Paramedics provide emergency medical care to people at a crisis scene, which could be a busy highway where a car accident has taken place or any other location where someone needs emergency medical services. They're trained to continue patient care in transport to a hospital or medical center via ambulance or aircraft. Most people become paramedics after completing a state-approved certificate or associate degree program at a community college or technical school. You must then either pass the National Registry of Emergency Medical Technicians (NREMT) exam or a state exam to be eligible for paramedic licensure, depending on your state's requirements. Before you can earn a paramedic credential from the NREMT, however, you must first earn either national or state EMT-Basic certification.

Licensure is a higher standard “” that means the person is able to take care of a patient in a pre-hospital setting.

K.C. JonesEducation Committee Chair for the National Association of Emergency Medical Technicians

Getting Paramedic Licensure and Certification

Licensure requires paramedics to prove they have both the education and the practical experience necessary to provide emergency medical services in a variety of situations. It also means they are held to a certain standard in their state because their license can be revoked for behavior that could negatively impact their patients, such as unprofessional conduct, gross negligence, incompetence, or certain criminal convictions. In fact, most states require individuals applying for a paramedic license to submit fingerprints for a criminal background check. Dr. Juan March, chair of the board of directors for the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS), said that licensure brings a sense of professionalism to EMS. Licensure is to "assure that we're performing to the technical and ethical standards to that given profession," March said.

"Licensure is a higher standard — that means the person is able to take care of a patient in a pre-hospital setting," said K.C. Jones, Education Committee chair for the National Association of Emergency Medical Technicians. "It's important to keep that confidence in the public's eye. The licensure holds with it that the standards are that of a professional, and that you have expanded your scope — the breadth and depth of the education process."

But before you can become licensed, you must complete a formal educational program consisting of both didactic courses and hands-on training in a clinical setting and in a field internship. This equips students with vital knowledge in areas such as anatomy and physiology, and training in essential skills such as patient assessment, managing traumas and respiratory/cardiac emergencies, emergency childbirth, etc. Often, paramedics start out as an EMT-Basic, progress to an EMT-Intermediate, and later advance to a full paramedic as they gain education and experience.

If your state requires you to earn national paramedic certification through NREMT to become licensed, you must first earn the EMT-Basic certification through your state or through the NREMT before you can earn a paramedic certification, according to the NREMT website. To become certified as an EMT-Paramedic through NREMT, you must be at least 18, have completed a state-approved paramedic course that meets national curriculum standards, and pass a cognitive and psychomotor exam. The NREMT cognitive exam focuses on important areas of emergency medical services, including airway, ventilation, oxygenation; trauma; cardiology; medical; and EMS operations, the NREMT website notes. The psychomotor exam requires you to demonstrate your ability to perform 12 emergency skills, such as trauma assessment, cardiac management, and IV and medication skills.

Maintaining Paramedic Licensure and Certification

EMS is a changing and advancing field. Paramedics must stay sharp and keep up to speed with these advancements so they can apply them and continually improve their level of care. For this reason, merely obtaining a paramedic license is not enough — paramedics must routinely maintain their licensure through continuing education and renew their licenses every two to three years, according to their state's requirements. "I think EMS professionals, like all health care professionals, realize that their unique skills and knowledge aren't static, and that every day we're adding new skills and knowledge," March said. "Only through continuing education can we assure that these new skills and knowledge are attained and brought around to provide good patient care."

Over the past five to 10 years, there’s been a significant move toward online courses.

Juan MarchChair of the Board of Directors for the Continuing Education Coordinating Board for Emergency Medical Services

Jones pointed out that continuing education is vital because best practices for paramedics change with new waves of research. "It is something, especially in the emergency medical field, that we have to stay up to date on because things change," Jones said, singling out one organization that provides cardiac care CE. "The American Heart Association, for instance, changes their standards every five years after a re-evaluation, and now they're saying that might be too long to wait. To stay up to date on field treatment, it's extremely important to take the continuing education."

While paramedic license renewal requirements are different for each state, often the most important factor in renewal is the completion of continuing education (CE) credits. The number of CE credits required for renewal also differs by state. For example, Florida requires 30 hours of CE for renewal every two years, a two-hour HIV/AIDS course, and a current Advanced Cardiac Life Support (ACLS) card, while California requires a minimum of 48 hours of CE every two years. Specific information pertaining to license renewal and CE requirements can be obtained through your state's licensing board.

Paramedics have demanding jobs and busy lives, making continuing education difficult at times to work into their schedules. We suggest completing your course work at a time of day that works best for you by taking your classes online. "Over the past five to 10 years, there's been a significant move toward online courses," March said, pointing out that while live classes are the most common way to accumulate CE, online courses are common as well. "The advent of computer technology has really changed continuing education as we know it. I know it's especially important for paramedics, who often work shifts, where being able to go to a class during the day may not be a possibility."

The classes you will need to take depend on your state's and credentialing organization's requirements, so we recommend consulting with your state licensing board or NREMT prior to signing up for online CE courses, and verifying that credits earned online are approved for your CE requirement.

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