# Scope of Practice for Each State - Discussion



## WuLabsWuTecH

Hi All!

I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf (outdated)

I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.

Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!

-Wu

---------List of States---------

California: (JPINFV)
EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)

Colorado: http://www.dora.state.co.us/medical/rules/500.pdf (outdated)

beow is added for the paramedics in state
http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89) (outdated)

Georgia: http://health.state.ga.us/programs/ems/Resource Documents/R-P-01-A Scope of Practice for EMS Personnel/R-P01-A- Scope of Practice for EMS Personnel.pdf (outdated)

Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf

Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)

Ohio: http://www.ems.ohio.gov/critical.aspx#scope
http://www.publicsafety.ohio.gov/links/ems_scope_practice.pdf

Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf

Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm

List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!


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## KEVD18

you can find the mass state protocols for review at the mass state oems website if your interested. i dont feel like digging up a link right now.


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## rhan101277

I wish I could find this information for Mississippi.  I found the EMS site but it has no info on protocols.


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## WuLabsWuTecH

rhan101277 said:


> I wish I could find this information for Mississippi.  I found the EMS site but it has no info on protocols.


I would assume that protocols would not be on a state site since protocols are designated by each department/hospital/company's medical director.  I was looking for a legal scope of practice.  I'll update my OP as I get more but I can't find one for missouri right now and massacussets was not easily found either.


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## VentMedic

rhan101277 said:


> I wish I could find this information for Mississippi.  I found the EMS site but it has no info on protocols.




http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf

The EMT-B starts at about page 91 with scope defined starting at page 103.


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## VentMedic

California's EMSA gives authority to each individual county.


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## JPINFV

VentMedic said:


> California's EMSA gives authority to each individual county.



Ah, but it's still defined by statute as well as locally.

EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf

Starts on bottom of page 6

EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf 

Starts on page 2. 

EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)


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## Jon

I'm not sure about scope of practice, but for PA:

State OEMS Website: http://www.dsf.health.state.pa.us/health/cwp/view.asp?Q=237548

BLS Protocols: http://www.dsf.health.state.pa.us/health/lib/health/ems/bls_protocols_2004.pdf

ALS Protocols: http://www.dsf.health.state.pa.us/health/lib/health/ems/als_protocols-effective_07-01-07.pdf

In PA, ALS and BLS protocols are now state-wide. On the ALS side, there are a few options that are service medical director options... including medication facilitated intubation.

And I merged the post, WuLabsWuTech


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## rhan101277

VentMedic said:


> http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf
> 
> The EMT-B starts at about page 91 with scope defined starting at page 103.



Thanks I had this document, guess I thought it would be different by county.


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## VentMedic

rhan101277 said:


> Thanks I had this document, guess I thought it would be different by county.



Your medical director will use the state's statutes to make the protocols you will follow.


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## zacdav89

heres the site for colorado to add to the list
http://www.dora.state.co.us/medical/rules/500.pdf 

this is added for the paramedics in state
http://www.dora.state.co.us/medical/Rules/800.pdf


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## WuLabsWuTecH

For some reason the edit button is still not appearing in my original post for me to be able to add these links to the main post.  I was hoping to be able to just keep a running list there with the date retrieved and then alphabatize the list by state.

Oh and thanks to whoever stickied this!


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## ffemt8978

WuLabsWuTecH said:


> For some reason the edit button is still not appearing in my original post for me to be able to add these links to the main post.  I was hoping to be able to just keep a running list there with the date retrieved and then alphabatize the list by state.
> 
> Oh and thanks to whoever stickied this!



The edit button disappears after 15 minutes.  However, you can PM me with a list of changes you'd like to make to the original post and I will fix it.



And you're welcome.


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## seanm028

I've been having trouble finding Arizona's.  If anyone has it, I'd appreciate the addition.


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## Jeremy89

seanm028 said:


> I've been having trouble finding Arizona's.  If anyone has it, I'd appreciate the addition.



www.azdhs.gov/bems/forms-pdf/r9-25-503-uc-013107_1.pdf

That's part of it.  Search around the DHS site for more...

J


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## seanm028

Jeremy89 said:


> www.azdhs.gov/bems/forms-pdf/r9-25-503-uc-013107_1.pdf
> 
> That's part of it.  Search around the DHS site for more...
> 
> J



Thanks.  I've actually seen that before, but I was hoping to find something that talked about general procedures, not just drugs.  I have searched around the BEMS site for more info, so I think I might have to call them soon.


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## WuLabsWuTecH

Ok here is where i stopped on the 9th of July

I pmed you ffemt with the changes.  Keep any more you find coming and I'll have them updated to the master list in the OP.


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## emtc9019

*ri ems protocols*

hello i am new here so i will start with my first post  http://health.ridisaster.org/index.htm#protocols


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## rchristi

*Minnesota*

Minnesota is writing model protocols, but does not intend to make them a state standard for scope of care.


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## ride2k

Here are the Connecticut state BLS guidlines.

http://www.northcentralctems.org/documents/blsguide.pdf


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## Blacke00

Found a good source (I think it's current):

http://en.wikipedia.org/wiki/Emergency_Medical_Technician_-_Intermediate




> Tennessee EMTs are licensed at either the EMT-IV (Intravenous Therapy) Level or the EMT-Paramedic Level. EMT-IVs are trained to the NREMT-B standard in accordance with DOT regulations, as well as receive additional training in advanced airway management, administration of Epinephrine 1:1000 in Anaphylaxis, administration of nebulized and aerosolized Beta-2 Agonists such as Xopenex and Albuterol, administration of D50W and D25W, IV Therapy and Access, and trauma life support including the use of MAST Trousers. EMT-IVs can also administer nitroglycerine and aspirin in the event of cardiac emergencies, and can give Glucagon. EMT-IVs can also administer the Mark 1 Autoinjector kit for Organophospate poisoning and suspected nerve gas exposure. The State of TN Board of EMS is currently evaluating allowing EMT-IVs to administer NARCAN and Nitrous Oxide, as well. The Board is also considering going to an Emergency Medical Responder, EMT-B, EMT-Advanced, and EMT-P format and eliminating the EMT-IV rank.



That's more than I would have expected for what would be an EMT-B anywhere else, right?


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## TransportJockey

My latest updated Scope of practice:
http://nmems.org/SOPFinal2007.pdf


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## flhtci01

You listed the Iowa scope of practice.

