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).