In the United<unk> s, the licensing of prehospital emergency medical providers (emergency medical technicians) (EMTs) and oversight of emergency medical services are governed at the<unk> <unk>  Each<unk>  is free to add or subtract<unk>  as each<unk>  sees fit. Therefore, due to differing needs and system development paths, the<unk> , education requirements, and scope of practice of prehospital providers varies from<unk>  to<unk> . Even though primary management and regulation of prehospital providers is at the<unk> <unk>  the federal government does have a model scope of practice including minimum skills for EMRs, EMTs, Advanced EMTs and Paramedics set through the National Highway Traffic Safety Administration (NHTSA). While<unk> s are able to set their own additional requirements for<unk>  certification, a quasi-national certification body exists in the form of the National Registry of Emergency Medical Technicians (NREMT). The NREMT offers a national certification based on the NHTSA National Standard curriculum for the<unk>  of EMR, EMT, Advanced EMT and Paramedic. Individual<unk> s are allowed to use NREMT certification as part of their certification process, but are not required to. As of 2011, 38<unk> s use the NREMT examination for EMT certification and 45<unk> s use the NREMT examination for Paramedic certification. These<unk>  are denoted below using an asterisk (*). At present time, use of the NREMT examination for EMT-Intermediate 85 and 99 have not been included in this list. Any provider between the<unk>  of EMT-Basic and EMT-Paramedic is either a form of EMT-Intermediate or an Advanced EMT. The use of the terms "EMT-Intermediate/85" and "EMT-Intermediate/99" denotes use of the NHTSA EMT-Intermediate 1985 curriculum and the EMT-Intermediate 1999 curriculum respectively. In addition, not all<unk> s use the "EMT" prefix for all<unk>  (e.g. Texas uses EMT-Paramedic and Licensed Paramedic). Finally, some<unk> s have<unk>  that have partially been phased out. While no new certifications are provided at this<unk>  providers can sometimes be grandfathered in provided they meet recertification requirements. Any<unk> that has been completely phased out (i.e. not used for new or continuing providers) is not listed. In some<unk> s there are also EMS-RN's which is a Registered Nurse trained in Pre-Hospital response. In the list, each<unk> 's certification<unk>  are provided from most basic at the top to most advanced at the bottom.
Emergency medical responder levels by U.S. state
Patient under investigation
Simulated patient
Safety of emergency medical services flights
Japan Air Lines food poisoning incident
Bihar school meal poisoning incident
HIV-affected community
Impossible trident