In the United States, the licensing of prehospital emergency medical providers 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).[1]

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.[2] 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.[3] 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 Emergency medical technician and 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.

In some states there are also EMS-RN's which is a Registered Nurse trained in Pre-Hospital response.

In the list, each state's certification levels are provided from most basic at the top to most advanced at the bottom.

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Colorado EMS Scope of Practice and Education Standard Comparison

Connecticut

Delaware

District of Columbia

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Transition to new levels began January 2011, and finished in March 2015.[22]

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

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

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Puerto Rico

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Now have been phased out of the state of Utah:

Vermont

Virginia

Washington

West Virginia

Wisconsin

Source:[60]

Wyoming

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.[63]

References

  1. ^ "National Standard Curriculum" (PDF). National Highway Transportation Safety Administration. Retrieved 2014-09-07.
  2. ^ "About NREMT Examinations". National Registry of Emergency Medical Technicians. Retrieved 2014-09-08.
  3. ^ "2011 Annual Report" (PDF). National Registry of Emergency Medical Technicians. p. 11. Retrieved 2012-11-11.
  4. ^ "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.
  5. ^ a b "ARKANSAS STATE BOARD OF HEALTH SECTION OF EMERGENCY MEDICAL SERVICES : RULES AND REGULATIONS FOR EMERGENCY MEDICAL SERVICES" (PDF). Healthy.arkansas.gov. Retrieved 4 August 2019.
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