Emergency Care Attendant (ECA)

People’s lives often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics, which are EMTs with additional advanced training who perform more difficult pre-hospital medical procedures. Incidents as varied as automobile accidents, heart attacks, drownings, childbirths, and gunshot wounds all require immediate medical attention. EMTs and paramedics provide this vital attention as they care for and transport the sick or injured to a medical facility.

Depending on the nature of the emergency, EMTs and Paramedics typically are dispatched to the scene by a 911 operator and often work closely with police and fire department personnel. Once they arrive, they determine the nature and extent of the patient’s condition, while trying to ascertain whether the patient has preexisting medical problems. Following policies and protocols, they give appropriate emergency care and, when necessary, transport the patient. EMTs and Paramedics also treat patients with minor injuries on the scene of an accident or at their home without transporting them to a medical facility. Some Paramedics work as part of helicopter flight crews that transport critically ill or injured. All treatments are carried out under the operating guidelines of medical doctors. In addition, Community Paramedics provide long-term care that addresses public health, primary care, disease management, social services, and wellness care.

EMTs and Paramedics may use special equipment such as backboards to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. Usually, one EMT or Paramedic drives while the other monitors the patient’s condition and gives additional care as needed. At the medical facility, EMTs and Paramedics transfer patients to the emergency department staff, report their observations and actions, and may provide additional emergency treatment. After each run, EMTs and Paramedics replace used supplies, check equipment, decontaminate the equipment and the interior of the ambulance, and write a patient care report.

Beyond these general duties, the specific responsibilities of EMTs and Paramedics depend on their level of qualification and training. The Texas Department of State Health Services certifies or licenses emergency medical service (EMS) providers and the National Registry of Emergency Medical Technicians (NREMT) registers providers at four levels: First Responder, also called Emergency Care Attendant (ECAs), EMT, Advanced EMT, and Paramedic. The lowest level, First Responder (ECA), is trained to provide basic emergency medical care because they tend to be the first persons to arrive at the scene of an incident. Many firefighters, police officers, and other emergency providers obtain this level of training. The EMT represents the first component of the emergency medical service (EMS) system. An EMT is trained to care for ill or injured patients on scene and during transport by ambulance to the hospital. The EMT, basic life support, has the skills to assess a patient’s condition and manage respiratory, cardiac, other medical, and trauma emergencies.

Working Conditions

EMS Providers work both indoors and outdoors, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These providers risk noise-induced hearing loss from sirens noisy accident scenes and back injuries from lifting patients. In addition, EMTs and Paramedics may be exposed to communicable diseases such as Hepatitis and HIV, as well as violence from drug overdose victims or mentally unstable patients. The work may not only be physically strenuous but also stressful, involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others.

EMTs and Paramedics should be emotionally stable, have good dexterity, agility, and physical coordination, and be able to lift and carry heavy loads. EMTs and Paramedics employed by fire departments work about 50 hours a week. Those employed by hospitals frequently work between 45 and 60 hours a week and those in private ambulance services, between 45 and 50 hours. Some of these providers, especially those in police and fire departments, are on duty for extended periods. Many EMTs and Paramedics work 24/48 hours shifts in which they work for 24 hours and are off the next 48 hours and 48/ 96 in which they work for 48 hours and are off for the next 96 hours. Because emergency services function 24 hours a day, EMTs and Paramedics have irregular working hours that add to job stress.

Formal training and certification are needed to become an EMT or Paramedic. In Texas, an applicant must complete a Department of State Health Services-approved course, and pass a credentialing exam and a skills exam. All initial applicants will be required to take the National Registry of EMTs examination to obtain a Texas certification or licensure. To maintain certification, EMTs and Paramedics must reregister, every 2 years for the National Registry, and/or every four years for the Texas Department of State Health Services. To re-register or recertify, an individual must meet the continuing education requirements set by the issuing entity.

Training is offered at progressive levels: EMT, Advanced EMT, and Paramedic. The EMT represents the first level of skills required to work in the emergency medical system. Formal classroom experiences are enhanced with combined time in an emergency room and an ambulance. Coursework typically emphasizes emergency skills such as managing respiratory, trauma, and cardiac emergencies and patient assessment. The program also provides instruction and practice in dealing with bleeding, fractures, airway obstruction, cardiac arrest, and emergency childbirth. Students learn to use and maintain common emergency equipment, such as backboards, suction devices, splints, oxygen delivery systems, and stretchers. The course is a prerequisite for further training as an Advanced EMT and Paramedic. Advanced EMT training requirements vary from State to State.

The most advanced level of training for this occupation is paramedic. At this level, the caregiver receives additional training in physiology, pharmacology, patient assessment, cardiology, trauma, airway management, and extensive training in other body systems. Paramedic coursework lasts eleven to twenty-four months and can result in an associate degree in applied science. Such education prepares the graduate to take the NREMT and/or the State Credentialing Examination and become certified as a Paramedic. Extensive classroom, clinical, and field training is required. Due to the longer training requirement, almost all Paramedics are in paid positions. Refresher courses and continuing education are available for EMTs and Paramedics at all levels.

Advancement beyond the paramedic level usually means leaving fieldwork. A Paramedic can become a supervisor, community Paramedic, flight Paramedic, operations manager, administrative director, or executive director of emergency services. Some EMTs and Paramedics become educators, or dispatchers, while others move into sales or marketing of emergency medical equipment. Several people become EMTs and Paramedics to assess their interest in healthcare and then decide to return to school and become registered nurses, nurse practitioners, physician assistants, physicians, or other healthcare providers.

Students or prospective students with disabilities can contact the Office of Disabilities and Accommodations. The Office of Disabilities and Accommodations exists to assist students with documented disabilities as they pursue their goal of a college education. The office serves as a liaison between students and the college in matters of communication and action toward the achievement of reasonable accommodations. Each student is encouraged to act as his or her advocate and take the major responsibility for securing accommodations. The Office of Disabilities and Accommodations provides students with the voluntary and confidential means to seek accommodations for academic and related needs. Early and regular contact will ensure the timely identification of needed services and the location of resources and options available to the student.

Eligibility for disability services at Weatherford College is dependent upon the nature of the disability and its impact on learning. A disability is defined as any mental or physical condition that substantially limits an individual’s ability to perform one or more major life activities. These disabilities may be: physical, visual, or auditory, neurological, or psychological in nature, and also include chronic health problems and learning and communication disorders.

Due to the high volume of students who receive services through this office, it is highly recommended that students make appointments with the counselor in the Office of Disabilities and Accommodations located in Student Services or call 817-598-6350.

Disability Services at WC