EMS vs EMT: What’s The Difference?

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Have you been considering a career in emergency medicine but can’t get your head around the difference between EMS and EMT? Are they the same thing? Don’t worry, you’re not alone. Fortunately, the answer isn’t too complicated and you’ll soon be better able to define what you want to focus your efforts on in this challenging and rewarding field of work. 

EMS stands for Emergency Medical Services and is a whole category of medicine. EMT stands for Emergency Medical Technician, which is a specific certification for a healthcare role in the Emergency Medical Service (EMS) system.

In this article, we will talk more about the EMS system, EMT training levels, the differences between EMS and EMT, as well as what an EMR is. Check it out below.

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Also read: Can You Live Off an EMT/Paramedic Salary?

What Is The Difference Between An EMT And EMS?

Difference EMS and EMT

What Is EMS?

EMS stands for Emergency Medical Services. This is talking about the whole emergency medical service system.

This is a definition that applies to all the services provided to a patient outside of a hospital when the patient will be transferred to a hospital (or equivalent facility) for additional treatment. (Also known as definitive care.)

So, EMS tends to incorporate life support (both basic and advanced), many traditional healthcare professions, including EMTs and Paramedics.

Both the fire service and the medical service can carry out duties as EMS professionals and, in fact, in many cases, both services will be deployed to deliver support at each incident. 

The level of care supplied by an EMS worker will be defined by their job title, their skills and qualifications, their expected role in any given situation and the state or country that they work for. 

EMS may also be involved in situations that require urgent medical knowledge, but which are not, yet, defined as an emergency. 

In these instances, EMS might be called upon to share information and develop strategies to prevent the loss of life and protect the health of a larger body of people. 

Also read: The Difference Between EMT And Paramedic? 

What Is An EMT?

An EMT, who may or may not be a paramedic, will usually work out of an ambulance, though most firefighters are also trained and function as EMTs and Paramedics.

EMT stands for Emergency Medical Technicians.

There are several levels of qualification for EMTs and each is capable of providing a different level of care. The first is EMT-basic, EMT-intermediate, EMT-Advanced, EMT-Critical-Care, and EMT-Paramedic

To learn about the differences between EMT certification levels, watch this video:

Note: Not all states recognize all the different levels of EMT.

All EMTs must be certified to work in the state in which they intend to practice, and they must complete a local training/certification program to qualify. These programs are only recognized at a local level and if an EMT intends to move to another state – they may need to re-qualify for the new state. 

Note: Most states also recognize the NREMT (National Registry of Emergency Medical Technicians, which allows you to transfer more easily between states.

Each of these qualifications allows the qualified individual to provide a specific level of support to patients at an emergency scene. 

EMTs are, normally, the first group of people to attend an incident. Many times the first responders on-scene will be firefighters, that are also EMTs or Paramedics.

I work as a firefighter/paramedic and the majority of the calls we are dispatched to are for emergency medical aid.

Also read: 7 Reasons Firefighters Show Up At Medical Emergencies

EMTs will assess the scene for any risks and then provide first aid to patients who cannot immediately be transported to a hospital or, alternatively, they may arrange or provide immediate hospital transportation themselves.

Also read: Can EMTs Start IVs/Intubate/Give Stitches?

EMTs make up the largest share of individuals who fall under the umbrella of EMS.  

Thus, while an EMT’s duties clearly fall under the category of “Emergency Medical Services” (EMS), they are not the whole of the discipline either.

However, it’s worth noting that some EMTs will be qualified above and beyond the EMT role that they normally fulfill as part of their duties.

These individuals, if a situation arises where this additional qualification becomes valuable, may be pulled out of EMT roles and placed into management/command EMS roles when needed. They would then return to their EMT role when the situation had been appropriately handled or resolved. 

Perhaps, the easiest way of defining the difference between an EMT and EMS, is that the EMS is the entire service/system and an EMT is a person within that service who carries out a specific set of duties. 

Also read: How to Become an EMT: Expert Guide and How Long Does It Take To Go From EMT To Paramedic?



Things become a little murkier when we throw in another three-letter acronym.

The EMR or Emergency Medical Responder’s role can often seem, to the untrained eye to be identical to that of an EMT, when, in fact, they are quite different and an EMR is not a fully qualified EMT.

Note: EMRs may also be referred to as medical first responders or certified first responders.

An EMR’s role is to provide basic first aid to people who are injured or hurt or, perhaps, have just fallen sick at work until an EMT team arrives to take over the job. As such, you are unlikely to find an EMR transporting someone to the hospital, for example, as it falls outside of the scope of the job.

EMRs are thus not qualified as full-time members of the EMS system, but rather they provide an intermediary bridge between the wider world and the EMS teams; when an EMS team is not currently available on site.

Typically, someone becomes an EMR when they join their workplace health and safety group and are given the appropriate level of training. 

One thing that might surprise you is that EMR training is not, at least directly, part of the EMT training program and an EMT will study EMT qualifications from the outset rather than beginning with an EMR qualification and then transferring to EMT when that period of study is complete. 

In other words, you don’t need to become an EMR before you can become an EMT.

This helps to clarify that an EMR’s role is complementary to an EMT’s and that an EMR is not, by any means, a junior EMT. This can be very important in helping to manage an onsite response effectively when someone’s life is at risk.

In the United States in 1995, the EMR role was brought about because the Department of Transportation had seen that there was a need for individuals who could provide basic first aid, but who did not need to become fully qualified at an EMT-basic level.

This was important to employers who were reluctant to send staff on 180-hour EMT-basic level courses to learn some simple first aid. It was particularly important in rural communities, when EMT support can take substantially longer to arrive on the scene of an incident than a city-based EMT is able to because of the distances that have to be traveled.

EMR training takes between 24 and 60 hours and is often delivered by someone who has an EMT-basic qualification, usually at the EMR’s place of work rather than at a college or university. This is also an advantage to employers who are reluctant to see staff leave the premises for long periods of time.

Most of the training focuses on keeping patients breathing and their hearts beating. Though in some states, thanks to the ongoing opioid epidemic, an EMR might also be trained and then be permitted to provide Naloxone (Narcan) in the case of a suspected overdose. 

EMRs are not meant to take part in rescue events with the fire service as they are not sufficiently qualified to do so. 

The term “Emergency Medical Responder” wasn’t coined until 2012, when it took the place of “Medical First Responder” and by 2015, the definition and terminology was accepted widely throughout the United States. 

To help you decide between EMR and EMT training, watch this video:


EMS vs EMT? What’s the difference? As you can see, the work of an EMT falls within the scope of the EMS system and thus, there’s not a huge amount of difference from an EMT’s point of view. However, there are many people working within Emergency Medical Services who are not specifically skilled to carry out an EMT’s work.

Also, when it comes to the difference between an EMT and an EMR. An EMR is essentially a backup professional to the role of EMT and they have a smaller, more narrowly defined skillset than an EMT which sees them providing support as opposed to leading an emergency medical effort. 

Related Articles:

Do Firefighters Have to Be Paramedics or EMTs?

What is a Firefighter Paramedic? The Job Explained

Paramedic vs Firefighter: What’s The Difference?

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