In the United States, EMTs are licensed according to their level of training. Although the National Registry of EMT's is one such licensing entity, individual states may set their own standards of licensure. All EMT's must meet the minimum requirements as set forth in the Department of Transportation's standards for EMT curriculum. National Registry recognizes three levels of EMT: EMT-B (Basic), EMT-I (Intermediate) and EMT-P (Paramedic). The paramedic level is the highest level of nationally registered positions. In addition to the basic-level skills of CPR, first aid, airway management, oxygen administration, spinal immobilization, traction splinting, bleeding control and splinting, as well as the intermediate skills of IV therapy, endotracheal intubation and initial cardiac drug therapy, the paramedic is also educated in EKG interpretation, advanced airway skills, pharmacology, trauma resuscitation, pediatric life support and advanced cardiac life support.
Paramedics are often employed by emergency medical services or as firefighters. Paramedics may respond to calls in an ambulance or have their own dedicated response vehicle, even sometimes a fire engine.
As nursing shortages become more and more prevalent, paramedics are being increasingly used in the Emergency Rooms and Intensive Care Units of hospitals. In addition, paramedics are often used as chief medical personnel on offshore drilling platforms and on MEDEVACS and airplanes. However, paramedics may be employed in many different medical fields, not necessarily in that of the transport of patients. Such positions may include phlebotomy, blood banks, research labs and educational fields.
In the U.S., salaries paramedics can expect range anywhere from unpaid, volunteer positions to around $60,000, depending on location and experience. It should be noted that volunteer paramedics can provide the same level of care as those at the upper end of the pay scale. Currently, in the United States, the busiest EMS service per ambulanceis New Orleans' Health Department EMS, which responds to approximately 4,000 "911" calls per month, utilizing six ambulances for the entire city of about 500,000 people.