As we continue in the fourth and largest wave of COVID-19 in Alberta where rapid testing has become more available, there is reported confusion among Emergency Medical Responders about what type of testing they are authorized to perform.

What kind of swabs can EMRs perform for COVID-19 testing?

There are three different types of swabs for COVID-19 testing. The three types are: throat swab, nasal swab and nasal pharyngeal swab. Emergency Medical Responders are authorized to perform the throat and nasal swabs but are not authorized or permitted to perform the nasal pharyngeal swab.

The throat swab consists of inserting an instrument or device into the pharynx, but not beyond, and therefore is not considered a restricted activity. All EMRs require additional training on performing this task (in-house, employer training is sufficient).

The nasal swab consists of inserting the swab in the nose, swabbing only the inside of the nostril which is approximately 2 cm deep. This swab is not to go further than where the nasal passages narrow, which means this is also not a restricted activity and can be performed by an EMR.

Performing a nasal pharyngeal swab is a restricted activity in accordance with Section 16 (1) c of the Paramedic Profession Regulation (PPR) for all regulated members and is not authorized (does not fall within the scope of practice) for EMRs. This type of swab enters a deeper part of the nasal cavity that EMR training and education does not adequately cover. This activity is not authorized for EMRs through the PPR and there is no training that could give EMRs the permission to perform this task.

It is important for all EMRs who are performing the throat and nasal swab to feel competent in these skills before they perform them. It is up to each regulated member to complete training if they do not feel adequately prepared. Employer training prior to performing these skills on a patient is appropriate for any EMR who does not feel competent.

Here are some other resources to help identify the difference between nasal swabs and nasal pharyngeal swabs:

Step-by-step rapid antigen screening test
Alberta Government rapid testing program 
Acceptable swab types for COVID testing 
Complications of nasal COVID testing

NOTE: All regulated members are reminded that before performing any procedure on a patient, it is their responsibility to ensure they have completed appropriate training and are competent to perform the procedure (Code of Ethics 3.1).

If you have questions or concerns, please contact the College at