The first level of training in the Pennsylvania EMS career structure is the EMT course. The course covers all techniques of emergency medical care presently considered within the responsibilities of the EMT, as well as operational aspects of the job, which they will be expected to perform. The course consists of 33 lessons, involving 116 hours of classroom and field training, plus 10 hours of in-hospital observation and training. Specific objectives of the course are: 1) teach students the overall role and responsibilities of the EMT in performing both the emergency care and operation aspects of his/her job; 2) develop student skill in diagnosis and all emergency treatment procedures, short of those rendered by physicians or by paramedical personnel under the direct supervision of a physician, and 3) develop student skill in the use and care of all equipment required to accomplish his/her job. Topics covered include an overview of the EMT's job, a description of the training course, and an overview of anatomy and physiology. It is followed by lessons on life threatening emergencies, hildbirth and problems of pediatric patients, lifting and moving patients, environmental emergencies, extrication from automobiles, and operation aspects of the EMT's job. Each lesson provides for practice of the skills taught in that lesson. The course also includes a final written exam of knowledge and a final practical evaluation of skills.