Becoming an EMT student is exciting. You’re learning new skills, getting a behind-the-scenes look at emergencies and finding out what it’s like to work on an ambulance. You’re no longer just watching emergencies on the news; you’re getting to participate in them.
You’re licensed and ready to save lives, right?
Well … maybe.
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EMT school gives you the foundation you need to become an EMT and prepares you to pass the National Registry exam. What it can’t fully prepare you for is real-world EMS. That part comes from running calls, making mistakes, asking questions and learning from the people around you.
When most of us earned our EMT licenses, we were wide-eyed and ready to save the world — fancy new Littmann around our neck, trauma shears strapped to our new EMS pants — we were ready to “BSI, scene safe” our way into the profession.
Then reality set in.
Most days were filled with picking Mee Maw up off the floor and responding to 2 a.m. toe pain. Occasionally, we got an MVA that sent our adrenaline surging. And when one of those calls came in, much of the advanced clinical care belonged to our paramedic partners.
So, what is a new EMT supposed to do?
Most people would say, “Just drive.”
Wrong.
There is much more to being a good EMT than driving an ambulance.
Logistics
Yes, you heard me right. Logistics.
One of the best things an EMT can learn is how to keep their head on a swivel and stay three steps ahead — not just of the paramedic, but of the call itself.
The minute you arrive, start looking around. How are you getting to the patient? What is between you and the patient? What kind of situation are you walking into?
And here is the question people sometimes forget until it is too late: How are you getting the patient back out?
Once you make patient contact, you and your paramedic should both be thinking ahead. You are simply thinking about different parts of the same problem.
Your paramedic may be considering a differential diagnosis and treatment plan. Meanwhile, you should be assessing the scene. What do we need now? What will we probably need in 5 minutes? How are we getting this patient to the ambulance?
Do we need the fire department for a bariatric patient? Is the patient trapped? Is there a fracture that needs to be stabilized before moving?
Maybe there is a narrow staircase, an aggressive dog or six family members packed into the hallway trying to “help.” Maybe somebody placed a giant recliner directly in the only path to the door.
Welcome to EMS.
Sometimes the resource you need is not more muscle. It is law enforcement. The call dispatch sends you to and the call you actually walk into are not always the same.
Pay attention.
A strong EMT recognizes when the plan needs to change and starts working on the next problem before it becomes everybody’s emergency. You are not simply performing the skills within your scope. You are watching, anticipating, communicating and problem-solving.
That is patient care, too.
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Protocols
Here is another question: Do you know your agency’s ALS protocols?
I know what some new EMTs are thinking: “Why do I need to know ALS protocols? I’m an EMT.”
Because the more you know, the more useful you become.
Knowing ALS protocols does not mean working outside your scope. It means understanding where a call may be headed. When you know what your paramedic is likely to do next, you can prepare equipment before being asked.
There is a huge difference between an EMT who waits for instructions and an EMT who pays attention and thinks ahead.
And since we are talking about EMTs and paramedics, we might as well bring out one of the cheesiest sayings in EMS: “Paramedics save lives. EMTs save paramedics.”
Go ahead and roll your eyes. I’ll wait.
It is cheesy, but there is some truth hiding in it.
A good EMT is not there only to drive, carry bags and wait for instructions. You are your partner’s second set of eyes, ears and hands. While your paramedic is focused on the patient, you may be the one who notices that the scene is changing. You may grab equipment before being asked, figure out how everyone is getting out of the house or occasionally say, “Hey … are you sure about that?”
That is not an EMT working for a paramedic. That is a crew — two clinicians working together and watching out for the patient and each other.
| MORE: To practice compassion in EMS, do the small things well
Stay three steps ahead
So yes, sometimes EMTs really do save paramedics.
Just don’t put it on a T-shirt.
Actually, never mind. It’s EMS. Someone already did.
I have heard EMTs say, “If I wanted to work in logistics, I’d work for UPS.”
Funny, but it is the wrong mindset.
Anticipating what comes next is a huge part of being good at this job. It is how you take what you learned in EMT school and apply it in the real world. It will also make you a stronger paramedic student if you choose that path someday.
But let me make one thing clear: Being an excellent EMT is a worthy goal all by itself.
A strong EMT is more than someone who knows their ABCs. It is someone who treats people with compassion, works well with a crew and notices problems before they become bigger problems.
Sometimes, the most important thing you do on a call will not be a skill you learned for the National Registry exam. It may be realizing that the stretcher will not fit before everyone is standing there staring at it. It may be requesting additional resources before you desperately need them, knowing exactly where a piece of equipment is or recognizing that something about the scene has changed.
Sometimes it is simply seeing what needs to happen next — and doing it.
So, you just became an EMT. Now what?
Learn everything you can. Know your protocols. Ask questions, even the stupid ones. Trust me, we have all asked them. Watch good clinicians work. Learn from experienced EMTs. When you work with someone who is truly good at this job, pay attention to what they do when nobody is telling them what to do.
Keep your head on a swivel. Think three steps ahead.
Not just three steps ahead of your paramedic.
Three steps ahead of the call.
And please, stop calling yourself “just an EMT.”
Because when things go sideways at 2 a.m., nobody needs you to be “just an EMT.”
They need you to be a damn-good one.
