EMT Paramedic - Scope of Practice

  1. All items in the EMT-Intermediate scope of practice
  2. Medical direction is required for all items in the EMT-Paramedic scope of practice.
  3. Allowable Skills
    1. Direct laryngoscopy.
    2. Endotracheal intubation.
    3. Thoracic decompression (needle thoracostomy).
    4. Surgical Cricothyroidotomy.
    5. Insertion of nasogastric tubes.
    6. Cardioversion and defibrillation.
    7. External cardiac pacing.
    8. Cardiac monitoring.
    9. Use of Infusion pumps.
    10. Initiation of blood and blood products with on-line medical control.
    11. Intraosseous access.
  4. Allowable Drugs and Routes:
    1. Administration of approved medications via the following routes:
      1. Intraosseous
      2. Topical
      3. Endotracheal
      4. Rectal
    2. Adenosine (Adenocard).
    3. Amioderone (Cordarone)
    4. Atropine Sulfate
    5. Benzodiazepines
    6. Bretylium Tosylate
    7. Calcium preparations.
    8. Diphenhydramine
    9. Dopamine Hydrochloride.
    10. Epinephrine.
    11. Furosemide
    12. Glucagon.
    13. Lidocaine.
    14. Magnesium Sulfate.
    15. Narcotic analgesics.
    16. Oxytocin.
    17. Phenylephrine nasal spray.
    18. Sodium Bicarbonate.
    19. Thiamine
    20. Topical anesthetic ophthalmic solutions.
    21. Vasopressin.
    22. ipratropium
  5. Drugs Allowed for Monitoring in Transport: Requires an infusion pump when given by continuous infusion unless otherwise specified.
    1. Potassium (no infusion pump needed if concentration not greater than 20mEq/1000cc).
    2. Anticoagulation type blood modifying agents (such as Fibrolytic Drugs, heparin, glycoprotein IIb-IIIa inhibitors/antagonists).
    3. Procainamide.
    4. Mannitol.
    5. Blood and blood products.
    6. Aminophylline.
    7. Antibiotics.
    8. Dobutamine (Dobutrex).
    9. Sodium Notroprusside (Nipride).
    10. Insulin.
    11. Terbutaline.
    12. Norepinephrine (Levephed).
    13. Diltiazem.
    14. Glycoprotein IIb-IIIa inhibitors/antagonists.
    15. Octreotide
    16. TPN
    17. beta blockers
    18. Nesiritide
    19. Propofol in patients that are intubated prior to transport
  6. Skills Approved for Monitoring in Transport.
    1. Internal cardiac pacing.
    2. chest tubes
  1. Medications For Administration During Patient Transfer.
    1. Retavase (second dose only).
    2. Protamine Sulfate.
    3. Non-depolarizing neuromuscular blocking agents in patients that are intubated prior to transport.
  2. Patient's Own Medication that May be Administered
    1. epoprostenol sodium

Prior to accomplishing a new skill, technique, medication, or procedure, it shall be documented by the service director, medical director, or approved EMS training institution that the EMS provider has been appropriately trained to perform those new skills, techniques, medications, or procedures.

Service Medical Director Approved: Prior to utilizing any skill, technique, medication or procedure designated as Service Medical Director Approved, it shall be documented by the service director, medical director, or approved EMS training institution that the EMS provider has been appropriately trained to perform the skills, techniques, medications or procedures. Additionally, each EMS provider must have a signed authorization from the service's medical director on file at the EMS service's headquarters or administrative offices.

Personnel with a limited licensure may not utilize items designated as Service Medical Director Approved.

[7.27.2.14 NMAC - Rp, 7.27.2.14 NMAC , 1/01/2006]

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