Policy 19–Scope of Practice

What is the purpose of the Scope of Practice policy?

To define the specific psychomotor skills that may be performed at the EMT-Basic, EMT-Intermediate/Advanced, and EMT-Paramedic levels.

Are all protocols standing orders?

Yes — all protocols are standing orders.

Can a higher-certification provider perform lower-level skills?

Yes — higher certification levels may perform all lower-level skills in addition to their own specific skills.

Name airway/ventilation skills within EMT-Basic scope.

Airway adjuncts (OPA/NPA), BIAD placement, BVM ventilation, automatic transport ventilator use, and upper airway suctioning.

Name assessment/monitoring skills within EMT-Basic scope.

Applying cardiac monitor leads, applying capnography devices, and blood glucose analysis.

Name IV/IO and medication skills within EMT-Basic scope.

Establishing/maintaining a peripheral or external jugular IV, establishing IO access, and administering certain medications under paramedic supervision (e.g., oral glucose, aspirin, oxygen, Zofran PO, ibuprofen, Tylenol, Benadryl PO, albuterol, atrovent).

Name other skills within EMT-Basic scope.

AED use, auto-injector/IM epinephrine, manual stabilization of the C-spine and extremity fractures, and hemorrhage control.

Name airway/IV skills within EMT-Advanced (Intermediate) scope.

Tracheobronchial suctioning of an intubated patient, establishing/maintaining a peripheral INT/IV or an IO, and performing endotracheal intubation.

Name other skills within EMT-Advanced (Intermediate) scope.

Accessing indwelling catheters/central IV ports, administering non-medicated IV fluid and IV medications per protocol, and performing gastric decompression.

Name cardiac procedure skills within EMT-Paramedic scope.

Cardioversion, manual defibrillation, and transcutaneous pacing.

Name airway/procedure skills within EMT-Paramedic scope.

Performing all airway measures, chest decompression, and spinal clearance.

Name interpretive and decision-making skills within EMT-Paramedic scope.

Interpreting/monitoring capnography and cardiac rhythms, discontinuing pre-hospital resuscitation, and administering all medications/IV fluids listed in the protocols.