Los Angeles County EMT Scope of Practice

Vocabulary practice flashcards covering the Los Angeles County EMT Scope of Practice under Policy 802, including medication administration, IV therapies, approved and unapproved medical devices, and protocol guidelines.

Policy 802

The Los Angeles County EMS policy that defines Treatment Protocols for Interfacility and 9-1-1 Responses, updated on 07-01-2024.

Policy 802.1

The Los Angeles County EMS Quick Reference Guide accompanying treatment protocols, updated on 07-01-2024.

Distress Management Protocol

The general care steps for a person in distress: place the patient in a position of comfort, provide high-flow oxygen, monitor vital signs, and place in shock position PRN.

Approved Maintenance IV Fluids

Intravenous solutions an EMT is permitted to monitor, maintain, and adjust to a preset rate: Glucose solutions ($\text{D5W}$), Isotonic balanced salt solutions (Normal Saline), and Ringer’s Lactate.

IV Infiltration Intervention

The action an EMT is authorized to take if an intravenous line infiltrates, which is to turn off the infusion using the roller clamp.

IV Fluid Additives (TKO Rate)

Pre-mixed IV additives that must be adjusted to a TKO (to keep open) rate by hospital personnel before EMT transport: Folic acid, Multi-vitamins (MVI), Magnesium Sulfate ($\text{MgSO}_4$) solely in conjunction with MVI, and Thiamine.

IV Fluid Additives Requiring Infusion Pumps

Specific IV additives that require an infusion pump set at a preset rate for EMT transport: Potassium Chloride ($\text{KCl}$) at a maximum concentration of $20\,\text{mEq}/1000\,\text{ml}$, and Total parenteral nutrition (TPN).

IV Chemotherapeutic Agents

Highly corrosive and toxic intravenous solutions that EMTs are strictly prohibited from transporting under updated protocols.

Patient Controlled Analgesia Pump (PCA)

An automated or patient-operated infusion device (implanted or external) delivering prescribed pain medications—such as Morphine Sulfate (MS) or Maperidine (Demerol®)—which an EMT is permitted to transport.

Saline / Heparin Lock

An intravenous access port capped off for intermittent medication or fluid delivery without continuous infusion, approved for EMT transport.

Foley Catheter

An indwelling urinary catheter and drainage collector approved for patient transport within the EMT scope of practice.

Tracheostomy Tube

A surgically created artificial airway through the neck into the trachea, classified as an approved medical device for EMT transport with physician authorization.

Ventricular Assist Device (VAD)

A mechanical circulatory support device designed to assist the pumping action of the heart ventricles, approved for EMT transport under physician authorization.

Jackson-Pratt Drain

A bulb-suction closed surgical drain system used to collect fluid from operative sites, approved for EMT transfer.

Peripherally Inserted Central Catheter (PICC Line)

An indwelling central venous catheter inserted through a peripheral vein and advanced to the superior vena cava, approved for EMT transport.

Prohibited Transfer Devices

Invasive medical lines and monitors an EMT is NOT authorized to transport: Central venous catheter (CVP) monitoring devices, Arterial lines, Swan Ganz catheters, and Thoracostomy (chest) tubes.

Arterial Line

A catheter inserted into an artery used for real-time invasive arterial pressure monitoring, which is NOT approved for EMT transport.

Swan Ganz Catheter

A pulmonary artery catheter threaded into the right heart and pulmonary vasculature for advanced hemodynamic monitoring, which is NOT approved for EMT transfer.

Thoracostomy Tube

A chest tube inserted through the thoracic wall into the pleural cavity for drainage of air or fluid, which is NOT approved for EMT transfer.

Nitroglycerin Administration Protocol

Assisting an alert patient with their prescribed NTG for chest pain: $1\,\text{tablet}$ or $1\,\text{metered dose spray}$ ($0.4\,\text{mg}$) sublingually, checking blood pressure after each dose, up to a maximum of $3\,\text{doses}$ total.

Nitroglycerin Contraindications

Conditions prohibiting NTG administration: systolic blood pressure $< 100\,\text{mmHg}$ or the patient having taken sexually enhancing drugs (SEDs) within the past $48\text{--}72\,\text{hours}$.

Bronchodilator Assistance Protocol

Assisting an alert patient with difficulty breathing in using their prescribed metered dose inhaler (MDI) or hand-held nebulizer (HHN).

EpiPen® Administration Protocol

The emergency injection procedure for severe allergic reaction (Anaphylaxis): insert the auto-injector into the upper-outer thigh, hold for $10\,\text{seconds}$, carefully secure the device, and bring it to the hospital.

ALS Response Mandate

The requirement stating that if medication assistance is administered to a patient prior to ALS arrival, the EMT must NOT cancel the EMT-P response and must ensure ALS is requested.

The 5 Patient Rights

The five essential checks required prior to administering any medication: Right patient, Right medication, Right dose, Right route, and Right time.

D-I-C-E Mnemonic

The inspection procedure performed on medications before administration: Drug / Dosage, Integrity, Clarity / Concentration, and Expiration Date.