The state approved protocols for all levels are at http://www.idph.state.ia.us/ems/protocols.asp


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## mycrofft

*Here's a joker: Standardized Procedures*

At least in CA, within a given medical director/company's bailiwick, some otherwise verboten procedures can be assigned for LVN's, RN's, and other non-traditional EMS operators by setting up approved training (good to have a provider's number as a training facility, not too hard to get), keep good records, teach the St Proc, then have a test and periodic refreshers. I once had this explained to me: as long as the employees did not leave the premises or even a company owned vehicle, they could perform the st proc. Scarey.


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## Northstar453

Here's the link to Maine's EMS Protocols, they are statewide protocols. We just had an update in Maine in July.

http://www.maine.gov/dps/ems/legal.html


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## RESQ_5_1

Scope of practice for Alberta EMS can be found at: www.collegeofparamedics.org and then follow the links to each level from EMR to EMT-P.

I would like to note, that we are regulated by a COLLEGE. This term confuses alot of people. However, our DRs are regulated by the COLLEGE of physicians and surgeons. And, our nurses are regulated by the COLLEGE of nursing. Also, as EMS practitioners, we also fall under the health PROFESSIONS act. At least up here, we receive the recognition as a necessary provider of medical treatment. The term COLLEGE in this case does not mean an institute of learning.


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## RESQ_5_1

UPDATE: The Alberta Scopes of Practice can be found at the following link: 
http://www.qp.gov.ab.ca/documents/regs/1993_048.cfm

Please disregard the previous link as a source for the Alberta scope of practice. However, additional information concerning EMS in Alberta can be found at the previous link.


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## MedCoast Ambulance

*county to county......So Cal*

Here in So Cal it varies from county to county.....in Los Angeles there is an expanded scope  policy 802- 802.2 but in Orange County the scope is limited


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## ResTech

Pennsylvania just underwent some progressive updates in their protocols for both BLS and ALS.

In summery here are the BLS changes and additions:

- CPAP carried on BLS units
- No longer required to carry activated charcoal
- Bleeding Control Protocol
     Tourniquet use emphasized for bleeding control
     Hemostatic agents (powders) for bleeding control
- Nerve agent kits (injectable meds) for personal use onboard BLS ambulance. May only administer to patients after ALS evaluation.

In summery here are the ALS changes and additions:
- Change in Benedryl dose from 25mg to 50mg
- Addition of IV NTG
- Benzo's for vertigo
- Intranasal - fentanyl, glucogon, Ativan, Versed, Naloxone
- Crush injury treatment (sodium bicarb & calcium chloride immediately prior to extrication)
- ACE inhibitors for CHF - pretty much done away with lasix
- Therapeutic hypothermmia
- Analgesic for fluid or med admin by IO in conscious patient

Any other states allow CPAP for BLS?


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## emtmomof2

*how about nj*

Anyone have a link with nj protocols?
Theresa


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## Blacke00

emtmomof2 said:


> Anyone have a link with nj protocols?
> Theresa



This it?

http://liberty.state.nj.us/health/ems/regs.shtml

Kevin


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## rchristi

*MN Guidelines*

Minnesota just posted these guidelines as a model for individual services to use.
http://www.emsrb.state.mn.us/default.asp
You can download them from this homepage


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## aandjmayne

anyone got anything on louisiana or is it parish mandated?


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## Dominion

Here is a link to the Kentucky state protocols, BLS and ALS 

http://kctcs.edu/kbems/version 4.4.pdf


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## chocchipsmom

WuLabsWuTecH said:


> Hi All!
> 
> I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.
> 
> Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!
> 
> -Wu
> 
> ---------List of States---------
> 
> California: (JPINFV)
> EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
> EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
> EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)
> 
> Colorado: http://www.dora.state.co.us/medical/rules/500.pdf
> 
> beow is added for the paramedics in state
> http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89)
> 
> Georgia: http://health.state.ga.us/programs/ems/Resource%20Documents/R-P-01-A%20Scope%20of%20Practice%20for%20EMS%20Personnel/R-P01-A-%20Scope%20of%20Practice%20for%20EMS%20Personnel.pdf
> 
> Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf
> 
> Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)
> 
> Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf
> 
> Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm
> 
> List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!


Here is the link for North Carolina:
http://www.ncdhhs.gov/dhsr/EMS/credcomp.htm


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## NomadicMedic

Washington State:

http://www.doh.wa.gov/hsqa/emstrauma/download/emssop.pdf


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## trevor1189

*Pennsylvania scope of practice*

Pennsylvania Scope of practice:

http://www.pabulletin.com/secure/data/vol35/35-32/1488.html


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## emtfarva

*MA State Protocols*



KEVD18 said:


> you can find the mass state protocols for review at the mass state oems website if your interested. i dont feel like digging up a link right now.



State OEMS
http://www.mass.gov/dph/oems


Treatmeant Protocols:
http://www.mass.gov/?pageID=eohhs2t...y_services_p_treatment_protocols&csid=Eeohhs2


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## southernbell

*Looking for SC Scope of Practice*

Im not sure if anyone has asked for a link to South Carolina's link to scope of practice but I would love this information.


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## LAS46

Colorado has just released a new version of its Rule 500. I have added a link to it below.

http://www.dora.state.co.us/Medical/rules/500.pdf

Dustin


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## OklaEMT

Any one have information on the scope of practice in Indiana?


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## Akulahawk

The PDF for Paramedics in California has some incorrect information that hasn't been corrected, at least as far as Sacramento County goes... Midazolam is authorized and carried. ASA is also authorized and carried. They also now carry the Combitube and the King Tube (Supraglottic Airway)... neither are on the list. The meds were on that list before 2000 and they authorized the Combitube around 2002. The King Tube was authorized this year. Sacramento County also now authorizes Intra Nasal admin of meds. Sacramento County also authorizes O2 powered ATV's, and has for quite some time. I would hope that eventually, they'll allow vents that can use more modes than what amounts to A/C.


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## VentMedic

Akulahawk said:


> Sacramento County also authorizes O2 powered ATV's, and has for quite some time. I would hope that eventually, they'll allow vents that can use more modes than what amounts to A/C.


 
The ATV is essentially for ventilating the barely living dead. Before a Paramedic in CA can advance to a more sophisticated ventilator, they must *first* expand their medication protocols (and education) to where they can manage a ventilator patient. I can not imagine transporting an ICU ventilator patient and not have the ability to make them comfortable. That would be doing more harm than good.



> They also now carry the Combitube and the King Tube (Supraglottic Airway)... neither are on the list. The meds were on that list before 2000 and they authorized the Combitube around 2002. The King Tube was authorized this year.


I have noticed some EMS agencies in CA (and FL) are using supraglottic devices more than ETI.


