ALS end of the spectrum, the model closely resembles the German version of the Franco-German model, with paramedics working with and under the direction of a physician. This represents, however, only the 5 percent of EMS personnel in the entire country who are paramedics, and only a single ambulance, out of 77 units in service. For the balance, the model much more closely resembles the Anglo-American model, with EMTs making their treatment decisions based upon local guidelines, albeit at a basic life support level, or at best, with the limited skill set of an EMT-I. Training Basic and Intermediate There is not currently an official national training standard for EMS personnel in Iceland. As a result, the training levels which operate by default are those currently in use in the United States. Training for EMT Basic, and EMT Intermediate are directly comparable with the U.S. standards. These are conducted by the Icelandic Centre for EMS Education. Paramedic Since paramedic training is currently unavailable in Iceland, most of these were trained and certified in the United States at the University of Pittsburgh's Center for Emergency Medicine. Paramedics scope of practice is similar to what paramedics in USA are used to, this includes stong analgesia, vasopressors and cardiac drugs. in Iceland. Paramedics are also sometimes used to provide care on air ambulance transports. Paramedics completing training in the U.S. are validated and certified by the Icelandic directorate of health. Skills There is, at the moment, limited governing legislation regarding the practice of EMS personnel in Iceland. This is particularly critical regarding the administration of medications. The Icelandic Parliament has assigned responsibility for oversight to the various local health authorities, and, as a result, there is considerable variation in permissible skills. The following, while far from complete, will serve as a general overview of permissible skills at the various levels of training: EMT-Basic Automatic External Defibrillator Supraglottal Airways (Laryngeal Mask, Laryngeal Tube, Fast Trach) EMT-Intermediate Automatic External Defibrillator Supraglottal Airways (Laryngeal Mask, Laryngeal Tube, Fast Trach) IV initiation Use of Epinephrine in Cardiac Arrest EMT-Paramedic Manual Defibrillation Supraglottal Airways (Laryngeal Mask, Laryngeal Tube, Fast Trach) IV initiation Use of Epinephrine in Cardiac Arrest Endotracheal Intubation Surgical Cricothyrotomy Communications Iceland uses the European emergency telephone number 112 for all emergencies. Dispatch, which used to be a local function, merged into two dispatch centres, and is in the process of merging into a single, integrated