Becoming an EMT in California
California Emergency Medical Technician (EMT) training is similar to many other states. Becoming an EMT in California begins with going through an approved EMT program, passing the National Registry of EMT (NREMT) exams, and then getting approved for a California state EMT license.
Scroll down for more detailed information about each step in the California EMT training process.This page will also discuss California EMT scope of practice skills that emergency medical technicians of all levels are allowed to perform on the job.
EMS Levels Recognized in California
• Emergency Medical Responder (EMR)
• Emergency Medical Technician (EMT)
• Advanced Emergency Medical Technician (AEMT)
• Paramedic (EMT-P)
• Critical Care Paramedic (CCP)
EMT Requirements California
EMT training in California is offered at many schools and institutions throughout the state. Most EMT schools in California only offer the Emergency Medical Technician (EMT) or Paramedic programs for study.
The Advanced emergency medical technician (AEMT) certification is used mostly in rural areas of California. In fact, the AEMT may be the only EMS personnel available to provide immediate medical attention in those areas.
The AEMT certification is not recognized statewide so if you want to work as an AEMT, you should contact the local Emergency Medical Services Agency (LEMSA) in the area you want to work in.
When signing up for a California Paramedic program make sure the course is accredited. For an extensive list of approved California EMT training programs and accredited Paramedic programs in California go here: List of EMT schools.
A Critical Care Paramedic (CCP) is the highest level of EMS personnel recognized by the State of California. CCPs are paramedics with additional training and an expanded scope of practice which allows them to do critical care transports.
Critical care paramedics don’t need to be accompanied by a registered nurse during transports and are frequently used by flight ambulances. Critical care paramedics are accredited by a LEMSA and CCP training is done at a local level.
Like the AEMT, the critical care paramedic accreditation is not recognized statewide.
EMT schools in California teach students to respond quickly to emergency situations and transport the sick and injured while providing life saving care.
California EMT training programs prepare graduates to work in the field, make them competent to complete patient assessments, identify signs and symptoms of an emergency, and respond with the appropriate treatments.
After graduating from EMT training, students in California will be able to perform life-saving skills and respond to emergency situations with confidence. Some of these life-saving skills include managing myocardial infarctions, stabilizing fractures, hemorrhage control, and administering oxygen.
Some common emergency situations a California EMT will respond to are cardiac arrest, motor vehicle accidents, gunshot wounds, and falls.
EMT Schools in California
EMT schools in California all have a set of requirements which must be met in order to be accepted into the different levels of EMT training. Each EMT school in California training program can have slightly different requirements for entry, but in general most schools will have the following prerequisites.
• A California EMT must be 18 years old to have a California state EMT license. Some EMT training programs allow candidates to enter their program at 17 1/2 years old. However, they must be 18 years old by the end of the EMT training program.
• EMT schools in California require a high school diploma or GED certificate.
• EMT schools in California require applicants to complete the American Heart Association CPR-BLS for the Healthcare Provider. An acceptable alternative is American Red Cross BLS–CPR for the professional rescuer. (Some EMT programs include this as part of the EMT course instead of as a prerequisite.)
• Some California EMT programs require a current Drivers License.
• EMT schools in California require candidates have proof of Current Health Insurance. Some schools require students to stay insured throughout the entire California EMT training program. Some only require Health insurance during the clinical and ride along portion of the program.
• Some EMT schools in California will require a fingerprint based National background check and clean drug test. All candidates will eventually be required to pass the background check to obtain a California state EMT license.
• Applicants for EMT training in California must have a current negative TB skin test.
• EMT schools in California require applicants show proof of immunizations or titers for the following:
– MMR (Measles, Mumps, Rubella)
– Varicella (Chicken Pox)
• California EMT training programs in California require applicants show proof they have begun the Hepatitis B series of vaccinations. Usually 2 of the 3 shots done by the first day of class.
• Many EMT schools in California require a flu vaccine within the last year.
• Some EMT schools in California will require students to complete an English, Math, or Reading class as a requirement for school enrollment.
• Many California EMT training programs require applicants to pass a physical and obtain medical clearance from a physician. This clears students to meet the physical demands involved in EMT schooling. Often this can be done at the schools Student Health Center.
California EMT School Curriculum
California EMT programs are approved by State and Local EMS agencies based in different counties. For this reason, EMT training programs throughout California may have extra training hours specific to local areas.
However, there is a set of basic requirements all EMT schools in California must meet in order to be approved.
Basic EMT training in California requires at least 170 hours of training. Most programs exceed this amount of training hours. The training requires candidates have at least 10 patient contacts with at least 24 hours of clinical training and 146 hours of didactic and skill training.
