Paramedic (PM)

Paramedic (PM)

Occupational Statement:

A GEMR certified Paramedic is physician extender and health professional whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical system. This individual possesses the complex knowledge and skills necessary to provide patient care and transportation for emergent patients. Paramedics function as part of a comprehensive EMS response, under medical oversight. Paramedics perform interventions with the basic and advanced equipment typically found on an advanced life support ambulance, response vehicle, or system. The paramedic is a link from the scene of the patient’s emergency event into the health care system.

A Paramedic functions as part of a comprehensive EMS response, under medical oversight and typically as part of an advanced care EMS system or remote care system.

A GEMR certified Paramedic (PM) may, under the direction of a Physician Medical Director, may:

  1. Perform all procedures that an Advanced Emergency Medical Technician may perform.
  2. Initiate the following airway management techniques:
    1. Endotracheal intubation without rapid sequence induction;
    2. Needle Cricothyrotomy; and,
    3. Transtracheal jet insufflation.
  3. Initiate intraosseous needle placement and maintain an intraosseous infusion.
  4. Provide advanced life support in the resuscitation of patients in cardiac arrest;
  5. Perform emergency cardioversion.
  6. Perform external transcutaneous pacing of bradycardia.
  7. Perform electrocardiographic interpretation.
  8. Initiate needle thoracostomy.
  9. Access indwelling catheters and implanted central IV ports for fluid and medication administration.
  10. Prepare and administer routine or emergency immunizations and tuberculosis skin testing, as part of an EMS Agency’s occupational health program, to the EMS agency personnel, under the Medical Director’s standing order.
  11. Prepare and initiate or administer any medications or blood products under specific written protocols authorized by the Medical Director, or direct orders from a licensed transferring physician.

The Global Emergency Medical Registry (GEMR) is honored to serve this healthcare workforce with an international standard certification following education, competency evaluation, and testing.

The GEMR Advanced Emergency Medical Technician (AEMT) Certification is designed to provide industry, governments, regulators, and administrations with a third-party certification for this level of healthcare provider around the globe which is referenceable and can be checked via the gemr.org “Verify Certification or Endorsement” box on the GEMR Home Page.

Paramedic – Initial Candidate Information for Certification

Pre-Certification Educational Outcomes:

Upon completion of a program of education, the candidate will:

  1. Be a minimum of 18 years old.
  2. Be prepared for and eligible to take the GEMR Written Examination and skills process to obtain certification from The Global Emergency Medical Registry (GEMR).
  3. Be prepared to upload all AEMT skills sheets with physician or instructor signature, indicating compliance to the standard during examination of that skill.
  4. Have completed a program of education, which the program attests to meeting the objectives and requirements outlined for the certification level and be prepared to upload all educational records to GEMR.
  5. Have a current GEMR (or equivalent) Emergency Medical Technician certification.
  6. Have a current Healthcare Provider level CPR certification, which meets all International Liaison Committee on Resuscitation (ILCOR) standards and upload the certification to GEMR.

Educational Program Expectations:

Educational programs, to meet the GEMR AEMT objectives, must have a minimum of 245 hours of training in the following sections during the educational program the candidate attended:

Didactic: 75 hours
Practical/Skills: 74 hours
Internship: 96 hours under the supervision of a Paramedic (or higher-level EMS certification) and/or Physician in a clinical setting, with daily observation reports done at the end of each workday; a minimum of 48 hours must be on an emergency medical services advanced life support (ALS) ambulance. The 96 hours must include a minimum of 40 documented patient contacts in which the AEMT candidate provided care within the AEMT scope.

Minimum Educational and Examination Objectives:

The Global Emergency Medical Registry (GEMR) establishes minimum standard educational objectives for the registry levels. The following are the current minimum educational objectives for an initial Advanced Emergency Medical Technician (AEMT) education program, the registry written examinations and psychomotor examinations are created from these objectives.

Click here for the PDF of the 2025 objectives

Responsibilities of Registry Certified Personnel:

Certified personnel must notify the Registry within 30 days regarding the following matters:

  1. Change in mailing address (the best way to update a mailing address is by editing your account profile)
  2. Any criminal conviction.
  3. Disciplinary action taken by any agency having jurisdiction (or government body) that has resulted in suspension, revocation, or expiration of registration/licensure; termination of right to practice; voluntary surrender of registration/licensure while under investigation.

