Emergency medical responder levels by U.S. state

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In the United States, the licensing of prehospital emergency medical providers (emergency medical technicians (EMTs)) and oversight of emergency medical services are governed at the state level. Each state is free to add or subtract levels as each state sees fit. Therefore, due to differing needs and system development paths, the levels, education requirements, and scope of practice of prehospital providers varies from state to state. Even though primary management and regulation of prehospital providers is at the state level, the federal government does have minimum requirements for EMT-Basics and EMT-Paramedics set through the National Highway Traffic Safety Administration (NHTSA).[1] In the list, certification levels are provided from most basic to most advanced.

While states are able to set their own additional requirements for state certification, a quasi-national certification body exists in the form of the National Registry of Emergency Medical Technicians (NREMT). The NREMT offers a national certification based on the NHTSA National Standard curriculum for the levels of First Responder, EMT-Basic, EMT-Intermediate 1985, EMT-Intermediate 1999, and EMT-Paramedic.[2] Individual states are allowed to use NREMT certification as part of their certification process, but are not required to. As of 2006, 39 states use the NREMT examination for EMT-Basic certification and 44 states use the NREMT examination for EMT-paramedic certification.[3] These levels are denoted below using an asterisk (*). At present time, use of the NREMT examination for EMT-Intermeidate 85 and 99 have not been included in this list.

Any provider between the levels of EMT-Basic and EMT-Paramedic is a form of EMT-Intermediate, but the use of the terms "EMT-Intermediate/85" and "EMT-Intermediate/99" denotes use of the NHTSA EMT-Intermediate 1985 curriculum and the EMT-Intermediate 1999 curriculum respectively. In addition, not all states use the "EMT" prefix for all levels (e.g. Texas uses EMT-Paramedic and Licensed Paramedic). Finally, some states have levels that have partially been phased out. While no new certifications are provided at this level, providers can be grandfathered in provided they meet recertification requirements. Any level that has been completely phased out (i.e. not used for new or continuing providers) is not listed.

Contents

Alabama

  • EMT-Basic*
  • EMT-Intermediate (No new licenses granted or reciprocated, however previous Intermediates can renew licenses)
  • EMT-Paramedic*[4]

Alaska

  • ETT* (Emergency Trauma Technician)
  • EMT-I* (One) (analogous to EMT-Basic)
  • EMT-II (Two) (analogous to EMT-Intermediate/85)
  • EMT-III (Three)
  • Mobile Intensive Care Paramedic (MICP)[5][6]

Arizona

  • EMT-Basic*
  • EMT-Intermediate/99
  • EMT-Paramedic*[7]

Arkansas

  • EMS First Responder
  • EMT-Ambulance* (analogous to EMT-Basic)
  • EMT-Intermediate/99
  • EMT-Paramedic*[8]

California

  • First Responder*
  • EMT*
  • Advanced EMT*
  • Paramedic*[9]

Colorado

  • EMT-Basic*
  • EMT-Intermediate/99
  • EMT-Paramedic*[10]

Connecticut

  • Medical Response Technician
  • EMT* (analogous to EMT-Basic)
  • EMT-I/85
  • EMT-Paramedic*[11]

Delaware

  • First Responder*
  • EMT-Basic*
  • EMT-Paramedic*

Florida

  • EMT* (analogous to EMT-Basic)
  • Paramedic[12]

Georgia

  • First Responder
  • EMT-Basic* (Certificate)[13]
  • EMT-Intermediate/85 (Certificate)[14]
  • EMT-Cardiac Tech (No new licenses granted since 1998, Similar to the NREMT-I/99)
  • EMT-Paramedic* (Diploma/Degree)[15][16][17]

Hawaii

  • EMT* (analogue to EMT-Intermediate)
  • EMT-Paramedic*[18]

Idaho

  • First Responder
  • EMT-Basic*
  • Advanced EMT (analogous to EMT-Intermediate/85)
  • EMT-Intermediate (State specific level)
  • EMT-Paramedic* [19]

Illinois

  • FRD-First Responder Defibrillator*
  • EMT-Basic*
  • EMT-Intermediate/99
  • EMT-Paramedic* [20]
  • Pre-Hospital Registered Nurse(PHRN, analogous to EMT-Paramedic)