Clinical Training: 24 hours
Didactic & Skills: 146 hours
Total: 170 hours
Advanced EMT training in California is usually offered as additional training after obtaining an EMT certificate. AEMT training in California requires at least 160 more hours of training, with a minimum of 15 patient contacts using Advanced Life Support (ALS).
At least 80 hours must be didactic and skill training, 40 hours must be clinical training, and there must be at least 40 hours of field internship.
Didactic & Skills: 80 hours
Clinical Training: 40 hours
Field Internship: 40 hours
TOTAL: 160 hours
There are many Paramedic training programs throughout California. Some require six months to a year of previous work experience as an EMT and some don’t require any experience for admission. All California Paramedic programs require at least a total of 1,090 hours of training with 40 ALS patient contacts.
At least 450 hours will be didactic and skill training and a minimum of 160 hours will be hospital and clinical training. The field internship training portion will be a minimum of 480 hours long.
Didactic & Skills: 450 hours
Hospital Clinical: 160 hours
Field Internship: 480 hours
TOTAL: 1,090 hours
California Critical Care Paramedic training programs can be found at local level by contacting LEMSAs. California programs require three years experience working as a paramedic before you can begin training to be a critical care paramedic. CCP training in California must be at least 202 hours.
There will be at least 108 hours of didactic and skills along with a minimum of 94 hours of hospital and clinical training.
Critical care paramedics are not tested through the NREMT like other levels of certification in California.
Instead a paramedic must get certification with the Board for Critical Care Transport Paramedic Certification (BCCTPC) by taking and passing their certification exam.
Didactic & Skills: 108 hours
Hospital Clinical: 94 hours
TOTAL: 202 hours
National EMT Certification
After completing EMT school in California, the next step is to pass the National Registry of EMT (NREMT) exams. Once candidates pass both these exams, they earn a National EMT certification from the NREMT. For more detailed information on both the exams check out our NREMT exam page.
The first NREMT exam is the Psychomotor exam and will be introduced to students by their EMT training instructor. The psychomotor exam is a practical, hands on test of the EMTs abilities.
Students usually schedule their exam towards the end of their California EMT training with the help of their school instructor.
Check out our tips for passing the psychomotor exam page for extra help.
The other exam candidates must pass to get their National EMT certification is the NREMT Cognitive Exam.
The Cognitive exam is a written exam administered using a computer which asks candidates to choose the MOST correct answer. California EMT Candidates can sign up for the computer adaptive test by going to the National Registry of EMT website and registering for a Cognitive exam test date.
Once a candidate has successfully passed both the psychomotor and cognitive exam in California, they will be contacted by the National Registry of EMTs.
The NREMT will automatically send a letter of congratulation along with your California EMT certification in the mail. At this point, many people want to begin working as a California EMT as soon as they can.
Can you begin working as an EMT once you get the NREMT certification?
The answer is:
First you must get your California State EMT License by applying at your local EMS agency (LEMSA). All candidates must get an EMT state license in California before they can work.
California State EMT License
The California state EMT license is also known as a California EMT certification or California EMT license. It is different from the National Registry of EMT certification because the California state EMT license is on a state level, while the NREMT certification is on a National level.
Candidates can apply for the California state EMT license at their local EMS agency (LEMSA). Below is a map of California LEMSAs by county:
EMT Requirements for Licensure
EMTs must apply for their state license at their local EMS office which means requirements will vary slightly by county. Most requirements are consistent throughout the state, but local agencies may require additional classes and charge different fees.
• A California EMT must be 18 years of age to be licensed by the state.
• An EMT in California must complete an EMT training program, this requires a High School diploma or GED.
• Turn in a completed application to their local EMS agency.
• A California EMT must successfully pass both NREMT exams.
• Have a government issued Drivers License, Passport, or California I.D.
• Complete a LiveScan fingerprint based FBI and Department of Justice (DOJ) background check.
• A California EMT must have active CPR and BLS for the Healthcare Provider (HCP) card.
• Pay a certification fee which varies by county. Examples: $75 in Monterey, $112 in Kern, and $160 in Los Angeles.
• A California EMT must complete any Local Agency Required training, which can vary by county. For example, Los Angeles requires a 4 hour Basic Tactical Casualty Care, Epinephrine Auto-injector, Glucometer, and Naloxone training classes.
California state EMT license applications will also require applicants to answer the following questions:
– Are there any criminal charges currently pending against you?
– Have you ever been arrested or convicted of any felony or misdemeanor offense in California or in any other state or place, including entering a plea of nolo contendere (no contest) or any conviction which has been sealed or expunged (set aside) under Penal Code Section 1203.4?
– Have you had a certification, accreditation, or professional healing arts license denied, suspended, revoked or ever placed on probation, or are you under investigation at this time?
– Have you applied for EMT certification with another EMS Agency or Department in California within the previous 12 months? If yes, list location(s)
Forms to Submit when Applying for EMT License
• Completed EMT Application
• Copy of government issued Photo I.D.
