure of NREMT certification for licensure, there are some variations in licensure requirements from state to state. Students are advised to familiarize themselves with the specific license requirements in their jurisdiction and make sure that whatever EMS/Paramedic course they consider will meet those specific requirements.
Who Provides Online EMS and Paramedic Training?
State-approved training courses for EMS professionals and paramedics, both on-campus and online, are offered by a variety of sources, including local community colleges, vocational schools, four-year colleges and universities and private for-profit course providers. In virtually all cases, online training providers offer courses that are exclusive by state, meaning that completion of a training program from that provider qualifies a student for licensure in that state alone. Therefore, it is imperative for anyone planning on an online EMS/Paramedic course to be sure that any course under consideration matches the state where he or she intends to work.
Online programs offered by public two-year community colleges and four-year colleges and universities are rare, but there are a few out there. These not-for-profit programs are particularly convenient in that the on-site training component (often referred to as a clinical practicum, clinical rotations or field rotations) is built into the course whereas some, but not all, for-profit online providers leave it to the students to procure the on-site components themselves.
EMS Online Training By Level - EMR
The first level of NREMT certification is the Emergency Medical Responder, or EMR. In the most basic sense, an EMR can be anyone, from an average citizen with CPR certification to highly-trained professionals such as first responders, doctors, nurses, paramedics, EMTs, police officers and firefighters. More specifically, EMRs are not supposed to replace EMTs or paramedics at an accident scene and are limited to only providing the care that is needed until the arrival of an ambulance or higher-level EMS professional.
EMR courses are plentiful, but very few are offered online. Whether online or on-site, EMR programs should include training that allows the student to respond to a wide range of emergency situations and conditions and to pass the NREMT cognitive and psychomotor exams. Areas of testing include: airway, respiration and ventilation, cardiology and resuscitation, trauma, medical and obstetrics/gynecology and EMS operations.EMR courses typically require 48 to sixty hours of initial training, approximately 12 hours of clinical (emergency room) observation and 12 hours of internship training in the field. Additionally EMR courses require participants to be 18 years of age (17 in some jurisdictions), be physically capable of performing essential EMR procedures and hold a current CPR course completion card.
EMS Online Training By Level - EMT
The most common certification offered by the NREMT is for the Emergency Medical Technician, or EMT. According to the NREMT, the primary focus of the EMT (also known as an EMT-Basic) is to, "provide basic emergency medical care and transportation for critical and emergent patients who access the emergency medical system." EMTs have also been described as a "link" between an accident scene and the emergency health care system. EMTs are trained in the basic skills necessary to assess a patient's condition and manage respiratory, cardiac and trauma emergencies.
Prerequisites for beginning an EMT course are the same as those for anEMRs including the holding of a current CPR certification. EMT programs typically consist of 130 to 150 hours or more of class work and emergency medical experience and take from two to four months to complete. Many online courses, however allow students to work at their own pace with a six-month maximum time for completion. Coursework itself is normally offered in segments or "modules". The following is a representative curriculum for a typical EMT program:
- Airway management. Covers the airway anatomy, airway management techniques and operation of oxygen equipment.
- Medical emergencies. Includes training for cardiac, respiratory, obstetric/gynecological, environmental, allergy, poisoning, behavioral and diabetic emergencies as well as basic pharmacology issues.
- Trauma emergencies. Topics include soft tissue and musculoskeletal injuries, bleeding, shock, and injuries to the head, neck, spine, chest and abdomen.
- Patient assessment. Covers the medical and trauma assessment of patients, assessment of vital signs, the taking of patient history and basic documentation and communication.
- Emergency care of children and infants. Concerns the differences between caring for adults and children as well as pediatric trauma and medical emergencies.
Additional topics normally covered include techniques for lifting and moving patients, basic anatomy and physiology, EMS systems operations, legal and ethical issues, rescue and extrication, multiple patient situations and triage, hazardous materials and ambulance operation.
Following successful completion of all coursework and field experience requirements, candidates for certification will take the NREMT cognitive and psychomotor examinations. Candidates can expect 70 to 120 test items and will have two hours to complete the exam. The EMT psychomotor examination will require the candidate to demonstrate his or her competence in 12 specific areas of patient illness and injury management.
Distance education EMT training courses are plentiful and provided predominantly by primarily online providers, although a small number of community colleges and four-year universities also offer online courses.
EMS Online Training By Level - AEMT
The Advanced Emergency Medical Technician, or AEMT (also referred to as an EMT-Intermediate) has completed the requirements for the EMT and additional instruction in more advanced skills in such areas as the use of complex airway devices, intravenous fluids, drug administration, patient assessment, life support and transport. In some locations, primarily rural and those with voluntary emergency response systems, the AEMT provides the highest level of out-of-hospital emergency care.
Programs for AEMTs typically require about 300 hours of instruction based on jurisdiction scope and practice. Students who complete an AEMT course of study should be prepared to take and pass the NREMT cognitive and psychomotor examinations for this level. The cognitive exam consists of 135 questions and covers the same general subject areas as the EMT cognitive exam. In the psychomotor exam, candidates must demonstrate and acceptable level of competency in the following skills: patient assessment - trauma; patient assessment - medical;ventilatory management; cardiac arrest management; IV and medication; pediatric intraosseous infusion; spinal immobilization; and other random EMT skills.
The number of distance education AEMT courses is relatively limited and, as you might expect, all are available only in hybrid format. These courses are typically around 18 weeks in length, involve coursework, practical labs and clinical field internships. AEMT programs are generally not offered in a self-paced format. Those that are may allow extended time (up to 11 months)for students to complete their coursework.
EMS Online Training By Level - Paramedic
Paramedic is the top certification level of the NREMT. A paramedic's scope of practice, according to the NREMT, includes, "invasive and pharmacological interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies." Paramedics may base care on their advanced assessment and formulation of a field impression. Paramedics also provide care designed to minimize secondary injury and provide patient comfort while transporting the patient to a health care facility. The main difference between the practice of paramedics and AEMTs is that paramedics have a broader range of advanced skills, which they can legitimately employ with patients during an emergency.
In order to qualify for NREMT paramedic certification, a candidate must, among other requirements, successfully complete a state-approved paramedic training program. Additionally, paramedic courses, whether offered online on on-site, must be accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). CAAHEP-accredited programs are found mainly on the campuses of local community colleges, vocational schools and a small number of four-year colleges and universities. These college-sponsored programs are, in most cases, included as part of the curriculum for associate's or bachelor's degrees in emergency medical services. As discussed earlier, there are currently only two online paramedic programs that are accredited by the CAAHEP, although several others are in the process of obtaining accreditation.
Once a studenthas completed a paramedic course and met all other prerequisites, he or she is eligible to take the NREMT examinations for paramedic certification. Candidates should expect to answer between 80 and 150 items on the cognitive exam. The psychomotor exam at this level consists of twelve separate skills presented in a scenario-type format to approximate the paramedic's ability to function in the out-of-hospital setting.
STATE APPROVAL AND ACCREDITATION
As discussed above, almost all states require NREMT certification for EMT and paramedic licensure. Certification for all NREMT levels requires completion of a state-approved course. Therefore, students must be certain that any EMS-related course that they consider is approved by the state where they plan to work.
Completion of a CAAHEP-accredited paramedic program is mandatory for NREMT paramedic certification. As mentioned, there are currently only two accredited online paramedic programs in the United States, so most paramedic students will have to opt for an on-site course. CAAHEP accreditation is not mandated by the NREMT for EMR or EMT programs taken by students who apply for certification. Only state-approval of those programs is required.