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Some paramedics have begun to specialize their practice, frequently in association with the environment in which they will work.

Some early examples of this involved aviation medicine and the use of helicopters, and the transfer of critical care patients between facilities.

While some jurisdictions still use physicians, nurses, and technicians for transporting patients, increasingly this role falls to specialized senior and experienced paramedics.

Other areas of specialization include such roles as tactical paramedics working in police units, marine paramedics, hazardous materials ( Hazmat ) teams, Heavy Urban Search and Rescue, and paramedics on offshore oil platforms, oil and mineral exploration teams, and in the military.