Allowable Skills: The Following allowed skills, procedures, and drugs may be performed without medical direction:

1. basic airway management
2. use of basic adjunctive airway equipment
3. suctioning
4. cardiopulmonary resuscitation
5. obstructed airway management
6. bleeding control via direct pressure
7. spine immobilization; basic splinting
8. scene assessment, triage, scene safety
9. use of statewide EMS communications system
10. Emergency Childbirth
11. glucometry
12. Oxygen

Medical direction is required for the following items:

Skills

1. Mechanical positive pressure ventilation.

Drugs and Routes:

1. Administration of approved medications by the following routes:

• Oral glucose preparations.
• Aspirin PO for adults with suspected cardiac chest pain.

Service Medical Director Approved:

• Semi-automatic defibrillation (including rhythm documentation of cardiac activity).
• Insertion of the laryngeal airway device
• IM drug administration by auto-injection device
• IM auto-injection of the following agents for treatment of chemical and/or nerve agent exposure.
  • atropine
  • pralidoxime
  • Albuterol via inhaled administration

Wilderness Protocols: The following skills shall only be used by providers who have a current wilderness certification, from a Bureau approved Wilderness First Responder Course, who are functioning in a wilderness environment as a wilderness provider (an environment in which transport time to a hospital exceeds two (2) hours, except in the case of an anaphylactic reaction, in which no minimum transport time is required.), and are authorized by their Medical Director to provide the treatment.

• administration of epinephrine
• Minor wound cleaning managment
• Cessation of CPR
• field clearance of the cervical-spine in wilderness areas to allow for patient ambulation/transport.
• reduction of dislocations resulting from indirect force of the patella, digit, and anterior shoulder

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, 1/01/06]