California

Dr. Steve Tharratt, Director
Emergency Medical Services Authority
State of California
1930 9th St., Sacramento, CA 95814
916/322-4336, Fax 916/324-2875
www.emsa.ca.gov

EMT: Skills include: Render basic life support, rescue and first aid; perform CPR, including use of mechanical adjuncts to basic CPR; perform automated external defibrillation; use of adjunctive breathing aids (oropharyngeal and nasopharyngeal airways; suction devices designed for prehospital use); obtain vital signs; use immobilization devices; transport the ill and injured; administer oral glucose; perform field triage; assist patients with physician-prescribed devices; and provide initial prehospital care of trauma. Hours of training: 120. Certification requirements: Pass the NREMT EMT certification examination. Recertification requirements: Every two years—must complete a 24-hour refresher course or 24 hours of continuing education from an EMS-approved continuing education provider, and provide proof of competency in 10 skills. Optional skills that require local EMS agency approval are: parilaryngeal airway adjuncts, administration of naloxone for suspected drug overdoes, administration of epinephrine by auto-injector for suspected anaphylaxis and/or severe asthma; administer atropine and pralidoxime chloride by auto-injectors.

Advanced EMT: Skills include: All the above and institute IV catheters, saline locks, needles or other cannulae in peripheral veins, administer IV glucose solutions or isotonic balanced salt solutions, including Ringer’s lactate solution, obtain venous and/or capillary blood samples for laboratory analysis, use blood glucose measuring device, and administer the following drugs in a route other than intravenous: sublingual nitroglycerin, aspirin, glucagon, inhaled beta-2 agonists (bronchodilators), activated charcoal, naloxone, epinephrine, and intravenous administration of 50% dextrose. Optional skills for existing EMT-IIs (Intermediates) only. in order to maintain their scope of practice include synchronized cardioversion and defibrillation and the administration of lidocaine hydrochloride, atroprine sulfate, sodium bicarbonate, furosemide, epinephrine, morphine sulfate and benzodiazepams (midazolam). Hours of training: 88 hours for Advanced EMT (existing EMT-II [Intermediate] hours of training were 306, which includes 210 hours of didactic and skills laboratory and 96 hours of clinical field internship. Also a minimum 20 ALS patient contacts in the combined hospital clinical field internship. Of the 20 ALS patient contacts, five must be in the field.) Certification requirements: Pass a competency-based written and skills certifying examination. Recertification requirements: Every two years complete 36 hours of continuing education from an approved EMS continuing education provider, and provide proof of competency in 6 skills.

EMT-Paramedic: Skills include: All the above and perform needle cricothyroidotomy, stomal intubation, endotracheal intubation or esophageal airway, laryngoscope, synchronized cardioversion, Valsalva’s maneuver, needle thoracostomy, glucose measuring device, obtain venous blood samples, and monitor thoracostomy tubes. Administer the following: adenosine, diazepam, aspirin, glucagon, diphenhydramine hydrochloride, calcium chloride, pralidoxime chloride, morphine sulfate, dopamine hydrochloride, activated charcoal, aerosolized or nebulized beta-2 specified bronchodilators, 25%–50% dextrose, midazolam, epinephrine, furosemide, lidocaine hydrochloride, glucose measuring device, naloxone hydrochloride, nitroglycerin, sodium bicarbonate and atropine sulfate. Additional items may be added at local level upon approval of state EMS director. Hours of training: Minimum of 1,090 hours, which includes 450 hours didactic and skills laboratory and 160 clinical training and 480 hours field internship, including a minimum of 40 ALS patient contacts in the field. Licensure requirements: Pass the NREMT competency-based paramedic written and skills examination. Relicensure requirements: Every two years complete 48 hours of continuing education from an approved EMS education provider.