Emergency medical responder levels by U.S. state Medicine

Medical Assistant Salary in Bellevue, Washington

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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 a model scope of practice including minimum skills for EMRs, EMTs, Advanced EMTs and Paramedics set through the National Highway Traffic Safety Administration (NHTSA). 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 EMR, EMT, Advanced EMT and Paramedic. Individual states are allowed to use NREMT certification as part of their certification process, but are not required to. As of 2011, 38 states use the NREMT examination for EMT certification and 45 states use the NREMT examination for Paramedic certification. These levels are denoted below using an asterisk (*). At present time, use of the NREMT examination for EMT-Intermediate 85 and 99 have not been included in this list.

Any provider between the levels of EMT-Basic and EMT-Paramedic is either a form of EMT-Intermediate or an Advanced EMT. 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 sometimes 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.

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Alabama

Emergency Care Provider (ECP)
Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Advanced Emergency Medical Technician (AEMT)
Paramedic

Medical Assistant Certification Washington State Video

Alaska

ETT* (Emergency Trauma Technician)-
EMT-I* (One) (analogous to EMT-Basic)
EMT-II (Two) (analogous to EMT-Intermediate/85)(50 hours of additional education)
EMT-III (Three)-(50 hours of additional education)
AEMT-level established in 2015 (follows and is certified via the NREMT testing process)
Mobile Intensive Care Paramedic (MICP)

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Arizona

EMT-Basic*
EMT-Intermediate. Please note: Arizona is no longer certifying new EMT-Is. However, existing certifications continue to be allowed to practice under this level of certification.
EMT-Paramedic*

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Arkansas

EMS First Responder (Phased out since 2012)
Emergency Medical Responder (Since 2012)
EMT-Basic
EMT-Ambulance* (analogous to EMT-Basic prior to 2000)
EMT-Intermediate/99
EMT-Paramedic*

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California

Emergency Medical Technician* (EMT)
Advanced Emergency Medical Technician* (AEMT)
Paramedic*
Mobile Intensive Care Nurse (MICN)

Colorado

WFR (Wilderness First Responder)
EMT*
EMT-I
Advanced EMT* (AEMT)
Paramedic*
Critical Care Endorsement for Paramedic level*

Connecticut

Emergency Medical Responder* (EMR)
Emergency Medical Technician* (EMT)
Advanced Emergency Medical Technician* (AEMT)
Paramedic* (Paramedics are Licensed professionals in Connecticut, whereas all other levels of EMS providers are certified and must participate in tri-annual recertification programs.)

Delaware

First Responder*
EMT-Basic*
EMT-Paramedic*

Florida

Emergency Medical Technician
Paramedic

Georgia

EMT
EMT-Intermediate/85 (no new licenses granted)
Cardiac Technician (no new licenses granted since 1998, similar to the NREMT-I/99)
Advanced-EMT
Paramedic* (at least 504 classroom hours plus 320 clinical hours)

Hawaii

EMT* (analogue to Advanced EMT)
Paramedic* (also known as Mobile Intensive Care Technician)

Idaho

Emergency Medical Responder (EMR-2011)
Emergency Medical Technician (EMT-2011)
Advanced Emergency Medical Technician-85 (AEMT-85) (No new licenses granted)
Advanced Emergency Medical Technician-2011
Paramedic-2011

Illinois

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

Indiana

Emergency Medical Responder
EMT
Advanced EMT
Paramedic*

Iowa

First Responder
EMT-Basic*
EMT-Intermediate (analogous to EMT-Intermediate/85)
EMT-Advanced
EMT-Paramedic (analogous to EMT-Intermediate/99)
Paramedic Specialist* (analogous to EMT-Paramedic)
Critical Care Paramedic Endorsement for Paramedic Specialist Level*

Transition to new levels began January 2011, and finished in March 2015.

Emergency Medical Responder* (EMR)
Emergency Medical Technician* (EMT)
Advanced Emergency Medical Technician* (AEMT)
Paramedic*
Critical Care Paramedic Endorsement for Paramedic Level*

Kansas

Emergency Medical Responder
Emergency Medical Technician* (EMT)
Advanced Emergency Medical Technician* (AEMT)
Paramedic* (EMT-P)

Kentucky

First Responder
Emergency Medical Technician* (EMT)
Advanced Emergency Medical Technician* (AEMT)
Paramedic*
Critical Care Paramedic Endorsement

Louisiana

Emergency Medical Responder
EMT-Basic*
EMT-Intermediate/85
EMT-Paramedic*

Maine

Emergency Medical Responder*
Ambulance Attendant (no new licenses granted since 1996)
EMT*
Advanced AEMT*
EMT-Critical Care (no new licenses after 1998)
Paramedic

Maryland

Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Cardiac Rescue Technician-Intermediate* (CRT-I) (analogous to EMT - Intermediate/99)
Paramedic

Massachusetts

First Responder (Emergency Medical Responder)
EMT-Basic
EMT-Intermediate/85
EMT-Paramedic