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## Akulahawk

VentMedic said:


> *The ATV is essentially for ventilating the barely living dead.* Before a Paramedic in CA can advance to a more sophisticated ventilator, they must *first* *expand their medication protocols (and education) to where they can manage a ventilator patient*. I can not imagine transporting an ICU ventilator patient and not have the ability to make them comfortable. That would be doing more harm than good.
> 
> I have noticed some EMS agencies in CA (and FL) are using supraglottic devices more than ETI.


I couldn't agree more, actually. Of course, once you start expanding a Paramedic's educational & skill level, you start encroaching on the "turf" of other providers... like RN's, PA's, and RRT's.  

[sarcasm]Heaven forbid that a Paramedic be capable of managing ICU patients during transports between facilities without requiring an RN to ride along... but that means so much more education... We just _can't_ have Paramedics getting Degrees...

[/sarcasm]

Can you tell that you just led right into a pet peeve of mine? Paramedics _can _do more, but they also need the _education _to do it... as well as the formal recognition of the training/education they've already received. 

On a side note: the supraglottic devices that we're authorized for up here won't allow for you to intubate through it. Once it's placed, if you want to/need to intubate the patient, you have to pull the supraglottic device.


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## VentMedic

Akulahawk said:


> I couldn't agree more, actually. Of course, once you start expanding a Paramedic's educational & skill level, you start encroaching on the "turf" of other providers... like RN's, PA's, and RRT's.
> 
> [sarcasm]Heaven forbid that a Paramedic be capable of managing ICU patients during transports between facilities without requiring an RN to ride along... but that means so much more education... We just _can't_ have Paramedics getting Degrees...
> 
> [/sarcasm]


 
Again, what's with using others as an excuse for not being able to do something? Paramedics in other states have had advanced scopes of practice for many years...like 40. They also transport ICU patients. I was transporting IABP patients as a Paramedic 25 years ago in Florida. California has just developed its only little frozen in time state that hasn't allowed for advancement. Perhaps EMS in CA should look at improving the prehospital emergency side of things before trying to move on to critical care. 

RNs, PAs and RRTs do not stop YOU from getting a degree as a Paramedic.  Degrees for the Paramedic are offered at most community colleges in CA.  But, one has to be motivated to provide the best possible care for their patients and not just do the minimum.   If you want a nursing example, RNs are only required to have a 2 year degree but many choose to do a 4 year degree.  The same for RRTs.   PAs could probably do a shorter route but most get their Masters degree. 

Do YOU not see a patient care issue with just giving a Paramedic a sophisticated ventilator without the ability to titrate or even use most of the meds required to keep a patient comfortable? I thought you had agreed about the meds. 



> On a side note: the supraglottic devices that we're authorized for up here won't allow for you to intubate through it. Once it's placed, if you want to/need to intubate the patient, you have to pull the supraglottic device.


 
Not many standard EMS agencies are going to buy LMAs that facilitate intubation.


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## Akulahawk

VentMedic said:


> Again, what's with using others as an excuse for not being able to do something? Paramedics in other states have had advanced scopes of practice for many years...like 40. They also transport ICU patients. I was transporting IABP patients as a Paramedic 25 years ago in Florida. California has just developed its only little frozen in time state that hasn't allowed for advancement. *Perhaps EMS in CA should look at improving the prehospital emergency side of things before trying to move on to critical care. *
> 
> RNs, PAs and RRTs do not stop YOU from getting a degree as a Paramedic.  Degrees for the Paramedic are offered at most community colleges in CA.  But, one has to be motivated to provide the best possible care for their patients and not just do the minimum.   If you want a nursing example, RNs are only required to have a 2 year degree but many choose to do a 4 year degree.  The same for RRTs.   PAs could probably do a shorter route but most get their Masters degree.
> 
> Do YOU not see a patient care issue with just giving a Paramedic a sophisticated ventilator without the ability to titrate or even use most of the meds required to keep a patient comfortable? I thought you had agreed about the meds.
> 
> 
> 
> Not many standard EMS agencies are going to buy LMAs that facilitate intubation.


Hard to "get" the sarcasm, _especially_ in the written medium. California _does_ have a restrictive scope of practice compared to most of the rest of the country. If you understood _how_ EMS developed in this state, then perhaps you would understand _why_ Paramedics don't have the expanded scope of practice that is enjoyed in other states. Paramedics weren't licensed here until the mid-90's and each local EMS agency still accredits Paramedics for practice in "their" system. 

The State to the North (Oregon) has a much wider scope than here... they've streamlined their EMT-P levels greatly. At one time, they had 6 different levels of Paramedic. Now they've got only ONE that I can find. However, they require a degree and LOTS of education. I am in total agreement with that. Looking at _their _educational requirements, I met all of _their _educational requirements either through my Bachelor's Program (non-EMS) or via separate EMT-P education/training. 

I believe that a well educated Paramedic should be able to handle most, if not all, the stuff that CCT-RN's do. I believe that a Paramedic should be able to handle a sophisticated Vent and use the appropriate meds to keep patients comfortable and appropriately ventilated. Simply turning a Paramedic loose on a ventilated patient without appropriate training and clinical experience, would be a negligent act, IMHO. Same with _any _other procedure or medication that could be administered in the field OR during interfacility transports. 

I am not providing an excuse for _ME_ to go do something. I *_want_* to be able to provide FAR better care than I'm restricted to... and I'm going to be stuck here in this state for a while. _That_ has _nothing_ to do with why California Paramedics are restricted in what they can do. 

As far as agencies & companies purchasing intubating LMA's, I agree... they're going to generally be too expensive for widespread use.


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## triemal04

Akulahawk said:


> The State to the North (Oregon) has a much wider scope than here... they've streamlined their EMT-P levels greatly. At one time, they had 6 different levels of Paramedic. Now they've got only ONE that I can find. However, they require a degree and LOTS of education. I am in total agreement with that. Looking at _their _educational requirements, I met all of _their _educational requirements either through my Bachelor's Program (non-EMS) or via separate EMT-P education/training.


Actually, Oregon at one point had 4 levels of EMT (technically it may have been 5 since I think there was some type of First Responder level) that was changed to 3 when things were restructured.
EMT 1:  current EMT-Basic minus asa, subq/IM epi, and assisted ntg/albuterol.  
EMT 2:  1+IV's.
EMT 3:  Damn near a paramedic minus some of the school, a few meds and certain procedures (pericardialcentesis, intracardiac epi, femoral lines and a couple other things that I can't remember now)  It's unfortunately what the "new and improved" EMT-Intermediate level has now become...biggest load of bull:censored::censored::censored::censored: I've seen in a long time.
EMT 4:  Today's paramedic minus the degree and with a couple procedures we generally don't do (pericardialcentesis, intracardiac epi).

