From an EMR to a paramedic: Difference is a matter of training

By Andrea Bitner Oct 15, 2013


Paramedics Andrea Bitner (the post's author) and Cooper Jensen pose in front of a Wyoming Medical Center ambulance.

Have you ever referred to a member of an ambulance crew as an EMT only to be corrected, “I’m a paramedic?” Or have you called a crew member a paramedic and she responded, “I’m an EMR?”

Have you ever wondered, “What’s the difference?”

The difference is in the training. Below is a brief explanation of the skill sets of each of the four nationally-recognized levels of emergency medical responders – Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT) and Paramedic.

Emergency Medical Responder (EMR)

The EMR course is about 80 hours long and trains a responder to provide basic care relating to managing a patient’s airway, breathing and circulation in an emergency.

EMRs are also trained in bandaging and splinting techniques. They are not approved to care for a patient in the back of an ambulance.

Emergency Medical Technician (EMT)

The EMT course is 180 to 240 hours long and goes into more detail in assessing and treating ill or injured patients. Training is a mix of classroom and in-the-field experience, either in an ambulance or an emergency room. While learning the same essential skills as the EMR, an EMT has a broader knowledge base.

EMTs can administer specific medications or help patients take prescribed medications. They are allowed to care for patients in the backs of ambulances.

Advanced Emergency Medical Technician (AEMT)

AEMT training includes 150 to 200 more hours than the EMT course, going into greater depth into various body systems and disease processes. The AEMT is better prepared to apply advanced assessment skills and interventions.

AEMTs are trained to establish intravenous access and administer various fluids and medications. They can use various airway management devices to protect and secure a patient’s airway if necessary. As with the EMT course, AEMT training is conducted in the classroom along with the hospital and ambulance settings.


The paramedic is at the highest level of nationally-recognized, prehospital providers. Paramedic training is between 1,000 and 1,400 hours and can result in either a certificate of completion or an associate’s degree from a community college.

At this level, the training is much more in depth and the responsibilities of a paramedic are significantly higher. The training builds upon that of the EMT and AEMT, expanding in the areas of anatomy, physiology, pathophysiology, pharmacology and cardiology. Assessment skills are improved and the ability of the paramedic to think critically regarding a patient’s illness or injury and the necessary interventions is enhanced.

Paramedics are exposed to a variety of clinical settings designed to reinforce the learning experience in addition to hundreds of hours in the emergency room and ambulance settings. All to better equip them to treat a patient from the elderly woman who is just feeling lonely, to the father of three who has gone into cardiac arrest. All in all, the difference is education and experience.