EMS Education in Wisconsin

Education for Wisconsin’s First Responders and EMTs is currently completed by Wisconsin’s EMS training centers spread throughout the state. These schools are certified by the Wisconsin Department of Health Services (DHS) to provide EMS education.

Following the completion of the training course, students complete a state practical and national written exam in order to become licensed. They are allowed three attempts to obtain a passing score of at least 70% in order to become licensed. Following initial licensure every EMT, Paramedic and First Responder must complete a refresher course every two years in order to retain their license.

While EMS education can be offered five days a week, the majority of First Responder and EMT-Basic courses are offered once or twice a week, often in the evening, to accommodate volunteers who often have full-time jobs. Day classes are often available to accommodate second and third shift workers.

In addition to the typical EMT or First Responder training courses, there are several schools in Wisconsin that offer either a two year or a four year degree in Emergency Medical Services. These schools run these programs just like any other college degree course. These courses are intended for those students hoping to obtain a career in EMS. However, there is no requirement whatsoever to obtain a two or four year degree in order to operate as an EMT or First Responder.

The requirements and length of the educational course depends on the level of training being taught. All students must start out by completing either a First Responder or an EMT-Basic course. After becoming an EMT, students are then eligible to enroll in any of the advanced levels of training from Intermediate Technician through Paramedic.In addition to the formal EMT or First Responder training courses, there are a large variety of additional courses that an EMT may take.

These include dealing with hazardous materials, bloodborne pathogens and bio terrorism; Basic Trauma Life Support (BTLS); Specialized pediatric and geriatric training, incident management training, and much more.EMTs also often spend time attending local, regional and state EMS conferences and training events.

There are multiple EMS magazines, web sites and continuing educational opportunities to also take advance of. While the initial training is often the longest and most important, like all forms of medical care, EMS is constantly changing and evolving. This requires EMTs of all levels to stay informed and essentially continue their education throughout their volunteer or full-time EMS career.It does not matter whether the EMT or First Responder will operate as a volunteer or a paid, full-time provider. The training and certification is the same for all EMTs licensed in Wisconsin regardless of the work they will perform. There are not separate licenses for volunteers and for full-time providers.

Every Emergency Medical Responder in Wisconsin and across the United States is trained to the same standards and must pass the exact same examination to become licensed Medical First Responder. The State of Wisconsin requires 49 hours of education for the First Responder course (Emergency Medical Responder), although there are some programs in Wisconsin that provide First Responder course in excess of 60 hours. Emergency Medical Responders are taught the basics of emergency medical care and are able to treat life threatening problems prior to the arrival of the ambulance. Their skills include operating a cardiac defibrillator, inserting simple and advanced airways and using an epinephrine auto injector. Bleeding control, CPR, cervical spinal immobilization, taking vital signs, and oxygen administration are also part of the course.

A Emergency Medical Responder is only able to treat patients at the scene. While they may assist in the back of an ambulance, a First Responder is not able to function as a licensed member of the ambulance crew. Following initial certification, every First Responder must complete a 16-hour refresher course every two years to retain that certification.

The backbone of EMS in Wisconsin and across the nation is the Emergency Medical Technician. These EMS providers actually receive a sizable amount of training. The EMT course consists of approximately 180 hours of instruction including classroom, practical and emergency room education.The training includes basic anatomy and physiology, understanding of various body systems, illnesses, injuries and their associated treatments. Besides administering oxygen, Wisconsin EMT-Basics are trained and authorized to administer several medications including aspirin, albuterol, atrovent, epinephrine, and glucagon. They are able to administer injections as well as test blood sugar.

Because the EMT is the only level of care required in Wisconsin, an EMT must learn and become familiar with a wide variety of patient conditions and treatments. Following their initial licensure, an EMT must complete 24 hours of continuing education plus six hours of “hot topics” (as required by the State) every two years or obtain training at one of the higher levels of EMS in order to retain their license. There are no requirements for an EMT to actively use their license in order to retain it.

After becoming licensed as an EMT some EMTs go on to obtain training and certification as an EMT-Intermediate Technician or Advanced EMT. This requires an additional 170 hours of training beyond the primary 180 hours to complete the initial EMT course. Approximately 76 of these hours are spent in the classroom, 44 hours in practical lab stations, with the remaining 50 hours spent in clinical experiences at the emergency room practicing their skills.

Advanced EMTs: (EMT-Intermediate Technicians) are able to start IVs and administer IV fluids. They carry and administer several additional medications including nitroglycerine for chest pain, Narcan to treat opiate (heroin, Oxycodone, Hydrocodone, etc.) overdose, and 50% Dextrose to treat diabetics. Advanced EMTs also receive additional education into pathophysiology, anatomy, diagnostics and critical thinking skills. Following course completion, the EMT must again pass a written and practical exam to become licensed as an Advanced EMT.

