A high school diploma is usually required to enter a formal emergency medical technician training program. Training is offered at progressive levels: EMT-Basic, EMT-Intermediate, and Paramedic. At the EMT-Basic level, coursework emphasizes emergency skills, such as managing respiratory, trauma, and cardiac emergencies, and patient assessment. Formal courses are often combined with time in an emergency department or ambulance. The program provides instruction and practice in dealing with bleeding, fractures, airway obstruction, cardiac arrest, and emergency childbirth.