Jose Montez, Theja Anderson and Scott Frasard, from left, all of Rural Metro Ambulance, practice reviving a patient during a recertification course. Metro Atlanta's growing population has increased the need for emergency medical technicians.

Jeff Lisle never knows what he's in for when he heads to work. The only thing he is sure of is that the day is going to be demanding, challenging and, in some cases, highly emotional. And it's going to require quick thinking and fast reactions on his part.

For 13 years, Lisle has worked as an emergency medical technician for Rural Metro Ambulance, an Alpharetta-based company that handles 911 calls for Forsyth County and all of Fulton County outside of Atlanta.

The company's 241 employees handle about 50,000 emergency calls each year. And no two are alike.

"One call, you go to a nursing home and pick up an elderly person with a fever, and the next call, you're holding a baby that's having an asthmatic reaction," Lisle said.

Yet it's that wide range of assignments that keeps Lisle enthusiastic about his job."You're not stuck in an office; your ambulance is your office," he said.

According to the Georgia Office of Emergency Medical Services, there aren't enough people like Lisle to go around. The need for EMTs and paramedics has been growing as the metro area's population has expanded.

"Generally, we've seen a shortage in most locations," said David Bean, who directs the Georgia EMS division. "Most licensed EMS agencies are carrying vacancies, so it's a good market for someone looking for a job and career.

"It can be a tough job; you have to develop a little bit of a hard shell," Bean said. "And it carries a lot of emotion, as well as a lot of reward. You are literally taking actions that save people's lives. You might deliver a baby one hour, and the next, hold the hand of someone who's dying."

Many EMTs come to the job with backgrounds in public service, working in law enforcement or with fire departments. Others have gained some experience in the military. But regardless of a candidate's background, the state requires that they complete specific courses.

"You can get into the field with as little as 133 hours of education," Bean said. "The basic EMT needs to be 18 years old, have a high school diploma and a driver's license. Intermediate EMTs take an additional 258 hours of education. And paramedics require 1,147 hours."

The training is based on established national criteria and is offered at most technical institutes and colleges. Many of the programs are covered by the HOPE scholarship.

EMTs learn about drugs and cardiac equipment. Paramedics are taught the specifics about administering medicines and performing some procedures, such as placing breathing tubes in airways. Students must pass written tests as well as practical components. Once they've passed the state licensing requirements, students will find salaries that vary from county to county, Bean said.

"It's all over the board: In some parts of the state, they struggle to pay their EMTs minimum wage," he said. "But some larger services offer very good salaries, benefits and retirement options."

EMTs with less than one year's experience generally earn about $24,500 at Rural Metro, said Reg James, the company's division general manager.

"Of course, that moves up as their certifications and experience goes up," he added."Salaries can easily get into the $50,000s.

"And beyond EMS, there are all kinds of administrative duties: field training, quality control, supervision and management, for example."