Wherever you go in America, the police will likely be identifiable in their blue or black (sometimes tan or khaki) uniforms, duty belts, sleeve patches, body cameras, badges and other standard professional accoutrements. Ditto for firefighters, be they in stationwear or bunker gear. In both cases, emergency professionals don’t usually look dramatically different from one town to the next.
EMS providers, on the other hand, often show a little more variety in their attire. Rather than the usual palette, some departments may opt for grey (especially among third services), white (especially among hospital-based services), high-visibility yellow or green to be seen on roadsides (sometimes with reflective striping) and even red (for high-visibility personnel at mass events, etc.). Some departments even allow short pants for certain warm-weather duties.
Like many other areas of the emergency medical services, this difference is a result of the unique historical path EMS took to become the third leg of the public safety tripod. Here’s what to know about EMT and paramedic uniforms.
What kinds of EMT and paramedic uniforms were worn historically?
Before the modern era of American EMS (1966 onward), emergency care was often provided by funeral homes or police or fire departments, and uniforms were not standardized. Those who drove early ambulances often wore police or fire uniforms or civilian clothing.
When organized EMS systems began developing in the early 1970s, many early fire-based services wore paramedic and EMT uniforms that were derived from or resembled firefighters’ – which made sense given many were cross-trained. Some wore turnout coats or bunker gear even on medical calls.
Other services developed different EMT and paramedic uniforms. Volunteer, private and hospital-based agencies wore a variety of white and light-colored shirts with shoulder patches; scrubs, jumpsuits or coveralls; and even civilian clothing with jackets or badges in some rural and lower-budget settings.
How did EMT and paramedic uniforms become more standardized?
With the 1980s and emergence of the national standard curriculum for paramedics, leaders at the U.S. Department of Transportation began working to improve EMS professionalism, and paramedic and EMT uniforms began to mature. Agencies started adopting distinct EMT and paramedic uniforms that distinguished EMS providers from police and fire, and the Star of Life – first trademarked in 1977 – became a common symbol on patches and jackets that identified EMS.
How did EMT and paramedic uniforms reach their current appearance today?
In the 1990s and early 2000s, with the rise of safety concerns, paramedic and EMT uniforms began adding reflective tape for further visibility. Boots, uniform shirts and tactical pants became standard. Color coding became a bit more developed, with many services adopting navy blue uniforms for EMS, darker or black for tactical medics, and red for special teams with high-visibility needs.
EMT and paramedic uniforms today adhere to ANSI/ISEA 107 for visibility on roadways and OSHA standards for safety. Certified garments are constructed of fabrics that are moisture-wicking and don’t melt or drip when exposed to flame. Badging and clear lettering help distinguish EMS from police.
Specialty uniforms may include dress and tactical uniforms, modular uniforms for different environments, and even body armor.
What are the standard current components of EMT and paramedic uniforms?
Uniforms must balance functionality, safety and professional appearance. Precise elements can vary by state and agency, but some components are universal:
- Shirt: Paramedic and EMT uniforms often feature shirts that are polo, button-down or tactical style. In some informal settings (e.g., in station or during training), T-shirts may be allowed. Colors may vary, but navy blue, black, grey and white are common. EMS shirts usually have department patches on the shoulders, an embroidered or metal name tag, and Star of Life insignia and/or “EMS,” “EMT” or “Paramedic” lettering. Materials are often moisture-wicking, flame-retardant and stain-resistant.
- Pants: The pants in EMT and paramedic uniforms may be standard uniform trousers, tactical pants or cargo pants, generally made of durable ripstop or poly-blend fabric. Knees may be reinforced. These pants will have multiple cargo pockets for the many items EMS providers must carry and be in dark colors to hide stains.
- Outerwear: Paramedic and EMT uniform outerwear can encompass duty jackets (lined and water-resistant), fleece or softshell jackets and high-visibility (ANSI Class II- or III-compliant) vests or coats. These often feature reflective striping, an agency name or provider designation on the back, and zip-out linings for varying temperatures. Outerwear may contain badge holders, radio loops and ID windows.
- Headgear: Rescue and tactical medics may wear helmets. Agencies may also allow baseball caps with an agency logo or the wearer’s title or knit caps if they’re in cold environments.
- Footwear: The footwear in paramedic and EMT uniforms is frequently black leather or composite-duty boots, often with a steel or composite toe. These are generally waterproof and resistant to bloodborne pathogens, with slip-resistant soles.