The Registry considers the individual to be solely responsible for their certification and reporting, any failure to follow process or report as required is solely the failure of the certified person and may result in immediate dismissal of their certification, as well as, immediate notification to any pertinent regulatory agency of their dismissal.

Disciplinary Policy and Rights of Appeal for The Registry can be found on The Registry website.

GEMR Required Skills Attestation for Initial Certification:

All initial Certification Candidates must upload the following skills sheet documentation forms (located at https://www.gemr.org/library/), signed by the medical director or Course Director, to their transcript page of their profile by creating a “Skills Documentation” course in their transcript and uploading all the following:

  1. Bag Valve Mask Ventilation
  2. Bleeding Control (BLS)
  3. Bleeding Control Combat Application Tourniquet
  4. Blood Glucose Assessment
  5. Bradycardia (Block)
  6. Bradycardia (Sinus Brady)
  7. Cardiac Arrest Ventricular Fibrillation (ALS)
  8. Cardiac Arrest Pulseless Electrical Activity (ALS)
  9. Continuous Positive Airway Pressure (CPAP)
  10. ECG Limb and 12 Lead Acquisition
  11. Hand Washing
  12. Intravenous Access
  13. Medication by Auto Injector
  14. Medication by Intramuscular and Subcutaneous Injection Routes
  15. Medication by Intranasal Route
  16. Medication ny Intravenous Route
  17. Medication by Nebulization Route
  18. Medication by Oral Chewable Route
  19. Medication by Oral Gel Route
  20. Medication by Oral Route
  21. Medication by Rectal Route
  22. Nasal Pharyngeal Airway
  23. Oral Pharyngeal Airway
  24. PPE Donning and Removing Gloves and Gown
  25. Physical Exam (Adult)
  26. Physical Exam (Pediatric)
  27. Quantitative Waveform Capnography
  28. Spinal Immobilization ALS Case (IMMO Protocol for Spinal Injury #1)
  29. Supraglottic Airway Respiratory Arrest

GEMR Written Examination:

At the conclusion of initial training, the candidate must complete their profile on gemr.org, upload all skills sheets, CPR certification, certificate or diploma, and highest level of education completion certificate to their skills and transcript area of their profile.

The candidate will then receive an invitation to test for the GEMR Online Testing System, the candidate must score a minimum of 85% to show compliance with the standard and successfully complete the examination process.

Initial Certification Completion:

Once all the above steps have been completed, and the candidate has been audited and completed the GEMR Exam with a score of 85% or greater, the candidate will be able to complete their registration payment and receive their certification.

Paramedic (PM) - Renewal Certification:

The GEMR Certification expires two years from the time of initial certification. During that two-year period, the certified individual must complete the following process to renew their certification.

GEMR Required Continuing Medical Education:

The certified individual must complete, document, and upload to their GEMR profile transcript the following continuing medical education (CME), prior to the end of their certification period. All CME must be from an accredited organization and the CME certificate must include the topic, the number of hours, the date, the instructor or course director, the name of the organization and contact information, as well as the CME certificate must bear the accreditation logo(s) and accreditation number for the educational program. A maximum of fifty percent (50%) of the CME may be done online.

The following 52 hours are the required CME for AEMT Renewal:

1 hour Current Healthcare Professional CPR certification, including in person instructor led skills portion to ILCOR standards.
3 hours Airway, ventilation, capnography, and oxygenation.
7.5 hours Cardiovascular (Cardiac arrest, post cardiac arrest, ventricular assist devices, cerebrovascular accident, congestive heart failure, acute coronary syndromes).
3 hours Trauma (Trauma triage, hemorrhage, central nervous system, special needs, fluid resuscitation, blood administration, trauma assessment, chest trauma, orthopedic trauma).
7.5 hours Medical (Special healthcare needs, OB emergencies, Infectious disease, Pharmacology, Medication delivery, Pain management, Psychiatric and behavioral emergencies, Toxicological emergencies, Neurological emergencies, Endocrine emergencies, Immunological emergencies)
5 hour Operations (At risk populations, ambulance safety, casualty incidents, EMS safety, EMS hygiene, Vaccines, Culture of safety)

