Emergency Medical Technicians (EMTs) are a vital service provider in emergency medical treatment. They frequently work on ambulances, fire engines, and in hospital emergency departments. They are trained in managing a wide variety of medical conditions with specialized training and equipment. Are they able to start an IV (intravenous line) to give fluids or medicaitons?
EMTs (also know as EMT-Basic) are trained in Basic Life Support (BLS) to treat sick and injured people. Basic level EMTs are not trained or authorized to place/insert IV lines in patients. There are higher-level EMTs in some areas that are allowed to start IV lines.
Inserting an IV is considered an advanced skill (sometimes called an invasive skill) that needs special training to be certified to perform. We will talk more below about the different levels of EMT training and the skills they can perform. This will give you a better understanding of what an EMT is trained and expected to do in emergency scenarios based on their training and location.
Can EMTs Start IVs?
Like we saw above, the EMT Basic is not trained to insert IVs, but other types of EMTs are able to perform this skill. Let’s take a look at the different types of EMT training and certification:
EMT Basic (EMT-B, or just EMT): This is the first level of EMT, which is why they call it basic. They receive 120-150 hours of classroom and lab instruction. They are trained in BLS and basic first aid. They can give oxygen and assist with some other medications (depending on the area).
EMT Intermediate (EMT-I): An EMT intermediate receives a slightly higher level of medical training (an additional 150 hours). They can do everything that an EMT basic can, plus some added skills like IVs, intramuscular injections, and intubation (placing an advanced airway). This level of EMT is not used in many states.
EMT Advanced (AEMT): The advanced EMT is the next level in emergency, pre-hospital training. They must complete an additional 168 hours of training after EMT Basic (but they may not need EMT intermediate training) that will include internship hours in the hospital and on an ambulance. They are permitted to give medications like Narcan, Dextrose, Aspirin, Epinephrine and Nitroglycerin. This level of EMT is not recognized in all states.
EMT Paramedic (usually just referred to as Paramedic): Paramedic is the highest level of EMT training. They go through 1200-1800 hours of training after their EMT basic class. They can give a variety of medications and are considered the highest medical authority outside of the hospital.
Note: Many states only have EMT basic and EMT Paramedic as recognized providers. This is why you may just hear them called EMTs and Paramedics, even thought they are all technically EMTs.
Intravenous lines (IV for short) are small plastic catheters or tubes that are inserted into a vein using a needle to puncture the skin. These are placed for a few reasons including, to give fluids and certain types of medications.
This video shows the basic procedure for inserting an IV:
The exact skills that each type of EMT is allowed to perform can vary by state. Though there are standards for the training of each level of EMT, each counties medical director will decide which skills, procedures and medications each provider is authorized to give or perform.
Also read: Can An EMT/Paramedic Work As A Phlebotomist?
But in general, EMTs (referring to EMT Basic) are not allowed to start IVs.
Can EMTs Intubate/Place Advanced Airways?
In certain types of medical emergencies, providers need to protect and keep open a patient’s airway. This can be done using a few techniques and tools, depending on the specific issue and severity.
EMTs are authorized to use positioning, Nasopharyngeal Airways (NPAs), Oropharyngeal Airways (OPAs), and Bag-Valve Masks (BVMs) to manage someone’s airways. These are all part of the Basic Life Support (BLS) scope of practice.
There is another category of airway management techniques that fall into the advanced airway category. These include Laryngeal Mask Airways (LMA), Esophageal-Tracheal Tube (combi-tube) and Endotracheal Intubation. These airway management tools are usually more effective, but are more difficult to use.
Take a look at the process when intubation is used to manage an airway:
EMT basics are not allowed to use advanced airways or intubate patients. These tools are reserved for more advanced EMTs and Paramedics (in most areas).
Can EMTs/Paramedics Do Stitches or Suture Wounds?
Cuts or wounds that are large, deep or in areas where a scar would be undesirable may require stitches or sutures. This process is basically using specific types of medical thread-like materials to sew the wound back together. It is used after injuries and surgeries.
Have a look at what stitching can look like:
Now, this procedure is very rarely done outside of the hospital (partially due to risk of infection if not cleaned properly first). In general, this procedure is only performed by medical doctors, physician assistants, and advanced practice nurses.
EMT basics are never allowed to give sutures or stitches and even paramedics do not receive training for this skill.
Note: Some paramedics in Canada and other areas may get training and be allowed to give stitches, but it is the exception.
Can EMTs/Paramedics Draw Blood?
Drawing blood is a procedure performed usually for the purpose of testing the blood for a variety of things. It is also used for blood donation. This procedure is usually done by phlebotomists, who are specifically trained for this very purpose.
While this procedure is not considered to be advanced, it is invasive. While it is most commonly performed by phlebotomists, it can be done by nurses, doctors and even paramedics in some areas.
However, basic level EMTs are not allowed to draw blood. They may be allowed to check a blood glucose level, which is technically drawing a tiny amount of blood, but they are not trained in regular blood draws.
Can EMTs Administer Narcan/Aspirin/Nitroglycerin?
EMTs are allowed to assist patients with taking their own medications, in some scenarios. The medications that EMTs are alllowed to assist with will vary by each state and county policies.
Nitroglycerin is medication that is used to treat pain the chest (angina) by relaxing blood vessels in the heart to improve their blood flow. In most areas, EMTs can assist patients with using their own pre-prescribed nitroglycerin, but they are usually not allowed to administer this medication otherwise. Again, there are exceptions, but this seems to be the norm.
Higher level EMTs and Paramedics can usually give all of these medications, in accordance with their protocols, in most areas of the US.
EMTs are very important in the emergency medical care system. They can work in a variety of different positions. The level of training they receive and the skills and tools the are allowed to use in their job can vary by location.
Make sure you know what you are authorized to perform in you area, as it can be very different.