The mission of the Emergency Medical Systems is to integrate the processes, protocols, technologies, policies, and practices that are designed to provide the best possible health outcome for individuals and communities - every day and during emergencies and disasters. This is accomplished through the development of statewide systems and programs described on this page.
Focus Areas
EMS Personnel
Proposed EMS Rules (8/2023)
EMS Personnel / Agency Registry (Big Picture) - (9/26/2025) Squad leaders are now able to delete members from their agency roster and add BLS personnel to their roster through the online system. Follow the instructions HERE.
*Upon your initial access to the Big Picture system, you will need to create a password. Follow the instructions located HERE. At this time, personnel can update their personal information and print their certificate/license. The ability to renew individual certifications/licensure online is not available yet. Please email the EMS office with any issues: dems@nd.gov.
EMS Agencies
Proposed EMS Rules (8/2023)
EMS Personnel / Agency Registry (Big Picture) - (11/19/2025) Our apologies: due to system issues, while squad leaders maintain the ability to update their vehicle roster and print their agency license, they can no longer edit their agency personnel roster. Email roster changes to: dems@nd.gov.
*Please note: Upon your initial access to the Big Picture system, you will need to create a password. Follow the instructions HERE to review your agency information and rosters.
COVID-19 Response
EMS COVID-19 Information