I think EMR/EMT-B scope of practice is actually different, and the differences vary state-to-state. I have no idea what the national competencies are for EMT-B, but from reading this forum, I've found instances where the EMT-B scope was below EMR (e.g. not allowed to take BGL) and where it was above (i.e. using Combitubes, King LTs, and LMAs). We are similar in some aspects (length of training, inability to do IVs, whatever), but you can't say that EMR > EMT-B, or vice versa. Just like EMTs/PCPs have slightly different scopes across the provinces....say, an Alberta EMT can administer Atrovent and a BC PCP can't, but a BC PCP can administer Narcan, while an AB EMT can't. Doesn't mean one is better than the other, there are just some differences. Now, PCP vs. ACP? That's a HUGE difference in training and scope of practice. But country vs. country or province vs. province comparisons don't amount to much when the levels are roughly the same.