Never had 6 levels, and definitely not at the paramedic level.

Cheers.

Edit:  and there are now disposable intubating LMA's out.  While they still probably aren't as cheap as an ET tube, they are definetly not as exspensive as the reuseable type.

Double edit:  If you meet the requirements for the degree, ever consider moving?  Even if you are short a couple of classes it is possible to get a provisional cert while you finish up, though there's several hoops to jump through.


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## Akulahawk

triemal04 said:


> Actually, Oregon at one point had 4 levels of EMT (technically it may have been 5 since I think there was some type of First Responder level) that was changed to 3 when things were restructured.
> EMT 1:  current EMT-Basic minus asa, subq/IM epi, and assisted ntg/albuterol.
> EMT 2:  1+IV's.
> EMT 3:  Damn near a paramedic minus some of the school, a few meds and certain procedures (pericardialcentesis, intracardiac epi, femoral lines and a couple other things that I can't remember now)  It's unfortunately what the "new and improved" EMT-Intermediate level has now become...biggest load of bull:censored::censored::censored::censored: I've seen in a long time.
> EMT 4:  Today's paramedic minus the degree and with a couple procedures we generally don't do (pericardialcentesis, intracardiac epi).
> 
> Never had 6 levels, and definitely not at the paramedic level.
> 
> Cheers.
> 
> Edit:  and there are now disposable intubating LMA's out.  While they still probably aren't as cheap as an ET tube, they are definetly not as exspensive as the reuseable type.
> 
> Double edit:  If you meet the requirements for the degree, ever consider moving?  Even if you are short a couple of classes it is possible to get a provisional cert while you finish up, though there's several hoops to jump through.


Question for ya? How long ago did they change over to what you're describing (4 level?) because I distinctly recall there being 3 levels of Paramedic - basically what you're describing as the Level 2-4. I also distinctly recall that was the streamlined version from what came before it... which was something like 6 levels of Paramedic... and each one was different. This was from something like about 10-15 years ago, if I recall correctly, perhaps longer.

Oh, and for why I can't move... got too many ties down here right now. I'd probably be much happier in Oregon (for Paramedic Scope, and other reasons...) but suffice to say, I'm stuck here for a few more years, barring something really strange happening.


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## triemal04

Akulahawk said:


> Question for ya? How long ago did they change over to what you're describing (4 level?) because I distinctly recall there being 3 levels of Paramedic - basically what you're describing as the Level 2-4. I also distinctly recall that was the streamlined version from what came before it... which was something like 6 levels of Paramedic... and each one was different. This was from something like about 10-15 years ago, if I recall correctly, perhaps longer.
> 
> Oh, and for why I can't move... got too many ties down here right now. I'd probably be much happier in Oregon (for Paramedic Scope, and other reasons...) but suffice to say, I'm stuck here for a few more years, barring something really strange happening.


Currently there are 3 levels of EMT; Basic, Intermediate and Paramedic.  The 1-4 was what it used to be before.  I think (but don't quote me on this one) that it changed to the current system a bit before the degree became mandatory, so say mid 90's.  You might be thinking of the old EMT-3 and EMT-4 that I mentioned; there wasn't a lot of difference between the two except that the EMT-4 could also call themselves a paramedic.


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## Hollywood

Quoted from Texas Department of State Health Services website:

 Texas does not have a rigid scope of practice for EMS personnel defined in rule or law as some other states do. That’s because Texas Medical Board rules allow physician-medical directors to delegate medical tasks to EMS personnel as long as they’ve trained and/or verified and documented the training, in the context of the Texas Medical Board language of 22 Texas Administrative Code, Section 197.1. Medical personnel with specific training and competencies may be able to perform skills outside the bounds of traditional practice if their medical director evaluates, provides additional training, authorizes them accordingly and develops protocols to match. For the purpose of this explanation, traditional practice may be defined as the knowledge and competencies described in the DOT National Standard Curriculum at each EMS training level.


----------



## JCampbell

http://www.scdhec.gov/health/ems/cskills.pdf

South Carolina


----------



## fbsemssocial

*New Mexico*

All information on New Mexico scope of practice can be found at www.nmems.org.


----------



## jjesusfreak01

*North Carolina*

SOP can be found here:
http://www.ncems.org/pdf/NCCEPStandardsSkillsImplementation2009.pdf

Complete list of protocols can be found here:
http://www.ncems.org/pdf/NCCEPStandardsProcedures2009.pdf


Exact protocols are written by the medical director of each system, and can vary by county, but for the most part they stick to the state guidelines. NC intermediates and paramedics have a slightly expanded scope past NREMT-P I have heard, and basics are not permitted to intubate, although they are taught the procedure in accordance with NREMT standards.


----------



## medicRob

Blacke00 said:


> Found a good source (I think it's current):
> 
> http://en.wikipedia.org/wiki/Emergency_Medical_Technician_-_Intermediate
> 
> 
> 
> 
> That's more than I would have expected for what would be an EMT-B anywhere else, right?



Should be, I am the one who updated the EMT-IV info on that page.


----------



## MEDIC802

ALABAMA



http://www.adph.org/ems/Default.asp?id=811


----------



## byoung57

*State of KY Protocols*

http://kbems.kctcs.edu/Home/Protocols/tabid/148/version 4.41.pdf


----------



## RuralMedik

*Virginia*

I didn't see Virginia's posted, so here it is.

www . vdh . virginia . gov/OEMS/Training/Transition . htm

Bear with me, I can't post links yet.  Just take out the spaces around the periods.

Click on Scope/Procedures & Scope/Formulary.


----------



## jjesusfreak01

RuralMedik said:


> I didn't see Virginia's posted, so here it is.
> 
> www.vdh.virginia.gov/OEMS/Training/Transition.htm
> 
> Bear with me, I can't post links yet.  Just take out the spaces around the periods.
> 
> Click on Scope/Procedures & Scope/Formulary.



There, fixed it. Thanks for posting the link.


----------



## 18G

*Pennsylvania 2011 ALS Protocols*

The new 2011 Pennsylvania protocols.... effective July, 2011. 