Indiana

  • First Responder
  • EMT-Basic
  • EMT-Basic Advanced
  • EMT-Intermediate/99
  • Paramedic*[21]

Iowa

  • First Responder
  • EMT-Basic*
  • EMT-Intermediate
  • EMT-Paramedic (analogous to EMT-Intermediate/99)
  • Paramedic Specialist* (analogous to EMT-Paramedic)[22][23]

Kansas

  • First Responder
  • EMT-Basic*
  • EMT-Defibrillator
  • EMT-Intermediate/85
  • EMT-Intermediate/Defibrillator
  • Mobile Intensive Care Technician* (analogous to EMT-Paramedic)[24]

Kentucky

  • First Responder
  • EMT-Basic*
  • EMT-Advanced* (analogous to EMT-Intermediate 95)
  • EMT-Paramedic*
  • Critical Care Paramedic endorsement[25]

Louisiana

  • Emergency Medical Responder
  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Paramedic* [26]

Maine

  • Emergency Medical Responder
  • Ambulance Attendant (no new licenses granted since 1996)
  • EMT-Basic*
  • EMT-Intermediate
  • EMT-Critical Care (no new licenses after 1998)
  • EMT-Paramedic[27]

Maryland

  • First Responder
  • EMT-Basic
  • Cardiac Rescue Technician-Intermediate (analogous to EMT-Intermediate/99)
  • EMT-Paramedic*[28]

Massachusetts

  • First Responder
  • EMT-Basic
  • EMT-Intermediate/85
  • EMT-Paramedic[29]

Michigan

  • Medical First Responder
  • EMT-Basic*
  • EMT-Specialist (analogous to EMT-Intermediate/85)
  • EMT-Paramedic*[30]

Minnesota

  • First Responder*
  • EMT-Basic*
  • EMT-Intermediate/99
  • EMT-Paramedic*[31]

Mississippi

  • Medical First Responder
  • EMT-Basic*
  • EMT-Intermediate/99 (No new licenses granted at this level since 2002, however previous holders can continue to renew theirs)
  • EMT-Paramedic*[32]

Missouri

  • EMT-Basic*
  • EMT-Intermediate*
  • EMT-Paramedic*[33]

Montana

(endorsements are listed below each level are optional and can be achieved in any order and combination)

  • EMT-First Responder
    • Immbolization
    • Monitoring
    • Ambulance
  • EMT-Basic*
    • Airway
    • Monitoring
    • IV and IO initiation
    • IV and IO maintenance
    • Endotracheal intubation
    • Medication
  • EMT-Intermediate
    • Needle decompression/surgical airway
    • Immunizations
    • Drips and pumps
    • 12 lead transmit
  • EMT-Paramedic*
    • 12 lead interpretation
    • Medications
    • Fibrinolytic with 12 lead interpretation
    • Critical Care Transport[34]

Nebraska

  • First Responder
  • EMT-Basic*
  • EMT-Intermediate
  • EMT-Paramedic*[35]

Nevada

  • First Responder
  • EMT-Basic
  • EMT-Intermediate/85
  • EMT-Advanced (analogous to EMT-Paramedic)[36]

New Hampshire

  • First Responder
  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Paramedic*[37]

New Jersey

  • EMT-Basic[38]
  • Mobile Intensive Care Paramedic* (MICP; also known as EMT-Paramedic)[39][40]
  • Mobile Intensive Care Nurse (MICN)[39]

New Mexico

  • EMS First Responder
  • EMT-Basic
  • EMT-Intermediate
  • EMT-Paramedic*[41]

New York

North Carolina

  • Medical Responder
  • EMT-Basic
  • EMT-Intermediate/85
  • EMT-Paramedic[43]
  • EMT-Advanced Practice Paramedic (Currently a pilot program in Wake County; the emergency scope of APPs is similar to a paramedic, but they do additional work in community preventative care)

North Dakota

  • First Responder
  • Advanced First Aid Ambulance (no new licenses)
  • EMT (analogous to EMT-Basic. Only used for providers under the age of 18 and providers requesting reciprocity from another state)
  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Paramedic*[44]

Ohio

  • First Responder
  • EMT-Basic*
  • EMT-Intermediate(Uses State approved Intermediate Course. Not Quite NREMT I-99 Standard)
  • EMT-Paramedic*[45]

