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Paramedics in Germany are the main providers of emergency care in emergency medical services in Germany. There exist two professional levels regulated by federal law, the Rettungsassistent and the Notfallsanitäter.
Both are able to provide the first level of pre-hospital emergency care. Additionally, they can get backup by an emergency physician on scene. Thus the German paramedic scope of skills include a set of advanced life support treatments, which they have to perform until an emergency doctor is on scene. Then the paramedics act under direct medical supervision of the physician.
Non life-threatening emergencies are handled solely by the paramedic ambulances without a physician on scene.
Other regulated qualifications in German EMS are Notarzt and the more basic emergency technician level Rettungssanitäter.