Emergency medical responder levels by U.S. state

Emergency medical responder levels by U.S. state

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).cite web |url=http://www.nhtsa.dot.gov/portal/site/nhtsa/template.MAXIMIZE/menuitem.2a0771e91315babbbf30811060008a0c/?javax.portlet.tpst=4670b93a0b088a006bc1d6b760008a0c_ws_MX&javax.portlet.prp_4670b93a0b088a006bc1d6b760008a0c_viewID=detail_view&itemID=1822abcc80c81010VgnVCM1000002c567798RCRD&overrideViewName=Article |title= National Standard Curriculum|accessdate=2008-03-10 |format=HTML |publisher= National Highway Transportation Safety Administration ] 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. [cite web |url=http://nremt.org/about/about_exams.asp |title= About NREMT Examinations|accessdate=2008-04-01 |format=HTML |publisher=National Registry of Emergency Medical Technicians ] 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. [cite web |url= http://nremt.org/downloads/2006_Annual_Report.pdf|title=2006 Annual Report |accessdate=2008-04-01 |format=PDF|publisher=National Registry of Emergency Medical Technicians |pages=10|quote=50 state-4 non-registry states-states not using NREMT for Basic or Paramedic level ] 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.

Alabama

*EMT-Basic*
*EMT-Intermediate
*EMT-Paramedic* [cite web |url=http://www.adph.org/ems/Default.asp?id=811 |title= EMS Rules and Protocol|accessdate=2008-03-27 |format=HTML|publisher=Alabama Department of Public Health Emergency Medical Services and Trauma]

Alaska

*EMT-I* (One) (analogous to EMT-Basic)
*EMT-II (Two) (analogous to EMT-Intermediate/85)
*EMT-III (Three)
*Mobile Intensive Care Paramedic (MICP) [cite web |url= http://www.chems.alaska.gov/EMS/Levels.htm|title= EMS Training Levels In Alaska|accessdate=2008-03-27 |format=HTML |date= 6/6/2005|publisher=Alaska Health and Human Services ] [cite web |url=http://hss.state.ak.us/apps/EMSCert/ResponderSearchPage.aspx |title=Certification Search |accessdate=2008-03-30 |format=HTML |publisher=Alaska Health and Human Services |quote=Certification search for ETT and Defib Technician returns zero results]

Arizona

*EMT-Basic*
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url= http://www.azdhs.gov/bems/faq1.htm#EMT_Certification_-_1 |title= EMT Certification - FAQs: How do I gain certification in Arizona as an EMT-B, EMT-I, or EMT-P?|accessdate=2008-03-27 |format=HTML |publisher=Arizona Department of Public Health Services ]

Arkansas

*EMS First Responder
*EMT-Ambulance* (analogous to EMT-Basic)
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url= http://www.healthyarkansas.com/ems/pdf/ems_regulations_01.pdf|title= Rules and Regulations for Emergency Medical Services|accessdate=2008-03-27 |format= PDF|pages=25-27|publisher=Arkansas State Board of Health ]

California

*EMT-I (One)* (analogous to EMT-Basic)
*EMT-II (Two)
*EMT-Paramedic* [cite web |url=http://www.emsa.ca.gov/emsdivision/emspersonnel.asp |title=EMS Personnel Division |accessdate=2008-03-27 |format=HTML |publisher=California Emergency Medical Services Authority]

Colorado

*EMT-Basic*
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url=http://www.cdphe.state.co.us/em/CertificationEducation/certification/EMTApplicationAndGuide.pdf |title=Colorado Emergency Medical Technician Certification Application Instructions/Guide |accessdate=2008-03-27 |format= PDF|publisher=Colorado Department of Public Health and Environment]

Connecticut

*Medical Response Technician
*EMT* (analogous to EMT-Basic)
*EMT-I/85
*EMT-Paramedic* [cite web |url=http://www.ct.gov/dph/cwp/view.asp?a=3127&q=387364&dphNav_GID=1827&dphPNavCtr=|#46950 |title=Emergency Medical Services - Licensure/Certification/Exams|accessdate=2008-03-27 |format= PDF|publisher=Connecticut Department of Public Health ]