Some nice changes and nice to see PA being progressive in their pre-hospital care. 

http://www.emsi.org/Files/Admin/Statewide ALS Protocols - 2011.pdf


----------



## emtmedic1258

*NM Scope of Practice*

Here is the link for the Scope of Practice in New Mexico from EMD to EMT-P.
http://www.nmems.org/practice_scope.shtml


----------



## RJ80

Well, I was gonna post a link to ours, but I'm too new here and I'm not allowed...I'll be back later


----------



## Crusader

Well since It doesn't want to allow me to post a link, if you go to google and search "Idaho Scope of Practice for EMT" you will see the website/PDF:

"Table of Contents  - Department of Administration, Idaho"


----------



## EFDUnit823

Indiana EMS Information

Training and Certification: http://www.in.gov/legislative/iac/T08360/A00040.PDF

IDHS EMS: http://www.in.gov/dhs/3525.htm

Good Article: http://www.emttrainings.com/emt-training-indiana/

In Indiana, as I am sure in most other places, our “Scope of Practice” varies according to a given Medical Director’s approved protocols. In many cases, local protocols allow for less of a Scope than what the State allows.


----------



## EFDUnit823

Had another link for Indiana;

http://www.in.gov/legislative/iac/T08360/A00010.PDF?


----------



## Jeremy89

Anyone have any specific changes with the new Advance EMT scope that the NREMT is switching over to?  In Arizona they've added SVN's and CPAP to ours, plus a couple of other small things I can't think of (I'd have to talk to my friend who took one of the classes).


----------



## MedicBrew

This is a little broad, and only if your transitioning.

I don’t have the circ. for the entire class right at hand.  

http://www.nremt.org/nremt/downloads/Newsletter_85_FINAL.pdf


----------



## CANDawg

Would a mod maybe be able to go through and update the first post with the links that have been shared?

Here are the scopes for some Canadian provinces. Note most provinces are based on the National Occupational Competency Profile with only minor (or no) changes. (http://paramedic.ca/nocp/) There are exceptions however, such as Alberta, which maintain their own detailed and separate scopes. If in doubt or unable to find the detail you want, you can be pretty confident that the NOCP is correct.


BC: http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/210_2010#Schedule1
Alberta: http://www.collegeofparamedics.org/home/becoming-a-practitioner/levels-and-scope-of-practice.aspx
Saskatchewan: http://www.health.gov.sk.ca/ems-protocol-manual (Select "Scope of Practice" on the index.)
Manitoba: http://www.gov.mb.ca/health/ems/guidelines/index.html
Ontario: http://www.ontarioparamedic.ca/index.php/paramedics/levels-and-scope-of-practice (Best I could find.)
Quebec: Unable to find. Refer to NOCP. (http://paramedic.ca/nocp/)
New Brunswick: Follows NOCP. (http://paramedic.ca/nocp/)
Nova Scotia: http://www.gov.ns.ca/health/ehs/paramedics/policies.asp (Under "6000 Essential Competencies")
PEI: Unable to find. Refer to NOCP. (http://paramedic.ca/nocp/)
Newfoundland: Unable to find. Refer to NOCP. (http://paramedic.ca/nocp/)


----------



## ffemt8978

Yep, when I get back to a computer.


----------



## truetiger

Missouri does not have a state regulated scope of practice...it is determined by your medical director.


----------



## Btalon

New Hampshire patient care protocols

http://nhoodle.nh.gov/irc/?page_id=262


----------



## lisha

Can we have an updated link for the Scope of Practice for the state of Georgia? The link listed says no page found. :huh:


----------



## DesertMedic66

Georgia:

http://ems.ga.gov/programs/ems/policy.asp


----------



## medicGee

*EMS System*

Doesn't this depend on your EMS system that you work for....


----------



## TransportJockey

medicGee said:


> Doesn't this depend on your EMS system that you work for....



In a way, yes. But most states have a scope of practice that covers everything an EMT or medic is legally allowed to do


----------



## joeyCC

*i hope i don't get shot.*



WuLabsWuTecH said:


> I would assume that protocols would not be on a state site since protocols are designated by each department/hospital/company's medical director.  I was looking for a legal scope of practice.  I'll update my OP as I get more but I can't find one for missouri right now and massacussets was not easily found either.



I'm beginning to understand why people can't come to NY and work start work if they're a NREMT. Setting NYC protocol aside, NY state protocol are extensive and very specific. Getting down to NYC is craziness. 


NYS
http://www.health.ny.gov/professionals/ems/protocolsnew.htm

NYC
BLS in NYC http://www.nycremsco.org/bls.asp?intCategoryID=3
ALS (Have fun..) http://www.nycremsco.org/als.asp?intCategoryID=4


----------



## NTXFF

It's gotta vary because EMT's in our FD can IO, push narcan, D50, Cpap, even call someone DOA.  I think we only have one EMT left though, everyone else is a Paramedic..


----------



## TransportJockey

NTXFF said:


> It's gotta vary because EMT's in our FD can IO, push narcan, D50, Cpap, even call someone DOA.  I think we only have one EMT left though, everyone else is a Paramedic..


You're in texas, where the medical director can set protocols as they see fit. There's no state scope here


----------



## jlicp112

Vermont protocols are on VT EMS web site. I can't post links yet


----------



## Christopher Rideout

I know this thread seems to be focused on the American side, however the scope of practice for New Brunswick, Canada can be found on the PANB website (paramedic association of NB), Would post a link if able


----------



## David Park

The link for Georgia is off. Not sure if it's already been posted but here is the one for Georgia.

https://dph.georgia.gov/sites/dph.georgia.gov/files/Scope_of_Practice_7-2014_0.pdf


----------



## EMT533

Texas: EMS Scope of Practice
http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.773.htm


----------



## TransportJockey

EMT533 said:


> Texas: EMS Scope of Practice
> http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.773.htm


It should be mentioned, that that is not a true statewide scope. Its just the minimum each level can do. It can be restrictd and expanded as each medical director sees fit


----------



## EMT533

Hey I'm trying here.


----------



## TransportJockey

EMT533 said:


> Hey I'm trying here.


Not saying that to be rude or knock you down. Just clarifying for people who aren't from here.


----------



## gotbeerz001

http://www.acidremap.com/

$10 a year for the app with a good representation of protocols from around the country.


----------



## EMT533

gotshirtz001 said:


> http://www.acidremap.com/
> 
> $10 a year for the app with a good representation of protocols from around the country.


Thanks!


----------



## NUEMT

WuLabsWuTecH said:


> Hi All!
> 
> I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.
> 
> Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!
> 
> -Wu
> 
> ---------List of States---------
> 
> California: (JPINFV)
> EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
> EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
> EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)
> 
> Colorado: http://www.dora.state.co.us/medical/rules/500.pdf
> 
> beow is added for the paramedics in state
> http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89)
> 
> Georgia: http://health.state.ga.us/programs/...01-A- Scope of Practice for EMS Personnel.pdf
> 
> Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf
> 
> Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)
> 
> Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf
> 
> Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm
> 
> List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!