- Accessories: Accessories to EMT and paramedic uniforms can include duty belts or vests to carry items such as gloves, flashlight, trauma shears, tourniquet, radio and phone. Some higher-risk jurisdictions and more safety-focused departments have added body armor.
- Personal protective equipment: PPE is essential to protect EMS providers against droplets, splashes and other potential vectors of transmission from those they treat. It generally includes gloves (nitrile or trauma gloves), safety goggles or eye protection, and potentially a mask or respirator. Paramedic and EMT uniforms may also feature radio accessories (earpieces, lapel mics) and portable body-worn cameras.
Is hearing protection part of paramedic and EMT uniforms?
Hearing protection generally isn’t a standard part of paramedic and EMT uniforms outside the flight setting. Because helicopter rotors and turbine engines can generate more than 100 decibels of noise, helicopter EMS crews wear aviation headsets with active noise cancellation and helmet-integrated communications.
Some EMS systems do recommend or issue earplugs or other protection, as sirens can reach 120–130 decibels inside the ambulance. Providers on tactical teams and responders to certain types of incidents may wear tactical hearing protection.
Risks to hearing must be balanced with the need to hear patient sounds, monitor medical equipment and communicate with others on the care team.
Do EMTs and paramedics have multiple uniforms for different occasions?
EMS providers may be issued dress uniforms in addition to their regular working gear. These may be worn for ceremonies, public events and colleagues’ funerals. They often include a white or blue button-down shirt, dress pants, blazer or tunic with a badge, service hat and polished shoes or boots, along with any commendation ribbons.
How do EMT and paramedic uniforms differ in fire-based EMS systems?
EMTs and paramedics in fire-based systems typically wear the same base uniform as fire-suppression personnel. This promotes unity, interoperability and a cohesive public image.
Fire departments may issue Class A uniforms for ceremonies, Class B uniforms for inspections and other public events, and stationwear for periods between calls. EMS providers in fire-based systems may be distinguished by special shirts or jackets, patches, vehicles or radio identifiers.
Dual-role firefighter-EMTs and firefighter-paramedics may wear full turnout gear for fires, vehicle extrications and hazardous-materials responses. Single-role EMS personnel may alternatively wear lighter gear that’s less fire-protective.
Where can I buy a paramedic or EMT uniform?
If you’re affiliated with an EMS agency, start by checking with your supervisor or logistics coordinator. Many agencies issue uniforms directly or have contracts with specific vendors.
Beyond that, major national vendors of uniforms and components include:
- 5.11 Tactical
- Blauer
- Elbeco
- First Tactical
- Flying Cross
- Galls
- Propper
- Quartermaster
- Red Kap
- TheFireStore
- Uniform Advantage
You can also look to local shops that serve police, fire and security personnel, as well as Amazon, which offers EMS pants, boots, polo shirts and accessories, and other major ecommerce platforms. Look for the ability to customize; agency purchasing portals and support for bulk ordering; compliance with NFPA, ANSI and other relevant guidelines; and customer-friendly fitting options and return policies.
What standards or certifications (e.g., ANSI, NFPA, OSHA) should EMT and paramedic uniforms meet?
Uniforms aren’t usually directly defined by statute; instead, agencies adopt consensus standards that may be written into federal rules or referenced in state codes. Buying garments accredited by third parties is the best way to exhibit compliance.
Core consensus standards often reflected in EMS clothing include the NFPA 1999-2018 standard on protective clothing for emergency medical operations; ANSI/ISEA 107-2020 for high-visibility safety apparel and accessories; and NFPA 1975-2019 for emergency services work apparel. Garments that comply with NFPA 1999 or 1975 must display a permanent label that shows the standard, edition year and logo of an accredited certifier such as the Safety Equipment Institute (SEI) or Underwriters Laboratories (UL).
Federal rules relevant to EMS uniforms that carry the force of law include 23 CFR Part 634 (the roadway worker visibility rule); OSHA 29 CFR 1910.1030 (bloodborne pathogens standard); and OSHA 29 CFR 1910.132 (general PPE rule). All states enforce these CFR sections.
How do paramedic and EMT uniform choices change for extreme heat, cold or wildland environments?
EMTs and paramedics often work outdoors and in the elements. This can make them vulnerable to environmental extremes.
Risks of extreme heat include sun exposure, heat stress and dehydration. Uniforms designed for this setting may include lightweight, breathable, moisture-wicking polos or t-shirts (when allowed); UPF-rated fabrics for UV protection; and vented or mesh-backed designs. Consider lightweight tactical EMS pants with breathable gussets and ripstop construction. Wide-brim hats and light caps can reduce sun exposure. Moisture-wicking socks may help avert blistering.