Delaware

*EMT-Basic*
*EMT-Paramedic*

Florida

*EMT* (analogous to EMT-Basic)
*Paramedic [cite web |url= http://www.doh.state.fl.us/mqa/emt-paramedic/emt-lic-requirements.html#Initial|title= Certification Requirements|accessdate=2008-03-27 |format=HTML |publisher= Florida Board of Emergency Medical Technicians (EMT) and Paramedics]


=Georgia=

*First Responder (commonly police, schoolteachers, & volunteers)All EMT levels above First Responder are progressive. EMT-Basics usually attend an EMT-Intermediate/85 program with the option to take the EMT-Basic National Registry exam once the EMT-Basic portion of the course is complete (approx. 6 months). In order to become an EMT-Intermediate/85 in Georgia (approx. 9 months including the 6 months of EMT-Basic) one must complete the EMT-Basic training that is the first portion of the EMT-Intermediate/85 program. However, EMT-Intermediates/85 are only required to take the EMT-Intermediate/85 level National Registry exam. Should they fail the EMT-Intermediate/85 National Registry exam they are not EMT-Basics unless they have taken and passed the EMT-Basic National Registry exam prior. This is to encourage those who have completed the EMT-Basic training to progress their training further to the preferred and more common EMT-Intermediate/85 level. To become an EMT-Paramedic one must complete the Basic & Intermediate levels first (approx. 27 months total from EMT-Basic to EMT-Paramedic/Diploma). (Program durations based on GA Technical College EMS Programs)
*EMT-Basic* (Certificate; the minimum requirement for GA firefighters referred to as "Firefighter/EMT") [cite web |url=http://www.laniertech.edu/academic-programs_/Emergency%20Medical%20Technology%20(Basic)-Certificate.asp?m=4&deptid=28&programid=84&t=Emergency%20Medical%20Technology%20(Basic) Certificate|title=Lanier Technical College EMT-Basic Program]

*EMT-Intermediate/85 (Certificate; level required by some city/county Fire Departments) [cite web |url=http://www.laniertech.edu/academic-programs_/Emergency%20Medical%20Technician%20%20(Intermediate)-Certificate.asp?m=4&deptid=28&programid=85&t=Emergency%20Medical%20Technician%20%20(Intermediate)|title=Lanier Technical College EMT-Intermediate Program]

*EMT-Cardiac Tech (No new licenses granted since 1998, Similar to the NREMT-I/99)
*EMT-Paramedic* (Diploma/Degree) [cite web |url=http://www.laniertech.edu/academic-programs_/Paramedic%20Technology-Diploma.asp?m=4&deptid=28&programid=52&t=Paramedic%20Technology Diploma|title=Lanier Technical College EMT-Paramedic Diploma Program] [cite web |url=http://www.laniertech.edu/academic-programs_/Paramedic%20Technology-Degree.asp?m=4&deptid=28&programid=248&t=Paramedic%20Technology Degree|title=Lanier Technical College EMT-Paramedic Degree Program] [cite web |url=http://health.state.ga.us/programs/ems/Procedures/PRO%20C-02%20EMS%20Initial%20License%20Exams/PRO-C-02%20EMS%20Initial%20Licensing%20Examinations%2001-10-07.pdf |title=Emergency Medical Services (EMS) Initial License Examinations |accessdate=2008-03-27 |format=PDF |publisher= Department of Human Resources Division of Public Health Office of Emergency Medical Services]

Hawaii

*EMT-Basic*
*EMT-Paramedic* [cite web |url=http://hawaii.gov/health/family-child-health/ems/har16-85.html#54 |title= Certifying Emergency Medical Service Personnel|accessdate=2008-03-27 |format= HTML|publisher=State of Hawaii]

