Emergency medical responders are people who are specially trained to provide out-of-hospital care in medical emergencies. There are many different types of emergency medical responders, each with different levels of training, ranging from first aid and basic life support. Emergency medical responders have a very limited scope of practice and have the least amount of comprehensive education, clinical experience or clinical skills of emergency medical services (EMS) personnel. The EMR program is not intended to replace the roles of emergency medical technicians or paramedics and their wide range of specialties. Emergency medical responders typically assist in rural regions providing basic life support where pre-hospital health professionals are not available due to limited resources or infrastructure. "Emergency medical responder" is a broad term, used either to describe a certain EMS certification level, or generally to describe those who respond to medical emergencies. Specifically used, an Emergency Medical Responder is an EMS certification level used to describe a level of EMS provider below that of an emergency medical technician and paramedic. Broadly used, a first responder is the first medically trained personnel who comes in contact with a patient. This could be a passerby, citizen volunteer, or fire department, police, or emergency medical services personnel. In Canada Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Advanced Care Paramedic (ACP) and Critical Care Paramedic (CCP) in Canada are the titles and levels of practitioners recognized by the National Occupational Competency Profile Paramedic Association of Canada. Generally speaking, Emergency Medical Responders (EMRs) require 80 to 120 hours of training. Primary Care Paramedic (PCP), depending on province, require generally a two-year diploma of paramedicine. Advanced Care Paramedics (ACP) require an additional year of training and clinical experience totaling three years of education, and Critical Care Paramedics (CCP) require a final year of education totaling four years of education. Under the new NOCP, most providers that work in ambulances are identified as 'paramedics'. However, in some cases, the most prevalent level of emergency prehospital care is that which is provided by the Emergency Medical Responder (EMR). Generally speaking, emergency medical responders (EMRs) require 80 to 120 hours of training. As a group, EMRs staff rural ambulance stations, community volunteer ambulance services, fire departments, police departments, industrial ambulances or mobile treatment centers. For many small communities, without this level of certification, the operation of a much-needed small community ambulance system might not be possible. EMRs across Canada