The licensing of prehospital emergency medical providers and oversight of emergency medical services in the United States are governed at the state level.
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.
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
Though levels and state requirement vary, herewith are the different levels for emergency responders:
The certified First Responder has successfully completed an approved First Responder Course which is typically 40-60 hours in length. First Responders are trained in the use of Automatic External Defibrillators (AED), CPR, oxygen administration, bandaging, splinting, and emergency childbirth.
Emergency Medical Technician (EMT) - Basic
The EMT-Basic has successfully completed an approved EMT Course which is typically about 150 hours in length. EMTs are trained in the use of Automatic External Defibrillators (AED), CPR, oxygen administration, bandaging, splinting, emergency childbirth, nonvisualized airways, blood glucose level testing and the administration of nitroglycerin, epinephrine with an Epi-Pen, aspirin and activated charcoal, although activated charcoal is not used in this
Emergency Medical Technician - Advanced
The Advanced EMT has successfully completed an approved EMT Course plus an Advanced EMT Course which is typically a total of about 250 hours in length. Advanced EMTs are trained in the use of automatic and manual defibrillators, CPR, oxygen administration, bandaging, splinting, emergency childbirth, nonvisualized airways, the administration of several medications, intravenous access (IV), and cardiac monitoring.
Emergency Medical Technician - Paramedic
The Paramedic has successfully completed an approved EMT Course plus a Paramedic Course which is typically a total of about 1,500 hours. Most paramedic courses now take between 18-24 months to complete. Paramedics are trained in all of the BLS skills and in the use of manual defibrillation, transcutaneous cardiac pacing, 12 lead ECGs, advanced airway management, including surgical airways, intravenous access, intraosseous access, which involves placing a needle in a bone and using the bone marrow as a fluid and medication route and pharmacology (LifeMed's paramedics have access to nearly 40 medications). Additionally, paramedics can perform pleural decompression which is a treatment to reinflate collapsed lungs, CPAP and Rapid Sequence Induction.
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