 For detailed description see article "Paramedics in Germany".Lower level qualifications enabling a person to work in EMS are the "Rettungssanitäter" (520 hour training) and "Rettungshelfer" (not standardized, around 240 hours out of the "Rettungssanitäter" curriculum).Both are not protected titles by federal law, but based on a national agreement of the German state ministry boards of 1977.