Not sure if mentioned yet but this site is maintained sort of automatically as I understand from the webmaster.

http://www.emsprotocols.org/


----------



## beaucait

http://www.maine.gov/ems/documents/Protocols_maine_ems.pdf

Maine protocols, but of course they can change with medical direction.  This is updated for July 2015


----------



## savemachine

WuLabsWuTecH said:


> Hi All!
> 
> I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.
> 
> Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!
> 
> -Wu
> 
> ---------List of States---------
> 
> California: (JPINFV)
> EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
> EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
> EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)
> 
> Colorado: http://www.dora.state.co.us/medical/rules/500.pdf
> 
> beow is added for the paramedics in state
> http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89)
> 
> Georgia: http://health.state.ga.us/programs/...01-A- Scope of Practice for EMS Personnel.pdf
> 
> Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf
> 
> Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)
> 
> Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf
> 
> Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm
> 
> List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!



Thank you for your forum post.  I greatly appreciate the websites that you have researched for the public to view about the scope of practice.  I know that Virginia's scope of practice is stated in the board of nursing in Virginia.  I believe that if you just look at the board of nursing websites in all of the states of America, that should be OK.  They should have a practice acts for nursing and all health care professions.


----------



## NomadicMedic

savemachine said:


> Thank you for your forum post.  I greatly appreciate the websites that you have researched for the public to view about the scope of practice.  I know that Virginia's scope of practice is stated in the board of nursing in Virginia.  I believe that if you just look at the board of nursing websites in all of the states of America, that should be OK.  They should have a practice acts for nursing and all health care professions.



Nope. Not even close.


----------



## TransportJockey

Why would my NM scope of practice ve listed on a nursing website? (Hint: it's not). And in Texas we dont even have a state scope   We are not regulated, thank the gods, by the nursing profession


----------



## savemachine

WuLabsWuTecH said:


> Hi All!
> 
> Thank you for the state nurses practice act of Ohio.  I greatly appreciate the information.  Virginia is the state that I live in and it has a lot of nurse practice acts.  For example, an LPN in Virginia can give an IV to a patient and also do piggyback as well depending on the education and experience that the LPN nurse has had.  A CNA in Virginia does basic care, but they can obtain more education and then do more nursing duties like give medications.  So, there are a lot of things that nurses can do in Virginia.  Thank you again for talking about your state.
> 
> I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.
> 
> Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!
> 
> -Wu
> 
> ---------List of States---------
> 
> California: (JPINFV)
> EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
> EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
> EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)
> 
> Colorado: http://www.dora.state.co.us/medical/rules/500.pdf
> 
> beow is added for the paramedics in state
> http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89)
> 
> Georgia: http://health.state.ga.us/programs/...01-A- Scope of Practice for EMS Personnel.pdf
> 
> Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf
> 
> Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)
> 
> Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf
> 
> Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf
> 
> Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm
> 
> List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!


----------



## savemachine

I live in Virginia and we also like many states have state practice acts that involve nursing.  Here is one of the links that talks about Virginia's state practice acts:
http://www.allnurses.com/ . . . /Virginia nursing  

That website tells about nursing in Virginia.  You can also go to the search engine http://www.google.com  and type in "nurse practice acts in Virginia."  That will also tell you and give you information about Virginia's practice acts in nursing.  I hope this was helpful to you.


----------



## STXmedic

savemachine said:


> I live in Virginia and we also like many states have state practice acts that involve nursing.  Here is one of the links that talks about Virginia's state practice acts:
> http://www.allnurses.com/ . . . /Virginia nursing
> 
> That website tells about nursing in Virginia.  You can also go to the search engine http://www.google.com  and type in "nurse practice acts in Virginia."  That will also tell you and give you information about Virginia's practice acts in nursing.  I hope this was helpful to you.


What?... It looks like VA has their own Department of EMS, separate from nursing, with their own scope of practice...


----------



## EpiEMS

CT's new scope of practice & protocols document -- yes, that's right, EMT scope now includes glucometry as a baseline skill.


----------



## savemachine

Virginia's nurse practice act can be found in the Virginia Board of Nursing Website.  It clearly states what each nurse whether they are a CNA, LPN, ADN, or BSN and nurse practioners can do in the state of Virginia.  The board of nursing in Virginia is located in Henrico, VA.  which is near Richmond which is the capital of Virginia.


----------



## STXmedic

savemachine said:


> Virginia's nurse practice act can be found in the Virginia Board of Nursing Website.  It clearly states what each nurse whether they are a CNA, LPN, ADN, or BSN and nurse practioners can do in the state of Virginia.  The board of nursing in Virginia is located in Henrico, VA.  which is near Richmond which is the capital of Virginia.


Why do you keep bringing up nursing?


----------



## Akulahawk

savemachine said:


> Virginia's nurse practice act can be found in the Virginia Board of Nursing Website.  It clearly states what each nurse whether they are a CNA, LPN, ADN, or BSN and nurse practioners can do in the state of Virginia.  The board of nursing in Virginia is located in Henrico, VA.  which is near Richmond which is the capital of Virginia.


We thank you for the information you have provided, however this forum isn't primarily nursing related as it is for the Emergency Medical Services (EMT, AEMT, Paramedic) folks and discussions. This thread is primarily to list and discuss various the Scope of Practice of EMS personnel across the various US States. Virginia does have its own EMS board, which is separate from the State BON there. 

Yes, we do have quite a few members that are Nurses, but the majority are not. I'm one of a few members that hold a license as a Registered Nurse and a Paramedic and my licenses are current. I, like a few others here, am also a member of AllNurses. Being that I'm both a Paramedic and an RN, I have to be very cognizant of which "hat" I'm wearing at the moment as that can impact my authorized scope of practice. While my scope of practice is generally wider as an RN, the autonomy I have as a Paramedic is greater as I'm more functionally independent as long as I'm utilizing the protocols (I don't have to ask "mother, may I").


----------



## savemachine

EMT533 said:


> Texas: EMS Scope of Practice
> http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.773.htm



I live in Virginia and we have a board called Virginia Board of Nursing.  My name is under the nurse aide registry of Virginia because I have taken the certification test in 1999.  When I just became certified, the board of nursing in Virginia gave me a paper copy of the scope of nursing for CNA's in Virginia and it basically states basic patient care.  Every state has there own state nursing practice acts.


----------



## TransportJockey

savemachine said:


> I live in Virginia and we have a board called Virginia Board of Nursing.  My name is under the nurse aide registry of Virginia because I have taken the certification test in 1999.  When I just became certified, the board of nursing in Virginia gave me a paper copy of the scope of nursing for CNA's in Virginia and it basically states basic patient care.  Every state has there own state nursing practice acts.


