Survey of Emergency Medical Services

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Survey of Emergency Medical Services

FAAN completed a survey of the EMS in each of the 50 states. Here is what we found.
Rules, regulations, and standards governing the Emergency Medical Services are developed at the state level. Although the National Highway Traffic Safety Administration issues guidelines about what these services should entail, the individual states have the discretion to adopt, reject, or modify these recommendations.

Most states have three levels of Emergency Medical Technicians (EMT): Basic, Intermediate, and Paramedic.

Basic EMT

The national guidelines for Basics suggest about 100 hours of training. Most states do not allow EMT Basics to carry epinephrine, but do allow them to assist patients in administering their own autoinjector (EpiPen®). This means that EMT Basics arriving at the scene of an anaphylactic reaction can either ask the patient for the location of their autoinjector, or look through the patient's belongings to find their EpiPen®. The EMT Basic will wrap the patient's hand around the EpiPen® and then wrap his or her own hand over it in order to assist in administering the medication.

Intermediate EMT

The national guidelines for EMT Intermediates recommend 400 hours of training. The standards vary greatly from one state to another. Some do not have an EMT Intermediate category and others allow their EMT Intermediates to carry and administer epinephrine via an autoinjector or ampoule and syringe. Others only allow them to assist patients with the patient's own autoinjector.

Paramedics

Paramedics have the most training of all the levels in the EMT system. The federal recommendation is approximately 1,000-1,200 hours of instruction, and a significant amount of time is spent on recognizing anaphylaxis and administering epinephrine, as well as other medications. All states allow Paramedics to carry and administer epinephrine.

KEY

A

does not carry epinephrine

B

can help patient administer their own perscribed epinephrine

C

authorized to carry and administer epinephrine

State

Basic

Intermediate

Paramedic

AL

A, B

A, B

C

AK

A, B

A, B

C

AR

A, B

A, B

C

AZ

A, B

C

C

CA

A, B

county decides

C

CO

A, B

C

C

CT

C

C

C

DE

A, B

n/a

C

FL

C

n/a

C

GA

A, B

C

C

HI

A, B

n/a

C

IA

A, B

A, B

C

IL

A, B

A, B

C

IN

A, B

A, B

C

KS

A, B

A, B

C

KY

A, B

n/a

C

LA

A, B

A, B

C

MA

C+

C

C

MD

A, B

C

C

ME

A, B

A, B

C

MI

A, B

C

C

MN

A, B

A, B

C

MO

A, B

n/a

C

MS

A, B

A, B

C

MT

A, B

A, B

C

NE

A, B

A, B

C

NC

A, B

C

C

ND

C++

C

C

NH

A, B

C

C

NJ

A, B

n/a

C

NM

A, B

C

C

NV

A, B

A, B

C

NY

C*

C

C

OH

A, B

C

C

OK

A, B

A, B

C

OR

C

C

C

PA

A, B

n/a

C

RI

C

C

C

SC

A, B

A, B

C

SD

A, B

A, B

C

TN

C

C

C

TX

A, B

A, B

C

UT

A, B

C

C

VA

A, B

C

C

VT

A, B

C

C

WA

C**

C

C

WI

C

C

C

WV

A, B

n/a

C

WY

A, B++

B

C

Adapted from Food Allergy News, Volume 8, Number 5.

*In 1999, New York enacted legislation authorizing all levels of EMTs, employees of summer camps, and others to carry and administer epinephrine following proper training.

**In 1999, Washington state enacted legislation allowing EMT Basics to carry epinephrine, and administer it only to patients under 18 years of age.

+ Has the option of becoming certified to carry and administer epinephrine.

++Local medical director decides if they may carry epinephrine.

Last modified on 7/31/00.

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