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Paramedic Fireline

Position Description

The Paramedic Fireline incumbent provides emergency medical care on an active fireline, division or other physically challenging assignment.  This resource may also provide care in the medical unit and/or at other locations as directed by the Incident Commander or representative.

Introduction

The Paramedic Fireline (EMPF) provides advanced emergency medical care for injured and sick persons.  The position has the knowledge associated with, and is expected to be competent in all of the skills of the EMT and AEMT.  A Paramedic completes a more thorough course of education, which in some states requires the completion of an Associate’s degree.  The paramedic has an in-depth understanding of human anatomy, physiology and pathophysiology which allows them to perform more advanced skills and a broader spectrum of medications than either an EMT or AEMT.  These skills carry a greater risk for the patient if improperly or inappropriately performed, are more difficult to attain and maintain competency in, and require significant background knowledge in basic and applied sciences.

While all Paramedics receive essentially the same training, the specific procedures that each individual Paramedic is authorized to perform vary depending on the Paramedic’s scope of practice.  A Paramedic’s scope of practice contains only those procedures for which he or she is educated, certified (by passing an exam), credentialed (medical director grants “permission” to practice), and licensed by a state to perform.  Therefore, the scope of practice of a Paramedic will vary by individual.

The EMPF will be required to work on the fireline or other remote areas of an incident.  The EMPF would be expected to lead, or at a minimum participate in the evacuation of a sick or injured person from this environment.  The EMPF would also be expected to perform these lifesaving skills with the equipment available to them on the fireline, which is significantly less than those EMTPs in the medical unit or typical urban EMS system.  The EMPF may be the only medical provider on scene for an extended period of time in less than ideal conditions.  The EMPF may direct the others on scene in providing care on critically injured or sick patients and will generally have the role of team leader in these situations.

Skills, Knowledge, and Abilities

The following are the minimum psychomotor skills of the Paramedic:

  • Airway and Breathing
    • Perform endotracheal intubation
    • Perform percutaneous (not to include ‘surgical’ access using a scalpel) cricothyrotomy
    • Decompress the pleural space of the chest cavity
    • Perform gastric decompression
    • Monitor and interpret Patient oxygen and carbon dioxide levels
  • Pharmacological interventions include
    • Insert an intraosseous (IO) cannula
    • Enteral and parenteral administration of approved prescription medications
    • Access indwelling catheters and implanted central IV ports for fluid and medication administration
    • Administer medications by intravenous (IV), intraosseous, intramuscular, intranasal, sublingual, and subcutaneous routes
    • Maintain an infusion of blood or blood products
  • Medical/Cardiac Care
    • Perform cardioversion, manual defibrillation, and transcutaneous packing
    • Perform and interpret the results of Electrocardiogram (EKG) including 12-lead
  • Evacuation/Transportation
    • Evacuation of a sick or injured patient using purpose made and improvised litters
    • Appropriate triage of sick or injured patients in order to assist with the formulation of an evacuation plan

Position Knowledge and/or Requirements

  • Current Paramedic license (must be issued by the Paramedic’s home-state EMS licensing authority)
  • Introduction to ICS (ICS-100)
  • NIMS:  An Introduction (IS-700)
  • Firefighter Training (S-130)
  • Introduction to Wildland Fire (S-190)
  • Annual Fireline Safety Refresher (RT-130)
  • Human Factors in the Wildland Fire Service (L-180)
  • An arduous physical fitness level has been established for this position

Other Training Supporting Development of Knowledge and Skills

  • Intermediate Wildland Fire Behavior (S-290)
  • Basic Air Operations (S-270)
  • Helicopter Crewmember (S-271)
  • Advanced Cardiac Life Support (if not required for state licensure)

 

NWCG Latest Announcements

NEW! S-219, Firing Operations (Blended) Now Available

Date: Sept 11, 2025
Questions? Please contact:
Fuels Management Committee 

The S-219, Firing Operations (Blended) course is now available on the Wildland Fire Learning Portal. Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Firing Boss, Single Resource (FIRB) incident qualifications.

This blended course combines online and instructor-led training to provide students with the knowledge and skills required to perform the duties of the FIRB, as described in the NWCG Incident Position Standards for Firing Boss, Single Resource, PMS 350-105.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2026.

References:

S-219, Firing Operations (Blended)

NWCG Firing Boss, Single Resource Position Page

Wildland Fire Learning Portal

NWCG Committees Observe Suicide Prevention Awareness Week: September 7-13, 2025

Date: Sep 5, 2025
Questions? Please contact:
Mental Health Subcommittee

The NWCG Mental Health Subcommittee (MHSC) and Risk Management Committee (RMC) recognize the unique challenges and demands faced by the wildland fire community. The MHSC and RMC know that we are all stronger together and believe in fostering a culture of support, understanding, and resilience.

Suicide Prevention Awareness encourages us to actively connect with and support each other. For more information that could make a difference for yourself or someone else please review the materials and resources provided for the 2025 Suicide Prevention Awareness Week.

References:

2025 Suicide Prevention Awareness Week Materials and Resources

NEW! Incident Performance and Training Modernization Story Map Now Available

Date: Aug 26, 2025
Questions? Please contact:
National Wildfire Coordinating Group

NWCG is excited to announce the launch of the Incident Performance and Training Modernization (IPTM) Story Map, a new interactive resource that showcases how NWCG is transforming wildland fire training and qualifications through a performance-based system.

Since its launch in 2023, IPTM has made major strides in updating how we manage incident positions:

  • 36 incident positions now have new Incident Position Standards and Next Generation Position Task Books available for field use
  • 6 more incident positions are nearing completion
  • 111 total incident positions are being analyzed through the IPTM initiative

The Story Map guides you through the IPTM process, highlights key accomplishments, and outlines what’s ahead. Whether you are a trainer or a trainee, this tool offers valuable insight into the modernization effort shaping the future of wildland fire training and qualifications.

This effort would not be possible without the contributions of NWCG staff, NWCG committees, and hundreds of subject matter experts across the wildland fire community.

References:

IPTM Story Map

Incident Performance and Training Modernization Webpage

NEW! S-290, Intermediate Wildland Fire Behavior (Blended) Available Now

Date: Aug 15, 2025
Questions? Please contact:
Fire Behavior Subcommittee

NWCG is excited to announce that the S-290, Intermediate Wildland Fire Behavior (Blended) training is now available on the Wildland Fire Learning Portal. S-290 (Blended) training combines online training and instructor-led training components that support individuals working towards any Single Resource Boss or Fire Effects Monitor incident qualifications.

This second course in the series collectively serves to develop fire behavior prediction knowledge and skills, and provides more detailed information on fuels, weather, and topography that affect wildland fire behavior for safety purposes.

Students are required to finish the prerequisite S-190, Introduction to Wildland Fire Behavior, before enrolling in S-290, Intermediate Wildland Fire Behavior (Blended).

References:

S-290, Intermediate Wildland Fire Behavior (Blended)

S-190, Introduction to Wildland Fire Behavior

Wildland Fire Learning Portal