• Copy of CPR-BLS for HCP card
• Copy of NREMT card
• Course completion certificate from EMT training program
• Completed LiveScan Form
AEMT Requirement for Licensure
• All the requirements listed above for EMTs.
• EMT Certificate.
• Submit copy of current AEMT course completion certificate.
• Pass both the written and practical National Registry of Emergency Medical Technician AEMT certification examinations.
• PALS Card (Required in Some Counties).
Paramedic State Licensure California
Paramedics in California have a different process than EMTs to apply for their state license. Unlike EMTs, Paramedics can apply for licensure on the California Emergency Medical Services Authority (EMSA) site.
Paramedic application packets can be found at https://emsa.ca.gov/paramedic/ and are the same for all applicants, regardless of county.
It’s important to fill out the application correctly and include all the requested paperwork because incomplete applications will be mailed back.
California Paramedic Requirements
• California paramedics must be 18 years of age to become licensed.
• Paramedics in California must have a High School diploma or equivalent.
• Have an EMT certificate.
• Have a CPR BLS for HCP Card.
• Complete a LiveScan Background check – Fingerprint based DOJ and FBI criminal history check.
• Submit Proof of passing the National Registry of EMT paramedic exams within the past two years or current NREMT paramedic certification.
• Submit proof of citizenship, alienage, or immigration status. Paramedic license applicants must submit documentation showing proof of citizenship, naturalization or eligibility.
• Pay a $250 fee to EMS Personnel Fund.
The paramedic license application will also ask the following questions which must be answered and explained to avoid having the application returned to you.
1. Have you ever been convicted of any felony or misdemeanor offense in California or in any other state or place, including entering a plea of nolo contendere or no contest and, including any conviction which has been expunged (set aside) or records sealed under Penal Code Section 1203.4?
2. Are there any criminal charges currently pending against you?
3. Have you ever had a certification, accreditation, or professional healing arts license denied, suspended, revoked, placed on probation, or are you under investigation at this time?
Forms to Submit when Applying for Paramedic License
• Completed Paramedic Application Packet.
• Copy of Course Completion Certificate from Paramedic training packet.
• Documents that prove successful completion of NREMT paramedic Cognitive and Psychomotor exams.
• Submit an original or certified copy of birth certificate. Can also submit other documents for proof of citizenship.
• Submit a copy of completed Live Scan form. (Form BCII)
• Pay $250 fee by credit card, check or Money order to EMS Personnel Fund.
California EMS Authority will review your completed documentation and your paramedic license will be issued within 45 days of the date it was received.
What is Paramedic Accreditation?
In California once licensed with the NREMT and the State, paramedics must get accredited to practice within a local jurisdiction. Paramedic accreditation is done through the local EMS agency and can have different requirements per county. Basically, the paramedic must be sponsored by their employer to get accredited.
Most counties require the paramedic to fill out an application for accreditation and some require additional testing and training. The paramedic may be required to submit a letter of sponsorship or verification of employment to their local EMS agency.
Many counties also have a fee that must be paid. Usually local accreditation is renewed along with the state paramedic license, as long as there is no gap in employment.
Critical Care Paramedic License Requirements
• Must have a Paramedic license.
• Must have three years experience working as a paramedic.
• Submit Course Completion Certificate for Critical Care Paramedic training course.
• Submit proof of passing the Certified Critical Care Paramedic (CCP-C) examination.
California Scope of Practice
The California EMT scope of practice is a set of EMS protocols that guide all Emergency Medical Response Personnel. EMT scope of practice helps emergency medical responders to manage emergency situations and provide the correct emergency medical care and treatment interventions for patients.
In California, scope of practice standard for all levels of EMT and Paramedic are developed, implemented, and governed by the EMS Authority. California allows LEMSA to give EMTs additional skills when desired by adding training classes.
EMT Scope of Practice California
A California EMT can perform all of the following skills per state protocols:
1. Can perform patient assessments.
2. Can apply advanced first aid to patients as needed.
3. Administer certain OTC Medications which are approved by local EMS agency (LEMSA).
4. EMT can assist the patient in self-administration of nitroglycerine, auto-injecting epinephrine and auto-inhalers.
5. Administer aspirin for chest pain that is suspected to be cardiac related.
6. Administer oral glucose paste.
7. Transport ill & injured persons.
8. Administer supplemental oxygen therapy.
9. Can use adjunctive breathing aides: A)Nasopharyngeal airway & B) Oropharyngeal airway.
10) Can perform basic management of cardiac emergencies including the use of an Automated External Defibrillator (AED).
11) Can perform cardiopulmonary resuscitation (CPR).
12) Can use tourniquets and hemostatic dressings for bleeding control.
