Paramedics are healthcare providers who are normally dispatched to an emergency scene by a 911 operator. Once they arrive, they often work with police and fire department personnel to determine the nature and extent of a patient's condition while trying to ascertain whether the patient has pre-existing medical problems. Following strict procedures, they provide appropriate emergency care and transport the patient. Incidents as varied as motor vehicle crashes, heart attacks, drownings, childbirth, and gunshot wounds all require the immediate medical attention provided by paramedics. Current EMT-B certification (or completion of EMSP-100, Emergency Medical Technician Basic) is a prerequisite for enrollment in EMSP-160, along with proof of experience as an EMT-B as outlined by Code of Maryland (COMAR) regulations.