The primary risk of extreme cold is hypothermia. Thermal or merino wool underlayers can wick moisture and retain heat, and thermal underwear can support standard EMS pants. Look for insulated, water-resistant duty jackets with ANSI-compliant reflective striping, fleece or softshell midlayers and zip-out liners. Footwear can include waterproof, insulated boots with cold-rated soles and multiple layers of socks. Cold-weather gloves can preserve dexterity while meeting NFPA and OSHA standards
Remote and wildland settings can subject providers to rough terrain and dynamic weather. Look for Nomex or FR-rated brush gear and wildland-rated overpants and jackets; lightweight outerwear that resists tearing and complies with wildland PPE standards; wildland boots with high-performance rubber soles and reinforced toe/heel; and helmets/hard hats with neck shrouds.
Are there special considerations to washing EMT or paramedic uniforms?
Because EMS providers are regularly subjected to bodily fluids, pathogens, hazardous chemicals and intense physical activity, laundering paramedic and EMT uniforms is especially important. Here are some key considerations:
- Decontamination and hygiene: EMS uniforms may be contaminated with blood, vomit, urine and other potentially infectious materials. Proper washing reduces contamination risk. EMT and paramedic uniforms should be washed separately from household laundry to prevent cross-contamination. Hot water – generally 140 degrees Fahrenheit or higher, if the fabric allows – helps kill pathogens. So does thorough drying on high heat. Disinfectant additives can be useful if allowed. Follow product-specific directions for best results.
- Fabric care: EMS uniforms often contain special materials (e.g., moisture-wicking, flame-resistant, stain-resistant fabrics) that need careful treatment. Check manufacturer labels and follow directions for washing temperatures and drying instructions. Avoid bleach or harsh chemicals, which can degrade fibers and protective coatings, unless specifically allowed. Turning garments inside out can reduce abrasion and help protect emblems and striping. Avoid fabric softeners, which can reduce moisture-wicking and flame-resistance.
- Biohazards: Uniforms that are visibly contaminated with blood or other biohazards should be pretreated with hydrogen peroxide or an enzymatic spray before washing. Wear gloves while handling soiled clothing and use a dedicated laundry bag that can be washed or disinfected. Consider double washing items for added safety.
- High-visibility garments: For jackets and ANSI-rated gear, avoid hot water and dryers if it could damage reflective elements; air drying can be a better alternative. Use mild detergent without brighteners or softeners. Hand washing or the gentle cycle is often preferred for outerwear.
Agencies may issue their own SOPs for uniform maintenance, and manufacturers may have specific instructions as well.
How often should items in EMT and paramedic uniforms be replaced?
A defined replacement schedule lets EMS agencies keep crews looking professional, avoid surprise failures and plan out their budgets.
Consider replacing shirts and trousers when they start to fade, fray along the cuffs or seams, or develop stains or lost creases. Their usual life cycle in a busy system is 12–24 months. With high-vis jackets and vests, consider change when background colors fade or retroreflective tape cracks – usually around 6–12 months of regular field use or 25–50 home washes.
Replace boots when the sole tread falls below 2 millimeters or they develop midsole compression, leaks or loss of support – probably after 12–18 months of daily use. Outer jackets can last 3–5 years absent failures of zippers, waterproofing, etc.
OSHA’s general PPE rule requires employers to replace items that no longer perform as designed. NFPA 1999 requires inspection after each use and removal when performance degrades.
What new technological features (e.g., body-camera mounts, RFID tags) are appearing in EMT and paramedic uniforms?
Modern technology is bringing key advances to next-generation paramedic and EMT uniforms. Some of these are:
- Integrated body-worn camera mounting.
- RFID and smart tagging to enable inventory tracking, laundering logs, inspection/expiration alerts, etc.
- Integrated power and connectivity features (e.g., power-routing uniform panels, USB pass-through ports).
- Advanced communication accessories (e.g., earpiece routing tabs, microphone cord channels built into epaulets and seams).
- Sensor-embedded fabrics and physiological monitoring.
- Identification, authentication and access control (e.g., uniform-based badge readers, ID patches).
How much leeway do providers have for personalizing their paramedic and EMT uniforms?
Providers generally have limited leeway to adorn and personalize their paramedic and EMT uniforms, which must remain standardized and professional.
Shirts, pants, outerwear and patches/insignia typically can’t be modified. More leeway may be given to footwear (as long as it meets safety requirements), undershirts, headgear and accessories. Some agencies may allow pins, ribbons or badges for special events.