In addition, they must be licensed and volunteering or working with an ambulance service licensed to operate at the Advanced EMT level in order to administer any of the Advanced EMT skills and medications.An Advanced EMT must complete a 42 hour refresher course every two years or obtain training at one of the higher levels of EMS in order to retain their license. There are no requirements for an Advanced EMT to actively use their license in order to retain it.

The next level of care is the EMT-Intermediate. The EMT-Intermediate course requires a minimum of 496 hours of additional training. About two-thirds of this training is completed in the classroom with the remaining time spent in various departments of the hospital, and in the back of an ambulance with an instructor or preceptor, performing and practicing their skills. EMT-Intermediates receive a much more detailed education in the various systems of the body and in the pathophysiology of the various emergency conditions they will treat. They are trained to interpret ECGs as well as perform a much more advanced and detailed patient assessment. They carry and administer over 20 different medications including cardiac drugs and narcotic medications to treat pain as well as seizures. They are able to perform a variety of advanced procedures including endotracheal intubation, placing a special needle into the leg bone or sternum, placing a catheter through the chest wall to treat a collapsed lung, and starting IVs in the external jugular vein of the neck.

EMS providers at this level may operate either as volunteers or as part of a paid ambulance service or fire department. EMT-Intermediates may only use their advanced skills while operating with an ambulance service licensed at this level of care. EMT-Intermediate ambulance services are often located in mid-sized communities who may not have the annual call volume or resources to provide paramedic level care. Along with these, however, are several very small communities who provide this level of care thanks to very dedicated volunteers or paid-on-call members. An EMT-Intermediate must complete a 48 hour refresher course and complete an Advanced Cardiac Life Support (ACLS) refresher course every two years to retain their license or complete the additional training required to become a paramedic.

The highest level of training for standard emergency medical care is the Paramedic. Paramedics must complete at least 1,100 hours of education to obtain their license. Typically 700 hours of this time is spent in the classroom with the remaining hours being spent in a large number of hospital departments and in the ambulance working with licensed paramedics or instructors/preceptors.

Paramedics receive a very detailed education in anatomy, physiology, pathophysiology, pharmacology, critical thinking and advanced medical procedures.The EMT-Paramedic is allowed to carry and administer as many as 50 or more different medications. In addition to all of the procedures of the EMT-Intermediate, a Paramedic can perform a chricothyrotomy, place a needle into the sac that surrounds the heart to remove blood and even completely sedate and paralyze a patient in order to facilitate the insertion of a breathing tube.

Paramedics often operate as part of a full-time paid ambulance service or fire department and make their living in EMS. However, there are areas of Wisconsin that have volunteer paramedics as well as those who only work in EMS part-time while they maintain their regular career in a completely different and often unrelated field. Typically Wisconsin’s larger cities have paramedic ambulance services and fire departments. Still, several very small communities also provide this level of care because of very dedicated volunteers. Like the Intermediate, the EMT-Paramedic must complete a 48 hour refresher every two years and complete an Advanced Cardiac Life Support (ACLS) refresher course to retain their license.

Critical Care Paramedic: As health care changes continue, the utilization of the Critical Care Paramedic and Critical Care Transport services have become more common throughout Wisconsin. Critical Care Paramedics are used primarily to transport critically ill and injured patients from one health care facility to another. Because increased knowledge and skills are required to handle these types of patients, development of training, testing and certification for the Critical Care Transport Paramedic (CCTP) was introduced in 2009.In order to obtain Critical Care Paramedic endorsement, students must already be currently-licensed as a Paramedic. Students receive additional training in a variety of patient conditions and medical interventions related to the transportation of a critically-ill or injured patient from one medical facility to another. Areas of care include mechanical ventilators, medication administrations or maintenance of medications not typically used in the pre-hospital setting, use of advanced medical devices, and further education related to patients with special medical needs.

While awaiting formal and final legislative approval, the Critical Care Transport Paramedic is currently added as a special endorsement to the standard Paramedic license. To obtain the endorsement, students must successfully complete all components, including clinical and field, and final evaluations of the Wisconsin Critical Care Transport Paramedic program. Upon successful completion of all the training program’s requirements, individuals may apply for Critical Care Transport Paramedic endorsement.Just like with all of the other levels of EMS care, individuals holding a valid endorsement as a Wisconsin CCTP and who wish to maintain their CCTP endorsement must complete a minimum of 24-hours of continuing education based on the current CCTP curriculum every two years. Those 24-hours are in addition to the required 48-hours of continuing education, recertification and endorsement as a regular Wisconsin Paramedic.

Information supplied by the Wisconsin EMS Association.