Idaho

*First Responder
*EMT-Basic*
*Advanced EMT (analogous to EMT-Intermediate/85)
*EMT-Intermediate (State specific level)
*EMT-Paramedic* [cite web |url=http://www.healthandwelfare.idaho.gov/DesktopModules/DocumentsSortable/DocumentsSrtView.aspx?tabID=0&ItemID=4138&MId=11151&wversion=Staging |title=Certification Standards Manual |accessdate=2008-03-27 |format= PDF|pages=8|publisher=State of Idaho, Emergency Medical Services Bureau]

Illinois

*EMT-Basic*
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url=http://www.idph.state.il.us/ems/ |title=Emergency Medical System and Highway Safety |accessdate=2008-03-27 |format=HTML |publisher=Illinois Department of Public Health ]

Indiana

*First Responder
*EMT-Basic
*EMT-Basic Advanced
*EMT-Intermediate/99
*Paramedic* [cite web |url=http://www.in.gov/dhs/files/emscertlevels.pdf |title= Levels of EMS Personnel Certification|accessdate=2008-03-27 |format=PDF |publisher= Indiana Emergency Medical Services Commission ]

Iowa

*First Responder
*EMT-Basic*
*EMT-Intermediate
*EMT-Paramedic (analogous to EMT-Intermediate/99)
*Paramedic Specialist* (analogous to EMT-Paramedic) [cite web |url= http://www.idph.state.ia.us/ems/common/pdf/training.pdf|title=Authorized Iowa EMS Training Programs|accessdate=2008-03-27 |format= PDF|publisher=Iowa Department of Public Health, Bureau of Emergency Medical Services ] [cite web |url= http://www.idph.state.ia.us/ems/common/pdf/para-transition.pdf|title=Iowa EMT-Paramedic to Paramedic Specialist Transition Application |accessdate=2008-03-27 |format=PDF |publisher=Iowa Department of Public Health, Bureau of Emergency Medical Services ]

Kansas

*First Responder
*EMT-Basic*
*EMT-Defibrillator
*EMT-Intermediate/85
*EMT-Intermediate/Defibrillator
*Mobile Intensive Care Technician* (analogous to EMT-Paramedic) [cite web |url=http://www.ksbems.org/FAQ.htm |title= Frequently Asked Questions|accessdate=2008-03-28 |format=HTML |publisher=Kansas Board of Emergency Medical Services ]

Kentucky

*First Responder
*EMT
*Paramedic [cite web |url= http://kbems.kctcs.edu/index.html|title=Kentucky Board of Emergency Medical Services |accessdate=2008-03-28 |format=HTML]

Louisiana

*First Responder
*EMT-Basic*
*EMT-Intermediate/85
*EMT-Paramedic* [cite web |url=http://www.dhh.louisiana.gov/offices/publications/pubs-220/CERTIFICATION%20FORM%202006%20with%20inst.doc |title= CERTIFICATION APPLICATION|accessdate=2008-03-28 |format= .DOC|publisher=State of Louisiana, Department of Health and Hospitals, Louisiana Bureau of Emergency Medical Systems]

Maine

*First Responder
*Ambulance Attendant (no "new" licenses granted since 1996)
*EMT-Basic*
*EMT-Intermediate
*EMT-Critical Care (no "new" licenses after 1998)
*EMT-Paramedic [cite web |url= http://mainegov-images.informe.org/dps/ems/documents/Maine_EMS_Rules.pdf|title=Maine Emergency Medical System Rules |accessdate=2008-03-28 |format= PDF|pages=45]

Maryland

*First Responder
*EMT-Basic
*Cardiac Rescue Technician (will be phased out on June 30, 2008)
*Cardiac Rescue Technician-Intermediate (analogous to EMT-Intermediate/99)
*EMT-Paramedic* [cite web |url=http://miemss.umaryland.edu/home/default.aspx?tabid=95 |title=Initial Certification & Licensure Requirements |accessdate=2008-03-28 |format=HTML |publisher=Maryland Institute for Emergency Medical Services Systems ]