Good for you? But what does this have to do with ems? Nursing SOP is different and under different boards or state offices. 

Sent from my SM-N920P using Tapatalk


----------



## savemachine

Virginia has a scope of practice for the EMS.  The scope of practice is in the board of nursing.  If you would like to learn about the scope of practice in Virginia, please do a google search for (EMS scope of practice in Virginia).


----------



## EMS Pursuit

LA County has a very low scope due to quick transport times, I know of many Paramedics who are envious of larger scopes in different areas that let you use all of your skills! 

Pediatric Intubation is the #1


----------



## MikeC

http://pehsc.org/wp-content/uploads/2015/08/EMS-Provider-Scope-of-Practice-08-28-15.pdf

Pennsylvania checklist which is easy to read for all the different levels


----------



## SpecialK

The list is almost getting too long to publish!

*Emergency Medical Technician*
Adrenaline (IM, IN, neb, top), glucagon, GTN spray, ibuprofen, LMA, laryngoscopy (obstruction), loratadine, methoxyflurane, midazolam (clinical desk), ondansetron, paracetamol, prednisone, PEEP, salbutamol neb, tramadol, urinary catheter troubleshooting

*Paramedic*
All of the above plus adrenaline IV (cardiac arrest), amiodarone IV (cardiac arrest), cardioversion, clopidogrel, coamoxiclav, enoxaparin, fentanyl, gentamicin, glucose, heparin, ketamine (agitated delerium), manual defibrillation, metoprolol, midazolam (seizures/agitated delerium), morphine, naloxone, olanzapine, ondansetron, 0.9% NaCl, ring blocks, tenecteplase, valproate.

*Intensive Care Paramedic*
All of the above plus adenosine, adrenaline (all route), amiodarone, CaCl, cricothyroidotomy, intubation, IO needle, ketamine (all routes), magnesium, midazolam (all routes), pacing, roc, 8.4% soda bic, suxamethonium IV (RSI Officers), thoracostomy

This list doesn't include ordinary things like OPAs, blood glucose measurement, ECG interpretation etc which all personnel can do


----------



## EpiEMS

SpecialK said:


> The list is almost getting too long to publish!
> 
> *Emergency Medical Technician*
> Adrenaline (IM, IN, neb, top), glucagon, GTN spray, ibuprofen, LMA, laryngoscopy (obstruction), loratadine, methoxyflurane, midazolam (clinical desk), ondansetron, paracetamol, prednisone, PEEP, salbutamol neb, tramadol, urinary catheter troubleshooting
> 
> *Paramedic*
> All of the above plus adrenaline IV (cardiac arrest), amiodarone IV (cardiac arrest), cardioversion, clopidogrel, coamoxiclav, enoxaparin, fentanyl, gentamicin, glucose, heparin, ketamine (agitated delerium), manual defibrillation, metoprolol, midazolam (seizures/agitated delerium), morphine, naloxone, olanzapine, ondansetron, 0.9% NaCl, ring blocks, tenecteplase, valproate.
> 
> *Intensive Care Paramedic*
> All of the above plus adenosine, adrenaline (all route), amiodarone, CaCl, cricothyroidotomy, intubation, IO needle, ketamine (all routes), magnesium, midazolam (all routes), pacing, roc, 8.4% soda bic, suxamethonium IV (RSI Officers), thoracostomy
> 
> This list doesn't include ordinary things like OPAs, blood glucose measurement, ECG interpretation etc which all personnel can do



To be clear, this is New Zealand? Also, quick q: what level of education are these? Undergraduate, graduate?


----------



## SpecialK

EpiEMS said:


> To be clear, this is New Zealand? Also, quick q: what level of education are these? Undergraduate, graduate?



This is yes, but it's pretty much standard across all services in Australasia with a few minor differences.  Australia just have Paramedics and ICPs though.

EMT is a Diploma, Paramedic is a Degree and ICP is a PGDip ontop of the Degree.


----------



## Chimpie

Updated the link for Ohio.

Would anyone like to work with me on a project this weekend? I'm thinking of creating a new thread with a clean list of all the states, and link to the proper pages/documentation for the scope of the practice for each of them. Then at the bottom, link to this thread for a discussion.

Thoughts?


----------



## NysEms2117

Chimpie said:


> Updated the link for Ohio.
> 
> Would anyone like to work with me on a project this weekend? I'm thinking of creating a new thread with a clean list of all the states, and link to the proper pages/documentation for the scope of the practice for each of them. Then at the bottom, link to this thread for a discussion.
> 
> Thoughts?


I can help with NYS if you want


----------



## Jdog

Chimpie said:


> Updated the link for Ohio.
> 
> Would anyone like to work with me on a project this weekend? I'm thinking of creating a new thread with a clean list of all the states, and link to the proper pages/documentation for the scope of the practice for each of them. Then at the bottom, link to this thread for a discussion.
> 
> Thoughts?



California might be hard. County scope of practice overrides state here. So, what I can do in Orange County vs. Los Angeles County vs. Kern County are different (and there's like 50 counties in all of CA).


----------



## Chimpie

Jdog said:


> California might be hard. County scope of practice overrides state here. So, what I can do in Orange County vs. Los Angeles County vs. Kern County are different (and there's like 50 counties in all of CA).


Okay... maybe it would be easier to add that as a separate post to keep it clean. Agree?


----------



## MyNameIsRobert

Jdog said:


> California might be hard. County scope of practice overrides state here. So, what I can do in Orange County vs. Los Angeles County vs. Kern County are different (and there's like 50 counties in all of CA).


I just checked the process for the L.A. County scope of practice and it looks like they have updated it so you do not need any extra scope of practice to work in L.A. County. Not sure about the other counties. I can't post a link because I haven't posted 5 times yet.


----------



## NomadicMedic

The Georgia stuff is all at the DOH website.


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## Bullets

Here is the NJ ALS standing orders

http://www.state.nj.us/health/ems/documents/reg-enforcement/als_adult_standing_orders.pdf

http://www.state.nj.us/health/ems/documents/reg-enforcement/als_pediatric_standing_orders.pdf


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## LifeAlert101

I don't see Connecticut on the other thread so here is the scope of practice: http://www.ct.gov/dph/lib/dph/ems/p...cut_statewide_ems_protocols_v2016.1_nosec.pdf

State site:
http://www.ct.gov/dph/cwp/view.asp?a=3127&q=387362&dphNav_GID=1827


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## TheEleventhHour

Does anyone have a link to an updated CA SOP? The one in the OP keeps giving me a 404 Error.


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## DesertMedic66

TheEleventhHour said:


> Does anyone have a link to an updated CA SOP? The one in the OP keeps giving me a 404 Error.


