Alexander J. Perricone, 26, was a little nervous six weeks ago after he became certified as an Emergency Medical Technician Paramedic.
He had attained the highest level of national certification available to ambulance personnel. But he knew that if people's lives were going to be in his hands, those hands had better not be shaking.
"People look at you as the leader, the one that can provide the ultimate care and give the most information on the crew," said Mr. Perricone, a Hampstead resident who volunteers on the local ambulance crew and works as a full-time paramedic in Baltimore.
Mr. Perricone, who also works part time in Howard County, and four other members of Carroll ambulance crews -- Robert A. McCurdy, Linas Saurusaitis, Ronald Green and Gregg MacDonald -- passed the National Registry of EMT tests in July and were accepted as certified paramedics in September.
Medics certified at this level are able to perform more complex medical procedures -- such as placing plastic tubes in injured patients' airways so they can breathe -- and they can administer more varieties of medication than other ambulance personnel.
Mr. McCurdy, another Hampstead resident and volunteer who also works full time as a Baltimore paramedic, said that if he and the others could get through the yearlong training and 15 hours of testing, the job shouldn't be a problem.
"We spent 463 hours in class in addition to any full-time, volunteer, or part-time work we were already doing in the field," said Mr. McCurdy, who also volunteers on ambulances in Westminster.
"We even spent time in hospital emergency rooms, [obstetrics] facilities, labor-and-delivery rooms as well as operating rooms to learn proper procedures," he said. "If you've ever been in any of those rooms, you know it's no picnic."
The test was no day in the park, either. "That was a major stress day," Mr. McCurdy said.
Mr. Saurusaitis, a Lineboro resident and full-time Reese paramedic, said he has seen seven instances "where my skills could have been used, but I was not fully certified. I had passed the test, but I had not received the state certification needed to practice."
Even though the state recognizes the paramedic training, the men said they believe that Maryland does not allow them to use all their skills.
"I was riding ambulance one day and a kid needed a chest decompression," said Mr. MacDonald, an Emergency Medical Service lieutenant in Sykesville and full-time pharmaceutical representative for a DuPont company, speaking of a procedure used to relieve pressure on the chest cavity. "But we aren't
allowed to do that and we had to wait for someone at the hospital to do it."
"It sounds silly, but we are actually trained to do things the state of Maryland does not allow us to do," Mr. McCurdy said.
Mr. Green said he and his colleagues are prepared to provide the highest level of medical care a patient would need before reaching a hospital, because, to become paramedics, they had to ascend the ranks of emergency services, learning and building on skills at each level.
"I'm not uncomfortable with any part of my job," said Mr. Green, who is an EMS captain in Gamber, a volunteer in Winfield and full-time paramedic in Baltimore. "We went through some pretty extensive training."
All five said they hope the new director of the Maryland Shock Trauma Center, who guides emergency services statewide, will increase their responsibilities.
"I'm anxious to start practicing my skills, but I don't want to wish anyone ill," Mr. Saurusaitis said. "I don't want to sound morbid, but when something happens, I want to be there."