Massachusetts

*EMT-Basic
*EMT-Intermediate/85
*EMT-Paramedic [cite web |url=http://www.mass.gov/?pageID=eohhs2subtopic&L=7&L0=Home&L1=Provider&L2=Certification%2c+Licensure%2c+and+Registration&L3=Occupational+and+Professional&L4=Emergency+Medical+Technicians+(EMT)&L5=Initial+Training&L6=Overview+of+Training+Requirements&sid=Eeohhs2 |title=Overview of Training Requirements |accessdate=2008-03-28 |format=HTML |publisher=Massachusetts Office of Health and Human Services ]

Michigan

*Medical First Responder
*EMT-Basic*
*EMT-Specialist (analogous to EMT-Intermediate/85)
*EMT-Paramedic* [cite web |url=http://www.michigan.gov/documents/mdch/License_Packet_4-07_197521_7.pdf |title= License Packet|accessdate=2008-03-28 |format= .PDF|pages=4|publisher= Michigan Department of Community Health, Emergency Medical Services and Trauma System]

Minnesota

*EMT-Basic*
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url= http://www.emsrb.state.mn.us/cert.asp|title= Certification|accessdate=2008-03-28 |format=HTML|publisher=Mnnesota Emergency Medical Services Regulatory Board ]

Mississippi

*Medical First Responder
*EMT-Basic*
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url=http://www.ems.doh.ms.gov/ems/faq_ems_pers_info.html |title=EMS Personnel Information Frequently Asked Questions (FAQ)|accessdate=2008-03-28 |format=HTML|publisher=Mississippi State Department of Health, Emergency Medical Services ]

Missouri

*EMT-Basic*
*EMT-Paramedic* [cite web |url=http://www.dhss.mo.gov/EMS/Faq.html#EMTI |title= Frequently Asked Questions: I am an EMT-Intermediate; can I work as an EMT-I in Missouri?|accessdate=2008-03-28 |format=HTML |publisher=State of Missouri, Department of Health and Senior Services ]

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 [cite web |url=http://mt.gov/dli/bsd/license/bsd_boards/med_board/pdf/med_rules.pdf |title=Montana State Board of Medical Examiners |accessdate=2008-03-28 |format=HTML |pages=93 |publisher= Department of Labor and Industry]

Nebraska

*First Responder
*EMT-Basic*
*EMT-Intermediate
*EMT-Paramedic* [cite web |url=http://www.hhs.state.ne.us/ems/emscert.htm |title=Certification for Out-of-Hospital Providers |accessdate=2008-03-28 |format=HTML |publisher=Nebraska Department of Health and Human Services ]

Nevada

*First Responder
*EMT-Basic
*EMT-Intermediate/85
*EMT-Advanced (analogous to EMT-Paramedic) [cite web |url= http://health.nv.gov/docs/EMSCertificationApplication.pdf|title= EMS Certification application|accessdate=2008-03-28 |format=PDF |publisher=State of Nevada, Department of Health and Human Services ]

New Hampshire

*First Responder
*EMT-Basic*
*EMT-Intermediate/85
*EMT-Paramedic* [cite web |url=http://www.nh.gov/safety/divisions/fstems/ems/documents/provider_license_application.pdf |title=New Hampshire EMS Provider License Application |accessdate=2008-03-28 |format= PDF|publisher=Department of Safety ]

New Jersey

*EMT-Basic*
*EMT-Paramedic* [cite web |url=http://www.state.nj.us/health/ems/regs.shtml|title= Regulations/ Legislative Bill List|accessdate=2008-03-27 |format=HTML |publisher=State of New Jersey, Department of Health and Senior Services ]

New Mexico

*EMS First Responder
*EMT-Basic
*EMT-Intermediate
*EMT-Paramedic* [cite web |url= http://www.nmems.org/tlr/licensing.htm|title=Licensing Info |accessdate=2008-03-29 |format= HTML|publisher= New Mexico Department of Health]

