{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/paramedics/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Paramedics",
    "soc_code": "29-2043",
    "category": "Healthcare",
    "us_employment": 100610,
    "median_annual_wage": 60600
  },
  "verdict": "SAFE",
  "risk_resistance": 86,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 16,
    "embodiment": 20,
    "liability_shield": 15,
    "trust_premium": 15,
    "judgment_accountability": 20
  },
  "reasoning": {
    "task_resistance": "Cricothyrotomy on a burn patient, needle decompression of a tension pneumothorax, and rolling a 300-pound patient onto a scoop stretcher in a bathroom are the core of the shift, and the only tasks software has meaningfully absorbed are the ePCR narrative and 12-lead machine interpretation you're required to override when it's wrong.",
    "embodiment": "Every call happens somewhere the paramedic did not choose — a ditch at 3 a.m., a third-floor walk-up, the shoulder of an interstate with traffic passing at 70 — and the work is physically carrying, positioning, and puncturing a body under those conditions, which is the ceiling of this dimension by definition.",
    "liability_shield": "State licensure plus NREMT certification and scope tied to a medical director's standing orders means a bad drug dose or a missed intubation goes on your license at a state EMS office hearing, though it sits at 15 rather than 19 because online medical control and protocol-driven scope give you a physician to share the call with in a way an independently practicing NP or physician doesn't get.",
    "trust_premium": "A stranger has to let you cut their clothes off and put a needle in their arm within thirty seconds of meeting you, and talking a panicking family through a cardiac arrest in their living room is unbillable but load-bearing work — it lands at 15 rather than 19 because the relationship lasts one transport, not years.",
    "judgment_accountability": "Deciding to bypass the nearest ED for a cath lab, calling a field termination of resuscitation, or choosing RSI on a combative head-injury patient are irreversible calls made on incomplete information with no second opinion available and a clock running."
  },
  "rationale": "The job is intubating in a moving ambulance, starting IVs on a hypotensive patient in a stairwell, and deciding in ninety seconds whether this is a STEMI, a stroke, or a diabetic crisis. AI can already draft the patient care report, assist ECG interpretation, and support protocol lookup and triage dispatch, but none of that touches the physical extrication, drug administration, or the licensed clinician's on-scene call under state protocols and medical direction. The bulk of a paramedic's hours are hands on bodies in uncontrolled environments — the part of healthcare robotics is furthest from touching.",
  "outlook": "Demand grows with an aging population; AI will absorb documentation, ECG screening, and dispatch triage, which frees time rather than headcount, and pay pressure — not automation — remains the real threat to this job.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "State EMS offices expanding paramedic scope-of-practice rules so that AI-assisted decision support (ECG interpretation, sepsis alerts, field triage algorithms) must be confirmed and signed by the licensed paramedic on scene, with the paramedic named as the accountable clinician in the ePCR — several states (e.g. Texas, Pennsylvania) already require a licensed EMS provider's signature on any protocol deviation, and NREMT/NASEMSO model rules are the vehicle to watch. Also: community paramedicine and treat-in-place/ET3-style programs converting paramedics into independently billing licensed practitioners with their own liability, rather than transport labor under medical direction.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift as dispatch triage, PCR narrative drafting, QA chart review, and billing documentation are automated: the remaining shift is concentrated on undifferentiated high-acuity calls and on-scene disposition decisions. This genuinely has two tiers today — a large share of paramedic hours is documentation and low-acuity transport that AI plus nurse-navigation lines can absorb, leaving the judgment tier. Note this cuts both ways: it can also reduce headcount while raising the resistance score of the remaining jobs.",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "Embodiment and judgment_accountability are already maxed, so realistic headroom is roughly 4 points total via liability and task-mix. The live risk for this occupation is not AI substitution but headcount: nurse-triage of low-acuity 911 calls and telehealth diversion shrink call volume, so a rising score can coexist with fewer jobs. Trust premium has no plausible route — nobody selects their ambulance crew."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2021,
        "emp": 96510,
        "wage": 46770
      },
      {
        "y": 2022,
        "emp": 95440,
        "wage": 49090
      },
      {
        "y": 2023,
        "emp": 98770,
        "wage": 53180
      },
      {
        "y": 2024,
        "emp": 99530,
        "wage": 58410
      },
      {
        "y": 2025,
        "emp": 100610,
        "wage": 60600
      }
    ],
    "from": 2021,
    "to": 2025,
    "change_pct": 4.2,
    "comparable_from": 2021,
    "spans_soc_revision": false
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}