Do you have to a high school diploma work in the hospital E.R as tech?

No, you don't *always* need a high school diploma to work as a technician in a hospital ER. However, it's highly unusual. Most ER tech positions require at least a high school diploma or equivalent (GED). Some may even prefer or require some post-secondary education or certification, depending on the specific role and responsibilities. While there might be *very rare* exceptions, a high school diploma or GED is the minimum expectation in the vast majority of cases.