Levels of Practice

Emergency Medical Responder (EMR)

EMR is the entry level designation to work on an ambulance in Alberta. They work at a BLS (Basic Life Support) level of care. The skills included in their scope of practice include:

  • Basic airway management
  • Low and high flow oxygen therapy
  • Ventilation support with bag valve mask
  • Circulation support
  • Automated defibrillation
  • Cardiopulmonary resuscitation (CPR)
  • Spinal immobilization
  • Vital sign evaluation (including respirations, pulse, blood pressure, skin condition, pupils, blood glucose, pulse oximetry, splinting, and bandaging).
  • Oral suctioning
  • Emergency childbirth

They can also assist with administration of patient’s personal asthma inhalers, Epi-Pens, and also give drugs that can assist patients experiencing hypoglycemic (low blood sugar) emergencies, and myocardial infarctions.


Primary Care Paramedic (Formerly EMT-A)

Primary Care Paramedic's operate at a highly functioning BLS (Basic Life Support) level of care. The skills in their scope of practice include all of that in an EMR’s scope, as well as:

  • Intermediate airway management, including BIAD (blind insertion airway devices)
  • 4 lead Electrocardiogram monitoring and interpretation
  • 12 lead Electrocardiogram placement
  • Peripheral intravenous cannulation
  • Intravenous infusions of fluids 
  • Pain control with nitrous oxide
  • Administer bronchodilators to patients experiencing respiratory emergencies
  • Administer ASA (Aspirin) and nitroglycerine to patients experiencing chest pain
  • Administer D50W (Dextrose) intravenously, and Glucagon via intramuscular injection to patients experiencing diabetic emergencies
  • Administer epinephrine via intramuscular injection to patients in anaphylaxis
  • Administer Narcan in case of opiate overdose


Advanced Care Paramedic (Formerly EMT-P)

Advanced Care Paramedic's operate at an ALS (Advanced Life Support) level. The scope of practice for ACP's is vast, it includes all of the skills that EMRs and PCP's can perform, as well as:

  • Advanced airway management, including endotracheal intubation, nasotracheal intubation, and emergency surgical airway
  • Advanced suctioning techniques such as deep tracheal suctioning and deep chest suctioning.
  • Use of positive pressure breathing adjuncts, such as Constant Positive Airway Pressure (CPAP)
  • Advanced resuscitation techniques, such as cardiac defibrillation, cardioversion (chemical and mechanical), and pacing
  • Cardiac pacing
  • Administration of over 40 medications via topical, oral, sublingual, rectal, subcutaneous, intramuscular, intravenous, endotracheal, nebulized, umbilical, intralingual, intradermal routes
  • Intraosseous (into bone) access, fluid, and drug administration administration
  • Needle thoracentesis (decompression)
  • Venipuncture for venous blood samples
  • Insertion of orogastric or nasogastric tubes for gastric lavage
  • Perform arterial cannulation, and retrieve arterial blood samples
  • Urinary catheterization

Paramedics perform more regulated medical acts than nearly any other health profession, made second only by physicians.