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Learn About NJ EMS

EMT vs Paramedic, What's the Difference?


An EMT stands for an Emergency Medical Technician. EMT is the entry-level for New Jersey's Emergency Medical Services (EMS) system. EMTs are trained in a variety of Basic Life Support (BLS) skills. EMT course in NJ are typically 220-250 hours long. EMTs are trained in the following:


  • Patient Assessment

  • Oxygen Administration

  • Bleeding Control

  • Lifting and Moving Patients

  • Cardiopulmonary Resuscitation (CPR)

  • Basic Burn Care

  • Basic Airway Management including oropharyngeal and nasopharyngeal airways

  • Automatic External Defibrillator (AED) utilization

  • Administering the following medications:

    • Aspirin

    • Naloxone (Narcan)

    • Epinephrine Auto Injectors (Epi Pens)

    • Oral Glucose

    • Inhaled Bronchodilators such as Albuterol**

  • Spinal Immobilization

  • Place Continuous Positive Airway Pressure devices (CPAP)

  • Splinting

  • Basic Trauma 

A paramedic is the highest tier of pre-hospital provider in New Jersey excluding physicians. In order to become a paramedic you must already be an EMT. You must then undergo an additional 2-3 years of continuous training before being eligible to sit for licensing exams. In New Jersey the actual title of paramedics is "Mobile Intensive Care Paramedic" or MICP for short. This is because the NJ EMS system prides itself on its paramedics being able to deliver an Intensive Care Unit (ICU) level of care in the pre-hospital environment to the benefit of those who call 911 within its borders. This is, in part, due to its dual paramedic system. Much like pilots flying commercial airplanes require having two pilots, having two paramedics significantly reduces the risk of errors. Especially in an environment that is far less controlled than that of a hospital. 

Paramedic training in New Jersey incorporates an additional 1,500-2000 hours of clinical training in addition to the training received to become an EMT. This includes a minimum of:

  • Approximately 750 classroom hours

  • 100 Hours in the Emergency Department

  • 40 Hours in the Intensive Care Unit

  • 24 Hours in the Operating Room

  • 16 Hours with the IV Therapy Team

  • 40 Hours in the Pediatric Unit

  • 24 Hours in Labor and Delivery

  • 8 Hours in the Psychiatric Unit

  • 8 Hours in the Cardiology Lab

  • 8 Hours in the Morgue

  • 8 Hours in the Laboratory

  • 24 Hours with Respiratory Therapy

  • A minimum of 400 hours of field experience

During this time the MICP learns an extraordinary amount of critical care medicine. NJ MICPs scope of practice includes:

  • Advanced Cardiac Life Support

    • Same level ER and ICU physicians and nurses are required to have​​​

  • Pediatric Advanced Cardiac Life Support​

    • Same level ER and ICU physicians and nurses are required to have

  • Prehospital Trauma Life Support​

  • Obtaining and interpreting Electrocardiograms (ECG/EKG)

    • In hospitals only physicians and mid-level providers such as PAs/NPs interpret EKGs​​​

  • Cardiac Monitoring ​

    • Same level ER and ICU physicians are required to have

  • Intravenous and Intraosseous Access​

  • Intravenous Medication Administration including infusions

  • MICPs are required to know the indications, contraindications, side effects, adverse effects, dosages, class, and interactions of all of these medications prior to administering them

  • MICPs are also often required to mix and dilute their own medications

    • Something typically only done by pharmacists in the hospital

  • MICPs can also insert advanced airways including supraglottic airways and endotracheal tubes​

    • ​This is a skill only performed by physicians and highly specialized nurses or PAs in the hospital

  • MICPs can perform surgical cricothyrotomies a procedure where a hole is cut with a scalpel in the front of a patient's neck and a tube is placed to ventilate them​

    • This is a procedure only performed by physicians in the hospital​

  • MICPs can initiate End Tidal Carbon Dioxide (EtCO2) monitoring and interpret values and waveforms

  • MICPs can place patients on mechanical ventilators and adjust ventilator settings

    • This is a skill typically only done by physicians and respiratory therapists in the hospital

  • MICPs can defibrillate, electrically cardiovert, and transcutatenously pace patients

  • MICPs can place patients under various levels of anestheisa for procedures or to intubate them and place them on a ventilator

    • These are procedures that are only performed under strict physician supervision in the hospital​​​​​​​​​​​​​​

Most importantly, MICPs are trained to use all of these skills and knowledge to continually assess, diagnose, and treat patients in the pre-hospital environment thereby shortening hospitalizations and improving outcomes. 


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