Michigan

EMR- Emergency Medical Responder (Also Medical First Responder)
EMT- Emergency Medical Technician (formerly EMT - Basic)
AEMT- Advanced Emergency Medical Technician (analogous to EMT-Intermediate/85)
Paramedic (formerly EMT-Paramedic*)

Minnesota

Emergency Medical Responder*
EMT-Basic
AEMT
EMT-Paramedic*
Community Paramedic
Registered Nurse-EMT
Registered Physician Assistant-EMT

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*

Missouri

First Responder
EMT-Basic*
EMT-Paramedic*

Montana

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

EMR
- Monitoring
EMT
- Airway
- IV and IO administration
- IV and IO maintenance
- Medication
Advanced EMT
Paramedic
- Critical Care Transport

Nebraska

First Responder
EMT-Basic*
EMT-Intermediate
EMT-Paramedic*

Nevada

First Responder
EMT
Advanced EMT
Paramedic
EMS-RN

New Hampshire

First Responder
EMT
Advanced EMT
EMT-Paramedic*

New Jersey

Current System Emergency Medical Responder (EMR)

Emergency Medical Technician (EMT)
Mobile Intensive Care Paramedic (MICP)
Mobile Intensive Care Nurse (MICN)

New Mexico

EMS First Responder
EMT-Basic
EMT-Intermediate
EMT-Paramedic*

New York

Certified First Responder
EMT-Basic
AEMT-Intermediate (No new licenses granted, will now be replaced with AEMT)
AEMT-Critical Care
AEMT-Paramedic

North Carolina

Medical Responder
EMT-Basic
EMT-Intermediate (The NC EMT-I scope of practice lies between the national I-85 and I-99 level)
EMT-Paramedic
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*

Ohio

Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Advanced EMT (AEMT)
Paramedic*

Oklahoma

Emergency Medical Responder (EMR)
EMT-Basic*
EMT-Intermediate/85
EMT-Paramedic*

Oregon

Emergency Medical Responder (EMR)(National Curriculum)*
EMT (National Curriculum)*
Advanced EMT (National Curriculum)*
Paramedic (National Curriculum)* (requires a college degree)

Pennsylvania

BLS

Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)

ALS

Advanced EMT (AEMT)New in 2014.
Paramedic
Prehospital Registered Nurse (PHRN)
Prehospital Physician Extender (PHPE)
Prehospital Physician (PHP)

Puerto Rico

EMT-Provisional License (Student)
EMT-Basic
EMT-Paramedic

Rhode Island

Emergency Medical Technician (EMT)*
Advanced Emergency Medical Technician (AEMT)*
EMT-Cardiac (State Specific)*
Paramedic*

South Carolina

Emergency Medical Responder
EMT-Basic*
EMT-Intermediate/85
EMT-Paramedic*

South Dakota

EMT-Responder (pending state recognition)
EMT
EMT-Intermediate/85
AEMT
EMT-Intermediate/99
Paramedic*

Tennessee

Emergency Medical Responder (EMR)
EMT-Basic
EMT-IV (Phasing out)
EMT-Advanced (New)
Paramedic
Critical Care Paramedic* (now officially endorsed by the state)

Texas

Emergency Care Attendant
EMT-Basic
Advanced EMT (formerly EMT-Intermediate)
EMT-Paramedic
Licensed Paramedic (paramedic with a college degree)

Utah

Emergency Medical Responder* (EMR)
Emergency Medical Technician* (EMT)
Advanced Emergency Medical Technician* (AEMT)
Paramedic*

Now have been phased out of the state of Utah:

EMT-Intermediate (state specific, phased out by Sept. 30, 2013 )
EMT-Intermediate Advanced (analogous to EMT-Intermediate/99, phased out by Sept. 30, 2013 )

Vermont

Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Advanced Emergency Medical Technician(AEMT)
Paramedic
Critical Care Paramedic (Service Specific)

Virginia

Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Emergency Medical Technician Enhanced (EMT-E) (Transition from EMT-E to AEMT begins 2013 providers have up to 3 recertification cycles to transition to AEMT)
Advanced Emergency Medical Technician (AEMT)
EMT-Intermediate (state-supported, will continue to use NREMT I-99 exam)
Paramedic
Critical Care Paramedic

Washington

Emergency Medical Responder (EMR)
EMT
AEMT (advanced EMT)
Paramedic

West Virginia

Emergency Medical Responder
EMT-Mining (specialty certification)
EMT-Basic
Advanced Care Technician
EMT-Paramedic
Mobile Critical Care Paramedic
Mobile Critical Care Nurse

Wisconsin

Medical First Responder
EMT-Basic
EMT-Intermediate Technician (analogous to EMT-Intermediate/85)
EMT-Intermediate/99
EMT-Paramedic
Critical Care Paramedic Endorsement

Wyoming

EMR
EMT
AEMT
IEMT
Paramedic

Wyoming has adopted the National Registry model with an addition of IEMT. The IEMT has all of the skills of an AEMT with the addition of additional medications, endotracheal intubation, cardiac drugs and skills (manual defibrillator, epi 1:10000, etc.) chest darts and pain management. National Registry is NOT required, and not accepted for licensing in Wyoming.

Source of the article : Wikipedia