AEMS Levels of EMS Professionals

AEMS Scope of Practice Model defines and describes three (3) levels of EMS professionals.

• Medical Responder (EMR) (Non - Professional)

• EMT (

• Advanced EMT (AEMT)

• Paramedic

Each level of EMS professional differs in knowledge, skills, judgment, critical thinking, and decision making. Not every country recognizes all levels of EMS professionals. Although the various levels of EMS professionals may differ from one country to another, all EMS professionals work to provide the best patient care at their level of training and expertise.

Each level of EMS professional has its own scope of practice.

The scope of practice for an EMT is not the same as the scope of practice for an AEMT or

a paramedic. Scope of practice is regulated by the state or country where the individual works and by the medical director.

As new technology or research appears, an EMS professional's scope of practice should change. These changes will reflect the new norms or expectations. An EMS professional can be legally liable if he or she functions outside his or her scope of practice.

Emergency Medical Responder

A Certified Emergency Medical Responder (EMR) is an EMS professional who provides initial basic life support care to patients who access the EMS system. EMRs were formerly called first responders. An EMR must work with an EMT or higher level personnel during the transport of emergency patients.

Emergency Medical Technician

A Certified Emergency Medical Technician (EMT) is the minimal level of training required to transport a patient to an acute care facility. This level of EMS professional can provide non-invasive emergency care, including performing assessments, administering oxygen, and immobilizing a patient. An EMT can assist patients in taking their own prescribed medications. An EMT can also administer specific over-the-counter medications (such as aspirin and oral glucose) with appropriate medical oversight.

Advanced Emergency Medical Technician (AEMT)

A Certified Advanced Emergency Medical Technician (AEMT) is an EMS professional who provides basic and limited advanced skills to patients who access the EMS system. An AEMT was formerly called an EMT-Intermediate. This level of EMS professional varies drastically from country to country .In some country AEMT skills include giving dextrose to patients who have a low blood sugar and starting intravenous lines. In other countries, AEMTs can perform advanced airway skills (including endotracheal intubation), apply cardiac monitoring, and give cardiac and respiratory medications.

Paramedic

A cerified paramedic is the highest level of EMS professional in the pre-hospital setting. This level of EMS professional performs advanced assessments, advanced procedures, and medication administration. A paramedic is competent in all the skills of the EMR, EMT, and AEMT and also can perform a broader range of advanced procedures that the other levels cannot.

Specialized Levels

More specialized levels are specific to individual states like in South Africa, US and UK. Generally, specialized levels are not replacements for the standard four levels, but rather additional training one can take after receiving the initial EMT or Paramedic credentials. For example : A wilderness EMT course is available for EMS personnel who work in remote areas. This course focuses on the long-term stabilization of patients within limited resources.

Paramedics are licensed healthcare professionals who provide the most extensive pre-hospital advanced life support. Paramedics provide care that is on par with that of the emergency room. During a medical emergency Paramedics can provide advanced life support care including: advanced airway management, endotracheal intubation (breathing tube), manual defibrillation, external transcutaneous pacing, EKG monitoring, 12-lead EKG acquisition, IV fluid therapy, intraosseus infusions, hemodynamic monitoring, needle chest decompressions, surgical airways, administration of a wide array of critical care medications and mechanical ventilation.

A certified and licensed critical care paramedic course teaches paramedics additional pharmacology and skills, such as the use of balloon pumps, to help with the care of critically ill patients who depend on equipment. Critical care paramedics commonly work on critical care transport ambulances, which are used to move patients between health care facilities.

Craig Gibson & Paul Baron ,REMT-P's

Other examples of expanding and emerging roles for paramedics include primary care, industrial medicine, sports medicine, and tactical medicine.

A certified and licensed Intensive Care Paramedic is an advanced clinical practitioner in Paramedicine who provides medical assessment, treatment and care in the out-of-hospital environment for acutely unwell patients with significant illness or injury. ICPs respond to patients experiencing an acute, life threatening emergency. They provide rapid and specialist clinical assessment by implementing a targeted management plan for patients with significant alteration or challenge to normal homeostatic function. Whilst this role is tasked with providing clinical oversight during the management of these cases all patient care is undertaken in collaborative context with other paramedic staff or health care professionals in attendance.The ICP is required to make rapid, often complex and critical clinical judgment without direct supervision. Individuals are responsible for their own continuing professional development which may be supplemented by employer-provided training.