GEMR Required Skills Attestation:

The GEMR Certified AEMT must complete their skills documentation on their profile page, and those skills must be attested to by a medical director or designee through their own GEMR profile, all the following skills competencies are required for renewal:

  1. Bag Valve Mask Ventilation
  2. Bleeding Control (BLS)
  3. Bleeding Control Combat Application Tourniquet
  4. Blood Glucose Assessment
  5. Bradycardia (Block)
  6. Bradycardia (Sinus Brady)
  7. Cardiac Arrest Ventricular Fibrillation (ALS)
  8. Cardiac Arrest Pulseless Electrical Activity (ALS)
  9. Continuous Positive Airway Pressure (CPAP)
  10. ECG Limb and 12 Lead Acquisition
  11. Hand Washing
  12. Intravenous Access
  13. Medication by Auto Injector
  14. Medication by Intramuscular and Subcutaneous Injection Routes
  15. Medication by Intranasal Route
  16. Medication ny Intravenous Route
  17. Medication by Nebulization Route
  18. Medication by Oral Chewable Route
  19. Medication by Oral Gel Route
  20. Medication by Oral Route
  21. Medication by Rectal Route
  22. Nasal Pharyngeal Airway
  23. Oral Pharyngeal Airway
  24. PPE Donning and Removing Gloves and Gown
  25. Physical Exam (Adult)
  26. Physical Exam (Pediatric)
  27. Quantitative Waveform Capnography
  28. Spinal Immobilization ALS Case (IMMO Protocol for Spinal Injury #1)
  29. Supraglottic Airway Respiratory Arrest

GEMR Written Examination:

No written exam is required for renewal certification

Renewal Certification Completion:

Once all the above steps have been completed, and the candidate has been audited, the candidate will be able to complete their registration payment and receive their certification.

Reciprocity:

A person with one, or more, of the following, may apply for GEMR AEMT certification through reciprocity:

  1. The candidate who holds a current certification with the National Registry of Emergency Medical Technicians (NREMT), at this level or higher, may apply for reciprocity at this level, if their initial or CME training meets the scope of practice listed above.
  2. The candidate who holds a current license with a Province of Canada, at this level or higher, may apply for reciprocity at this level, if their initial or CME training meets the scope of practice listed above.
  3. The candidate who holds a current license with a Freely Associated State of the United States, at this level or higher, may apply for reciprocity at this level, if their initial or CME training meets the scope of practice listed above.
  4. The candidate who holds a current license with a State in the United States, at this level or higher, may apply for reciprocity at this level, if their initial or CME training meets the scope of practice listed above.
  5. The candidate who holds a current registration with the Paramedicine Board of Australia (PBA), at this level or higher, may apply for reciprocity at this level, if their initial or CME training meets the scope of practice listed above.
  6. The candidate who holds a current certification with the Pre-Hospital Emergency Care Council (PHECC), at this level or higher, may apply for reciprocity at this level, if their documented training meets the scope of practice listed above.
  7. The candidate who holds a current certification with the Health & Care Professionals Council (HCPC), at this level or higher, may apply for reciprocity at this level, if their documented training meets the scope of practice listed above.
  8. The candidate who holds a current certification with the Health Professions Council of South Africa (HPCSA), at this level or higher, may apply for reciprocity at this level, if their documented training meets the scope of practice listed above.
  9. The candidate who holds a current position with the National Fire Agency of Korea (NFA) and has completed the national examination process, at this level or higher, may apply for reciprocity at this level, if their documented training meets the scope of practice listed above.
  10. The candidate who holds a federal or state qualification in Germany (Rettungssanitäter, Notfallsanitäter/Notfallsanitäterin), at this level or higher, may apply for reciprocity at this level, if their documented training meets the scope of practice listed above.

In addition to the above, the candidate must show they have met all requirements for Certification Renewal at the time of application; if they are unable to do so, they must follow the initial application for certification process.