Oklahoma

  • First Responder
  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Paramedic*[46]

Oregon

  • EMT-Basic*
  • EMT-Intermediate (state specific)
  • EMT-Paramedic* (requires a college degree)[47]

Pennsylvania

Current System (Up Until 2012)

  • First Responder
  • EMT
  • EMT-Paramedic
  • Medical Professional (PHRN)

New System (Effective 2012)

  • Emergency Medical Responder
  • EMT-Basic
  • EMT-Advanced
  • EMT-Paramedic*
  • Prehospital Registered Nurse
  • Prehospital Physician Extender (Physician Assistant)
  • Prehospital EMS Physician[48]

Rhode Island

  • EMT-Basic*
  • EMT-Cardiac
  • EMT-Paramedic*[49]

South Carolina

  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Paramedic*[50]

South Dakota

  • EMT-Responder (pending state recognition)
  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Intermediate/99
  • EMT-Paramedic*[51]

Tennessee

  • First Responder
  • EMT-IV - Analogous to the Intermediate/85 Level.
  • EMT-Paramedic*[52]
  • Critical Care Paramedic* - Now endorsed by the state of TN officially.[53]

Texas

  • Emergency Care Attendant
  • EMT-Basic*
  • EMT-Intermediate
  • EMT-Paramedic*
  • Licensed Paramedic (paramedic with a college degree)[54]

Utah

  • EMT-Basic*
  • EMT-Intermediate (state specific)
  • EMT-Intermediate Advanced (analogous to EMT-Intermediate/99)
  • EMT-Paramedic*[55]

Vermont

  • EMT-Basic*
  • EMT-Intermediate-1990 curriculum(State specific, no new certifications)
    • EMT-Defibrillation (No new certifications. Providers maintaining this certification operate at the EMT-I-1990 level with the addition of manual defibrillation)[56]
  • EMT-Intermediate-2003 curriculum (State specific)
  • EMT-Paramedic*[57]

Virginia

  • EMS First Responder
  • EMT-Basic
  • EMT-Enhanced (State Specific, analogous to Intermediate/85)
  • EMT-Intermediate/99
  • EMT-Paramedic
  • [58]
    • Virginia also has two levels no longer in use: EMT-Shock Trauma and EMT-Cardiac Tech

Washington

  • First Responder
  • EMT-Basic
  • Intravenous Therapy Technician
  • Airway Management Technician
  • IV/Airway Technician
  • Intermediate Life Support Technician
  • ILS and Airway Technician
  • Paramedic[59]

West Virginia

  • First Responder
  • EMT-Mining (specialty certification)
  • EMT-Basic*
  • EMT-Intermediate/99
  • EMT-Paramedic*
  • EMT-Paramedic C-3 IFT (Inter-Facility Transport)
  • Critical Care Transport-Paramedic
  • Critical Care Transport-Registered Nurse[60]

Wisconsin

  • Medical First Responder
  • EMT-Basic*
  • EMT-Intermediate Technician (analogous to EMT-Intermediate/85)
  • EMT-Intermediate/99
  • EMT-Paramedic*[61]

Wyoming

  • EMT-Basic*
  • EMT-Intermediate/85
  • EMT-Paramedic*[62]

