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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.
The purpose of the model is to provide a guide toward standardization in patient care that both improves patient outcomes but allows for reciprocity between states. [36] Prior to certification as a paramedic, candidates must be a certified EMT. Traditionally, a paramedic is allowed to perform all skills an EMT may perform. [37]
For instance, a paramedic might not list an MBA, but a supervisor might choose to do so. The provider's credentials are separated from the person's name (and from each other) with commas. There are usually no periods within the credentials (e.g. "EMT" not "E.M.T." or "PMD" not "Paramedic").
Most states use or require NREMT testing for some level of state certification. [2] [7] [8] NREMT recognizes four levels of EMS: EMR, EMT, Advanced EMT, and Paramedic (some states may have additional certifications). [7] NREMT certification at an EMT Intermediate level may or may not be sufficient for some state EMT-I requirements. [9]
Reciprocity - that is, recognition of one state's EMT certification being valid in another state - between states is somewhat limited, and after 30 years of operation by the National Registry of Emergency Medical Technicians, only about 40 states provide unlimited recognition of the NREMT certifications. [46]
Is usually made up of 3 levels in the US. EMT-B, EMT-I (EMT-A in some states) and EMT-Paramedic. The National Registry of EMT New Educational Standards for EMS renamed the provider levels as follows: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT-B), Advanced EMT (AEMT), and Paramedic (EMT-P).
Texas has a five-tier system, consisting of emergency care attendant, EMT-basic, advanced EMT, EMT-paramedic, and paramedic. [16] In Virginia, the first level of ALS is advanced EMT. The AEMT certification replaced the EMT-enhanced, unique to Virginia, starting in 2013 and fully replaced in the EMT-E certification in 2016.
EMR training is intended to fill the gap between first aid and EMT. The American Red Cross conducts a course titled "emergency medical response" that fits this definition. In the US the term "emergency medical responder" has largely replaced the term "certified first responder" or "medical first responder" beginning in 2012.
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