13) Can use pulse oximetry devices on patients.
14) Can use a humidifier for supplemental oxygen as needed.
15) Can use Positive Pressure Ventilation Devices.
16) Can use suctioning equipment.
17) Can use a bag-valve mask.
18) Can use CPAP and BiPaP devices.
19) Can use a manually triggered oxygen powered ventilation device.
20) Can use Mechanical CPR Device – An automated device used to provide chest compressions on a patient in cardiac arrest.
Optional EMT skills that can be added at the local level
1. Use of Perilaryngeal airways.
2. Use of Epi-pens.
3. Use of Duodote auto-injector kits. (Nerve agent)
4. Can administer Naloxone.
5. Can administer Epinephrine.
6. Can use Glucometer testing.
7. Can use Impedance Threshold Device – enhances the changes in intrathoracic pressures during CPR.
AEMT Scope of Practice California
Can perform all interventions and administer all medications the EMT can, including optional EMT skills, along with the following:
1. Can perform peripheral intravenous (IV) insertion.
2. Can administer IV fluid therapy including: A)Lactated Ringer
B)Dextrose solution and C)Normal Saline.
3. May administer four approved medications/solutions through IV access.
4. Can perform Intraosseous Infusions (IO) in pediatric patients as an Advanced Life Support (ALS) procedure when IV access is not available.
5. Administer Glucagon in a hypoglycemic patient who is unconscious or cannot take oral glucose.
6. Administration of the following drugs in a route other than intravenously: Nitroglycerin, Aspirin, Glucagon, Beta-2 agonist (bronchodilators), Naloxone, and Epinephrine. (Many EMTs can get trained on a local level to administer these medications.)
7. Administer Activated Charcoal Suspension.
8. Obtain IV access for the purpose of obtaining a venous blood sample.
9. Can perform Tracheo-bronchial suctioning.
Optional AEMT Skills at a Local Level
1. Capnography for ET Tube and Airway placement confirmation.
Paramedic Scope of Practice California
Can perform all EMT & AEMT skills and medications along with the following:
1. Can use Automatic Transport Ventilator – provides positive pressure ventilation automatically.
2. Can perform Endotracheal Intubation in an adult patient.
3. Can perform Facilitated Intubation – use of a non-paralytic sedative to assist intubation.
4. Can administer 25 medications.
5. Can insert Supraglottic Airway Device: Laryngeal Mask Airway and iGel are acceptable in California.
6. Can perform Nasotracheal Intubation.
7. Can perform Indirect Laryngoscopy using Video Devices: This is to visualize the airway help facilitate endotracheal intubation using a video laryngoscope device.
8. Can perform a foreign body obstruction (FBO) with forceps using a Laryngoscope to visualize the airway.
9. Can perform Synchronized Electrical Cardioversion.
10. Can perform Manual Defibrillation
11. Can perform Manual Electrocardiography Interpretation – using an electrocardiograph (EKG) to record and interpret the electrical activity of the heart.
12. Can perform Transcutaneous Pacing.
13. Can perform Vagal Maneuvers – for example carotid sinus massage and Valsalva maneuver.
14. Can perform a needle thoracostomy.
15. Can perform a percutaneous needle cricothyroidotomy.
16. Can perform nasogastric and orogastric tube insertion and suction.
17. Can monitor thoracostomy tubes.
18. Can monitor and adjust potassium (< 40 mEq/L) IV lines.
Optional Paramedic Skill at Local Level
1. Can perform Pediatric Oral Endotracheal Intubation.
2. Perform Blood Chemistry Analysis
3. Can treat patients with mechanical circulatory support devices. This includes a range of devices that include Ventricular Assist Devices (VAD) and total artificial hearts.
4. Able to use magnets for control of Automatic Implantable Cardioverter Defibrillators (AICD).
5. Emergency administration of a vaccine/immunization during a public health medical emergency.
6. Can apply Reactive Skin Decontamination Lotion (RSDL) to remove or neutralize chemical warfare agents.
7. Can apply Pneumatic Anti-shock Garment (PASG).
8. Can perform Surgical Cricothyrotomy.
Critical Care Paramedic Scope of Practice California
Can perform and administer all EMT, AEMT and Paramedic skills and medications. A CCP can also perform the following:
1. Can set up and maintain thoracic drainage systems.
2. Can set up and maintain mechanical ventilators.
3. Can initiate and maintain IV fluid delivery pumps and devices.
4. Can initiate and maintain blood and blood products.
5. Can administer Glycoprotien IIB/IIIA inhibitors.
6. Can administer IV Heparin and IV Nitroglycerin.
7. Can administer Norepinephrine.
8. Can administer Thrombolytic agents.
9. Can initiate and maintain total parenteral nutrition (TPN).