frameworks vary from province to province, and include direct government regulation (such as Ontario's method of credentialing its practitioners with the title of A-EMCA, or advanced emergency medical care assistant) to professional self-regulating bodies, such as the Alberta College of Paramedics. In Alberta, for instance, only someone registered with the Alberta College of Paramedics can call themselves a paramedic; the title is legally protected. Almost all provinces have moved to adopting the new titles, or have at least recognized the NOCP document as a benchmarking document to permit inter-provincial labour mobility of practitioners, regardless of how titles are specifically regulated within their own provincial systems. In this manner, the confusing myriad of titles and occupational descriptions can at least be discussed using a common language for comparison sake. Emergency medical responder Most providers that work in ambulances are identified as "paramedics" by the public. However, in many cases, the most prevalent level of emergency pre-hospital care is that which is provided by an emergency medical responder (EMR). This is a level of practice recognized under the National Occupational Competency Profile, although unlike the next three successive levels of practice, the high number of EMRs across Canada cannot be ignored as contributing a critical role in the chain of survival, although it is a level of practice that is least comprehensive (clinically speaking), and is also generally not consistent with any medical acts beyond advanced first-aid and oxygen therapy, administration of ASA, I.M. epinephrine and glucagon, oral glucose and administration of intranasal Narcan with the exception of automated external defibrillation (which is still considered a regulated medical act in most provinces in Canada). Primary care paramedic Primary care paramedics (PCP) are the entry-level of paramedic practice in Canadian provinces. The scope of practice includes performing semi-automated external defibrillation, interpretation of 4-lead ECGs, administration of symptom relief medications for a variety of emergency medical conditions (these include oxygen, epinephrine, dextrose, glucagon, salbutamol, ASA and nitroglycerine), performing trauma immobilization (including cervical immobilization), and other fundamental basic medical care. Primary care paramedics may also receive additional training in order to perform certain skills that are normally in the scope of practice of advanced care paramedics. This is regulated both provincially (by statute) and locally (by the medical director), and ordinarily entails an aspect of medical oversight by a specific body or group of physicians. This is often referred to as "medical control", or a