New York

*Certified First Responder
*EMT-Basic
*EMT-Intermediate
*EMT-Critical Care
*EMT-Paramedic [cite web |url=http://www.health.state.ny.us/nysdoh/ems/stat.htm |title= Emergency Medical Services Statistical Information|accessdate=2008-03-29 |format= HTML|publisher=New York State Department of Health ]

North Carolina

*Medical Responder
*EMT*
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url= http://www.ncdhhs.gov/dhsr/EMS/curricul.htm|title= http://www.ncdhhs.gov/dhsr/EMS/curricul.htm|accessdate=2008-03-29 |format=HTML |work=North Carolina Office of Emergency Medical Services ]

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* [cite web |url=http://www.health.state.nd.us/EMS/personnel.html |title= Training, Testing and Certification Requirements|accessdate=2008-03-29 |format=HTML |publisher=North Dakota, Department of Health, Emergency Medical Services ]

Ohio

*First Responder
*EMT-Basic*
*EMT-Intermediate(Uses State approved Intermediate Course. Not Quite NREMT I-99 Standard)
*EMT-Paramedic* [cite web |url=http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice101707.pdf |title= Scope of Practice|accessdate=2008-03-29 |format=HTML |publisher= Ohio Department of Public Safety, Ohio Emergency Medical Services]

Oklahoma

*First Responder
*EMT-Basic*
*EMT-Intermediate/85
*EMT-Paramedic* [cite web |url= http://www.health.state.ok.us/program/ems/curriculum.html|title= Oklahoma Approved EMS Curriculum|accessdate=2008-03-29 |format= HTML|publisher=Oklahoma State Department of Health, Emergency Medical Services Division]

Oregon

*EMT-Basic*
*EMT-Intermediate (state specific)
*EMT-Paramedic* (requires a college degree) [cite web |url=http://egov.oregon.gov/DHS/ph/ems/certific/educate.shtml#degree |title= Welcome to EMT Educational Requirements|accessdate=2008-03-29 |format=HTML |work= Oregon Department of Human Services, Emergency Medical Services and Trauma Systems ]

Pennsylvania

*Ambulance Attendant
*First Responder
*EMT-Basic
*EMT-Paramedic*
*Prehospital Registered Nurse
*Health Professional Physician [cite web |url=http://www.pacode.com/secure/data/028/chapter1003/028_1003.pdf |title=Pennsylvania Code: Part VII: Emergency Medical Services, Chapter 1003, Personnel |accessdate=2008-03-28 |format= PDF|pages=8-20|publisher= State of Pennsylvania]

Rhode Island

*EMT-Basic*
*EMT-Cardiac
*EMT-Paramedic* [cite web |url=http://www.health.ri.gov/hsr/professions/amb.php#Requirements |title= Office of Health Professionals Regulation, Ambulance Service Advisory Board|accessdate=2008-03-29 |format= HTML|publisher= Rhode Island Department of Health]

South Carolina

*EMT-Basic*
*EMT-Intermediate/85
*EMT-Paramedic* [cite web |url= http://www.scdhec.gov/health/ems/process.pdf|title=South Carolina Certification Process |accessdate=2008-03-29 |format= PDF|publisher=South Carolina Emergency Medical Services ]

South Dakota

*EMT-Basic*
*EMT-Intermediate/85
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url=http://www.state.sd.us/dps/EMS/ |title= South Dakota Emergency Medical Services|accessdate=2008-03-29 |format= HTML]

Tennessee

*First Responder
*EMT-IV(Not to be confused with I/99 or I/85; this rank is EMT-Basic with several extended skills from the EMT-I/85 Curriculum, and is usually taught using an EMT-I textbook)
*EMT-Paramedic* [cite web |url=http://health.state.tn.us/ems/PDF/Reciprocity.pdf |title= Reciprocity Requirements for EMT Personnel License|accessdate=2008-03-29 |format=PDF |work= ]
*Critical Care Paramedic* - Not yet fully implemented due to a lack of Critical Care program offerings in the state of Tennessee, although it does plan to recognize reciprocation from CCEMT-P or Critical Care Paramedic courses taken from other states. [cite web |url=http://health.state.tn.us/Downloads/ems_CriticalCareStandardizedModules.pdf |title=Critical Care Paramedic Standardized Modules and Objectives |accessdate=2008-04-10 |format= PDF|publisher=State of Tennessee Department of Health ]