AEMS Paul Aiden Barson, REMT-P in Sudan

An ICP is usually engaged by a statutory ambulance service, private paramedic service or defense force and may operate in a variety of community, industrial, resource sector, defense or event/public gathering settings including disaster response. professional may be deployed as part of a two-person crew operating in an ambulance equipped with a stretcher and specialist clinical equipment or may practice as a single operator from a purpose-designed response vehicle (typically a marked station wagon).Defence force ICP’s deliver out-of-hospital care as solo practitioners and in team environments alongside other health professionals or a merger of specialties. ICP’s engaged in defence forces provide health care to support and maintain the health and well being of defence force/allied personnel and civilians in times of conflict, disaster or peacetime. This may include the delivery of health care within austere environments and on/in a variety of platforms such as on land (on foot or in-vehicle), aerospace or on ships. They may attend in situations ranging from a controlled environment through to routine and emergency medical management where a paramedical response is required. ICP may take professional responsibility for the mentoring and support of paramedics, developing ICP’s, paramedics and students.

Craig Gibson demonstrating traction splinting to AEMS students - Davao City.

AEMS Craig Gibson, REMT-P and AEMS EMT's in Kidapawan City's 911.

AEMS's Students on patient care reports - Kidapawan City

AEMS Scholar Alpha in Kidapawan City.

The AEMS Paramedic Instructors :

Paul A. Barson, REMT-P has NDip in Paramedical Sciences from Churchill Education Australia, is an ALS (Advanced Life Support) Paramedic and an EMT Assessor of AREMT (Australasia Registry of Emergency Medical Technicians), currently registered and licensed with Health Professions Council of South Africa (HPCSA), the government agency handling Paramedic licensing and registration of healthcare professionals and paramedics in South Africa and has more than 20 years of professional experience in the EMS field as Paramedic/Project Manager with international & national institutions both in the medical and rescue industry, with extensive field work in Sudan, Afghanistan, Somalia and South America. Paul is a Remote / hostile Site Specialist and has an EMS Operations Consultant background inclusive of training and management expertise. Paul is a civilian Paramedic with independent license ( can work without medical supervision of an EMS physician) with Military experience, has spent a large portion of time in hostile and remote locations providing managerial and medical support on the ground as and when it is required.

Craig A. Gibson,REMT-P is current and registered as an Independent Intensive Care Paramedic registered with Health Professions Council of South Africa, an EMT Assessor of AREMT (Australasia Registry of Emergency Medical Technicians). He has more than 20 years of professional experience in the EMS field and remote medicine industry. His previous work experience includes Hospital Manager for African Union Darfur Mission in 2005 to 2006. Prior to this position, Craig was project manager for Medical Support Solutions with head office based in the UK.

In 2004, Paul Barson and Craig Gibson worked for the United Nations Joint Military Commission (JMC) at Nuba Mountains in Sudan for which they were awarded a medal of honor for their exemplary performance as JMC Paramedic - Head of Medical Services by Brigadier General Jan Erik Wilhelmsenl Chairman of JMC and Head of Joint Monitoring Mission in Nuba Mountains, Sudan.

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Licensure, Certification, and Registration

To ensure the competence of EMS personnel, all personnel in an EMS system must be certified or licensed by the country in which they provide patient care.

Certification and registration is available via TESDA (local) or AREMT (International) through its accredited training centers and assessors (who are connected directly with a Training Center in the Philippines).

Although certification and licensure are terms that often are used interchangeably in EMS, their EMS meanings differ from the other.

Local : TESDA

 Qualified graduates of TESDA’s NC II can find employment as any of the following :

• First Responder

• Medical First Responder

• Ambulance Care Assistant

Students enrolled in EMS NC II may be required to undergo a Competency Based assessment before graduation.

Internationally Recognized : AREMT

 For international certification and registration, EMT’s may undergo a written and practical assessment at AREMT through its accredited assessors and training centers in the Philippines.