There have been several listings for National Registry of Emergency Medical Technicians "Tactical Paramedic Patch" "Subdued, VERY RARE" These patches are counterfeit! The NREMT only issued 1 type of subdued patch.. A BASIC EMT patch for use by military Medics. These patches somewhere have the ® symbol on them, as do ALL NREMT patches. The "Tactical Paramedic" Patches not only do not have that symbol, they are SMALLER than the standard patch size. It's a scam. I've been contacted a couple of times asking if I'm sure that they are not authorized NREMT patches. For those doubtful, call NREMT and ask.