Texas

*Emergency Care Attendant
*EMT-Basic*
*EMT-Intermediate
*EMT-Paramedic*
*Licensed Paramedic (paramedic with a college degree) [cite web |url= http://www.dshs.state.tx.us/emstraumasystems/CertInfo.shtm|title=Requirements for initial certification/licensure: |accessdate=2008-03-27 |format=HTML |publisher= Texas Department of State Health Services]

Utah

*EMT-Basic*
*EMT-Intermediate (state specific)
*EMT-Intermediate Advanced (analogous to EMT-Intermediate/99)
*EMT-Paramedic* [cite web |url=http://health.utah.gov/ems/stdseval/training/ |title=Training |accessdate=2008-03-29 |format=HTML |publisher=Bureau of Emergency Medical Services ]

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) [cite web |url=http://healthvermont.gov/regs/emsrules.pdf |title= EMS Rules|accessdate=2008-07-07 |format=PDF|publisher=Vermont Department of Health|pages=19 ]
*EMT-Intermediate-2003 curriculum (State specific)
*EMT-Paramedic* [cite web |url=http://healthvermont.gov/hc/ems/ems_cert.aspx |title= EMS Certification|accessdate=2008-03-29 |format=HTML |publisher=Vermont Department of Health ]

Virginia

*EMS First Responder(State Certified)
*EMT-Basic(State Certified)
*EMT-Enhanced(State Certified)
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url= http://www.vdh.state.va.us/OEMS/Training/tprog.htm|title= EMS Training Programs Summery|accessdate=2008-03-29 |format=HTML |publisher=Virginia Department of Health, Office of Emergency Medical Services ]

Washington

*First Responder
*EMT-Basic
*Intravenous Therapy Technician
*Airway Management Technician
*IV/Airway Technician
*Intermediate Life Support Technician
*ILS and Airway Technician
*Paramedic [cite web |url=http://www2.doh.wa.gov/hsqa/emstrauma/initcert.htm |title=Initial Certification Process |accessdate=2008-03-29 |format= |work= Washington State Department of Health, Office of Emergency Medical Services and Trauma System]

West Virginia

*First Responder
*EMT-Mining (specialty certification)
*EMT-Basic*
*EMT-Intermediate/99
*EMT-Paramedic*
*Critical Care Transport-Paramedic
*Critical Care Transport-Registered Nurse [cite web |url=http://www.wvoems.org/LinkClick.aspx?fileticket=4pvgJOu8wW0%3d&tabid=120&mid=503 |title= EMS Personnel Application|accessdate=2008-03-29 |format=PDF |work=West Virginia Department of Health and Human Resources, Office of Emergency Medical Services ]

Wisconsin

*Medical First Responder
*EMT-Basic*
*EMT-Intermediate Technician (analogous to EMT-Intermediate/85)
*EMT-Intermediate/99
*EMT-Paramedic* [cite web |url= http://dhfs.wisconsin.gov/forms/dph/dph07477.pdf|title= First Responder/Emergency Medical Technician Certification/License Application|accessdate=2008-03-29 |format=HTML |publisher=Washington Department of Health and Family Services, Emergency Medical Services ]

Wyoming

*EMT-Basic*
*EMT-Intermediate/85
*EMT-Paramedic* [cite web |url= http://www.health.wyo.gov/Media.aspx?mediaId=3173|title= Certification Application|accessdate=2008-03-29 |format=PDF |publisher= Wyoming Department of Health, Office of Emergency Medical Services]

References


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