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During the transport of a patient, one team member drives, while the other monitors the patient's vital signs, and gives additional care as needed to stabilize the patient. In ambulance crews, the paramedic is usually the senior officer, while the EMT may serve as a technical assistant. Incidents as varied as automobile accidents, heart attacks, childbirth, and gunshot wounds require critical intervention, and transport to a medical facility. In an emergency, paramedics respond to a 911 dispatch, often arriving at the scene prior to the police and fire fighters.

Formal courses are often combined with time in an emergency room or ambulance. Graduates of approved EMT-Basic training programs must pass a written and practical examination administered by the State licensing agency or the NREMT. Such education prepares the graduate to take the NREMT examination to become certified as a Paramedic. In addition to carrying out the procedures of the other levels, paramedics administer medications orally and intravenously, interpret electrocardiograms (EKGs), and use monitors and other complex equipment.