Are you looking for the CA state policies (title 22) or a more specific county protocol?


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## TheEleventhHour

DesertMedic66 said:


> Are you looking for the CA state policies (title 22) or a more specific county protocol?



County if possible. Thanks for replying.


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## DesertMedic66

TheEleventhHour said:


> County if possible. Thanks for replying.


Which county?


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## TheEleventhHour

DesertMedic66 said:


> Which county?



LA County.


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## DesertMedic66

TheEleventhHour said:


> LA County.


Google is an amazing tool: http://bfy.tw/FtwW


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## TheEleventhHour

DesertMedic66 said:


> Google is an amazing tool: http://bfy.tw/FtwW



Indeed it is, thank you. For anyone else who needs the Revised 12/1/2017 EMT Scope Of Practice for LA County here is the Direct Link-> http://file.lacounty.gov/dhs/cms1_206313.pdf

http://file.lacounty.gov/dhs/cms1_206315.pdf


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## AZEMSPRO

ARIZONA:

http://www.azdhs.gov/documents/prep...s-trauma-system/training/str-skills-final.pdf


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## CityEMT212

WuLabsWuTecH said:


> Hi All!
> 
> I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf (outdated)
> 
> I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.
> 
> Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!
> 
> -Wu
> 
> ---------List of States---------
> 
> California: (JPINFV)
> EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
> EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
> EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)
> 
> Colorado: http://www.dora.state.co.us/medical/rules/500.pdf (outdated)
> 
> beow is added for the paramedics in state
> http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89) (outdated)
> 
> Georgia: http://health.state.ga.us/programs/ems/Resource Documents/R-P-01-A Scope of Practice for EMS Personnel/R-P01-A- Scope of Practice for EMS Personnel.pdf (outdated)
> 
> Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf
> 
> Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)
> 
> Ohio: http://www.ems.ohio.gov/critical.aspx#scope
> http://www.publicsafety.ohio.gov/links/ems_scope_practice.pdf
> 
> Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf
> 
> Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm
> 
> List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!


 

According to www.health.ny.gov: Viewed in 2018.

*Q: Where can I find the scope of practice document for a NYS DOH Bureau of EMS Certified First Responder/EMT/AEMT?\*

A: New York State does not have a specific scope of practice document for the CFR/EMT/AEMT. Instead, in NYS, scope of practice for the CFR/EMT/AEMT is defined by curriculum, protocol, and physician medical direction at the EMS agency, region, and State levels. In order to determine whether a particular skill falls within the EMS provider's scope of practice, one would need to refer to the appropriate curriculum and protocol.

~ Estrella


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## Joshua Henson

Alabama’s is on the adph website.


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## SpecialK

*Emergency Medical Technician*
Methoxyflurane, oral pracetamol, oral ibuprofen, oral tramadol, adrenaline (IM, IN, neb, topical), glucagon, aspirin, GTN spray, salbutamol, ipratropium,  oral loratadine, ondansetron (oral), oral prednisone, PEEP, urinary catheter troubleshooting, mizadolam (IM - seizures), laryngoscopy (airway obstruction).

*Paramedic*
IV cannulation, 0.9% NaCl (IV), glucose 10% (IV), lignocaine SQ digital blocks, manual defibrillation, synchronised cardioversion, adrenaline (IV) for cardiac arrest only, amiodarone (IV) for cardiac arrest only, amoxicillin and clavulanic acid, gentamicin, morphone, fentanyl, naloxone, ondansetron IM or IV, oxytocin, midazolam IM for agitated delerium, midazolam IV for sezirues, valproate IV, oral olanzepine, ketamine (IM for severe agitation and IV for analgesia).  For thrombolysis trial officers: clopidogrel, enoxiparin, heparin, metoprolol.

*Intensive Care Paramedic*
Adenosine, adrenaline IV for all indications, amiodarone IV for tachydysrhythmia, atropine, calcium chloride, chest decompression and thoracostomy, cricothyrotomy, intraosseous access, endotracheal intubation, ketamine, midazolam for all indications, magnesium, pacing, rocuronium, sodium bicarbonate, suxamethonium (RSI officers only).


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## SentinelGary

WuLabsWuTecH said:


> Hi All!
> 
> I found the following as the scope of practice in Ohio: http://www.ems.ohio.gov/PDF/EMS_SCOPE_Practice0608.pdf (outdated)
> 
> I was wondering if there are similar files/sites for other states. I'm particularly interested in Missouri since I'll be splitting my time between St. Louis, MO and Columbus, OH.
> 
> Feel free to add your state(s)'s scope of practice as well and maybe we can keep a kind of a database for easy reference!
> 
> -Wu
> 
> ---------List of States---------
> 
> California: (JPINFV)
> EMT-One (Basic): http://www.emsa.ca.gov/personnel/files/emt/FinalApprovedChapter3242007.pdf (Starts on bottom of page 6)
> EMT-Two (Intermediate): http://www.emsa.ca.gov/personnel/files/emt/regs3.pdf (Starts on page 2. )
> EMT-Paramedic:http://www.emsa.ca.gov/paramedic/files/scopechart.pdf (listed by county)
> 
> Colorado: http://www.dora.state.co.us/medical/rules/500.pdf (outdated)
> 
> beow is added for the paramedics in state
> http://www.dora.state.co.us/medical/Rules/800.pdf (zacdac89) (outdated)
> 
> Georgia: http://health.state.ga.us/programs/ems/Resource Documents/R-P-01-A Scope of Practice for EMS Personnel/R-P01-A- Scope of Practice for EMS Personnel.pdf (outdated)
> 
> Iowa: http://www.idph.state.ia.us/ems/common/pdf/scope_of_practice.pdf
> 
> Mississippi: http://www.ems.doh.ms.gov/pdf/ems_rules_regs_2-08.pdf (The EMT-B starts at about page 91 with scope defined starting at page 103.)  (Ventmedic)
> 
> Ohio: http://www.ems.ohio.gov/critical.aspx#scope
> http://www.publicsafety.ohio.gov/links/ems_scope_practice.pdf
> 
> Oregon: http://www.oregon.gov/DHS/ph/ems/docs/scope.pdf
> 
> Wisconsin: http://dhs.wisconsin.gov/ems/License_certification/scope_of_practice.htm
> 
> List updated 9 July 2008 by WuLabsWuTecH.  Thanks to those who helped me find these links whose names are in parentheses after the state they found!




KBEMS provides education standards, but as far as scope goes... it takes some searching and reading into things to know. Here are the Ed standards at least.





__





						Kansas EMS Scope of Practice
					





					www.ksbems.org


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