EMT Basic - Scope of Practice
Revised 01/27/16

(1) The following allowed drugs may be administered and skills and procedures may be performed without medical direction:

(a) basic airway management;

(b) use of basic adjunctive airway equipment;

(c) suctioning;

(d) cardiopulmonary resuscitation, according to current AHA guidelines;

(e) obstructed airway management;

(f) bleeding control to include appropriate tourniquet usage;

(g) spine immobilization; 7.27.11 NMAC 5

(h) splinting;

(i) scene assessment, triage, scene safety;

(j) use of statewide EMS communications system;

(k) childbirth (imminent delivery);

(l) glucometry;

(m) oxygen;

(n) other non-invasive procedures as taught in EMT-B courses adhering to DOT curricula;

(o) wound management.

(2) The following have service medical director approval:

(a) allowable skills:

(i) mechanical positive pressure ventilation utilizing a device that may have controls for rate, tidal volume, FiO2, and pressure relief/alarm and does not have multiple automatic ventilation modes. This skill includes devices that provide non-invasive positive pressure ventilation via continuous positive airway pressure [CPAP]); (only with specific training)

(ii) use of multi-lumen, supraglottic, and laryngeal airway devices (examples: PTLA, king airway, LMA, I-gel) to include gastric suctioning;

(iii) application and use of automatic defibrillators, including cardiac rhythm acquisition for ALS caregiver interpretation or transmission to a care facility; this includes multi-lead documentation;

(iv) acupressure;

(v) transport of patients with nasogastric tubes, urinary catheters, heparin/saline locks, PEG tubes, or vascular access devices intended for outpatient use;

(vi) hemostatic dressings for control of bleeding.

(vii) glucometry

(b) administration of approved medications via the following routes:

(i) nebulized inhalation;

(ii) subcutaneous;

(iii) intramuscular;

(iv) nasal mucosal atomization (MA);

(v) oral (PO);

(vi) intradermal;

(c) allowable drugs:

(i) oral glucose preparations;

(ii) aspirin PO for adults with suspected cardiac chest pain;

(iii) activated charcoal PO;

(iv) acetaminophen PO in pediatric patients with fever;

(vi) albuterol (including isomers), via inhaled administration;

(vii) ipratropium, via inhaled administration, in combination with or after albuterol administration; (viii) naloxone by SQ, IM, or IN route;

(ix) epinephrine, 1:1000, no single dose greater than 0.3 ml, subcutaneous or intramuscular injection with a pre-measured syringe (including autoinjector)  for anaphylaxis or status asthmaticus refractory to other treatments;

(d) patient’s own medication that may be administered:

(i) bronchodilators using pre-measured or metered dose inhalation device;

(ii) sublingual nitroglycerin for unrelieved chest pain, with on line medical control only;

(iii) situations may arise involving patients with uncommon conditions requiring specific out of hospital administered medications or procedures; family members or the designated caregiver trained and knowledgeable of the special needs of the patient should be recognized as the expert regarding the care of the patient; EMS can offer assistance in airway management appropriate to their level of licensure, and administer the patient’s prescribed medications where appropriate only if the medication is in the EMS provider’s scope of practice; EMS services are not expected to provide the prescribed medications for these special needs patients. 7.27.11 NMAC 6

(3) in the event of a disaster or emergency, the state EMS medical director or chief medical officer of the department of health may temporarily authorize the administration of pharmaceuticals or tests not listed above.

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