How to Become an EMT in Virginia

So you've decided to become an EMT in Virginia to help save lives or you're at least thinking about it because if you weren't you wouldn't be reading this article. Getting into EMS is a rewarding move and your logical first step is to become an EMT-Basic, the entry-level EMS provider. If you're not sure you want to become an EMT, you could become a First Responder, an advanced first aid provider. You can always move up from there. But anyway, onto to what you're here for.

Before we get into how to become an EMT-B, you will need to meet some minimum requirements. In order to become an EMT-B in Virginia (or an EMS provider of any level) you must be 16 when you start the class, be fluent in English (reading, writing and speaking), have no physical or mental impairment that would keep you from being able to perform your duties, must have CPR training (more on that later), not have been convicted of or found guilty of certain crimes (see Office of EMS site for details), must be neat and clean in appearance and must not be under the influence of drugs or alcohol any time you are in class or in clinicals.

Your very first step is learning about what an EMT-B is and what an EMT-B can do. The letters "EMT" might conjure images of Johnny and Roy or Third Watch in your mind, but a lot of what you see on TV isn't entirely accurate. An EMT-B is the basic (hence the "B") level of EMS provider, trained to deliver basic life support, or BLS. In Virginia, the scope of practice (what you are allowed to do) of an EMT-B consists of CPR and automatic external defibrillation (AED, you've probably seen them in airports or grocery stores), providing artificial respirations (no not mouth-to-mouth, don't worry) inserting non-invasive airway devices, first aid including splinting and hemorrhage control, oxygen administration, assisting patients with taking some medications (usually nitroglycerin, aspirin, inhalers and an Epi-pen), and administering oral glucose. A Virginia EMT-B does not start IVs, give medications (except as already noted), monitor heart rhythms (EKG monitoring), insert advanced airway devices like endotracheal tubes (breathing tubes), or perform manual defibrillation. Each EMS council and each agency may extend or restrict the EMT-B's scope of practice, but what I've listed is what is in the EMT-B curriculum.

Your second step is to find an EMT-B course. Volunteer rescue squads and many community colleges offer the classes. The cost will vary from agency to agency, and some agencies may require you to commit to volunteering with them if you take their class (but this is pretty rare). You can look online or you can call your local EMS council to find the upcoming classes in your area.

The third step in the process is to obtain your CPR certification. A prerequisite for any EMT-B course is CPR. If you're lucky, CPR may be offered as part of the EMT-B course, but you may have to obtain the certification on your own. Check out your local Red Cross or call your local EMS council to find classes. You will then be certified in adult, child and infant CPR and AED use and your certification will last for two years.

So now you that know what an EMT-B is and does, you're CPR certified, and you've enrolled in a class you're probably wondering what you've gotten yourself into. An EMT-B class consists of a minimum of 111 hours of classroom instruction and a minimum of 10 hours of clinical rotations, usually in your local ER. During class you will not only learn through lectures, you will be given plenty of hands-on opportunity to practice what you've learned. Practice, practice, practice and more practice. Ideally, you'll be given hands-on time every class but not every instructor plans classes that way. You'll learn about a wide variety of medical and traumatic emergencies, and of course how to treat them. Chest pain, difficulty breathing, seizures, strokes, abdominal pain, childbirth, diabetic emergencies, behavioral emergencies, environmental emergencies like hypothermia, and poisonings and overdoses are the medical emergencies you'll be trained to recognize and treat at the BLS level. You'll learn spinal immobilization, extremity immobilization (aka splinting), hemorrhage control, burn care, blunt and penetrating trauma care, and head injury management as well.

The next step is to pass your class final exam and be cleared to take the state exam. The state exam is a 100-question written test and a series of practical exams. EMT-B practicals are divided into three different stations: medical, trauma and a random skill. Each station has a 10-minute maximum time limit. All examinations and treatments must be finished within that time. On September 1, 2009, the practical test will change and all new candidates will test under the new rules. This article contains information on the new tests.

During the medical station, you will encounter a moulaged patient, will be given a basic scenario and you will have to physically perform an assessment, including obtaining a full set of vital signs. You must decide if the patient needs to be transported immediately, or if you can wait until you've finished your detailed exam. You will verbalize all physical findings and treatments. You will be testing alone but you will have an infinite number of imaginary EMT assistants that can be given tasks, but you must tell the evaluator that an imaginary EMT is performing a task. And most importantly, make sure your evaluator acknowledges you!

The trauma station is similar to the medical station in that you will find a moulaged patient that you have to physically assess. You must obtain a full set of vital signs and can designate tasks to an unlimited number of imaginary EMTs. All treatments are verbalized. Like the medical station, you will need to decide if the patient needs immediate transport or if you can do the detailed assessment prior to transport.

The third station is the random skills station. Before you begin the station, you will be presented with a set of seven cards. To find out what random skill you'll have, point to one of the cards (no touching!). Airway management, bleeding and shock management, immobilizing a joint, immobilizing a long bone, using the traction splint, spinal immobilization of a seated patient and spinal immobilization of a supine patient are seven the possible scenarios. Once you know your scenario, you will either be led to the proper area in the room or your evaluator will set up the necessary equipment, depending on the size of the room. For a full description of each random skill, please see the "Practical Exam Users Guide" PDF on the Office of EMS website (link below).

If you survive the practical exam and pass the written, you will be a certified Virginia EMT-Basic. Your certification will be good for four years. You have several options as to what you can do now that you're an EMT-B. For example, you can volunteer for a rescue squad or fire department, you can work for a paid EMS agency or fire department, or work in an emergency room. In order to keep your certification, you will have to attend 36 hours of continuing education classes before your four years are up. It's not as painful as it sounds, I promise.

Now that you know all that's involved in becoming a Virginia EMT-Basic, what are you waiting for? We need you!