 These Critical Care Paramedics generally perform high acuity transports that require skills outside the scope of a standard paramedic (such as mechanical ventilation and management of cardiac assist devices).In addition, EMTs can seek out specialty certifications such as Wilderness EMT, Wilderness Paramedic, Tactical EMT, and Flight Paramedic.In 2009, the NREMT posted information about a transition to a new system of levels for emergency care providers developed by the NHTSA with the National EMS Scope of Practice project.