All posts by Andrea Bitner

Andrea is a paramedic at Wyoming Medical Center.

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

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.


AndreaBitnerAndrea Bitner is a paramedic at Wyoming Medical Center. Click here to read more of Andrea’s posts.

Ambulance on the town: Crew visits daycare

Lacey, Maranda, Elijah, Gage and Andrew enjoy a ride on the ambulance gurney at a daycare in Casper on Wednesday.
Lacey, Maranda, Elijah, Gage and Andrew enjoy a ride on the ambulance gurney at a daycare in Casper on Wednesday.

Our ambulance crew has been to preschools and daycares before.  It’s a great opportunity for us to teach kids about when and how to dial 9-1-1 and they get the added bonus of seeing the ambulance up close and personal.  They love the lights and sirens, of course.

When Emmalee Thaut of Casper Playschool inquired about our ambulance crew stopping by, our manager, Mark Meyer, jumped on the opportunity to schedule a visit.  We let them walk through the inside of the ambulances and ask questions.  Their attention spans are short, so it never takes long.

The kids always have a lot to say, and Wednesday was no exception.  This group informed me and the rest of the crew that they were not afraid of vampires – not even real ones.  Haha!

At the end of our visits, we usually have

the kids cover their ears while we turn the sirens on.  Even though they’re expecting it, it still startles them before they giggle and plead for more.

I love that my job allows me to get out and help people in need every day, but it’s a nice change of pace to go visit a group of kids.

Our crew is happy to set up a visit with other schools and daycares in our community, but please understand that our schedules are very unpredictable and we’re always on call.  If you or someone you know is interested in a visit from our ambulance crew, email Mark Meyer at or call (307) 577-2102.

Teach your children about 9-1-1

  • Remind children that 9-1-1 is reserved for emergencies such as fire, an intruder or an unconscious or badly hurt friend or family member. Ask them what they would do if there was a fire in the house and other emergency questions.
  • Talk to your children about when NOT to call 9-1-1. Example: Should you call 9-1-1 when you can’t find the dog?
  • Make sure your children understand that calling 9-1-1 as a joke can be considered a crime and is never OK.
  • When you see ambulances and fire trucks on the road, explain to your children the importance of getting out of the way so that they can respond to an emergency.