Emergency medical technician-basic

Emergency Medical Technician-Basic (EMT-B) is the entry level of prehospital emergency medical provider in the United States. EMT-Bs are employed in a variety of industries. EMT-Bs are not trained to provide definitive medical care, but instead focus on rapid in-field treatment and transport to higher medical providers. EMT-Bs work in conjunction with other medical providers such as paramedics, nurses, and physicians, as well as with other EMT-Bs. When operating in the prehospital environment, their actions are governed by protocols and procedures set by their system's physician medical director.

Education and training
EMT-B training is regulated at both the state and federal level. At the federal level, the National Highway Traffic Safety Administration (NHTSA) has developed a minimum content and hour requirement that all states must at least meet. This requirement is known as the National Standard Curriculum. Under the NHTSA curriculum, students receive 110 hours of lecture and lab time covering anatomy, physiology, legal aspects of medical care, assessment, and treatment of medical, trauma, behavioral, and obstetric emergencies. In addition to class time, the NHTSA recommends clinical rotations on board ambulances and in emergency departments, but these experiences are less regulated due to local variations.

Utilizing NHTSA guidelines, the National Registry of Emergency Medical Technicians have developed and implemented a certification tests for the NHTSA EMT levels, including the EMT-Basic level. As of 2006, 39 US states utilize the NREMT EMT-Basic exam as part of the state licensing and/or certification procedure.

Once certified, EMT-Basics are required to obtain continuing education hours to recertify at the end of the certification period. Recertification requirements and conditions vary from state to state. Continuing education courses can cover a variety of topics, provided that they cover material relevant to the work performed by EMT-Basics. This can include background material, such as college courses covering anatomy, physiology, or psychology, to more applied courses that are either standardized, such as a Prehosptial Trauma Life Support (PHTLS), or tailored to the needs of an individual EMS system or region.

Scope of practice
The scope of medical practice for EMT-Bs is regulated by state law, and can very significantly both among states as well as inside states. In general, EMT-Bs provide what is considered basic life support and are limited to essentially non-invasive procedures. Besides employing basic medical assessment skills, typical procedures provided by EMT-Bs include CPR, Automated external defibrillation, mechanical ventilation using a bag-valve mask, placement of air way adjuncts such as oropharyngeal and nasopharyngeal airways, splinting (including spinal immobilization and traction splints), and suctioning. In addition, EMT-Bs are trained to assist patients with administration of preprescribed nitroglycerin, Metered-dose inhaler such as albuterol, and epinephrine auto injectors such as the EpiPen.

Individually, each state is free to add or subtract to their EMT-Bs scope of practice as they please. For example, EMT-Bs working in California (known as EMT-Is (one)) are not allowed to administer activated charcoal, an NHTSA approved intervention, under a standard certification. Local EMS systems (i.e. counties in California) can apply to the state to implement an extended scope of practice for EMT-Basics that includes activated charcoal as well as other pharmaceutical interventions not normally allowed to be administered by EMT-Basics. Oregon, though, allows EMT-Bs to utilize a type of advanced airway known as a pharyngeal esophageal airway device. An example of such a device is the Combitube.