If necessary, they request additional help from police, fire, or electric company personnel, or they may enlist bystanders to direct traffic or remove debris. They determine the nature and extent of the patient's injuries or illness while also trying to determine whether the patient has epilepsy, diabetes, or other preexisting medical conditions. EMT's then give appropriate emergency care following strict guidelines for which procedures they may perform. EMT-Paramedics provide the most extensive prehospital care. In addition to the procedures already described, paramedics may administer drugs orally and intravenously, interpret EKG's, perform endotracheal intubations, and use monitors and other complex equipment.
Some conditions are simple enough to be handled following general rules and guidelines.
When victims are trapped, as in the case of an automobile accident, cave-in, or building collapse, EMT's free them or provide emergency care while others free them. When transporting patients to a medical facility, EMT's may use special equipment such as backboards to immobilize them before placing them on stretchers and securing them in the ambulance. While one EMT drives, the other monitors the patient's vital signs and gives additional care as needed. Some EMT's work for hospital trauma centers or jurisdictions which use helicopters to transport critically ill or injured patients. At a medical facility, EMT's transfer patients to the emergency department, report to the staff their observations and the care they provided, and may help provide emergency treatment.