Very interesting. You guys have added an extra level to the three basic levels we have here - EMT-3. Our basic recognized levels are EMT-Basic, EMT-Intermediate, and EMT-Paramedic. Basic = EMT-1 Intermediate=EMT-2 with the addition of D50 and Patient assisted MEdications (ie the pt's own NTG and ASA). The also get Cardiology and defibrillation. Paramedic - You EMT-P as well. All the drugs, offline protocols, etc. The roles here are also being changed currently. Within a few years there will be a recognized Advanced Practice Paramedic who basically does what your PP's do now. On a side notw, currently I actually fill that role offshore, but since it's not an actual nationally recognized "level" yet I am titled a Paramedic with Advanced Clinical Practice - ie I took an extra course to do what I do. Oh, and those skills are only recognized by my offshore service. I can't use them anywhere else.