References

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  1. ↑ "National Standard Curriculum". National Highway Transportation Safety Administration. Retrieved 2008-03-10. 
  2. ↑ "About NREMT Examinations". National Registry of Emergency Medical Technicians. Retrieved 2008-04-01. 
  3. ↑ "2006 Annual Report" (PDF). National Registry of Emergency Medical Technicians. p. 10. Retrieved 2008-04-01. 50 state-4 non-registry states-states not using NREMT for Basic or Paramedic level 
  4. ↑ "EMS Rules and Protocol". Alabama Department of Public Health Emergency Medical Services and Trauma. Retrieved 2008-03-27. 
  5. ↑ "EMS Training Levels In Alaska". Alaska Health and Human Services. 2005-06-06. Retrieved 2008-03-27. 
  6. ↑ "Certification Search". Alaska Health and Human Services. Retrieved 2008-03-30. Certification search for ETT and Defib Technician returns zero results 
  7. ↑ "EMT Certification - FAQs: How do I gain certification in Arizona as an EMT-B, EMT-I, or EMT-P?". Arizona Department of Public Health Services. Retrieved 2008-03-27. 
  8. ↑ "Rules and Regulations for Emergency Medical Services" (PDF). Arkansas State Board of Health. pp. 25–27. Retrieved 2008-03-27. 
  9. ↑ "EMS Personnel Division". California Emergency Medical Services Authority. Retrieved 2008-03-27. 
  10. ↑ "Colorado Emergency Medical Technician Certification Application Instructions/Guide" (PDF). Colorado Department of Public Health and Environment. Retrieved 2008-03-27. 
  11. ↑ "Emergency Medical Services - Licensure/Certification/Exams" (PDF). Connecticut Department of Public Health. Retrieved 2008-03-27.  Text "#46950 " ignored (help)
  12. ↑ "Certification Requirements". Florida Board of Emergency Medical Technicians (EMT) and Paramedics. Retrieved 2008-03-27. 
  13. ↑ Certificate "Lanier Technical College EMT-Basic Program" Check |url= value (help). 
  14. ↑ "Lanier Technical College EMT-Intermediate Program". 
  15. ↑ Diploma "Lanier Technical College EMT-Paramedic Diploma Program" Check |url= value (help). 
  16. ↑ Degree "Lanier Technical College EMT-Paramedic Degree Program" Check |url= value (help). 
  17. ↑ "Emergency Medical Services (EMS) Initial License Examinations" (PDF). Department of Human Resources Division of Public Health Office of Emergency Medical Services. Retrieved 2008-03-27. 
  18. ↑ "Certifying Emergency Medical Service Personnel". State of Hawaii. Retrieved 2008-03-27. 
  19. ↑ "Certification Standards Manual" (PDF). State of Idaho, Emergency Medical Services Bureau. p. 8. Retrieved 2008-03-27. 
  20. ↑ "Emergency Medical System and Highway Safety". Illinois Department of Public Health. Retrieved 2008-03-27. 
  21. ↑ "Levels of EMS Personnel Certification" (PDF). Indiana Emergency Medical Services Commission. Retrieved 2008-03-27. 
  22. ↑ "Authorized Iowa EMS Training Programs" (PDF). Iowa Department of Public Health, Bureau of Emergency Medical Services. Retrieved 2008-03-27. 
  23. ↑ "Iowa EMT-Paramedic to Paramedic Specialist Transition Application" (PDF). Iowa Department of Public Health, Bureau of Emergency Medical Services. Retrieved 2008-03-27. 
  24. ↑ "Frequently Asked Questions". Kansas Board of Emergency Medical Services. Retrieved 2008-03-28. 
  25. ↑ "Kentucky Board of Emergency Medical Services". Retrieved 2008-03-28. 
  26. ↑ "CERTIFICATION APPLICATION" (.DOC). State of Louisiana, Department of Health and Hospitals, Louisiana Bureau of Emergency Medical Systems. Retrieved 2008-03-28. 
  27. ↑ "Maine Emergency Medical System Rules" (PDF). p. 45. Retrieved 2008-03-28. 
  28. ↑ "Initial Certification & Licensure Requirements". Maryland Institute for Emergency Medical Services Systems. Retrieved 2008-03-28. 
  29. ↑ "Overview of Training Requirements". Massachusetts Office of Health and Human Services. Retrieved 2008-03-28. 
  30. ↑ "License Packet" (.PDF). Michigan Department of Community Health, Emergency Medical Services and Trauma System. p. 4. Retrieved 2008-03-28. 
  31. ↑ "Certification". Mnnesota Emergency Medical Services Regulatory Board. Retrieved 2008-03-28. 
  32. ↑ "EMS Personnel Information Frequently Asked Questions (FAQ)". Mississippi State Department of Health, Emergency Medical Services. Retrieved 2008-03-28. 
