An emergency medical technician (EMT) license is a requirement in all US states, as well as all the provinces of Canada and territories of Australia, to practice emergency medicine from an ambulance. In the US, this basic license is referred to as EMT-B, and, in the UK, the position is known as an Ambulance Technician. Other countries like France, Germany, and Japan link their emergency medical services to their fire and police services, as does the US, and this can lead to emergency medical services being provided by a fire department when a local ambulance isn't available.
Obtaining an EMT license can vary in terms of time commitment and schooling, as each nation and local province has unique requirements that must be met. There are also different licensing levels in each country. In the US, a EMT license can be EMT-basic (EMT-B) or EMT-paramedic (EMT-P). The EMT-B level requires about 135 hours of training, while an EMT-P needs, on average, 1,500 hours of training. In Canada, an EMT is generally referred to as a Paramedic. The basic training level in Canada, which is somewhat longer than EMT-B training in the US, is for an emergency medical attendant (EMA-1), and EMA-2 is on a par with paramedic service in the US.
In the United States, most states also require, as a part of the emergency medical technician license process, that individuals register with the National Registry of Emergency Medical Technicians (NREMT) and pass a psychomotor and cognitive exam. This ensures that proper standards of care are practiced across the entire nation. The NREMT also has four broad areas of certification: NREMT-Emergency Medical Responder (EMS); NREMT-B or basic; NREMT-I or intermediate; and NREMT-P or paramedic. The EMS level refers to someone trained in basic first aid and cardiopulmonary resuscitation (CPR), which is a requirement that all emergency service personnel such as firefighters and police must meet. NREMT-paramedic level, at the opposite end of the spectrum, involves EMT license training in emergency medication administration, emergency surgical techniques, and more.
Someone with an EMT license can be expected to generally fall within one of two categories regardless of the nation within which they operate. They may have certification in Basic Life Support (BLS), which involves all the fundamental life-saving techniques used in trauma situations. If they have advanced training, they then are approved to perform Advanced Life Support (ALS), which can involve sophisticated medical intervention under the remote guidance of a doctor, such as cardiac defibrillation and the administration of intravenous cannulation (IVs).
Certain requirements to obtain a EMT license involve traits that go beyond formal training. An EMT has to have the physical capacity to lift and carry people of various weights down stairs or extended distances. The psychology to effectively deal with the stress of life and death situations is also important. As well, the ability to make fast, appropriate decisions on someone's care are a day-to-day requirement of the job.
Some nations such as Mexico, other Latin American countries, and elsewhere, have no formal EMT license process. They instead use on the job training to prepare their emergency medical staff. This fact makes it important to know what the certification level for an EMT may be when someone is traveling abroad, as the services provided by this industry can vary greatly from place to place.