  33. ↑ "Frequently Asked Questions: I am an EMT-Intermediate; can I work as an EMT-I in Missouri?". State of Missouri, Department of Health and Senior Services. Retrieved 2008-03-28. 
  34. ↑ "Montana State Board of Medical Examiners" (PDF). Department of Labor and Industry. p. 93. Retrieved 2008-03-28. 
  35. ↑ "Certification for Out-of-Hospital Providers". Nebraska Department of Health and Human Services. Retrieved 2008-03-28. 
  36. ↑ "EMS Certification application" (PDF). State of Nevada, Department of Health and Human Services. Retrieved 2008-03-28. 
  37. ↑ "New Hampshire EMS Provider License Application" (PDF). Department of Safety. Retrieved 2008-03-28. 
  38. ↑ "Mobility Assistance Vehicle and Basic Life Support Ambulance Services" (PDF). New Jersey Administrative Code. State of New Jersey. NJAC 8:40. Retrieved 2010-01-04. 
  39. ↑ 39.0 39.1 "Advanced Life Support Services; Mobile Intensive Care Programs, Specialty Care Transport Services and Air Medical Services" (PDF). New Jersey Administrative Code. State of New Jersey. NJAC 8:41. Retrieved 2010-01-04. 
  40. ↑ "Mobile intensive care paramedic; certification from commissioner; written standards; examination; register of applicants". New Jersey Statutes. State of New Jersey. NJSA 26:2K-8. Retrieved 2010-01-04. 
  41. ↑ "Licensing Info". New Mexico Department of Health. Retrieved 2008-03-29. 
  42. ↑ "Emergency Medical Services Statistical Information". New York State Department of Health. Retrieved 2008-03-29. 
  43. ↑ "http://www.ncdhhs.gov/dhsr/EMS/curricul.htm". North Carolina Office of Emergency Medical Services. Retrieved 2008-03-29.  External link in |title= (help)
  44. ↑ "Training, Testing and Certification Requirements". North Dakota, Department of Health, Emergency Medical Services. Retrieved 2008-03-29. 
  45. ↑ "Scope of Practice" (PDF). Ohio Department of Public Safety, Ohio Emergency Medical Services. Retrieved 2008-03-29. 
  46. ↑ "Oklahoma Approved EMS Curriculum". Oklahoma State Department of Health, Emergency Medical Services Division. Retrieved 2008-03-29. 
  47. ↑ "Welcome to EMT Educational Requirements". Oregon Department of Human Services, Emergency Medical Services and Trauma Systems. Retrieved 2008-03-29. 
  48. ↑ "Pennsylvania Code: Part VII: Emergency Medical Services, Chapter 1003, Personnel" (PDF). State of Pennsylvania. pp. 8–20. Retrieved 2008-03-28. 
  49. ↑ "Office of Health Professionals Regulation, Ambulance Service Advisory Board". Rhode Island Department of Health. Retrieved 2008-03-29. 
  50. ↑ "South Carolina Certification Process" (PDF). South Carolina Emergency Medical Services. Retrieved 2008-03-29. 
  51. ↑ "South Dakota Emergency Medical Services". Retrieved 2008-03-29. 
  52. ↑ "Reciprocity Requirements for EMT Personnel License" (PDF). Retrieved 2008-03-29. 
  53. ↑ "Critical Care Paramedic Standardized Modules and Objectives" (PDF). State of Tennessee Department of Health. Retrieved 2008-04-10. 
  54. ↑ "Requirements for initial certification/licensure:". Texas Department of State Health Services. Retrieved 2008-03-27. 
  55. ↑ "Training". Bureau of Emergency Medical Services. Retrieved 2008-03-29. 
  56. ↑ "EMS Rules" (PDF). Vermont Department of Health. p. 19. Retrieved 2008-07-07. 
  57. ↑ "EMS Certification". Vermont Department of Health. Retrieved 2008-03-29. 
  58. ↑ "EMS Training Programs Summery". Virginia Department of Health, Office of Emergency Medical Services. Retrieved 2008-03-29. 
  59. ↑ "Initial Certification Process". Washington State Department of Health, Office of Emergency Medical Services and Trauma System. Retrieved 2008-03-29. 
  60. ↑ "EMS Personnel Application" (PDF). West Virginia Department of Health and Human Resources, Office of Emergency Medical Services. Retrieved 2008-03-29. 
  61. ↑ "First Responder/Emergency Medical Technician Certification/License Application" (PDF). Wisconsin Department of Health and Family Services, Emergency Medical Services. Retrieved 2008-03-29. 
  62. ↑ "Certification Application" (PDF). Wyoming Department of Health, Office of Emergency Medical Services. Retrieved 2008-03-29. 
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